Felix Savoie

Felix Savoie
Tulane University | TU · Tulane Institute of Sports Medicine

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309
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Publications

Publications (309)
Article
Background Hepatitis C (HCV) is associated with increased complication risk after arthroplasty. The purpose of this study was to examine the impact of HCV and pre-arthroplasty antiviral treatment on complications following total shoulder arthroplasty (TSA). Methods A retrospective matched cohort study was conducted using an administrative claims d...
Article
Humeral shaft fractures account for an estimated 3% of all adult fractures. When operative treatment is indicated, intramedullary (IM) nailing and open reduction and internal fixation with plating are the 2 most common techniques. Early IM nails were associated with poor outcomes, but with advancements in nail design, patient outcomes have been imp...
Chapter
In the elbow with an acute or chronic posterolateral rotatory instability (PLRI), repair of the avulsed lateral ulnar collateral ligament (LUCL) complex can be very efficacious in restoring stability. This repair can be performed arthroscopically, our preferred method, or open. Here, we describe the technique for each.
Chapter
Endoscopic distal triceps tendon repair is a reliable and reproducible technique to address both degenerative and traumatic triceps tendon injuries. The most preferred technique for repairing a distal triceps tendon tear is through an open posterior approach and may be associated with wound healing problems and increased surgical site morbidity. Us...
Chapter
Elbow surgery has advanced rapidly in the last decade, and several new techniques offer the advantages of better outcomes and minimal invasiveness. The process of developing a new technique is simplified by application of the six key concepts. Any new technique should be performed in a safe manner and ideally first in a cadaveric model. There must...
Chapter
Injury to the lateral ulnar collateral ligament (LUCL) can be a complex problem in the adolescent as well as the adult athlete. Early recognition and treatment are paramount in giving the athlete the best chance to return to sport. Individuals who have sustained trauma to the elbow, particularly elbow dislocation, are at high risk of developing pos...
Chapter
The diagnosis of posterolateral rotatory instability (PLRI) of the elbow is made by a combination of patient history and physical examination. The diagnosis may be confirmed by radiologic studies, such as MRI arthrography. Four clinical tests for PLRI are described: (1) supine pivot shift, (2) prone pivot shift, (3) internal rotation wall push-up,...
Chapter
Lunotriquetral instability is treated based upon the degree of instability and concomitant pathology, although there is no consensus on treatment of lunotriquetral instability. Lunotriquetral instability, with or without concomitant pathology, has been surgically managed with arthrodesis, ligament graft reconstruction, ligament repair, percutaneous...
Chapter
Arthroscopy of the elbow is an evolving technique used for numerous conditions in the thrower. This chapter explores the indications for elbow arthroscopy, the author’s preferred surgical technique, as well as some of the commonly indicated pathologies including Medial Ulnar Collateral Ligament injuries, Valgus Extension Overload, Osteochondritis D...
Chapter
Osteochondritis dissecans is a multifactorial focal insult to the articular surface resulting in separation of the articular cartilage and subchondral bone. In the elbow, the most common location is the capitellum and generally occurs in younger (12 to 14 years old) athletes with a history of overuse. Most often patients present with pain and inabi...
Article
Full-text available
Localized cartilage lesions in early osteoarthritis and acute joint injuries are usually treated surgically to restore function and relieve pain. However, a persistent clinical challenge remains in how to repair the cartilage lesions. We expressed doublecortin (DCX) in human adipose-derived stromal/stem cells (hASCs) and engineered hASCs into carti...
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Background As the aging population expands, proximal humerus fractures have become more prevalent. This study aimed to evaluate acute management of proximal humerus fractures in females and males over age 50 to determine how gender and age have affected definitive treatment selection over the last decade. Methods Patient records were retrospective...
Article
Full-text available
Purpose The purpose of this study is to describe the placement and evaluate the safety of the far anterior proximal and distal anteromedial portals by comparing them to previously defined portal techniques in a cadaveric model of the elbow. Methods Six paired (left and right) fresh, frozen cadaveric elbow joints were dissected. .62-mm Kirschner wi...
Chapter
Preparation of the tissue is as important, if not more important, than the repair technique itself in the setting of failed or revision rotator cuff repair. Tissue preparation including thorough debridement of adhesions, removal of old sutures and anchors, and various tissue releases allows for adequate mobilization of the rotator cuff muscle and t...
Chapter
As the incidence of retears after a rotator cuff repair remain high, a comprehensive treatment and rehabilitation protocol must be chosen depending on the circumstances of the injury. When choosing between an operative versus a nonoperative approach, surgeons must consider multiple factors including patient presentation and goals of the patient. Ro...
Article
Full-text available
Background: Proximal humerus fractures are the third most common fracture in older adults. Because of the aging population, the incidence of these fractures and their impact will continue to grow. With advancement in treatment options for proximal humeral fractures, the aim of this study was to evaluate the trends in acute management of proximal h...
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Full-text available
Background When compared with fluid arthroscopy, carbon dioxide (CO 2 ) insufflation offers an increased scope of view and a more natural-appearing joint cavity, and it eliminates floating debris that may obscure the surgeon’s view. Despite the advantages of CO 2 insufflation during knee arthroscopy and no reported cases of air emboli, the techniqu...
Chapter
The subacromial balloon spacer is a novel alternative treatment for failed, massive, or irreparable rotator cuff tears. The procedure works by implanting a biodegradable spacer between the acromion and humeral head, which depresses the humeral head and allows for deltoid rehabilitation and potential restoration of normal biomechanics about the glen...
Chapter
Subscapularis failure and insufficiency after prior repair surgery represent a difficult problem. Although one option is revision to reverse shoulder prosthesis, in many cases of a young, active patient, other options should be considered. The problem of subscapularis failure after surgery becomes even more debilitating in the setting of a failed s...
Chapter
Since its invention by Dr. Paul Gramont, the reverse shoulder replacement has been a miracle for both the rotator cuff tear arthropathy patient with pseudoparalysis and the patient with a failed rotator cuff surgery. Results are generally quite good in restoring function and alleviating pain. This has led to an expansion of indications, which has u...
Chapter
Despite technical advancements and rising numbers of rotator cuff repair (RCR) procedures, the rate of failure and re-tearing remains a significant issue. An effort to augment the repair with various types of patches or implants has made its way into practice in an attempt to increase successful outcomes. The goal of augmentation is to decrease the...
Article
Purpose The purpose of this study was to quantify and compare the biomechanical properties and change in graft size when adding the sartorius tendon as a fifth strand to a four-strand ST-G hamstring autograft. Additionally, the sartorius tendon was tested individually to quantify its independent biomechanical properties. Methods Four-strand and fi...
Article
Introduction: Rates of osteoporosis evaluation and management after primary fragility fractures have remained low in recent years. The extent to which this treatment gap affects patients with diabetes is unclear. This study aimed to compare the risk of secondary fractures and rates of osteoporosis diagnosis and management after sentinel fractures...
Article
In 2020, the coronavirus disease 2019 (COVID-19) pandemic limited musculoskeletal care to urgent or "nonelective" office visits and procedures. No guidelines exist to inform patients or physicians what meets these criteria. The purpose of this multi-institutional study was to describe the differences in perceptions of urgency for musculoskeletal co...
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Full-text available
Background Medial ulnar collateral ligament (MUCL) repair has been proven to be effective in nonprofessional overhead-throwing athletes, with faster and higher rates of return to play (RTP) than the more traditional Tommy John reconstruction. Biomechanical studies and clinical data suggest that MUCL repair augmented with a collagen-coated internal...
Article
Background:. Fragility fractures are often sentinel events in documenting new cases of osteoporosis. Numerous analyses have demonstrated low rates of adequate osteoporosis evaluation and treatment following primary fragility fractures. The purpose of this study was to quantify the incidence of primary fragility fractures in America and the rates of...
Article
Elbow arthroscopy can be a challenge, however, indications and benefits compared to open elbow surgery are rapidly evolving. The elbow has seemed to lag behind other joints including the knee, shoulder, ankle and the hip, both in number of cases and in widespread acceptance, as a joint amenable to arthroscopic management. This has occurred despite...
Chapter
Injuries to the medial ulnar collateral ligament (MUCL) can be devastating in overhead and throwing athletes. Prior to 1986, injury to this ligament was considered to be career ending. In that year, Dr. Frank Jobe reported on his initial experiences with reconstruction of the MUCL. His first case was pitcher Tommy John, who underwent what at that p...
Article
Rotator cuff tears are common shoulder injuries expected to increase with the growth of the aging population. Although a small subset of patients with low functional demands can be treated nonoperatively, surgical intervention is a cost-effective solution, which can restore shoulder function and help patients return to activity sooner. While multip...
Article
Background: The acquisition of surgical skills required to correctly perform orthopedic procedures varies among different institutions due to the diversity of training curriculums. With its technologic advances, surgical simulation can provide trainees with an accurate, safe, and standardized mean to practice procedures throughout their time in res...
Article
The overhead throwing motion is a complex movement which requires soft tissue flexibility and neuromuscular control to generate force from the legs and truck and propel the ball forward. Repetitive motions and high levels of torque on the shoulder can compromise soft tissue balance and contribute to the high rate of shoulder injuries commonly seen...
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Background The outcomes and complication rates of patients with isolated greater tuberosity fractures are not well documented. The present study aimed to evaluate the reoperation rates, types of reoperations, and complications for patients undergoing open reduction internal fixation and those undergoing initial nonoperative treatment of isolated gr...
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Background Glenoid loosening is the most common complication of Total Shoulder Arthroplasty (TSA) resulting in revision. Inaccurate reaming and thermal osteonecrosis from heat generated during the reaming process may contribute to TSA failure by creating a suboptimal bone-implant interface for osteointegration. This biomechanical study investigated...
Article
Traumatic elbow instability is a difficult condition to manage. Many surgeons consider the elbow a perplexing black box and evaluating damaged structures in the setting of pain and swelling a diagnostic challenge. Injury most commonly occurs from a fall onto an outstretched hand but also results from elbow dislocation, direct trauma, and sporting a...
Article
Purpose To systematically review the literature to compare the efficacy and safety of tranexamic acid (TXA) as a means to minimize hemarthrosis-related complications following arthroscopic procedures of the knee, hip, and shoulder. Methods A systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline...
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Full-text available
Purpose To compare the likelihood of spiral fracture of the humerus using torsional load to failure after intraosseous biceps tenodesis at the position of the arthroscopic suprapectoral tenodesis versus the subpectoral meta-diaphyseal location. Methods Eight matched pairs of humeri were dissected. Unicortical tenodesis holes were drilled, either a...
Article
This study was performed to analyze the effect that coronavirus 2019 (COVID-19) has had on orthopedic surgeons’ practices, their patients, and orthopedic surgeons themselves through a survey distributed to members of the Louisiana Orthopaedic Association (LOA). An anonymous 22-question online survey was created and distributed to 323 LOA members. O...
Article
Background: Patients with a patient-reported penicillin allergy may be at greater risk for postoperative prosthetic joint infection (PJI) after total joint arthroplasty of the hip, knee, or shoulder. The increased risk of PJI in these patients has been attributed to these patients receiving a less-effective perioperative antibiotic. However, prior...
Article
Case: A 58-year-old man presented with acute respiratory distress syndrome and coagulopathy secondary to COVID-19. He developed acute compartment syndrome (ACS) of the left hand. He underwent a bedside 10-compartment decompression of the hand with volar forearm and carpal tunnel release while in the ICU. This report adds to the scarce body of lite...
Chapter
Upper extremity (UE) stress fractures are less common than lower extremity stress fractures and account for 2.8% of all stress fractures among high school athletes (Changstrom et al. Am J Sports Med 43:26–33, 2015). Early diagnosis hinges on understanding the etiology and having an index of suspicion. Repetitive stress and loading of upper extremit...
Article
Medial ulnar collateral ligament (MUCL) insufficiency is becoming common in younger, nonprofessional athletes. In contrast to elite athletes who develop valgus extension overload syndrome and associated chronic pathologic changes in the MUCL, younger patients present with sprains and partial tears that can often be managed non-operatively with succ...
Article
BACKGROUND Historically, anatomic total shoulder arthroplasty (TSA) has been the gold-standard of care for patients with glenohumeral osteoarthritis refractory to nonoperative treatment. With expanding indications, utilization of reverse total shoulder arthroplasty (RSA) has been rapidly increasing. The purpose of this study was to use a nationwide...
Article
Full-text available
Ulnar collateral ligament (UCL) injury is commonly seen in overhead throwing athletes resulting from the repetitive valgus stress placed on the medial elbow. UCL injuries (attenuation, insufficiency, or rupture) can result in medial elbow pain, a loss of pitch velocity and accuracy, and increased fatigue. Diagnosis can be made by performing a thoro...
Article
Injuries to the medial ulnar collateral ligament (MUCL) can be devastating in overhead and throwing athletes. Prior to 1986 injury to this ligament was considered to be career ending. Dr Frank Jobe performed an experimental surgery on professional baseball pitcher Tommy John, utilizing the palmaris longus tendon to reconstruct the MUCL. The success...
Article
The anterior bundle of the medial ulnar collateral ligament (MUCL) is the prime valgus stabilizer of the elbow. Athletes who throw overhead, such as baseball players, and javelin throwers, most commonly fall victim to this type of injury as the MUCL is subject to significant loads during the late cocking phase/early acceleration phase of the throwi...
Article
Triceps tendon ruptures (TTRs) are rare and often occur as a result of falling on an outstretched hand, forceful eccentric contraction, direct trauma to the elbow, or lifting against resistance. TTRs are most commonly seen in middle-aged men, football players, and weightlifters. Radiography, ultrasonography, and magnetic resonance imaging may be ut...
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Full-text available
Background Medial epicondylitis (ME) is characterized as an overuse injury resulting in pathological alterations of the common flexor tendon at the elbow. Platelet-rich plasma (PRP) has recently become of interest in the treatment of musculoskeletal conditions as an alternative to operative management. Purpose To compare the outcomes of recalcitra...
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Full-text available
Purpose of review: Reverse total shoulder arthroplasty (RTSA) is a procedure that has been increasingly utilized since its inception over 20 years ago. The purpose of this review is to present the most up to date practice and advances to the RTSA literature from the last 5 years. Recent findings: Recent literature on RTSA has focused on identify...
Chapter
Triceps injuries, including triceps tendon ruptures, are relatively rare. Recently, the knowledge of tendon lesions has increased, and it seems to be related to more precise diagnostic and clinical assessments. The most common mechanism of injury remains a forceful eccentric contraction of the muscle. Several other risk factors have been studied, s...
Chapter
Posterolateral rotatory instability (PLRI) is the most common cause of residual instability following a simple elbow dislocation. PLRI may result from trauma or iatrogenic injury to the radial ulnohumeral ligament (RUHL) during treatment for other conditions, such as lateral epicondylitis. PLRI can be identified through a combination of history and...
Chapter
Triceps injuries are relatively uncommon, but the character of the tendon attachment lends itself to arthroscopic repair. The diagnosis is made by a history of injury, pain, and weakness localized to the posterior elbow. On examination, the triceps stress test provides evidence of triceps injury. Radiographs may show triceps traction spurs, and MRI...
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Full-text available
Background Various techniques have been described for surgical treatment of recalcitrant medial epicondylitis (ME). No single technique has yet to be proven the most effective. Purpose To evaluate the clinical outcomes of a double-row repair for ME. Study Design Case series; Level of evidence, 4. Methods A retrospective review was performed on 3...
Article
Full-text available
Articular surface partial rotator cuff tendon tears are a common source of shoulder pain and dysfunction, and there is no consensus regarding the optimal arthroscopic treatment. Commonly accepted techniques, such as transtendinous repair or tear takedown with primary repair, may violate healthy tendon tissue and increase the suture anchor density....
Article
Purpose: To systematically review available literature comparing location and safety of 2 common anteromedial portals with nearby neurovascular structures in cadaveric models and to determine the correct positioning and preparation of the joint before elbow arthroscopy. Methods: The review was devised in accordance with Preferred Reporting Items...
Article
Background: Failure of repair of large and massive rotator cuff tears is a challenging problem within orthopaedics. Poor tendon tissue and vascularity are known causes for failure of rotator cuff repairs. Purpose: To assess the safety, outcomes, and healing rates when large and massive rotator cuff repairs are augmented with a bioinductive colla...
Chapter
Surgical treatment of the overhead athlete’s shoulder requires an in-depth knowledge of the pathologic processes of internal impingement in order to optimize treatment outcomes in patients who have failed conservative treatment. Overhead athletes have a predictable pattern of injury that includes superior labrum anterior-posterior (SLAP) tears, rot...
Article
Rotator cuff tears are a common problem in our growing and aging population. Because of this, rotator cuff repair is consistently one of the most frequently performed operations by orthopaedic surgeons every year. Successful outcomes have been directly correlated to a successful repair to the tuberosity; however, healing rates have varied greatly d...
Article
To minimize the risk of subscapularis failure after shoulder replacement, a method of preserving the subscapularis while allowing access to the glenohumeral joint was developed. Only the inferior 30% to 50% of the subscapularis tendon is detached from the humerus, leaving the superior aspect attached to the lesser tuberosity. This subscapularis-spa...
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Full-text available
Objectives Failures of large, massive, and revision rotator cuff repairs is a challenging problem within orthopedics. Poor tendon tissue and vascularity are known causes for failure of rotator cuff repairs. The purpose of this study was to assess the outcomes and healing rates when large and massive rotator cuff repairs are augmented with a bio-ind...
Article
Full-text available
Background Jobe revolutionized the treatment of medial ulnar collateral ligament (MUCL) tears with his reconstruction technique. However, not all MUCL injuries require operative management; Rettig showed that 42% of MUCL injuries respond to conservative management. This was improved by Podesta, who showed that augmentation of nonoperative managemen...
Article
Purpose: To evaluate the proximity to the radial nerve on cadaveric specimens of 2 modified anterolateral portals used for elbow arthroscopy. Methods: Ten fresh cadaveric elbow specimens were prepared. Four-millimeter Steinman pins were inserted into 3 anterolateral portal sites in relation to the lateral epicondyle: (1) the standard distal ante...
Article
Arthroscopic management of fractures and dislocations of the elbow encompasses a set of evolving techniques that are often advantageous in the treatment of these challenging injuries. The arthroscopic approach allows for direct visualization of fracture patterns and reductions without an open exposure, minimizing soft tissue trauma to a region noto...
Article
Osteochondritis dissecans lesions of the elbow occur in 3.4% of adolescent baseball players, and the lesions will inevitably progress without intervention. Fifty percentage of patients who initially presented with advanced lesions had decreased range of motion and pain with activities of daily living. Patients treated early have high return to spor...
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Full-text available
Objectives Traditional treatment of acromioclavicular (AC) sprains has been a sling with rest and rehabilitation. We have developed a protocol that uses a static scapular retraction brace (Figure 1) to reduce the displaced upper extremity back to the clavicle. We hypothesized that the brace in combination with oral and injected steroid and a rehabi...
Chapter
The long head of the biceps brachii tendon (LHB) has commonly been described as a pain generator of the shoulder joint, whether in isolation or in conjunction with associated shoulder pathology. Research delving into the anatomy of the long head of the biceps tendon, its function, and disease states has led to various techniques to address LHB tend...
Chapter
Dislocation of the glenohumeral joint is a painful injury that requires immediate management. Failure to relocate the joint in a timely fashion usually results in significant destruction of the bone and cartilage of the joint, as well as severe contracture and scar formation in the soft tissues. The incidence of chronic dislocation is unknown, with...
Article
Full-text available
Damage to the medial collateral ligament of the elbow from an instability episode usually heals with non-operative treatment. In some cases, residual instability may occur, leading to functional impairment. Non-operative management can be successful when bracing, taping and therapy are used to stabilise the elbow. A recent report detailing the effi...