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Introduction
Publications
Publications (155)
Purpose
To determine, from a sizable cohort of reverse shoulder arthroplasty (RSA), whether the deltopectoral (DP) or anterosuperior (AS) approach grant better outcomes at a minimum follow-up of 24 months.
Methods
The authors reviewed 743 RSAs in patients with primary osteoarthritis (OA) with or without rotator cuff lesions and secondary OA due to...
Purpose:
To compare outcomes of reverse shoulder arthroplasty (RSA) for primary osteoarthritis (OA) with and without rotator cuff (RC) tears to those with secondary OA due to RC tears.
Methods:
We reviewed records of all patients that received RSA for primary OA or secondary OA. All patients had preoperative radiographs, computed tomography arth...
PurposeThe purpose of this multi-centre study was to report outcomes of a large cohort of reverse shoulder arthroplasty (RSA) at a minimum follow-up of two years and to determine patient and surgical factors that influence postoperative outcomes. The hypothesis was that surgical indication, surgical approach, and implant design would affect clinica...
Introduction:
Rotator cuff repair remains associated with high retear rates which range from 13% to 79%. The objective of this study was to evaluate the long-term clinical and structural results after revision rotator cuff repair at a minimum 10-year follow-up.
Methods:
We retrospectively studied the records of all patients who underwent revisio...
Introduction:
Sugaya et al described a classification system to assess postoperative rotator cuff tendon healing. While Sugaya I and II tendons can be considered as healed and Sugaya type IV and V can be considered as retorn, the exact status of Sugaya III tendons remains unclear. The objective of this study was to evaluate the impact of Sugaya II...
Background:
Return to sport after stabilization surgery using the open Latarjet procedure remains challenging. Additional knowledge is needed about postoperative shoulder functional deficits in order to better design return-to-sport programs.
Purpose:
To investigate the effects of the dominance status of the operated shoulder on the shoulder fun...
Background
Posterior shoulder dislocations are rare injuries that are often missed on initial presentation. Cases left untreated for more than three weeks are considered chronic, cannot be reduced closely (they become locked) and are usually associated with a significant reverse Hill-Sachs defect. The aim of this study was to evaluate the outcomes...
Introduction
En arthroscopie le tendon supérieur du sous-scapulaire apparait horizontal, classiquement croisé par le ligament gléno-huméral moyen. Les lésions du sous-scapulaire sont parfois difficiles à reconnaitre et peuvent passer inaperçues. Notre hypothèse était que la visualisation du tendon supérieur horizontal en place ne permettait pas d’é...
Background:
The middle glenohumeral ligament (MGHL) is one of the three ligaments that stabilize the anterior capsule of the shoulder. Recent work suggests that it inserts distally into the deep layer of the subscapularis tendon. The role of the MGHL remains debated. The hypothesis of this study was that the MGHL plays a significant functional rol...
Background
Posterior shoulder dislocations are rare injuries that are often missed on initial presentation. Cases left untreated for more than three weeks are considered chronic, cannot be reduced closely (they become locked) and are usually associated with a significant Hill-Sachs defect. The aim of this study was to evaluate the outcomes of chron...
Background
Short-stem implants in shoulder arthroplasty were recently developed and reported clinical outcomes are good. However, radiological analysis often reveals humeral stem misalignment in the frontal plane, along with high filling ratios that can lead to proximal bone remodeling under stress shielding. The aim of this cadaveric study was to...
Gabriel Nové-Josserand (1868-1949) studied medicine in Lyon under Professor Louis Léopold Ollier at the very end of Ollier's career. He wrote his thesis on a subject close to his master's heart, bone growth disorders due to growth plate alteration, with an experimental and a clinical part, following the principles of Claude Bernard. In 1894, he cam...
Introduction
Les lésions du subscapularis sont de diagnostic difficile en peropératoire. Les classifications manquent de reproductibilité. Une classification anatomique (Anat) basée sur la structure tendineuse comme pour le supra-épineux (rupture partielle superficielle, interstitielle, profonde et transfixiante) a été proposée. Notre hypothèse éta...
Background:
The time elapsed since surgery is the primary criterion for allowing athletes to return to sport after shoulder stabilization surgery using the Latarjet procedure. The objective assessment of shoulder functional status through the return-to-sport continuum demands a scoring instrument that includes psychological and physical dimensions...
Résumé
Introduction
Les lésions du tendon subscapularis (SSC) sont différentes de celles du tendon supraspinatus bien que ces 2 tendons de la coiffe des rotateurs présentent une structure histologique similaire avec 2 couches tendineuses distinctes liées à l’organisation des fibres collagènes.
Hypothèse
La classification lésionnelle basée sur la...
PurposeReverse shoulder arthroplasty (RSA) is often indicated in elderly patients with displaced proximal humerus fractures (PHF). The rate of greater tuberosity (GT) healing varies from 37 to 90% in this population. The aim of this study was to assess greater and lesser tuberosity (LT) fixation and healing on CT scan after RSA for PHF. Our hypothe...
Introduction: Subscapularis (SSC) tendons differ from supraspinatus tendons, although both have similar histologic structure comprising two layers with distinct collagen fiber organization.
Hypothesis: The partial/full-thickness tear classification for the supraspinatus based on tendon structure can be applied to the subscapularis tendon on objecti...
PurposeThe study objective was to compare the clinical results of reverse total shoulder arthroplasty (rTSA) and anatomical total shoulder arthroplasty (aTSA) in patients with osteoarthritis and intact rotator cuff. We hypothesised that the clinical results using rTSA would be comparable with those obtained with aTSA in this group of patients.Metho...
Background
Some full-thickness subscapularis tendon tears and partial tears of the deep layer are difficult to characterize, leading to misdiagnosis.
Purpose
To evaluate the association between displacement of the middle glenohumeral ligament (MGHL) and retracted tears of the subscapularis tendon as a possible test to improve diagnosis.
Study Des...
Background
Avec l’arthroscopie, les lésions du sous scapulaire bénéficient d’un meilleur diagnostic mais elles restent difficiles à dépister. Le Ligament Gléno-Huméral Moyen (LGHM), dont le rôle est imprécis, développe des rapports anatomiques étroits avec le tendon sous-scapulaire. Son insertion distale a la particularité de s’insérer sur la face...
Arthroscopy has improved the diagnosis of subscapularis tendon lesions, and the outcomes of arthroscopic repair are satisfactory. Nonetheless, the diagnosis of some partial- and full-thickness subscapularis tears remains challenging. The middle glenohumeral ligament inserts distally into the articular surface of the subscapularis tendon and can be...
Background:
Ultrasound-guided interscalene block (ISB) is the reference technique for pain control after ambulatory upper limb surgery, but supraclavicular block (SCB) is an alternative.
Objectives:
The aim of this study was to compare the efficacy of SCB vs. ISB in patients undergoing ambulatory arthroscopic rotator cuff repair (ARCR), with the...
Arthroscopic repair is a well-established treatment option for tears of the subscapularis tendon. However, it is clear that to further our understanding, additional study is required to more clearly define the influence of tear morphology, repair type, and associated pathologies and procedures on outcomes. It should be noted that there is rather sp...
Glenoid exposure should offer frontal access to the glenoid to allow the ancillary tools to be used freely and thus facilitate the good positioning of the glenoid implant. The two classically recognized approaches for shoulder arthroplasty are the deltopectoral and the transdeltoid approach. The axillary nerve is the most important anatomical struc...
Background
Although subscapularis tendon lesions seem to differ from those of the supraspinatus tendon, the features they have in common suggest that the subscapularis tendon may also have 2 distinct layers. Our aim was therefore to characterize the histologic structure of the subscapularis tendon from its humeral insertion point to the musculotend...
Purpose
The middle glenohumeral ligament (MGHL) has seldom been studied and its function is unknown. The aim of this study was to describe its anatomical presentations.
Methods
A prospective study was conducted of MGHL anatomy in 107 arthroscopies, with a description of its shape and superior and inferior insertion in the articular surface of the...
Visualisation of subscapularis lesions is difficult during open surgery. Introduction of arthroscopic procedures for rotator cuff surgery improved the diagnosis of subscapularis tears, but it still can be more challenging than for other rotator cuff tendon tears. The SFA classification of subscapularis tears is reproducible and correlates well with...
Background:
Many authors recommend systematic biceps tenotomy or tenodesis when repairing rotator cuff tears, regardless of whether the biceps is normal or pathologic. The purpose of this study was to determine whether 10-year outcomes of repairs of isolated supraspinatus tears are influenced by adjuvant biceps tenodesis or tenotomy.
Methods:
Pa...
Purpose:
Glenoid loosening is a common cause of reverse total shoulder arthroplasty (RTSA) failure, and grafting of the glenoid is often required for revision due to bone loss due to the central peg in most glenoid baseplates. Helical blades have been used in the hip to optimize bone fixation in proximal femoral fracture. This study presents the i...
Résumé
Au niveau de l’épaule, l’arthrite rhumatoïde se caractérise par une atteinte articulaire volontiers sévère combinant destruction osseuse et lésions de la coiffe des rotateurs. Ces raisons expliquent à terme les échecs de l’hémiarthroplastie ou de la prothèse totale anatomique dont les résultats se dégradent dans le temps. La prothèse inversé...
Introduction
Si les résultats à moyen terme des réparations de coiffe des rotateurs sont bien rapportés, les résultats à long terme sont moins bien connus. Plusieurs études ont significativement démontré l’effet néfaste d’une infiltration graisseuse de stade 2 ou plus sur la cicatrisation et la fonction postopératoire. Si cette infiltration graisse...
Valgus-impacted proximal humerus fracture is a classic but rare entity in shoulder traumatology. Surgical treatment is controversial, with increasing use of minimally invasive techniques. Our technique uses a minimally invasive approach under fluoroscopic control. Raising the humeral head to reduce the valgus enables spontaneous and well-positioned...
Glenoid exposure is agreed to be a difficult step, but is also a key step in total shoulder arthroplasty, both anatomic and reverse. It conditions unhindered use of the ancillary instrumentation and thus correct glenoid component positioning. The main stages comprise arthrotomy, by opening the rotator cuff, humeral head cut, and inferior glenohumer...
Background
Anterosuperior rotator cuff tears are more frequent than expected. We report the results of a 10-year follow-up study after repair. Our hypothesis was that the extent of the subscapularis tear influenced the prognosis.
Materials and methods
The study population consisted of all 138 patients who underwent surgery in 14 participating cent...
Background:
Despite the increasing numbers of reverse total shoulder arthroplasty (RTSA) procedures, the long-term results have been rarely reported. We previously reported early outcomes of a cohort of patients treated with a Grammont-style RTSA. The purpose of this study was to evaluate the outcomes after a minimum of 10 years, and to document p...
Purpose The purpose of this study was to analyse the relationship between long head of the biceps brachii (LHBT) lesions and subscapularis tears. The hypothesis was that a bicipital pulley might remain intact, even in the case of a subscapularis tear. Methods
Between 2010 and 2011, all patients who had a primary arthroscopic repair of a subscapular...
PurposeThe purpose of this study was to investigate the influence of tendon tear size, in terms of length and retraction, on clinical and anatomic outcomes following repair for isolated subscapularis tears. Methods
The records of 47 consecutive repairs of isolated subscapularis lesions were studied to correlate pre-operative tear characteristics wi...
Tears in the gluteus medius and minimus tendons have been recognized as an important cause of recalcitrant greater trochanteric pain syndrome. Because of the frequency of partial-thickness undersurface tears, this relatively unknown pathology is often misdiagnosed and left untreated. Surgery is indicated in case of 4 associated conditions: (i) Fail...
Introduction
Long-term follow-up (FU) and survivorship of reverse shoulder arthroplasty (RSA) are limited. The goal of this study was to provide long-term overall survivorship, clinical and radiographic assessments and late complications of a monocentric cohort with a minimum FU of 10 years.
Objectives
Provide clearer data concerning long-term exp...
La réparation directe anatomique des ruptures rétractées de la coiffe des rotateurs reste un défi, compte tenu du risque élevé de rupture itérative.
Introduction:
Anatomical tendon-to-bone repair of retracted rotator cuff tear is a difficult challenge given the high rate of recurrence.
Hypothesis:
The study hypothesis was that side-to-side repair of U-shaped retracted tear allows tendon healing with satisfactory medium-term clinical results.
Materials and methods:
Between 1999 and 2007, 35...
The aim of the present study was to describe the precise anatomy of the so-called "Comma Sign" which has been observed during arthroscopy in retracted subscapularis (SSC) tears.
Fourteen fresh cadaveric shoulders were prepared to obtain an articular view comparable to arthroscopic posterior portal view. A step-by-step dissection was carried out to...
Les ruptures partielles de la coiffe des rotateurs, interstitielles, articulaires et bursales, se définissent par l'interruption de fibres tendineuses ne concernant pas toute l'épaisseur du tendon. La classification de Ellman en trois grades, basée sur l'importance de la lésion par rapport à l'épaisseur du tendon, est utilisée pour les indications...
Les lésions non transfixiantes du moyen et du petit glutéal ont été récemment reconnues comme une source de douleurs trochantériennes chroniques résistantes au traitement médical. Le but de cet article était de détailler une technique endoscopique originale permettant de reconnaître et réparer ces lésions. Nous utilisons un arthroscope standard à 3...
Partial-thickness tear of the gluteus medius and minimus muscles has recently been recognized as a cause of chronic trochanteric pain resistant to medical treatment. The present article reports an original endoscopic technique of identification and repair. It uses a standard arthroscope at 30°, with the patient in lateral decubitus, without fluoros...
Les ruptures du subscapulaire peuvent être évoquées cliniquement devant une rotation externe passive augmentée en comparatif par rapport au côté opposé, des manœuvres de rotation interne contrariée (Lift-Off test [LOT], Belly-Press test [BPT], Napoléon test et Bear-Hug test [BHT]) et des signes de rappel automatique positifs (Internal Rotation Lag...
Jusqu’à l’utilisation de l’arthroscopie dans la chirurgie de la coiffe des rotateurs, la fréquence des lésions du subscapulaire est restée longtemps sous-estimée. Par ailleurs, leur traitement même sous contrôle arthroscopique reste difficile. L’absence de classification réellement spécifique des lésions du subscapulaire a rendu difficile la commun...
L’absence d’un système cohérent de classification des lésions du sub-scapularis a rendu difficile la communication en matière de traitement et de pronostic pour les différents types de rupture du sub-scapularis. En outre, une classification fiable fournit un moyen de comparaison des données épidémiologique et thérapeutiques. Les classifications jus...
Purpose:
The purpose of the study was to assess the repair site integrity after transosseous equivalent/suture-bridge (TOE/SB) repair with the use of magnetic resonance imaging (MRI).
Methods:
One hundred seven consecutive shoulders with a small to medium-size full-thickness supraspinatus tear were repaired arthroscopically with use of the TOE/S...
Background:
Until the introduction of arthroscopic-assisted surgery for rotator cuff repair, the frequency of subscapularis tears was underestimated. These tears remain challenging to treat even with arthroscopy. The absence of a specific classification system has hampered communication about the treatment and outcomes of the various types of subs...
Background:
The absence of a coherent classification system has hampered communication about the treatment and outcomes of the various types of subscapularis tendon lesions. In addition, a reliable classification system allows comparisons of epidemiological and therapeutic data. The classification systems used until now fail to incorporate the rad...
Hypothesis:
Clinically, subscapularis tendon tears are suggested by the presence of increased passive external rotation compared to the opposite side, resisted internal rotation manoeuvres (Lift-Off test [LOT], Belly-Press test [BPT], Napoleon test and Bear-Hug test [BHT] and positive Internal Rotation Lag Sign and/or Belly-Off Signs). Associated...
Even though the frequency of arthroscopic repair of isolated lesions of the subscapularis tendon has increased, few studies have presented clinical and anatomical outcomes of this treatment. We hypothesized that, after an arthroscopic repair, structural outcomes in the muscle have an influence on functional results.
A retrospective study was perfor...
The goal of this study was to compare 2 consecutive series of 240 reverse total shoulder arthroplasties (TSA) in order to evaluate if the increase in surgeon experience modified the indications, clinical and radiographic results, and rate of complications.
Two hundred forty reverse TSA performed between July 2003 and March 2007 were clinically and...
But
L’objectif de l’étude était d’établir le devenir professionnel des patients opérés d’une réparation de la coiffe des rotateurs en accident de travail (AT) ou maladie professionnelle (MP) et de mettre en évidence les facteurs influençant la reprise du travail et ses conditions. Hypothèse : la reprise du travail est possible pour cette catégorie...
Unlabelled:
The goals of this study were to establish the occupational outcome after surgery in patients with a rotator cuff tear from a work-related injury (WRI) or occupational disease (OD) and determine which factors and conditions affected return to work.
Hypothesis:
return to work was possible for this type of patient. This questionnaire-ba...
The arthroscopic capsular release appears as an indication of interest in the therapeutic arsenal for treating such difficult pathology as adhesive capsulitis. Today, the surgical technique of arthroscopic capsular release is well codified, even if some points are still debated. It has to be followed by specific, early postoperative physiotherapy t...
Lesions of the long head of the biceps tendon are rarely primitive and isolated. In most cases, they are associated with rotator cuff tears. Three different types of lesions are observed: tears, tendinopathies with a tendon in its bicipital groove, and medial subluxations-luxations. The large prevalence of long head of the biceps lesions associated...
Introduction
Les ruptures myotendineuses de l’infraspinatus appartiennent aux muscles strain injury. Elles se différencient des ruptures de la coiffe par quatre éléments : elles respectent l’insertion tendineuse sur le trochiter et la capsule articulaire ; la phase de début est caractérisée par un œdème musculaire intense remplacé en six à 12 mois...
Background
Musculotendinous infraspinatus ruptures belong to the category of “muscle strain injuries”. They differ from a classic rotator cuff tear by the following features: tendon attachment remains intact and the acute initial stage typically undergoes an intense muscular edema, replaced, 6 to 12 months later, by complete and permanent fatty inf...
Rupture of the supraspinatus and infraspinatus tendon (and teres minor) can cause loss of active external rotation (ER), entailing severe functional disability in daily activities. Latissimus dorsi tendon transfer (LDTT), proposed by Gerber in 1988, appears to be the best adapted solution in these cases of irreparable posterior and superior cuff te...
Le transfert du latissimus dorsi est proposé devant les ruptures postérosupérieures non réparables avec déficit de la rotation externe active. Les résultats portent sur 27 patients opérés revus au recul moyen de 34 ± 12 mois. Il y avait 14 hommes et 13 femmes pour un âge moyen de 55,5 ans (36–71). Le déficit de rotation externe active était nul dan...
Las enfermedades del manguito de los rotadores son muy frecuentes y representan la primera causa de consulta por hombro doloroso. Se distinguen las tendinopatías sin ruptura calcificantes o no y las tendinopatías con ruptura, parciales o transfixiantes, que pueden evolucionar hasta la artrosis excéntrica. En la exploración física se evalúan las amp...
Recurrent anterior dislocations associated with full thickness rotator cuff tear (RCT) carry a difficult therapeutic problem: should we treat instability and rotator cuff tear at the same time or only one of both pathologies? The goal of this study was to analyse a retrospective series of patients operated on to try to answer this question.
Twenty-...
Purpose of the study:
Recurrent anterior dislocations associated with full thickness rotator cuff tear (RCT) carry a difficult therapeutic problem: should we treat instability and rotator cuff tear at the same time or only one of both pathologies? The goal of this study was to analyse a retrospective series of patients operated on to try to answer...
Les rapports anatomiques arthroscopiques entre ligament gléno-huméral supérieur (LGHS) et tendon sous-scapulaire sont mal connus. Lors d’une réparation arthroscopique du tendon, il est indispensable de retrouver le bord supérieur du tendon souvent rétracté, parfois non visible par voie postérieure arthroscopique. Le but de cette étude était de décr...
Introduction
L’objectif de ce travail est d’évaluer les résultats des réparations de la coiffe sous arthroscopie en fonction des conditions d’application de la rééducation postopératoire : ambulatoire après retour à domicile ou séjour en centre de rééducation.
Matériel et méthodes
Il s’agit d’une série continue de 139 épaules opérées d’une réparat...
Les ruptures de la coiffe des rotateurs sont des lésions à prendre en compte dans la pathologie du rugby moderne. Elles représentent 3 à 10 % des lésions traumatiques de l'épaule dans cette population et semblent en constante augmentation du fait de la croissance du nombre de pratiquants et de l'intensité du jeu. Un bilan clinique permettra d'orien...
The stabilization of an unstable chronic shoulder is a difficult challenge in the contact sportsman especially the rugby player. We report our experience of the modified Latarjet procedure with a retrospective series of 85 shoulders (79 rugbymen at 75 months follow-up). It acted all young men with a prevalence of dominant shoulder, occupying all th...
The stabilization of an unstable chronic shoulder is a difficult challenge in the contact sportsman especially the rugby player. We report our experience of the modified Latarjet procedure with a retrospective series of 85 shoulders (79 rugbymen at 75 months follow-up). It acted all young men with a prevalence of dominant shoulder, occupying all th...
Reverse total shoulder arthroplasty provides a surgical alternative to standard total shoulder arthroplasty for the treatment of selected complex shoulder problems. The purpose of the present study was to evaluate the effects of etiology on the results of reverse total shoulder arthroplasty.
Between May 1995 and June 2003, 240 consecutive reverse t...
