F. Gouin

Unité Inserm U1077, Caen, Lower Normandy, France

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Publications (109)151.54 Total impact

  • P Perrot · U Lancien · P Ridel · F Gouin · F Bodin · F Duteille
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    ABSTRACT: Among all complications that affect patients with neurofibromatosis, type I (NF1) are very aggressive malignant nerve sheath tumors (MPNSTs). Surgery is their first line therapy. We report the case of a non metastatic neurofibrosarcoma of the axillary area in a 22-year-old male with NF1. An interscapulothoracic resection was performed to resect the tumor and had sacrificed the homolateral latissimus dorsi pedicled myocutaneous flap. In this extreme and not codified situation, the coverage of the tissue loss was possible in the same time using a free flap harvested on the amputated limb (fillet flap). The free flap based on the humeral pedicle was composed of the entire skin and muscles of the amputated forearm. It was anastomosed on the subclavian vessels. Only a free flap was suitable in this tissue loss. The use of a fillet flap allows a wide and reliable coverage without donor site morbidity. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
    No preview · Article · Jul 2015 · Annales de chirurgie plastique et esthetique
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    ABSTRACT: Receptor activator of nuclear factor kappa-B (RANK) and RANK-ligand are relevant targets for the treatment of polyethylene particle-induced osteolysis. This study assessed the local administration of siRNA, targeting both human RANK and mouse Rank transcripts in a mouse model. Four groups of mice were implanted with polyethylene (PE) particles in the calvaria and treated locally with 2.5, 5 and 10μg of RANK siRNA or a control siRNA delivered by the cationic liposome DMAPAP/DOPE. The tissues were harvested at day 9 after surgery and evaluated by micro-computed tomography, tartrate-resistant acid phosphatase (TRAP) immunohistochemistry for macrophages and osteoblasts, and gene relative expression of inflammatory and osteolytic markers. 10μg of RANK siRNA exerted a protective effect against PE particle-induced osteolysis, decreasing the bone loss and the osteoclastogenesis, demonstrated by the significant increase in the bone volume (P<0.001) and by the reduction in both the number of TRAP(+) cells and osteoclast activity (P<0.01). A bone anabolic effect demonstrated by the formation of new trabecular bone was confirmed by the increased immunopositive staining for osteoblast-specific proteins. In addition, 5 and 10μg of RANK siRNA downregulated the expression of pro-inflammatory cytokines (P<0.01) without depletion of macrophages. Our findings show that RANK siRNA delivered locally by a synthetic vector may be an effective approach for reducing osteolysis and may even stimulate bone formation in aseptic loosening of prosthetic implants.
    Full-text · Article · Nov 2014 · Acta Biomaterialia
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    ABSTRACT: Receptor Activator of Nuclear factor Kappa-B (RANK) and RANK-ligand are relevant targets for the treatment of polyethylene particle-induced osteolysis. This study assessed the local administration of siRNA, targeting both human RANK and mouse Rank transcripts in a mouse model. Four groups of mice were implanted with polyethylene (PE) particles in the calvaria and treated locally with 2.5, 5 and 10 μg of RANK siRNA or a control siRNA delivered by the cationic liposome DMAPAP/DOPE. The tissues were harvested at day 9 after surgery and evaluated by: micro-CT, Tartrate Resistant Acid Phosphatase (TRAP), immunohistochemistry for macrophages, osteoblasts and gene relative expression of inflammatory and osteolytic markers. Ten μg of RANK siRNA exerted a protective effect against PE particle-induced osteolysis, decreasing the bone loss and the osteoclastogenesis, demonstrated by the significant increase in the bone volume (p < 0.001) and by the reduction in both the number of TRAP+ cells and osteoclast activity (p < 0.01). A bone anabolic effect demonstrated by the formation of new trabecular bone was confirmed by the increased immunopositive staining for osteoblast-specific proteins. In addition, 5 and 10 μg of RANK siRNA downregulated the expression of pro-inflammatory cytokines (p < 0.01) without depletion of macrophages. Our findings show that RANK siRNA delivered locally by a synthetic vector may be an effective approach for reducing osteolysis and may even stimulate bone formation in aseptic loosening of prosthetic implants.
    Full-text · Article · Nov 2014 · Acta Biomaterialia
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    ABSTRACT: La mesure radiographique de l’angle alpha (AA) dans le conflit fémoro-acétabulaire (CFA) n’est pas bien codifiée et les techniques invasives telles que l’arthro-tomodensitométrie (TDM) et l’arthro-IRM restent la référence. La couverture acétabulaire excessive décrite dans le CFA peut être visualisée sur les radiographies standards mais n’a jamais été quantifiée de manière plus précise de même que l’angle de couverture antérieur (VCA) mesuré sur le faux profil de Lequesne (FP) n’a pas été évalué dans le CFA.
    No preview · Article · Jun 2014 · Revue de Chirurgie Orthopédique et Traumatologique
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    ABSTRACT: Radiographic measurement of the alpha angle (AA) in femoroacetabular impingement (FAI) is not well codified and invasive techniques such as MR- or CT-arthrography remain the gold standard. Excessive acetabular coverage described in pincer-type FAI can be seen on plain radiographs but has never been quantified and anterior center edge (ACE) angle, described on the false-profile view (FP) to measure anterior acetabular coverage has never been evaluated in FAI. In this study we wanted to determine if a plain radiograph could efficiently measure AA compared to CT-arthrography and if ACE could quantify the acetabular coverage in FAI. We developed a hip view combining a lateral view and a FP, called profile view in impingement position (PIP). Twenty-six patients operated for FAI had CT-arthrography, PIP and FP. Nineteen control subjects had the PIP. AA were measured twice by three raters and ACE once. We compared AA measured on patients between CT and PIP, on PIP between patients and controls, ACE measured on patients between PIP and FP, and did a reproducibility analysis. Means were compared by paired or unpaired t-tests; reproducibility was measured by intraclass correlation coefficient (ICC). Mean AA was 65.8° (range, 48-85°) on CT-arthrography and 63.9° (range, 50-87°) on PIP (P>0.05). ICC for PIP measures were 0.8-0.9 for intra-rater and 0.6-0.9 for inter-rater reliability. Mean AA on PIP in patients was 63.3° (range, 52-87°) and 44.9° (range, 34-67°) in controls (P<0.001). Mean ACE was 26.8° (range, 14-41°) on PIP and 32.8° (range, 18-56°) on the FP (P=0.015). The PIP is a reliable view to measure the AA in FAI as measures on PIP and CT-arthrography were not significantly different with a good reproducibility. All of the painful hips and 2 controls had an AA>50°. PIP was not efficient to measure ACE. Level III, case-control study.
    Preview · Article · May 2014 · Orthopaedics & Traumatology Surgery & Research
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    ABSTRACT: Introduction Dans le cadre de la prise en charge des sarcomes osseux de l’extrémité supérieure de l’humérus, la reconstruction par arthrodèse scapulo-humérale (ASH) a montré son efficacité en cas de résection du système abducteur de l’épaule : coiffe des rotateurs, deltoïde ou son innervation. Le greffon de référence pour cette arthrodèse est la fibula libre vascularisée. Nous utilisons dans cette indication un greffon osseux vascularisé autologue de pilier de la scapula homolatérale. Hypothèse L’objectif de l’étude est d’évaluer les résultats fonctionnels et la consolidation osseuse radiologique après arthrodèse par pilier vascularisé de la scapula. Patients et méthode Une étude rétrospective monocentrique, mono-opérateur a donc été conduite chez 12 patients entre 1994 et 2011 ayant bénéficié d’une arthrodèse scapulo-humérale par pilier vascularisé de la scapula homolatérale après résection carcinologique de l’extrémité supérieure de l’humérus (ESH). Le greffon était prélevé aux dépens du pilier de la scapula homolatérale et laissé pédiculé sur l’artère circonflexe de la scapula. Il était ensuite encastré dans l’humérus distal restant et fixé à la glène par vis. L’arthrodèse était stabilisée par plaque spino-humérale. Les résultats radiographiques étaient évalués sur des radiographies standard au plus long recul. Le résultat fonctionnel a été évalué par le score Musculoskeletal Tumor Society Score (MSTS) et Toronto Extremity Salvage Score (TESS). Résultats Au recul moyen de 4,9 ans, 87,5 % des jonctions de l’ASH étaient consolidées. Le MSTS et le TESS score moyen étaient respectivement de 71 % et 70 %. Discussion Ces résultats sont comparables à l’ASH par fibula vascularisée mais avec une technique ne nécessitant pas de microchirurgie. Cette technique simple, reproductible et efficace trouve ses indications de choix après résections intra- ou extra-articulaires de l’extrémité supérieure de l’humérus, emportant les insertions des tendons de la coiffe des rotateurs et le muscle deltoïde ou son innervation. Niveau de preuve Niveau IV (rétrospectif).
    No preview · Article · Apr 2014 · Revue de Chirurgie Orthopédique et Traumatologique
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    ABSTRACT: Background Scapulo-humeral arthrodesis (SHA) is a proven reconstruction method in patients with proximal humerus malignancies requiring resection of the shoulder abduction apparatus (rotator cuff and deltoid muscles) or its nerve supply. Standard practice consists in using a pedicled fibular flap. We use instead a pedicled autologous bone graft harvested from the ipsilateral scapular pillar. Hypothesis The objective of this study was to assess functional outcomes and radiological healing after SHA using a pedicled scapular pillar graft. Materials and methods We retrospectively reviewed the charts of the 12 patients managed at a single center by a single surgeon between 1994 and 2011. SHA was performed using a vascularised ipsilateral scapular pillar graft after proximal humerus resection to treat a bone malignancy. The graft was harvested from the ipsilateral scapular pillar, pedicled on the circumflex scapular artery, fitted into the remaining proximal humerus, and secured to the glenoid using screws. A humerus-scapular spine plate was added to stabilize the arthrodesis. Radiographic results were assessed on standard radiographs obtained at last follow-up. Functional outcomes were evaluated using the MusculoSkeletalTumour Society (MSTS) score and Toronto Extremity Salvage Score (TESS). Results After a mean follow-up of 4.9 years, 87.5% of SHA junctions were healed, mean MSTS score was 71%, and mean TESS score was 70%. Discussion The outcomes in our patients were similar to those reported after SHA using a pedicled fibular flap. However, our technique does not require microsurgery. It is simple, reproducible, and effective. Its indications of choice are intra- or extra-articular resection of the proximal humerus including the attachments of the rotator cuff and deltoid muscle tendons or the nerves supplying these muscles. Level of evidence Level IV (retrospective study).
    Full-text · Article · Apr 2014 · Orthopaedics & Traumatology Surgery & Research
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    ABSTRACT: Background Radiographic measurement of the alpha angle (AA) in femoroacetabular impingement (FAI) is not well codified and invasive techniques such as MR- or CT-arthrography remain the gold standard. Excessive acetabular coverage described in pincer-type FAI can be seen on plain radiographs but has never been quantified and anterior center edge (ACE) angle, described on the false-profile view (FP) to measure anterior acetabular coverage has never been evaluated in FAI. Hypothesis In this study we wanted to determine if a plain radiograph could efficiently measure AA compared to CT-arthrography and if ACE could quantify the acetabular coverage in FAI. Materials and methods We developed a hip view combining a lateral view and a FP, called profile view in impingement position (PIP). Twenty-six patients operated for FAI had CT-arthrography, PIP and FP. Nineteen control subjects had the PIP. AA were measured twice by three raters and ACE once. We compared AA measured on patients between CT and PIP, on PIP between patients and controls, ACE measured on patients between PIP and FP, and did a reproducibility analysis. Means were compared by paired or unpaired t-tests; reproducibility was measured by intraclass correlation coefficient (ICC). Results Mean AA was 65.8° (range, 48–85°) on CT-arthrography and 63.9° (range, 50–87°) on PIP (P > 0.05). ICC for PIP measures were 0.8–0.9 for intra-rater and 0.6–0.9 for inter-rater reliability. Mean AA on PIP in patients was 63.3° (range, 52–87°) and 44.9° (range, 34–67°) in controls (P < 0.001). Mean ACE was 26.8° (range, 14–41°) on PIP and 32.8° (range, 18–56°) on the FP (P = 0.015). Discussion The PIP is a reliable view to measure the AA in FAI as measures on PIP and CT-arthrography were not significantly different with a good reproducibility. All of the painful hips and 2 controls had an AA > 50°. PIP was not efficient to measure ACE. Level of evidence Level III, case-control study.
    No preview · Article · Jan 2014 · Orthopaedics & Traumatology Surgery & Research
  • F. Gouin · V. Dumaine
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    ABSTRACT: Le curetage des tumeurs à cellules géantes de l’os est le traitement de référence de ces lésions. Le but de cette étude menée au sein du Groupe sarcome français-Groupe d’étude des tumeurs osseuses est d’analyser les facteurs de présentation et de traitement qui pourraient influencer le taux de récidive.
    No preview · Article · Oct 2013 · Revue de Chirurgie Orthopédique et Traumatologique
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    F Gouin · V Dumaine
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    ABSTRACT: Curettage is a well-established treatment modality for giant cell tumors of bone. The purpose of this retrospective study by the French Sarcoma and Bone Tumor Study Groups (GSF-GETO) was to analyze various tumor-specific and surgery-specific factors that could influence the rate of local recurrence. Data was collected from patients with giant cells tumors of the appendicular skeletal who were treated by intralesional curettage. The hazard ratio for tumor recurrence was calculated for the different variables collected and a multifactorial analysis carried out. One hundred and ninety-three surgical procedures were included from nine centers. One hundred and seventy-one (89%) were primary tumors and 22 had been referred after one or more recurrences. The mean follow-up was 6years and 11months. The distal femur and proximal tibia were the most common locations: 42.5 and 34.2% of cases, respectively. The bone defect after curettage was filled in 176 cases (91.2%) and left empty in 16 cases. Local adjuvant treatment (phenol, alcohol, cryotherapy or combination treatment) was used in 39 cases (20.2%) and systemic adjuvant treatment used in 24 cases (calcitonin 11 and zoledronic acid 13). Local recurrence occurred in 71 cases (36.8%). Risk factors for local recurrence were an empty defect, a defect filled with autograft, and patients treated before 2005. Multivariate analysis showed that the only risk factors for local recurrence were a surgical procedure before 2005 (odds ratio 3.6 (95% CI: 1.2, 7.9) P=0.017) and a bone defect filled with autograft (odds ratio 3.9 [95% CI: 1.3, 11.6] P=0.013) CONCLUSION: Neither tumor-specific nor surgery-specific factors such as adjuvant treatment were found to be as risk factors for local recurrence after curettage of giant cell tumors in the appendicular skeleton. As recently reported, high-quality local curettage is probably the most effective technique to prevent local recurrence. The current study suggests that two factors associated with more recent management of these tumors in France, high-speed burring and centralization to skilled surgical teams, can improve the quality of curettage. 4, retrospective cohort study.
    Preview · Article · Aug 2013 · Orthopaedics & Traumatology Surgery & Research
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    Full-text · Article · Dec 2012 · Revue de Chirurgie Orthopédique et Traumatologique
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    ABSTRACT: Préalable Les marges de résection sont un facteur de risque reconnu de récidive local, mais leur influence sur la survie est moins claire. Hypothèse Une prolifération de type infiltrant et la présence de nodules satellites sont des facteurs pronostiques d’agressivité locale et systémique. Type d’étude Étude rétrospective de cohorte. Patients et méthodes Étude de 105 patients traités en curatif. La qualité de résection a été évaluée selon l’Union internationale contre le cancer (UICC) (R0/R1) et une version modifiée (R0 M/R1 M) prenant en compte les limites et les nodules satellites pour les marges fines (< 1 mm). Une analyse uni- et multivariée a été conduite. Les courbes de survie, selon Kaplan et Mayer ont été comparées par Log-Rank. Résultats La survie sans récidive locale (LRFS) était de 0,64 (0,52 ; 0,76) à cinq ans après chirurgie R1, 0,9 (0,85 ; 0,95) après chirurgie R0, 0,64 (0,519 ; 0,751) après chirurgie R1 M et 0,92 (0,87 ; 0,96) après chirurgie R0 M. Le type de résections selon la classification R était associé avec la survie sans maladie (DFS) (p = 0,028), mais pas la survie sans métastase (MFS) (p = 0,156). Le type de résection selon la classification RM était associé avec la DFS et la MFS. L’analyse multivariée a montré une association du taux de LRFS avec le type de résection RM (HR 6,77 [1,78–25,7], p = 0,005), de la DFS avec le type de résection RM (HR 2,83 [1,47–5,43], p = 0,001) et le grade (HR = 3,17 [1,38–7,27], p = 0,003), et de la MFS avec le grade (HR = 3,96 [1,50–10,5], p = 0,006). Discussion L’aspect microscopique des limites de prolifération et la présence de nodules satellites sont bien des facteurs pronostiques d’agressivité locale et systémique. Ils influencent à la fois les courbes de DFS, et sans métastases pour les marges inférieures à 1 mm. Leur prise en compte systématique pourrait permettre de distinguer les patients à haut risque systémique. Niveau de preuve IV.
    No preview · Article · Jun 2012 · Revue de Chirurgie Orthopédique et Traumatologique
  • F. Colin · F. Lintz · G. Odri · N. Passuti · F. Gouin
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    ABSTRACT: Les recommandations concernant les soins postopératoires et la durée d’hospitalisation entourant le geste d’ablation de clou de jambe ne sont pas précisées dans la littérature. L’ablation de clou de jambe est recommandée une fois la consolidation acquise chez les patients jeunes. L’extrémité proximale du clou ainsi que les vis de verrouillage sont souvent source de conflits, de douleurs et de gêne fonctionnelle pour le patient. Cette intervention est réalisée habituellement en hospitalisation conventionnelle avec utilisation d’un drainage. L’hypothèse de cette étude est l’efficacité comparable de l’ablation de clou de jambe en ambulatoire sans drainage, cela avec un coût moindre pour le système de santé. Une étude rétrospective cas témoin a été conduite comparant 43 patients opérés en ambulatoire sans drainage postopératoire versus 43 patients opérés en hospitalisation conventionnelle avec drainage postopératoire. Dans le groupe ambulatoire, on notait trois complications postopératoires dont une reprise chirurgicale pour hématome. Dans le groupe conventionnel, on notait trois complications dont deux reprises chirurgicales. Il n’y avait pas de différence significative du nombre de complications entre les deux groupes. La diminution de la durée d’hospitalisation a permis de réaliser une économie de 1273 € par patient. L’ablation de clou de jambe en ambulatoire semble être une pratique sûre et plus efficiente que la chirurgie programmée en hospitalisation conventionnelle. Niveau de preuve 3 Étude rétrospective cas-témoins.
    No preview · Article · Jun 2012 · Revue de Chirurgie Orthopédique et Traumatologique
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    F Lintz · A Moreau · G-A Odri · D Waast · O Maillard · F Gouin
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    ABSTRACT: Resection margins constitute a recognized risk factor for local recurrence, but their impact on survival is less clear. Infiltrative proliferation and satellite nodules are prognostic factors for local and systemic aggressiveness. Retrospective cohort study. In 105 patients under curative treatment, resection quality was assessed on UICC criteria (R0/R1) and on a modified version (R0M/R1M) taking account of proliferation contours and satellite nodules for narrow margins (<1mm). Uni- and multi-variate analysis was performed, and Kaplan-Meier survival curves were compared on log-rank. Mean 5-year local recurrence-free survival (LRFS) was 0.64 [0.52-0.76] after R1 surgery, 0.9 [0.85-0.95] after R0, 0.64 [0.519-0.751] after R1M and 0.92 [0.87-0.96] after R0M. Resection type according to R classification correlated with disease-free survival (DFS) (P=0.028), but not with metastasis-free survival (MFS) (P=0.156). Resection type according to RM classification correlated with DFS and MFS. Multivariate analysis disclosed correlations between LRFS rate and RM resection type (HR 6.77 [1.78-25.7], P=0.005), DFS rate and RM resection type (HR 2.83 [1.47-5.43], P=0.001) and grade (HR=3.17 [1.38-7.27], P=0.003), and MFS and grade (HR=3.96 [1.50-10.5], P=0.006). The microscopic aspect of the proliferation contours and presence of satellite nodules were confirmed as prognostic factors for local and systemic aggressiveness. They impact both disease-free survival and metastasis-free survival in case of margins less than 1mm. Their systematic consideration may help identify patients with elevated systemic risk. IV.
    Full-text · Article · May 2012 · Orthopaedics & Traumatology Surgery & Research
  • F. Gouin · G. Odri · R. Revert · M.-F. Heymann · F. Rédini
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    ABSTRACT: El tumor de células gigantes (TCG) es un proceso tumoral benigno que representa el 5% de los tumores óseos primarios. Afecta sobre todo al adulto joven entre los 20-40 años de edad. La proliferación tumoral está compuesta por células estromales mononucleadas, consideradas como el contingente tumoral, células mononucleadas precursoras de los osteoclastos y células multinucleadas parecidas a los osteoclastos, responsables de la destrucción ósea. La mayoría de las veces, este proceso tumoral produce áreas de osteólisis en la región metafisoepifisaria de los huesos largos (fémur, tibia, húmero, radio). Puede afectar a los huesos planos (hueso coxal, vértebras, sacro). La fragilización ósea provoca dolores, con mucha frecuencia reveladores de la lesión, y expone al riesgo de fracturas patológicas. El diagnóstico debe confirmarse mediante una biopsia para no confundir esta lesión con otra parecida o con un sarcoma de células gigantes. El tratamiento se basa en un legrado amplio y lo más completo posible. Los tratamientos adyuvantes intraoperatorios (fenol, nitrógeno líquido, termocoagulación, crioterapia, cemento, etc.) se tienen en cuenta en función de su efecto sobre la prevención de las recidivas, que se observan en el 10-40% de los casos y que en raras ocasiones se acompañan de metástasis pulmonares benignas. Las terapias dirigidas antiosteoclásticas parecen ser eficaces sobre la proliferación tumoral, pero su lugar en la estrategia terapéutica está siendo evaluado.
    No preview · Article · May 2012
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    ABSTRACT: La technique de ligamentoplastie tape locking screw (TLS®) utilise le polyéthylène téréphtalate (PET) comme moyen de fixation du transplant à l’os. Deux cas d’arthrite aseptique sont rapportés dans les suites de reconstructions du ligament croisé antérieur utilisant ce matériel. Le diagnostic a été porté sur la négativité des prélèvements et la guérison complète après arthroscopie lavage et synovectomie sans antibiothérapie curative. Cette complication avait été décrite pour d’autres matériaux synthétiques utilisés dans cette indication (dacron, PFTE, carbone) et pour le PET comme transplant mais jamais comme moyen de fixation intra-osseux. L’hypothèse physiopathologique est celle d’un relargage de particules de PET dans le cul de sac quadricipital. L’enfouissement intra-osseux le plus complet possible des bandelettes lors de la pose pourrait éviter un conflit avec ce dernier. Il est nécessaire de rapporter de plus grandes séries avec un recul suffisant de ligamentoplastie selon la technique TLS® afin de pouvoir évaluer l’incidence réelle de cette complication.
    No preview · Article · May 2012 · Revue de Chirurgie Orthopédique et Traumatologique
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    F Colin · F Lintz · K Bargoin · C Guillard · G Venet · A Tesson · F Gouin
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    ABSTRACT: In Tape Locking Screw (TLS(®)) ligamentoplasty, transplant bone fixation uses polyethylene terephthalate (PET). We report two cases of aseptic arthritis following anterior cruciate ligament (ACL) reconstruction using this material. Diagnosis was founded on negative sampling and complete cure following arthroscopic lavage and synovectomy without curative antibiotherapy. This complication was also described with other synthetic materials used in this indication (Dacron, PFTE, carbon), and with PET as transplant material but never as bone fixation material. The physiopathological hypothesis is in terms of PET particle release in the suprapatellar bursa; sinking the strips into the bone as fully as possible on implantation could avoid impingement. Longer TLS(®) ligamentoplasty series with adequate follow-up will be needed in order to estimate the true incidence of this complication.
    Preview · Article · Mar 2012 · Orthopaedics & Traumatology Surgery & Research
  • F. Gouin · G. Odri · R. Revert · M.-F. Heymann · F. Rédini

    No preview · Article · Jan 2012
  • F. Gouin · F. Redini · M.-F. Heymann
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    ABSTRACT: Los tumores óseos primarios son tumores raros de naturaleza y expresión clínicas variables. El hueso al lado de tumores benignos y malignos puede ser asiento de procesos reactivos o la expresión de enfermedades sistémicas seudotumorales. En algunos casos, las células tumorales pueden ser el asiento de anomalías cromosómicas que caracterizan la entidad tumoral, como las que implican al gen EWS en los tumores de la familia de los sarcomas de Ewing. Algunas anomalías del genoma también tienen un papel en la patogénesis tumoral, como la deleción del gen RB en el osteosarcoma y la pérdida de su función más importante en el ciclo celular. Numerosas observaciones clínicas apoyadas por recientes estudios fundamentales defienden el papel del microentorno óseo en la génesis de los tumores óseos. El mejor conocimiento de los factores intrínsecos y microambientales en la oncogénesis de los tumores óseo debe conducir a nuevos enfoques terapéuticos.
    No preview · Article · Dec 2011

  • No preview · Article · Oct 2011 · International Journal of Oral and Maxillofacial Surgery

Publication Stats

950 Citations
151.54 Total Impact Points

Institutions

  • 2007-2014
    • Unité Inserm U1077
      Caen, Lower Normandy, France
    • French Institute of Health and Medical Research
      • Unit of Pathophysiology of Bone Resorption and Therapy of Primary Bone Tumors
      Lutetia Parisorum, Île-de-France, France
    • Polytech Nantes
      Naoned, Pays de la Loire, France
  • 2006-2014
    • University of Nantes
      • Faculté de Médecine
      Naoned, Pays de la Loire, France
  • 2013
    • Hôtel-Dieu de Paris – Hôpitaux universitaires Paris Centre
      Lutetia Parisorum, Île-de-France, France
  • 2001-2011
    • Centre Hospitalier Universitaire de Nantes
      • Service d'orthopédie
      Naoned, Pays de la Loire, France
  • 2009
    • Hospital Centre University of Fort de France
      Fort Royal, Martinique, Martinique
  • 2005
    • CHU de Lyon - Groupement Hospitalier Edouard Herriot
      Lyons, Rhône-Alpes, France
  • 1998
    • Centre Hospitalier Régional et Universitaire de Besançon
      Becoinson, Franche-Comté, France