Biomedical subjects

C Chantelot

Publications and source records attributed to C Chantelot.

At least 19 recordsLinked to original sources

PubMed2003

[Guepar anatomical trapeziometacarpal prosthesis].

INTRODUCTION: A choice of surgical techniques of treatment for trapeziometacarpal (TMC) Osteo-Arthritis (OA) have been described. Total arthroplasty is often used, especially in France. Many papers have been published, presenting various prostheses. In English literature, this device is not thoroughly used. MATERIALS AND METHODS: [corrected] Guepar total arthroplasty is a cemented ball-in-socket prosthesis in metal-polyethylene. It includes an anatomical stem available in 4 sizes. After failure of the conservative treatment, total arthroplasty must be reserved to elderly patients, painful, with OA Dell stage III or IV aligned or not. The trapezial height must be sufficient. The authors reports the preliminary results of 64 Guepar prostheses, anatomical new design, implanted since 1995. RESULTS: Results of 63 prostheses are presented. One removal had been necessary at 9 months for metacarpal loosening (failure). Mean follow-up was 29 months. Clinical results were judged excellent or good in all cases. Regarding the radiological results, no modifications has been observed in 56 cases. Six radiolucent lines without displacement of the implants has been noted, with no incidence on clinical results. In one case, a metacarpal stem penetrated into the medullary canal in the bone axis but without any clinical modifications. DISCUSSION AND CONCLUSION: Clinically, in addition to pain relief, trapeziometacarpal prosthesis allows to preserve the first column length and to obtain a better opposition of the thumb as well of a better thumb-digits pinch, compared after trapeziectomy. Radiologically, as for total hip arthroplasty, the exact adaptation of an anatomical stem (new design) to the canal has probably a better prognosis at long term follow-up.

Adult↗

PubMed2003

[Extensor tendon rupture after dorsal surgery of the rheumatoid wrist: analysis of nine reviewed cases].

We led a retrospective study to determine the causes of the tendon ruptures post-operating in the surgery of the wrist rheumatoid dorsal and to estimate the clinical result. At follow-up, we measured the extension lag and the rolling-up of fingers by the distance palm-pulps. Nine patients were so revised in the average of 40 months, average age was of 50.7 years. The tendon ruptures arose in 3 months in 67% of the cases. Seven times, a procedure on the distal radio-ulnar joint had been necessary (5 Sauvé-Kapandji and 2 Darrach). Thirty tendons had been concerned in this study, that is 3.3 tendons on average (1-5). Two main causes were found: attrition on the stub ulnaire and great intra-tendinous synovitis (per operating observation). At the revision, the lag extension means was 23 degrees (0-40). Rolling-up of the long fingers was complete 4 times on 7. The best results were observed after tendinous grafting or index proprius transfer with a lateral suture. Tendinous adhesions had arisen 6 times and persisted still at 3 patients. Our study underlines the interest to stabilize the stub ulnaire to prevent the post-operating ruptures and proposes a transfer or a graft in front of tendons very weakened by the synovitis.

Adult↗

PubMed2003

[A 36 month prospective study of 12 plate osteosyntheses of distal radius fractures].

INTRODUCTION: We performed a prospective study of 12 intra-articular distal radial fractures. The fractures were treated with an anterior plate together with posterior pinning. The aim of the study was to examine whether it was technically feasible to fix such fractures using this technique and to assess the stability of the fixation at follow up. METHOD: Twelve articular fractures were included with a mean age of 47.1 years. All patients were followed up from first admission to the 36th postop month with clinical and radiological checks. RESULTS: At follow up, we found 8 good and excellent clinical results, 3 fair and 1 poor. The combination of an anterior plate with posterior pinning allowed a good initial reduction but could not protect from secondary displacement particularly in the presence of a comminuted metaphysal fracture. DISCUSSION: This procedure gave clinically satisfactory results but did not control ulnar variance. This procedure should be combined with bone grafting in complex metaphysal fractures and epiphysal screws should be used whenever possible.

Bone Nails↗

PubMed2003

[Surgical correction of fifth finger permanent abduction by tenodesis. Preliminary cadaver study].

Permanent abduction of the little finger can be responsible for daily embarrassment in patients with an ulnar nerve palsy. To correct this deformity, active transfers are usually performed utilising the extensor tendons of the hand. Because of the anatomical variability of the extensor system of the hand, these active transfers can be responsible for postoperative loss of full extension of the little finger. Analysis of the orientation of the forces generated by these transfers shows that they are only weak adductors. A surgical technique using tenodesis is proposed in this preliminary study. This tenodesis has the objective of increasing the adductive forces on the little finger without an extensor tendon transfer. The advantages and disadvantages of this technique are discussed. A clinical evaluation will be undertaken at a later date to confirm the reliability of this technique.

Activities of Daily Living↗

PubMed2002

[Stability of the forearm after resection of the distal ulna and proximal radius in rheumatoid arthritis: report of 11 cases].

Combined resection of radial head and distal ulna could jeopardize the stability and kinematics of the forearm bones. The goals of this retrospective study was to investigate these data after resection of distal ulna and proximal radius in rheumatoid arthritis. Between 1990 and 1998, eleven patients had these bone resections combined with implantation of elbow prostheses (eight Kudo and three GSB III). Wrist surgery consisted in five wrist arthrodeses combined with Darrach procedure, four Sauvé-Kapandji procedures and two isolated Darrach procedures. Mean age at surgery was 58 years and the average follow-up was 40 months. We assessed at follow-up: 1) wrist and elbow pain according to Gschwend; 2) stability of the forearm bones (cubitus valgus angle, impingement of the proximal radial stump with humerus, giving away accident of the ulnar distal stump); 3) wrist and elbow mobility. At follow-up six patients had no pain at the elbow and five had slight occasional pain. At the wrist, five patients had no pain and six slight occasional pain. Elbow motion was increased (from mean 83 degrees [50 degrees-100 degrees] to mean 110 degrees [85 degrees-135 degrees]) excepted in supination which slightly decreased (from mean 3 degrees [40 degrees-90 degrees] to mean 75 degrees [85 degrees-90 degrees]). Mean wrist mobility was impaired because of the five combined radiocarpal arthrodeses. If these five wrist arthrodeses were excluded, the mean ranges of motion were: 10 degrees in flexion, 16 degrees in extension, 2 degrees in radial deviation, 14 degrees in ulnar deviation. At follow-up, no patient had giving away accident of the ulnar distal stump nor impingement between radial stump and humerus in full flexion. Average cubitus valgus was 10 degrees. This study pointed out the predominant effect of the interosseous membrane in stability of the forearm bones.

Adult↗

PubMed2002

[Role of external fixators for treatment of humeral fractures: report of 23 cases using Orthofix fixators].

From 1991 to 1998, 23 humeral fractures has been treated using the Orthofix external fixator. Average age of the patient was 42 y and average follow-up 55.5 m. Initial trauma was: 13 traffic accidents, four falls at home, two devastating farming accidents, two sports accidents, one aggression and one gun accident. AO classification was used and location of the fracture was classified using Hackethal classification modified by de la Caffinière. Majority of fractures were located at the one-third distal humerus and the majority was also comminuted. At follow-up, elbow range of motion was 130 degrees, shoulder range of motion 161 degrees, external rotation 69.5 degrees and internal rotation 92.5 degrees. Using the classification of Stewart and Hundley, eight excellent, seven good, three fair and two bad results were obtained. There were no postoperative radial nerve palsy. Two external fixators had to be removed because of pin mobility. Failures were: non union and pin mobility in one patient which has to be reoperated on; two non unions have been grafted on and plated. There were no malunion in the postoperative X-rays. This device is our favourite for this type of injury because of its rigidity and the possibility of secondary dynamization. The external fixator was removed after union: this explains the long delay of union in our series.

Accidents↗

PubMed2002

[Kudo non-constrained elbow prosthesis for inflammatory and hemophilic joint disease: analysis in 30 cases].

PURPOSE OF THE STUDY: We analyzed retrospectively 30 Kudo non-constrained elbow prostheses to determine: 1) functional outcome and mobility, 2) frequency of loosening and any complications. MATERIAL AND METHODS: From 1992 to 1998, 30 Kudo total elbow arthroplasties were performed in 29 patients, mean age 55 years. Mean follow-up was 36 months. These patients had severe joint disease: rheumatoid arthritis for 24, psoriatic arthritis for 2, and hemophilic arthritis for 3. The 29 patients experienced severe pain before surgery. RESULTS: At review, 21 elbows were pain free and the 9 others had only occasional pain. Among these 9 elbows, 3 exhibited a rupture of the humeral implant; one had already been revised but remained painful. One patient had a stiff painful elbow after reflex dystrophy and five others had pain but no other complication. Twenty-six patients were satisfied or very satisfied. Three patients were unsatisfied because of the humeral implant fracture. Mean mobility at last follow-up was: 128 degrees flexion, -35 degrees extension, 72 degrees pronation, and 74 degrees supination. Mean gain in flexion-extension was 15 degrees and mean gain in pronosupination was 3 degrees. Pronosupination was greater than 100 degrees except for two patients. There was one immediate post-operative dislocation with failure of prolonged orthopedic treatment after reduction; this patient underwent revision reconstruction with repair of the ulnar collateral ligaments (plasty of the medial collateral ligament with a synthetic ligament). Painful movement of the radial stump was observed with one Kudo prosthesis and required resection to achieve cure. In all, there were 3 fractures of the Kudo I prosthesis at the junction of the trochlea and the humeral stem. Among these patients, one underwent revision due to persistent pain, and two others with currently acceptable symptoms are awaiting revision. At last follow-up, we had: 1 ulnar loosening associated with cortical thinning facing the end of the ulnar implant that had migrated and showed a circular lucent line measuring > 1 mm and progressing; 9 unique ulnar lucent lines measuring<1 mm without progression at the proximal part of the implant (6 at the bone-cement interface and 3 at the bone-implant interface); 3 humeral radiolucent lines (<1 mm without progression) on the distal part of the Kudo II humeral stems corresponding to a zone without surfacing. We also observed 13 cases of incomplete ossification between the humerus and ulna and among these 13, 7 elbows had amplitudes of less than 100 degrees. DISCUSSION AND CONCLUSION: Elbow arthroplasty can restore a painless joint and maintain or improve elbow motion. The procedure is indicated when the joint disease impair daily life activities. Final mobility basically depends on the preoperative mobility. The bone stock remains the greatest problem with these resurfaced prostheses. The GUEPAR elbow prosthesis would appear to be more adapted due to the reconstruction of the trochlea. Resection of the radial head is a source of instability for elbow prostheses and should lead to the design of three-compartment prostheses.

Activities of Daily Living↗

PubMed2001

Variations of pelvic anteversion in the lying and standing positions: analysis of 24 control subjects and implications for CT measurement of position of a prosthetic cup.

The position of the acetabular implant plays a dominant role in the displacement of a total hip prosthesis. CT allows precise measurement of the position of the cup, but the influence of pelvic rotation on this measurement is unknown. The aim of this study was to determine, in a group of healthy subjects, whether a pelvic equilibrium exists specific to each individual, and whether this is constant over time on the one hand and between the standing and lying positions on the other. The study concerned 15 men and 9 women with a mean age of 31 years. Each subject had strictly lateral radiographs of the pelvis, lying and standing, repeated at two different times. Pelvic version was measured in these radiographs. Each individual had a pelvic position constant over time, both in the lying and standing positions. However, there were important variations of the position of the pelvis during passage from the lying to the standing position: 22 patients had retroversion of the pelvis by a mean of 7 degrees (2-18 degrees) and 2 others had an anteversion of 3 degrees. These major variations of the pelvic position between the standing and lying positions explain why CT studies made in the lying position do not allow for the anteversion of the cup in the standing position, which is close to the dynamic situation during which displacement may occur. Thus, an excessive anteversion of the cup may be masked when the scan is made in the lying position, since in this position the anteversion of the pelvis leads to retroversion of the cup. The error may reach 20 degrees, so that we recommend that CT measurements made without allowing for the position of the pelvis should be interpreted with caution.

Adult↗

PubMed2001

[Anterior iliopsoas impingement after total hip arthroplasty: diagnosis and conservative treatment in 9 cases].

PURPOSE OF THE STUDY: Impingement of the iliopsoas muscle due to a protruding acetabular component is an uncommon cause of pain after total hip arthroplasty. Diagnostic signs may be misleading and therapeutic management has varied, leading to divergent findings reported in the literature. The purpose of this prospective work was to determine the frequency of groin pain due to iliopsoas impingement (with or without an identified causal mechanism) in patients with painful total hip arthroplasties and to identify diagnostic criteria that can be used to determine the appropriate therapeutic strategy. MATERIAL AND METHODS: This prospective study was conducted between 1998 and 2000 and included 206 painful total hip arthroplasties. From this series, we excluded cases where pain was related to loosening (139 cases, 67%), infection (45 cases, 21.7%), bursitis on trochanteric sutures (2 cases, 1%), and aortic aneurysm with gluteal claudication and resulting from a lumbosacral disorder (10 cases, 4.8%). This left 9 cases (4.3%) with a clinical picture suggestive of iliopsoas impingement. These 9 patients (mean age 50 years, age range 38 - 65) had 8 uncemented press-fix cups and 1 cemented cup with an acetabular mesh. Mean delay to the development of pain after the arthroplasty procedure was 7.3 months (1 - 48 months). The most suggestive clinical sign was groin pain triggered by active flexion of the hip and flexion of the hip against force with a painful arc measuring 30 degrees to 70 degrees. None of these 9 patients had any sign of material loosening and puncture aspiration ruled out infection. The final diagnosis was confirmed by sedation of pain after extra-articular infiltration at the anterior border of the cup (overhanging cup in 6/9 cases) under computed tomographic guidance. RESULTS: Infiltrations with xylocaine and long-release corticosteroids led to complete sedation of pain in 4 out of 9 patients and partial sedation in 1 other. Recurrent pain led to terminal tenotomy of the iliopsoas in 4 patients, that provided total sedation in 3 and partial sedation in 1. In all, successful pain relief was achieved in 7 out of 9 cases: 4 after infiltration (repeated in 1 cases) and 3 after tenotomy. At last follow-up physical examination has not identified any loss of flexion force. DISCUSSION AND CONCLUSION: Irritation of the iliopsoas muscle can be the cause of pain in 4.3% of patients experiencing pain after total hip arthroplasty. The delay to symptom onset is variable but there appears to be a pain-free period after implantation. An anatomic element (anterior cup overhang) is not necessary for diagnosis since the infiltration test was positive in 1 out of 3 cases without any identified acetabular factor. The infiltration test is an important element for positive diagnosis and should be the first therapeutic measure taken. We achieved success in 4 out of 9 cases. Tenotomy is indicated in case of recurrence, providing complete cure in 3 out of 4 cases in our series. Cure may be achieved without changing the cup by simple infiltration or tenotomy of the iliopsoas that led to complete cure in 7 out of 9 cases in our series, even in patients with an overhanging cup (6 out of 9 cases). An elective procedure might be indicated if a specific anomaly is identified (overly long screw, cement leakage) or for a screwed cup. The infiltration test should however be performed beforehand to confirm the diagnosis.

Adrenal Cortex Hormones↗

PubMed2000

Effect of the Steindler procedure on the median nerve branches to the medial epicondylar muscles.

Usually the median nerve gives off six branches to the muscles arising from the medial epicondyle, which could be tightened during Steindler's procedure. We studied these branches before and after Steindler's procedure in 20 fresh cadavers and observed a considerable variation in the origin of the branches. The muscular branches arising from the median nerve did not seem to limit the mobilization of the medial epicondyle when performing Steindler's transfer. The limitation of the flexion observed after Steindler's procedure was mainly related to the tension of the transferred forearm flexor muscles. The variability of the origin of the branch to the flexor digitorum superficialis muscle could explain a lesion of this branch when Steindler's procedure is carried out with Brunelli's modification. The lateral transfer and the anterior transfer on to the humeral shaft did not influence the limitation of elbow flexion or result in tightness in any nerve branch to the transferred muscles.

Humans↗

PubMed2000

[Primary carpal bone defect].

We present a review of management options in case of carpal bone defect, a relatively frequent discovery. In the literature, diagnosis is usually a fortuitous radiographic finding showing one or several images of carpal defect. Pain is observed in some cases, more exceptionally pathological fracture. The scaphoid, lunatum and hamatum are most frequently involved. Bilateral defects may be observed. Different mechanisms have been put forward to explain the development of intraosseous defects in the carpal bones including intraosseous penetration of synovial tissue, or in situ metaplasia of bone tissue. The main differential diagnoses are osteonecrosis sequellae (for the lunatum and the scaphoid), subchondral defects due to hyperpression and arthropathies in dialysis patients. All authors propose simple surveillance for asymptomatic images. In case of pain, with soft tissue swelling or pathological fractures, filling-excision is warranted depending on the severity of the clinical signs. Prognosis is generally good and recurrence exceptional.

Bone Diseases↗

PubMed2000

[Bankart procedure: clinical and radiological long-term outcome].

PURPOSE OF THE STUDY: There are few reports onlong-term outcome after Bankart procedure. The purpose of this study was to determine the rate of recurrent dislocation, the clinical results and the incidence of glenohumeral osteoarthritis after a minimum 10-year follow-up. MATERIAL AND METHODS: Ninety-seven Bankart procedures were performed in 97 patients between 1972 and 1986 for treatment of anterior shoulder instability with recurrent dislocations. We retrospectively reviewed 74 patients and obtained 64 complete radioclinical evaluations for an average follow-up of 16 years. Clinical evaluation was based on the G. Walch and the Duplay group score but for easier comparisons, we also calculated the Rowe et al. score. Radiographical evaluation was established on the Samilson and Prieto classification but real glenohumeral osteoarthritis with joint narrowing was noted independently as grade four. We also studied the contralateral shoulder. RESULTS: At last follow-up, 7 shoulders (9.5%) had recurrent dislocation, but two of them occurred subsequent to severe trauma over 18 months. Most patients (95 %) were satisfied or very satisfied. Six patients (8.1%) had persistent apprehension but in some it was not due to anterior apprehension. According to the Duplay score (or the Rowe score), 25 shoulders (44.6%) had an excellent result (35/61.4 %) 16 (28.6%) a good result (7/12.3%), 11 (19.7%) a fair result (11.19.3) and 4 (5.4 %) a poor result (4/7%). Operated shoulders were pain free for 75% and painful for forced movements only for 25%. External rotation at 90 degrees of abduction was reduced by 8.7 +/- 15.7 degrees. There was no limitation of internal rotation. Patients returned to preoperative sports activities at the same level for 70.9 % and at a lower level for 12.7%. According to the Samilson classification, 7 (13%) of the shoulders had grade 2 and 2 (3.7%) had grade 3 glenohumeral osteoarthritis. We found 4 cases (7.4%) of real glenohumeral osteoarthritis (grade four) and 2 of these patients had contralateral osteoarthritis of a non unstable shoulder. There was no perioperative complication. DISCUSSION: In our hands the Bankart procedure is appeared as a safe procedure with a low rate of glenohumeral osteoarthritis and a high rate of patient satisfaction.

Adolescent↗

PubMed1999

Innervation of the medial epicondylar muscles: an anatomic study in 50 cases.

The median nerve is classically distributed to the medial epicondylar muscles by two branches (superior and inferior) for the pronator teres muscle, a common trunk for the flexor carpi radialis and palmaris longus muscles, and a branch for the flexor digitorum superficialis muscle. The 50 dissections were made by two workers on 30 upper limbs of formalized cadavers and 20 limbs from fresh-frozen cadavers. The innervation of the pronator teres m. was classical in only 26% of cases, and the "normal" pattern for the flexor carpi radialis and palmaris longus mm. was found in only 40% of cases. The innervation of the flexor digitorum superficialis m. was the least subject to variations, a single branch being observed in 68% of cases. We found a solitary medio-ulnar anastomosis of Martin-Gruber to the flexor carpi ulnaris muscle. This study confirmed the great variability of the branches of the median nerve at the elbow, and the importance of identifying them in surgical procedures for transposition of the medial epicondyle.

Cadaver↗

PubMed1999

Martin-Gruber communicating branch: anatomical and histological study.

We dissected 72 upper limbs of fresh cadavers and found 17 cases with a Martin-Gruber communicating branch (23.6%). These were classified into 4 types: type I (n = 5, 29.4%): communicating branch between the anterior interosseous and ulnar nn, type II (n = 3, 17.6%): Communicating branch between the median and ulnar nn., type III (n = 3, 17.6%): Communicating branch between the muscular branches to the flexor digitorum profundus m., type IV (n = 6, 35.3%): combination of type I or II and type III. At histologic examination the number and size of the nerve bundles each communicating branch contained proved to be very different. In one case of type II only a single nerve bundle was found. We suggest that the different numbers of nerve bundles innervate different amounts of the intrinsic hand musculature. The communicating branch with a single nerve bundle probably innervated only the first dorsal interosseous muscle.

Aged↗

PubMed1999

A trans STT, trans capitate perilunate dislocation of the carpus. A case report.

We report a case of carpal injury not previously described, associating three lesions of the carpus secondary to a hyperextension mechanism: fracture of the capitate, scapho-trapezio-trapezoid sprain and lunotriquetral ligament rupture. The patient was operated by percutaneous pinning after closed reduction. The capitate fracture was not fixed. At follow-up, the patient had no restriction of his everyday activities and was very satisfied.

Carpal Bones↗

PubMed1999

Synovectomy combined with the Sauvé-Kapandji procedure for the rheumatoid wrist.

The aim of synovectomy-stabilization (synovectomy combined with the Sauvé-Kapandji procedure) of the rheumatoid wrist is to obtain a stable painless wrist, retaining enough mobility for function. Thirty-nine wrists were retrospectively examined, at a mean follow up of 64.8 months. The improvement in pain was very significant. We noticed a decrease in wrist motion affecting both flexion and radial deviation. The arthritic change in the wrist continued to increase. We noticed a mean ulnar shift of 2.2 mm and a mean increase in the radial deviation of the wrist of 7 degrees. Only transfer of the extensor carpi radialis longus tendon to the extensor carpi radialis brevis tendon was effective in correcting radial deviation of the carpus. Ninety-seven per cent of patients were very satisfied or satisfied. These encouraging results, even at advanced stages of wrist arthritis, have prompted us to lessen the indications for wrist arthrodesis.

Adult↗

PubMed1999

[Anatomic study and review of the literature on the Martin Gruber anastomosis].

We dissected 72 upper limbs of fresh cadavers and found 17 cases of the Martin-Gruber anastomosis. The incidence was 23.6%. They can be classified into 5 types. Type I (n = 5, 29.4%): Communication between the anterior interosseous and the ulnar nerves. Type II (n = 3, 17.6%): Communication between the median and the ulnar nerves. Type III (n = 3, 17.6%): Communication between the muscular branches of the flexor digitorum profundus muscle (FDP). Type IV (n = 3, 17.6%): Communication between the anterior interosseous and the ulnar nerves, the muscular branches of the flexor digitorum profundus muscle (FDP) originated from the connection. Type V (n = 3, 17.6%): The anastomotic branch originated from the median nerve and joined the ulnar at two different points as well as connecting with the ulnar branch of the FDP. Through histologic examination, we found the number and size of nerve fascicles which every connection contained to be very different. In one case of type II only one single nerve fascicle was found. We propose the hypothesis that the different amounts of nerve fascicles innervate different amounts of intrinsic hand musculature. The communication which contained one single nerve fascicle only innervate the first dorsal interosseous muscle (FDI).

Aged↗

PubMed1999

[Reliability of the KT-1000 arthrometer in measuring anterior laxity of the knee: comparative analysis with Telos of 48 reconstructions of the anterior cruciate ligament and intra- and interobserver reproducibility].

PURPOSE OF THE STUDY: The goal of this study was to compare KT-1000 and Telos measurements after anterior cruciate ligament reconstruction (ACLR). MATERIAL AND METHOD: Forty eight patients with asymptomatic ACLR (4 failures with positive pivot shift and 12 knees with positive (+) Lachman test) were assessed (mean 2.5 years after surgery) by the same examiner by means of: 1) Lachman radiographic with Telos at 150 N, 2) MEDmetric KT-1000 at 69 N, 89 N and maxi-manuel (MM). The examiner tested more than 200 patients each year. Measurements were performed for KT-1000 according to the manufacturers' recommendations and for Telos according to Staübli. Only side to side differences in millimeters are reported. Reproducibility of KT-1000 measurements were also evaluated: interobserver reproducibility was assessed by 16 examiners on a healthy patient, and the experienced examiner tested 20 times a healthy patient. RESULTS: An Interobserver error of 4 mm range (+/- 2 mm related to 0) was observed by 12 to 44 p. 100 of the examiners, respectively at 69 N to MM. An intraobserver error of 4 mm range (+/- 2 mm related to 0) was observed in 10 p. 100 at MM and in 20 p. 100 at 89 N. Mean side to side laxity with KT-1000 was 0.93 mm +/- 1.1 [-1 to 5] at 69 N, 1.3 mm +/- 1.6 [-2 to 6] at 89 N, and 1.41 +/- 1.8 [-2 to 6] at MM. With Telos the mean side to side laxity was 3.95 mm +/- 3.84 [0 to 15]. Significant differences (p = 0.0001) were found between measurements obtained by the two methods. No statistical correlation could be detected between values observed by Telos and KT-1000 (R < 0.1). If we consider a 3 mm side to side difference 23 knees (48 p. 100) had abnormal anterior laxity with Telos and with KT-1000 only 3 (6.2 p. 100) at 89 N and 6 (12.5 p. 100) at MM (1 (2 p. 100) at 69 N). With a 5 mm side to side difference, 12 knees (25 p. 100) had abnormal anterior laxity with Telos and with KT-1000 only 1 (2 p. 100) at 89 N and 1 (2 p. 100) at MM (0 at 69 N). Only Telos measurements were correlated to positive pivot shift (p = 0.007) and positive Lachman test (p = 0.01). CONCLUSION: Interobserver reproducibility of KT-1000 measurements was low, but improved for intraobserver agreement. However, even for a unique KT-1000 experienced examiner, reliability of KT-1000 was poor when comparing Telos and KT-1000 predicitive value to diagnose ACLR failure. Telos results were much more pejorative but the only ones corelated with ACLR failures. We recommand Telos instead of KT-1000 to assess laxity after ACLR.

Adolescent↗