Biomedical subjects

C Hulet

Publications and source records attributed to C Hulet.

22 records · Page 2Linked to original sources

PubMed1999

Naproxen in the prevention of heterotopic ossification after total hip replacement.

The effectiveness of naproxen, indomethacin, and a placebo were compared for the prevention of heterotopic ossification after total hip arthroplasty. Eighty-four men at high risk of experiencing heterotopic ossification received randomly either naproxen 750 mg per day, indomethacin 75 mg per day, or a placebo for 6 consecutive weeks after surgery. Efficacy analysis showed that in 70% of patients treated with naproxen, in 34.8% of those treated with indomethacin, and in 15% of those treated with a placebo, no heterotopic ossification appeared on radiographs taken at 6 months. Naproxen was significantly more effective than the placebo or indomethacin in preventing the development of heterotopic ossification. Stratification into five categories, according to Brooker's classification at 6 months, showed that both drugs were equally superior to the placebo. Class III heterotopic ossification occurred only in patients who were given the placebo. The improvement in clinical criteria was comparable in the three groups, although at 6 months there was an improvement in abduction in patients treated with indomethacin compared with those treated with naproxen and the placebo. The overall tolerance was rated good by 87% of patients and 86% of physicians, with no difference between the groups. The results show that naproxen, given daily for 6 weeks, is an effective and safe medication for the prevention of heterotopic ossification after total hip replacement.

Aged↗

PubMed1998

[Incidence of arthrosis in the results of the treatment of coxarthrosis in the young adult with Chiari's osteotomy. Retrospective study of 52 hips with 10.5 years of follow-up].

PURPOSE OF THE STUDY: Fifty two of 53 Chiari pelvic osteotomies performed between 1974 and 1991 were reviewed clinically and radiographically with an average follow-up of 10.5 years. MATERIAL AND METHODS: In more than 46 per cent of cases, the osteotomy was performed on a dysplastic painful hip with severe osteoarthritis. Major complications were rare. The Chiari's osteotomy fixation screw was removed in 16 cases. Technically, the average displacement was 22 mm. A ascending osteotomy, related to the level of the osteotomy (p = 0.001), provided good displacement. RESULTS: The functional results were very good or good in 65 per cent of the patients and lasted more than 10 years. Seventy five per cent of the hips were pain free. Radiographically, the center edge angle and the femoral head covering were corrected by the procedure. Degenerative changes of the hip joint were improved or stabilized in 63.5 per cent of the cases. Fifteen hips had undergone secondary total hip replacement, seven during the first five years and 8 after 13 years. DISCUSSION: Factors associated with a positive outcome included: age under 30 at the time of surgery (80 per cent of survivorship up to 15 years of follow up), low stage (I or II) of osteoarthritis, and a technically perfect Chiari osteotomy. The outcome of initial stage III or IV initial osteoarthritis were not as long lasting. Chiari osteotomy functional results were good for the initial 10 years, after this time they deteriorated quickly. CONCLUSION: Chiari pelvic osteotomy is an alternative procedure to early total hip replacement for severe painful dysplastic hips with low stage of osteoarthritis in young patients.

Adolescent↗

PubMed1998

[Lateral meniscal cyst. Retrospective study of 105 cysts treated with arthroscopy with 5 year follow-up].

UNLABELLED: A retrospective study was performed on 122 patients with 124 lateral meniscal cysts, selected from a series of 8100 knee arthroscopies (1.5 per cent). Eight of the patients were lost for follow up, 11 patients had chronic anterior cruciate ligament deficiency or previous medial meniscectomy. Therefore 105 of 124 patients were included in this study. Average follow-up was 5 years (range of 1 to 12.5 years). MATERIAL AND METHODS: Mean age was 33 years (range of 12 to 69 years). All patients had pain over the joint line with a palpable mass. All were noted to have a meniscal tear at the time of surgery and 60 (57 per cent) had a horizontal cleavage component. They were all arthroscopically treated. RESULTS: Meniscal tears were treated by arthroscopic partial meniscectomy in 104 cases and meniscal repair in one case. Cysts were treated by intra-articular debridement in 91 cases and open cystremoval in 14 cases. Eleven cysts recurred and a second arthroscopy was required. The clinical results, including cysts recurrence, were excellent or good in 87 per cent of cases. Osteoarthritis following treatment of these meniscal cysts occurred in 9 per cent of cases. CONCLUSION: When there is a cyst and no other intra-articular damage, the prognosis was excellent at 5 year follow-up. For lateral meniscal cysts; arthroscopic partial meniscectomy with intra-articular debridement yields predictable results.

Adolescent↗

PubMed1998

[Villonodular synovitis of the knee. Analysis of a series of 17 cases and review of the literature].

PURPOSE OF THE STUDY: Pigmented villonodular synovitis is a rare pathology found predominantly in the knee. We report management and treatment of 17 cases of pigmented villonodular synovitis of the knee. MATERIAL AND METHODS: The mean follow-up was 9 years (maximum: 17 years). The diagnosis was always confirmed at histopathology. There were 12 women and 5 men. The average age at the initial symptoms was 28 years. Six cases were diffuse, 7 localized and 4 cases were mixed. RESULTS: First treatment was only arthroscopic in 8 cases, and open synovectomy in 6 cases and mixed in 2 cases. Six patients had a recurrence, one had more than one recurrence. The mean delay for recurrence was 2 years and 5 months. Loss of range of motion was noted in 6 cases. For these 6 cases, flexion was always greater than 90 degrees and flessum always inferior to 10 degrees. DISCUSSION: Ethiopathogeny of this disease is unclear and no etiopathogenic theory is defined. Magnetic resonance imaging is useful for diagnosis, and absolutely necessary for preoperative tumor localization, and also for survey. In localized types, arthroscopic synovectomy can be performed with success but in diffuse or mixed form an open synovectomy must be performed according to the high rate or recurrence observed after incomplete synovectomy. Synoviorthesis with Yttrium 90 seems to be a good adjuvant for the treatment of recurrent pigmented villonodular synovitis. CONCLUSION: Arthroscopy is the treatment of choice for localized forms. We propose a mixed concept with an anterior and parameniscal arthroscopic synovectomy (without meniscectomy), an open synovectomy for the posterior localization, and an open anterior synovectomy when the tumor mass is too voluminous.

Adolescent↗