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D Goutallier

Publications and source records attributed to D Goutallier.

At least 127 records · Page 7Linked to original sources
PubMed1985

[Resection in the treatment of osteosarcoma of the limbs. Is amputation still indicated?].

The authors have treated 30 cases of limb sarcoma by conservative surgery since 1980. During this period only one limb had to be amputated. The follow-up period is short and this is a preliminary report. The early results of cases treated by resection followed by radiotherapy and chemotherapy appear to be encouraging. Up to date, only one recurrence has occurred which has been treated by another local resection with no further recurrence 18 months later. 10 patients have had metastasis: 6 died--3 metastasis were resected with success and the patients are still alive. It is concluded that amputation is rarely, indicated, provided there is adequate initial information about the extent of the tumour and continuing post-operative co-operation between Surgeon and Physician.

Adolescent↗
PubMed1985

[Healing of ruptures of the anterior cruciate ligament treated with simple sutures. Possibilities, usefulness, clinical evaluation. Apropos of a series of 51 anterior cruciate ligament sutures using barbed wire with macroscopic verification of the healing].

Fifty-one ruptures of the anterior cruciate ligament were treated by early suture using barbed wires followed by plaster cast for 6 weeks. The state of healing was assessed by a second look during arthrotomy to remove the wire after an average of 6 months. In addition, 45 knees have been examined more than 20 months after the initial repair. Three out of 4 ligaments were found to be healed, but only one out of 3 had adequate tension and was correctly sited. The rate of satisfactory healing was high in cases of clear-cut rupture and when the pre-operative laxity was moderate. Associated lesions of the collateral ligaments healed satisfactorily thanks to the period of 6 weeks treatment in the plaster cast. The cases in which the cruciate ligaments had healed demonstrate subjective and objective stability better than others, even when the ligament had been found to be loose or incorrectly re-implanted and were superior from the functional point of view. There was no parallel between the true state of healing of the ligament and the clinical tests of stability. It is concluded that early suture of the cruciate ligament is worthwhile in cases of clear-cut rupture. In cases of attenuation or when there are severe lesions of the collateral ligaments, suture of the cruciate ligaments should be reinforced by carbon fibres. This management is valuable in active people or amateur sportsmen in whom rehabilitation is somewhat slow. In professional athletes peripheral ligamentoplasties lead to earlier resumption of sporting activities. In older patients, plaster cast immobilisation is sufficient to produce satisfactory results.

Adolescent↗
PubMed1985

[Unicompartmental arthroplasty (Lotus type) in the treatment of lateralized gonarthrosis in the elderly. Outcome after more than 5 years of 56 prostheses analyzed in 1981].

The progress of 56 uni-compartmental knee arthroplasties has been studied. Five were lost to follow-up after 3 or 4 years: at that time the knees were pain-free and the radiological appearances were good. Seven knees had to be operated on again because of pain after 3.5 years following insertion of the prosthesis. Forty-four prosthesis were still in place after 5 years (average follow-up 6.7 years), 35 of them being almost painless. The knees which became painful did so during the first 3 years and were associated with radiological deterioration. There were 2 loosenings, 11 narrowings of the non-prosthetic tibio-femoral compartment and 3 antero-posterior subluxations with laxity. The authors consider that the main reasons for loosenings were increased stresses and over-correction for narrowing of the non-prosthetic compartment. Subluxation was aggravated by joint obliquity. it is concluded that uni-compartmental knee prosthesis for single compartment arthrosis is a valuable procedure provided that there is good surgical technique and correct indications for operation. However, the long-term prognosis is uncertain because the design of the prosthesis cause increased stresses and some degree of permanent anteroposterior obliquity.

Aged↗
PubMed1983

[Replacement of the anterior cruciate ligament by carbon fibers. An experimental study].

The authors have excised the anterior cruciate ligament in 14 sheep and replaced it by carbon fibres. The animals were sacrificed after 12 to 18 months. Eight had a satisfactory new ligament without any evidence of arthrosis and with stability of the knee. In 2 cases, there was moderate instability and arthrosis associated with a lax ligament and in 3 cases the new ligament had ruptured with severe instability and arthrosis. Microscopic examination shows a satisfactory acceptance of the carbon filament both inside the bone as well as in the joint. There was no difference between cases repaired immediately or 6 months after excision of the ligament. A study of aortic lymph nodes showed the presence of carbon particles. The rupturing strength of the new ligaments and of normal ligaments were similar. The visco-elasticity of the new ligaments was also studied and was found to be satisfactory. It was considered that the use of carbon fibre may be valuable but more studies should be done to improve the elasticity and to decrease the migration of carbon material.

Animals↗
PubMed1982

[Treatment of inflammatory hip disease in rheumatoid arthritis with cemented total prostheses. Apropos of 62 total hip prostheses, of which 38 were followed for more than 3 years].

The authors have operated on 62 hips in 43 patients. Thirty-eight were followed for more than three years. Out of 62 cases there were 2 early deaths, 2 instances of pulmonary embolus and 1 of sepsis. Five different types of prosthesis were used. On 11 occasions a border appeared around the cement of the femoral component and in three of these loosening was demonstrated. The number of these appeared to be higher than after total replacement for other etiologies and seemed to be aggravated by technical errors, such as varus positioning and lack of cement. In most cases a remarkable functional improvement was obtained but progressively secondary worsening of walking ability was seen due to involvement of other joints. It is concluded that special precautions should be observed in such cases and that other joints should be replaced earlier when necessary.

Adult↗
PubMed1982

[Knee prosthesis].

Explore the source record for details and available documents.

Bacterial Infections↗
PubMed1981

Bone histomorphometric reproducibility in normal patients.

To study bone histomorphometry reproducibility in normal subjects, we performed during orthopedic surgery bone biopsies in 16 postmenopausal women. Each woman had four bone biopsies, two at the usual site in the iliac crest, one on the left and one on the right side, and two other biopsies just behind the usual site, one at each side. We performed measurements of trabecular bone volume, relative osteoid volume, osteoid surfaces, osteoclastic resorption surfaces and calcification front. The average values of the 16 patients were compared, on the one hand, two by two, by a student test, and on the other hand, by a variance analysis. By these two methods the results showed no significant difference between the average values of the 16 patients at each location for any of the histomorphometric parameters studied. However, there was a location variation which was estimated by the intra-individual variation for a given patient. On the other hand, we calculated from the variance analysis the location variance for a group of 10 to 100 patients. In any case all the parameters had a location variation which was high for osteoclastic resorption surfaces and relative osteoid volume when expressed in % of the absolute value of these parameters. The variation of the trabecular bone volume was 0--46. 15% (95% confident limit interval) in a single patient and the hypothetical value of the location variation was 41.6% for a group of 10 patients and 13.0% for a group of 100 patients.

Aged↗
PubMed1981

[The surgical management of the forefoot in rheumatoid arthritis. A review of 150 cases (author's transl)].

The authors have performed 150 surgical procedures in 95 patients. In most of the cases, the procedure was a resection - realignment of the metatarsal heads. The results were assessed in 80 patients and were found to be satisfactory as regards pain and functional ability. Good results persisted as regards pain which remained absent in 90% of cases but the functional results tended to worsen with time. Good results being present in only 70% after a 10 year follow up. In 34 cases a prosthetic implant (Swanson type) was used. The results were deceptive.

Adolescent↗
PubMed1981

[Early failure of uni-compartmental tibio-femoral resurfacing arthroplasty in the treatment of arthrosis of the knee (author's transl)].

The authors have studied 14 failures of tibio femoral resurfacing arthroplasties. The cases were arthroses of the knee with angulation in the frontal plane without dislocation. The prosthesis used was of the Lotus type. In only two cases the loosening was due to faulty prosthesis. The cause of failure in the majority of cases was a deterioration of the other compartment which occurred only in cases in which there had been correction to normal or overcorrection. It is concluded that the knee should remain under-corrected. This type of procedure is indicated in elderly in unstable deformities which are partially reducible and with an intact opposite compartment. In other cases osteotomy is to be preferred.

Aged↗