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Biomedical subjects

G Bousquet

Publications and source records attributed to G Bousquet.

At least 19 recordsLinked to original sources

Results with a cementless alumina-coated cup with dual mobility. A twelve-year follow-up study.

Between April 1980 and December 1981, 135 alumina-coated hemispherical cups were inserted without cement in patients with degenerative lesions. The cups were anchored by press fit and secured with a tripod attachment. The follow up was for over ten years. A bipolar polyethylene insert was used. Only one patient was lost to follow up in less than 2 years. Forty-four implants worked perfectly up to the time of death of the patients. Four cups were replaced, two after the patients sustained violent trauma, and there was an isolated instance of replacement of the insert only. The cumulative survival rate was 95.4% at 10 and 12 years follow up. The 78 surviving patients (85 cups) were examined, and radiographs were taken in 62 of them. Three patients showed clinical signs of deterioration and radiological signs of loosening, 2 others showed radiological signs of cup displacement without clinical symptoms. There was no evidence of osteolysis at the bone-cup interface in well functioning implants. These results confirm that cementless hemispherical cups survive well and demonstrate the value of a cup without holes for screws which can allow migration of polyethylene particles which might induce osteolysis of the adjacent ilum.

Adult

[Surgical treatment of ruptures of the Achilles tendon. Apropos of 42 cases treated by Bosworth's technique].

PURPOSE OF THE STUDY: There is no consensus on the treatment of acute ruptures of the Achilles tendon. We have chosen surgical technique with early muscle stimulation. This study analyses possibilities of functional recovery and complications in Athletes. MATERIALS AND METHODS: Between 1983 and 1994, we treated surgically 42 Athletes who had Achilles tendon ruptures with early musculo-tendinous stimulation. The 39 male and 4 female patients had a mean age of 41 years (range, 15 to 70). We have always used Bosworth's technique with gastrocnemius flap procedure. Immediately after surgery, weightbearing with below-the-knee cast was initiated for 6 weeks followed by rehabilitation. RESULTS: There was no local major complication, deep vein thrombosis or pulmonary embolism. Only one patient suffered from a traumatic rerupture one month after surgery. Mean value of the calf atrophy was less than 1 cm. 93 per cent of patients returned to previous activity levels and 78.5 per cent of patients returned to their usual sport activity. DISCUSSION: Like this study recent results confirm the low complication and recurrence rate of the surgical treatment. Percutaneous technique and conservative treatments seem to be worse for rerupture and sportive functional recovery. Early muscle stimulation decrease morbidity and calf atrophy. Our protocol with weightbearing in ankle neutral position reduces calf atrophy. CONCLUSION: A rigid and stable reconstruction, allowing early weightbearing without equinus position seems to be a rational treatment for Achilles tendon rupture in athletes.

Achilles Tendon

[Long-term results of active-passive ligament repair of the external lateral ligament of the ankle].

We reviewed 95 ankles at an average of 9 years after an "activo-passive" operation performed for chronic lateral instability. All the patients had suffered recurrent ankle sprain or instability, with pain in 67 patients. Ten ankles showed a subtalar injury at operation. Degenerative changes were noted in 11 ankle joints. On review, 81 ankles (85%) were stable. The 14 cases with persistent instability had developed the problem one to five years after operation. Two cases presented with limitation in mobility. Osteoarthritis, found in 15 ankles, was severe in only two, and had been present on preoperative films. We found no correlation between functional results (talar tilt, anterior-drawer test) and radiological evaluation. The "activo-passive" operation provides long-term stabilization with preservation of the ankle and of subtalar mobility without severe osteoarthritis.

Adolescent

[Wear characteristics of different metal-polyethylene beating surfaces. An experimental study of a new model of knee prosthesis].

PURPOSE OF THE STUDY: Wear of artificial components joint is the most important factor in long term durability. Only few studies have analysed in laboratory experimentation the quality of different alloys on the same type of prosthesis. MATERIAL: During the development of a new knee prosthesis, we studied the friction mechanisms of the metal/polyethylene (UHMWPE) couple and particularly the value of titanium alloy (Ti-6AI-4V) treatment using an ionic nitrogen implantation process (IMPLATEC). Two friction surfaces were studied in vitro: one in flexion-extension between femoral component and tibial plateau, the other in rotation between tibial plateau and "metal-back". METHODS: The implanted Ti-6AI-4V was compared with 316L stainless steel, cobalt chromium molybdenium alloy and with Ti-6AI-4V using a prosthesis of each configuration. The samples were tested on a TRIBOCUP friction machine during 3 x 10(6) cycles in Ringer 's solution. The friction couples were controlled every 200,000 cycles and the loss of polyethylene mass every 500,000 cycles. We have also evaluated the roughness and the rubbing surface macroscopically. RESULTS: The results analysis shows that friction couples such as Cobalt Chromium and implanted Ti-6AI-4V are weakest but implanted Ti-6AI-4V over time, tends to match the strength of Ti-6AI-4V without treatment. With implanted Ti-6AI-4V and with Cobalt Chromium alloy, the loss of polyethylene is slight comparatively to the stainless steel and non implanted Ti-6AI-4V. Surface analysis showed good protection of titanium alloy by ionic implantation especially in the femoral component where roughness is close (0.04 micron) to that of Cobalt Chromium alloy (0.07 micron). DISCUSSION: Our study confirms the results with pin-on-disk and cup-on-ball with results for the Ti-6AI-4V implanted and Cobalt Chromium alloys with protection of the metal surface and decrease of polyethylene wear comparatively to stainless steel and non implanted Ti-6AI-4V. CONCLUSION: Our conclusion is for this type of experimental device that the surface condition is satisfactory for such friction couples as implanted Ti-6AI-4V/polyethylene and Cobalt-chromium/polyethylene, with very similar results. However, the long-term durability of the nitrogen implanted on Titanium Alloy remains unknown.

Biodegradation, Environmental

Acceptance of a connective tissue equivalent for grafting and capsuloligamentary reconstruction.

A strip of a connective tissue equivalent prepared by using the patient's fibroblasts cultivated in vitro and calf skin collagen, was used for capsuloligamentary reconstruction of the knee. The study of the humoral and cell-mediated immune responses indicated that there was no cell-mediated immune reaction and only a transient humoral reaction 2 months after implantation. This first assay in human surgery gave a good functional result, and an immunological response was no longer observed 5 months after grafting.

Animals

[Stabilization of the external condyle of the knee in chronic anterior laxity. Importance of the popliteal muscle].

The authors have made an anatomical and experimental study in cadavers. They consider that one of the main features of chronic anterior instability of the knee is related to the instability of the lateral femoral condyle. This is due to the loss of its two stabilizers: the anterior cruciate ligament and the popliteal muscle. The signs of a lesion of the postero-lateral structures have to be looked for: antero-posterior drawer sign in extension, hypermobility of the tibia in lateral rotation and varus laxity. Such instability leads to arthrosis in the long-term. The proposed treatment is based on a reconstruction of the anterior cruciate ligament, using semitendinosus associated with a postero-lateral reconstruction using either the biceps or the fascia lata, or a free transplant from the patellar ligament. Corrective osteotomy of an associated varus deformity may be indicated.

Biomechanical Phenomena

[The treatment of genu recurvatum (author's transl)].

50 cases of genu recurvatum were classified into three types: osseous (malunion, epiphysiodesis), capsular and ligamentous (congenital hyper-extension, sequelae of old ligament rupture) and combination of the two types. The author's have analysed the results of 44 surgical procedures. The main procedure practised has been an opening wedge osteotomy of the upper end of the tibia above the level of the tibial tubercle with a graft to fill the gap. It is important to avoid distal displacement of the patella by detachment of the tibial tubercle and reattachment more proximally at the end of the surgical procedure. Osteotomy is always indicated but should be combined with a capsular repair or combined types. The results are satisfactory especially in cases due to premature closure of the growth plate.

Bone Transplantation