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Biomedical subjects

J Bejui

Publications and source records attributed to J Bejui.

At least 19 recordsLinked to original sources
PubMed2001

[Unstable pelvic ring fracture: osteosynthesis of the posterior lesion by percutaneous sacroiliac fixation].

PURPOSE OF THE STUDY: We report our experience with percutaneous sacroiliac screwing for unstable pelvic ring fracture. MATERIAL AND METHODS: Twenty unstable pelvic ring fractures with sacroiliac disjunction (9 cases), trans-sacral fracture (9 cases), or bilateral posterior fractures (5 cases) were managed with percutaneous sacroiliac fixation using 1 or 2 screws. There was also pubic disjunction in 7 cases, managed by osteosynthesis in 5 cases. No fixation of fractures of one or both of the obturator rings, present in 13 cases, was attempted. The posterior screwing was performed under fluoroscopic guidance in 15 cases and computed tomographic guidance in 5. RESULTS: There were no infectious or neurological complications. Radiographically, anatomic reduction of the posterior fracture was achieved in 10 cases. A vertical ascension persisted in 4 patients and a rotation in 6. Radiographic results were correlated with delay to surgery: correction of the vertical displacement was achieved in 80% of the patients operated before five days and in 55% of the others. Two patients experienced a secondary displacement. There was no cases of nonunion of either the anterior or posterior fracture. Follow-up was available for 14 patients (2 patients died and follow-up was too short for 4). The mean Majeed score was 92/100 and none of the patients experienced anterior pain. Three patients had moderate pain in the sacroiliac area. DISCUSSION: The ventral position appears to be best adapted for percutaneous sacroiliac screwing but can be contraindicated by concomitant lesions. We prefer fluoroscopic guidance for these emergency procedures. Two views, ascending and descending, appear sufficient. The better stability provided by two screws can be achieved under computed tomographic guidance without risk of neurovascular damage. CONCLUSION: Percutaneous sacroiliac screwing is a good management strategy for unstable pelvic ring fractures with little risk of morbidity.

Activities of Daily Living↗
PubMed2000

Analysis of retrieved polymer fiber based replacements for the ACL.

The present retrospective analysis of 117 surgically excised anterior cruciate ligament (ACL) prostheses was designed to elucidate the etiology and mechanisms of failure of synthetic ligamentous prostheses. They were harvested from young and active patients (26 +/- 7 yrs) at various orthopaedic centers in France between 1983 and 1993. The average duration of implantation of augmentation and replacement prostheses were 21.5 +/- 12.6 and 33.2 +/- 25.3 months, respectively. The principal causes for their excision were ruptures and synovitis. Each ACL prosthesis was examined macroscopically, histologically, and, after tissue removal, by scanning electron microscopy (SEM) to determine the model, manufacturer, surgical technique used at implantation, the extent of healing, the site of rupture, and the morphology of the damaged fibers. Fourteen types of ACL prostheses were analysed, each fabricated using a different combination of polymers, fibers and textile constructions. Consequently, they generated a variety of healing characteristics and mechanical responses in vivo. SEM observations revealed that abrasion of the textile fibers as a result of yarn-on-yarn and/or yarn-on-bone contact was a common phenomenon to almost all models, and was the primary cause of prosthetic failure. Healing inside the synthetic ACL was poorly organized, incomplete and unpredictable as the extent of collagenous infiltration into the textile structure did not increase with the duration of implantation. In fact, the collagenous infiltration into certain models appeared to be more detrimental than beneficial since it caused deterioration and fraying of the textile structure rather than serving as a reinforcing matrix around the prosthesis. In conclusion, the present study shows that three mechanisms may be involved in the failure of ACL prostheses: (1) inadequate fiber abrasion resistance against osseous surfaces; (2) flexural and rotational fatigue of the fibers, and (3) loss of integrity of the textile structure due to unpredictable tissue infiltration during healing.

Adult↗
PubMed1999

[Total hip arthroplasty. Risk factors and prevention of iatrogenic vascular complications].

Vascular injuries during orthopaedic hip surgery are rare. However, they must always be feared because they threaten life and limb. We present 11 vascular injuries observed over a 12-year period. Seven women and 4 men, treated by elective surgery, presented 14 vascular injuries (6 arterial, 5 venous and 3 prosthetic vascular graft). Four injuries occurred during revision procedures. They were all operated as an emergency for ischaemic syndrome (6 cases) and/or haemorrhage (7 cases). Four patients (37%) died and 4 developed sequelae, various directly attributable to the vascular injury. In the light of these cases, we tried to determine the various mechanisms of the injury and the orthopedic and vascular risk factors. Preoperative detection and well defined therapeutic rules are very important for the prevention of these severe vascular accidents.

Adult↗
PubMed1998

Quantitative measurement of joint space narrowing progression in hip osteoarthritis: a longitudinal retrospective study of patients treated by total hip arthroplasty.

OBJECTIVES: To evaluate the rate of progression of radiological joint space narrowing (JSN) in patients operated on for hip osteoarthritis (OA) and to determine its predictive factors. METHODS STUDY DESIGN: retrospective longitudinal trial of 61 patients who underwent total hip arthroplasty (THA) for hip OA (69 operated hips). Mean follow-up 81.2 +/- 9.9 months. Collected data: (1) standing frontal radiographs of the pelvis from diagnosis to surgery (246 films) for morphological evaluation and quantitative measurement of joint space width (JSW) (computerized reading of digitized X-rays); (2) demographic data (sex, age, body mass index, smoking status, professional and sporting activities, family history of OA); (3) clinical data (age at onset-diagnosis and THA, drug consumption, time from diagnosis to permanent disability, OA at other joints, previous THA of the contralateral hip). STATISTICS: multivariate analysis. RESULTS: The yearly mean narrowing (YMN) of MeanJSW was 0.43 +/- 0.43 mm/yr (median 0.29, range 0.03-2.55). YMN correlated inversely with joint space width at operation and follow-up duration, and was increased in atrophic OA (r = 0.71). The time between diagnosis and THA correlated with JSW at diagnosis, and was inversely correlated with age at onset and YMN. It was longer in patients with hypertrophic OA (r = 0.69). CONCLUSION: Rapid progression of JSN, older age and absence of osteophytes appear to be the main factors leading to THA.

Adult↗
PubMed1997

[Evaluation of the predictive value of fibrin degradation products in the detection of deep venous thrombosis after total knee prosthesis].

The total knee arthroplasty (TKA) favours deep venous thrombosis (DVT), more often sural thrombosis. In this case, pulmonary embolism is exceptional but sural thrombosis can give a poor functional prognostic by trophic disorders. The purpose of this work is to verify the predictive value of D-Dimer by Elisa technic in the detection of DVT after TKA. We have studied 42 TKA at the Edouard HERRIOT Hospital(Lyon) between April 2, 1992 and October 20, 1994. Patients were divided in two groups: with DVT (n = 5) and without DVT (n = 37). Prophylactic heparinotherapy was systematic. The biologic follow-up by ELISA technic(Fibrinostika FbDP, Organon Teknika) of the D-Dimer were realized at D0 (Day 0) preoperative period and D1, D4, and D6 postoperative period. An echo-Doppler exam were effected at D8 postoperative. The analysis of mean rate of the D-Dimer didn't show significative difference between the two groups at D0, D1, D4 and D6. But, we observed that the rate of D-Dimer increased after TKA significantly in both groups. We can't evaluate predictive interest of the D-Dimer after TKA but the little number of DVT authorizes to pursue this study and to moderate our conclusion.

Aged↗
PubMed1995

The upper end of the femur: dimensions of the endosteal canal.

Based on a prospective study of 30 right or left femurs removed in a continuous series in the anatomy department, a study was made of the dimensions of the endosteal canal of the upper end of the femur. The femora were analysed by means of 12 CT scans below the lesser trochanter. The sections were numbered and the dimensional parameters calculated by computer, using an original plan. The results were subjected to descriptive and correlative analysis. From these dimensional findings it appeared that the anatomy of the upper end of the femur is not random; morphotypic models exist and the laws of a normal model are regulated by a mathematical equation.

Cadaver↗
PubMed1995

[Preliminary and multidisciplinary study of three Coptic mummies of the Testut-Latarjet museum at Lyon].

In 1901 Albert Gayet raked up from Antinoe three mummies exhibited to day at the Anatomy Museum of Lyon. The study of the three mummies was made in detail as to their dress, anthropometric and scannographic findings. The clothes were characteristic of coptic civilization. The radiographic date gave a life span of around 40 years. The X-ray imagery shows the remains of cerebral and visceral organs. The sexual criteria are thought to be those of two women and undetermined for the child. Later, several investigations like endoscopic autopsy, tooth microscopy and chromosomic map will be necessary.

Anthropometry↗
PubMed1993

Detection and measurement of vitamins K1 and K2 in human cortical and trabecular bone.

Vitamin K plays an essential role in the gamma carboxylation of the gla-containing proteins of bone matrix, such as osteocalcin. We have measured the concentration of vitamin K1 (VK) and of the menaquinones MK-6, MK-7, and MK-8, the three major vitamin K2 moieties, in trabecular and cortical bone taken from the femoral neck of patients undergoing hip replacement. Both bone compartments were found to contain large amounts of VK, MK-6, MK-7, and MK-8. Concentrations were as high as those reported for the liver, the major storage organ for vitamin K. Further research is required to examine the association between vitamin K in bone and the gamma carboxylation of vitamin K-dependent bone proteins.

Aged↗
PubMed1991

Study of an inhibitor of plasminogen activator (tranexamic acid) in the treatment of experimental osteoarthritis.

The effects of tranexamic acid, an inhibitor of plasminogen activator, were evaluated in a rabbit model of osteoarthritis induced by section of the knee joint anterior cruciate ligament. Prophylactic treatment administered intramuscularly thrice weekly for 12 or 24 weeks significantly reduced cartilage destructive lesions, increased cartilage hypertrophy but did not prevent changes in cartilage water and proteoglycan content. A suppression of synovial membrane stromelysin and collagenase activity was found while phospholipase A2 activity was unaffected.

Animals↗
PubMed1990

Serum bone-gla protein after fracture.

Serum bone Gamma-carboxyglutamic acid (bone-gla) protein (BGP), a marker of bone formation, was measured in serial blood samples drawn from 14 patients who had fractured at least one of their tibial or femoral diaphyses and from two other patients who had sustained major trauma without fracture but who had been immobilized. A total of 85 samples were taken and analyzed during the first three months after the fractures occurred. Serum BGP significantly increased and positively correlated with the time that had elapsed after the fracture, with an average twofold increase after two months. The fracture site and the duration of immobilization had no influence on the serum BGP levels. Serum BGP levels from the two non-fractured cases increased in the first two weeks with no subsequent consistent trend. These data suggest that serum BGP increases one to two months after a major fracture, possibly as a manifestation of bone repair. Further studies are required to determine the potential clinical value of serum BGP in the management of such patients.

1-Carboxyglutamic Acid↗
PubMed1987

Screening of degradative enzymes from articular cartilage in experimental osteoarthritis.

Sixteen rabbits were killed 12 weeks after sectioning of the right knee anterior cruciate ligament. The left unoperated knee served as a control. The surface area of fibrillated cartilage from femoral condyles and tibial plateau was evaluated and expressed as a percentage of articular surfaces area. Cartilage from the femoro-patellar surfaces was homogenized for the quantification of several degradative activities, based on the release of digested products. Acid phosphatase, several glycosidases and neutral protease activity from the operated joint cartilage were significantly elevated, while collagenolytic activity was unmodified. The percentage of fibrillated cartilage correlated positively with arylsulfatase, glucosidase and neutral protease but negatively with mannosidase and fucosidase. The results may be consistent with the hypothesis of a sequential degradative process leading to cartilage destruction.

Animals↗
PubMed1987

Histological cartilage changes in a rabbit model of osteoarthritis.

The anterior cruciate ligament was severed in the right knee of 36 rabbits which were then killed 12 weeks after surgery. Changes in water content and fixed charge density were correlated with the surface area of induced cartilage fibrillation. Histological changes including cartilage hypertrophy, reduced cell density, matrix alterations, cystic lesions, and enlarged perichondrocytic lacunae were found to precede cartilage fibrillation. The observed histological changes are in agreement with an enzymatic degradation of articular cartilage in osteoarthritis.

Animals↗