Search PubMed⌕ Search

Biomedical subjects

L Galois

Publications and source records attributed to L Galois.

12 recordsLinked to original sources
PubMed2006

[Optoelectronic gait analysis after metatarsophalangeal arthrodesis of the hallux: fifteen cases].

PURPOSE OF THE STUDY: Degeneration of the metatarsophalangeal joint of the hallux is a frequent secondary lesion of the first ray subsequent to hallux valgus. Different surgical techniques have been proposed for cure, including metatarsophalangeal arthrodesis. Joint fusion relieves pain but sacrifices joint motion. The purpose of this work was to assess changes observed in gait after metatarsophalangeal arthrodesis of the hallux using a three-dimensional optoelectronic system. MATERIAL AND METHODS: Gait analysis was performed with a Vicon 3D system with five cameras and two AMTI force platforms in twelve patients who had undergone metatarsophalangeal arthrodesis more than six months earlier. The kinetic and kinematic curves and ground reaction forces were analyzed. Changes in the gait cycle and any compensations observed in the talocrural and interphalangeal joints were noted in the three dimensions. Wilcoxon test for paired series was applied for the statistical analysis. RESULTS: The general gait parameters and kinetic and kinematic values were not modified (excepting a non-significant decline in maximal dorsiflexion of the ankle joint). There was a significant decrease in propulsion force in the anteroposterior and vertical planes, with significantly later heal lift-off and systematic displacement of ground reaction forces anterior to the metatarsophalangeal joint on the arthrodesis side. Reflectors positioned on the distal extremity of the hallux demonstrated that the essential part of compensation occurred at the level of the interphalangeal joint. DISCUSSION: Gait analysis after tibiotalar arthrodesis has been widely reported in the literature. The consequence of joint fusion on the rear foot and/or the torsion couple have also been studied. However, to our knowledge, there has been only one report using a different methodology devoted to metatarsophalaneal arthrodesis of the hallux. In this study, only step length and interphalangeal moment as well as ankle force were found to be decreased. Function of the interphalangeal joint was not assessed. The Vicon system enabled an adapted study of gait after metatarsophalangeal arthrodesis. This method offers several perspectives: study of the effect of the position of the arthrodesis in the sagittal plane on gait, changes over time in interphalangeal joint motion, or consequences of fusion on walking up and down stairs. CONCLUSION: Metatarsophalangeal arthrodesis of the hallux does not modify general gait parameters nor the kinetic and kinematic values. Compensation is achieved via the interphalangeal joint.

Aged↗
PubMed2005

[Cartilage tissue engineering: state-of-the-art and future approaches].

Lesions of the articular cartilage have a large variety of causes among which traumatic damage, osteoarthritis and osteochondritis dissecans are the most frequent. Returning damaged cartilage in articular joints back to a functionally normal state has been a major challenge for orthopaedic surgeons. This interest results in large part because cartilage defects cannot adequately heal themselves. Current techniques used in orthopaedic practice to repair cartilage give variable and unpredictable results. Bone marrow stimulation techniques such as abrasion arthroplasty, drilling and microfracture produce mostly fibrocartilage. Autologous osteochondral transplant systems (mosaicplasty) have shown encouraging results. Autologous chondrocyte transplantation has led to a hyaline articular cartilage repair but little is known about the predictability and reliability of the procedure. The rapidly emerging field of tissue engineering promises creation of viable substitutes for failing cartilage tissue. Current tissue engineering approaches are mainly focused on the restoration of pathologically altered tissue structure based on the transplantation of cells in combination with supportive matrices and molecules. Among natural and synthetic matrices, collagen and polysaccharidic biomaterials have been extensively used with promising results. Recently, interest has switched to the use of mesenchymal stem cells instead of chondrocytes. Tissue engineering offers the possibility to treat localised cartilage lesions. Genetic engineering techniques using genetically modified chondrocytes offer also the opportunity to treat diffuse cartilage lesions occurring in osteoarthritis or inflammatory joint diseases. Electroporation is specially a reliable and inexpensive technique that shares with electrochemotherapy an ability to target the chondrocytes despite the barrier effect of the extracellular matrix without viral vectors. The authors review recent research achievements and highlight the potential clinical applications of new technologies in the treatment of patients with cartilage injuries.

Animals↗
PubMed2005

[Not Available].

Explore the source record for details and available documents.

Journal Article↗
PubMed2004

Cartilage repair: surgical techniques and tissue engineering using polysaccharide- and collagen-based biomaterials.

Lesions of articular cartilage have a large variety of causes among which traumatic damage, osteoarthritis and osteochondritis dissecans are the most frequent. Replacement of articular defects in joints has assumed greater importance in recent years. This interest results in large part because cartilage defects cannot adequately heal themselves. Many techniques have been suggested over the last 30 years, but none allows the regeneration of the damaged cartilage, i.e. its replacement by a strictly identical tissue. In the first generation of techniques, relief of pain was the main concern, which could be provided by techniques in which cartilage was replaced by fibrocartilage. Disappointing results led investigators to focus on more appropriate bioregenerative approaches using transplantation of autologous cells into the lesion. Unfortunately, none of these approaches has provided a perfect final solution to the problem. The latest generation of techniques, currently in the developmental or preclinical stages, involve biomaterials for the repair of chondral or osteochondral lesions. Many of these scaffolds are designed to be seeded with chondrocytes or progenitor cells. Among natural and synthetic polymers, collagen- and polysaccharide-based biomaterials have been extensively used. For both these supports, studies have shown that chondrocytes maintain their phenotype when cultured in three dimensions. In both types of culture, a glycosaminoglycan-rich deposit is formed on the surface and in the inner region of the cultured cartilage, and type II collagen synthesis is also observed. Dynamic conditions can also improve the composition of such three-dimensional constructs. Many improvements are still required, however, in a number of key aspects that so far have received only scant attention. These aspects include: adhesion/integration of the graft with the adjacent native cartilage, cell-seeding with genetically-modified cell populations, biomaterials that can be implanted without open joint surgery and combined therapies, aimed at disease modification, pain relief and reduction of inflammation.

Biocompatible Materials↗
PubMed2003

Tuberculosis of the patella.

BACKGROUND: A rare case of patella tuberculosis in a 33-year-old man is presented. In the last two decades, tuberculosis has made a vigorous comeback, due mainly to large-scale migration of populations and the increasing number of immunosuppressed patients. Extrapulmonary tuberculosis accounts for less than 3% of cases, and sites like the patella are very rare. Fewer than 10 cases were found in the international literature. METHODS: A 33-year-old man presented in our department with a 9-month history of pain and swelling of the left knee. Tuberculosis of the patella was diagnosed after biological and radiological investigations. RESULTS: Imaging studies, especially MRI, are of great interest for the diagnosis and to assess the extent of tuberculosis. Histology of the curettage specimen is also required to reach a definitive diagnosis and develop an adapted management strategy (chemotherapy and rehabilitation). CONCLUSION: Diagnosis and treatment should be urgent, including surgical debridement and well-conducted antitubercular therapy to yield a satisfactory functional outcome.

Adult↗
PubMed2002

Beta-tricalcium phosphate ceramic as a bone substitute in orthopaedic surgery.

Synthetic beta-tricalcium phosphate ceramic (Biosorb, S.B.M., Lourdes, France) was used as a bone substitute in 110 patients whose mean age was 48 (14-83) years. There was a wide spectrum of indications, and the material was used alone in 86, combined with a corticocancellous bone autograft in 22, and combined with a corticocancellous allograft in two. The patients were assessed clinically and radiographically. Incorporation of the ceramic was excellent in 30, good in 51, and fair in 26. There were no poor results. In three patients the implanted material was removed because of infection. Incorporation was good or excellent in about 75% of all 110 patients. We consider beta-tricalcium phosphate ceramic to be the substitute of choice for medium-sized bone defects.

Adolescent↗
PubMed2002

Modified shoelace technique for delayed primary closure of the thigh after acute compartment syndrome.

The authors report a case of acute compartment syndrome in the thigh in a 19-year-old man with multiple injuries including fracture of the femoral diaphysis. Decompressive fasciotomy was performed emergently. Complete progressive closure of the wound without split-thickness skin grafting was achieved using a modified shoelace technique: sutures were run inside wide drains placed in contact with the muscles and were then tightened over the skin. These drains enlarged the contact area between sutures and muscles, preventing damage to muscles.

Acute Disease↗
PubMed2002

Polydactyly of the foot. Literature review and case presentations.

Polydactyly is a fairly common congenital condition of the foot and is characterized literally by supernumerary toes (digit or metatarsal). The frequency of polydactyly varies widely among populations. It may be an isolated condition or part of a congenital syndrome. Polydactyly is generally classified into three major groups: medial ray (preaxial), central ray and lateral ray (postaxial). The duplication may appear at the distal and middle phalanges or at the whole digit and metatarsal. The complexity of the deformity ranges from a simple soft-tissue problem to a completely developed accessory ray. Careful clinical and radiographic evaluation should be made prior to treatment to achieve good functional and cosmetic results. Most cases are treated during childhood before walking age. Adult cases are more rare, and surgical management of the deformity is still debated. Nevertheless, surgery can be performed at any age as in our series with good results.

Adult↗
PubMed2000

[Filling of bone defects with tricalcium phosphate beta in traumatology].

AIM OF STUDY: Synthetic bone substitutes like calcium phosphate ceramics have been used in orthopaedic surgery for several years. The aim of this study was to assess the results of the use of tricalcium phosphate beta for filling bone defects in trauma cases. PATIENTS AND METHOD: beta tricalcium phosphate was used in 24 trauma cases. The GESTO classification (Association pour l'étude des Greffes et Substituts Tissulaires en Orthopédie) and a qualitative scale were used to estimate the integration. RESULTS: With a mean follow-up of 20 months, integration was excellent in 41.2%, good in 29.2% and moderate in 17.4%. No fibrous encapsulation was observed around the implants in any case. Sepsis occurred in 3 cases with open fractures. CONCLUSION: beta-Tricalcium phosphate seems in our experience to be an excellent bone substitute for filling bone defects in trauma cases.

Adult↗
PubMed2000

[Quality of life assessment one year after total hip or knee arthroplasty].

PURPOSE OF THE STUDY: The development of quality of life (QOL) instruments has made it possible to obtain an objective assessment of the impact of surgical procedures taking into consideration the physical, psychological and social aspects of the patient's everyday activities. The aim of this work was to evaluate the short-term and long-term course of QOL after total hip arthroplasty (THA) and total knee arthroplasty (TKA). MATERIALS AND METHODS: This study included a prospective multicentric cohort of patients with a first intention indication for degenerative bone and joint disease. Clinical assessment was obtained preoperatively and 6 weeks, 6 months and 12 months postoperatively. The Merle d'Aubigné and Harris scores were determined for THA and the Hospital Special Surgery score for TKA. Clinical data (pain, walking distance), and QOL scores [French version of the Nottingham Health Profile (NHP) and the French version of the Arthritis Impact Measurement Scale 2 (AIMS2)] were also obtained. RESULTS: One hundred twenty-three patients had a THA (mean age 62 years) and 60 had a TKA (mean age 68 years). Preoperative clinical features were those commonly found in these populations. For THA, the 6-week, 6-month and 1-year assessments showed an improvement (2.7 and 2.8 points on the 0 to 10 NHP). For TKA, improvement came later and was less significant with 0.8, 1.8 and 1.5 point improvements. The AIMS 2 did not appear to be perfectly adapted to measure this dimension. Improvement in pain came earlier and was greater for THA than for TKA on all measurement scales. For THA, psychological capacity improved by 0.7, 1.4 and 1.5 points on the 0 to 10 AIMS 2 at 6 weeks, 6 months and 12 months respectively. For TKA, improvement was to the same order with 1.1 and 1.2 point improvements at 6 weeks and 6 months respectively. DISCUSSION: These findings confirm the clear improvement in QOL after THA and TKA, mainly due to physical and psychological dimensions. The QOL measurements allow comparisons with other surgical procedures in other fields. They provide supplementary information, notably concerning pain and are particularly useful in orthopedic surgery. The questionnaires are generally well accepted by the patients, particularly short self-administered questionnaires. They provide useful information on the efficacy of THA and TKA in terms of human and social costs and open new perspectives for analysis of prognostic factors for optimal QOL of operated patients.

Activities of Daily Living↗