PubMed Health⌕ Search

Biomedical subjects

A Nogier

Publications and source records attributed to A Nogier.

6 recordsLinked to original sources
PubMed2005

Validation of new clinical quantitative analysis software applicable in spine orthopaedic studies.

The objective of this study was to evaluate an X-ray films analysis software, i.e. to estimate the reliability and validity of clinical measurements by means of this software. The authors first performed tests of precision and reproducibility of measures. The precision for dynamic modules was estimated at +/-2 degrees for the lumbar analysis and +/-3 degrees for the cervical one. Mean reproducibility coefficients calculated for postural modules are about 4 degrees for the angular parameters and 3 mm for the linear ones. We also evaluated clinical applicability of the software through its validity. Reference values calculated on a population of healthy subjects showed agreement with the literature. Then, when analysing postural X-ray films of severe scoliotic patients, we found that inter-observer reproducibility coefficients show a lower reliability of measurements; the main cause seems to be the low visibility of anatomic landmarks due to the quality of X-ray films and to the degree of deformity. This study allowed to better estimate the reliability and the usefulness of this tool, allowing for multicentric studies and exchanges.

Cervical Vertebrae↗
PubMed2005

[Osteolysis in revision total knee arthroplasty: a comparative study of osteolysis with and without metallosis].

PURPOSE OF THE STUDY: Metallic debris from metallosis can compensate for the radiolucency resulting from bony destruction and compromise preoperative diagnosis of osteolysis. We compared the radiological findings in two groups of patients: those with pure osteolysis resulting from polyethylene debris and those with osteolysis associated with metallosis. MATERIAL AND METHODS: This study compared ten total knee arthroplasties free of metallosis at revision (pathology examination revealed only polyethylene debris) with ten total knee arthroplasties with pathologically confirmed metallosis of the synovium and periprosthetic bony tissue. Revisions were performed for loosening or a femoropatellar problem. At revision, the localization and the degree of tibial and/or femoral osteolysis were noted. Preoperative x-rays were analyzed to search for femoral, tibial or patellar osteolysis and were compared with operative findings. On the AP and lateral views, ten osteolysis zones were defined for each knee (four tibia, five femur, and one patella). RESULTS: Ten knees had osteolysis associated with polyethylene debris alone. Tibial osteolysis was found intraoperatively in 16 of the 40 theoretically possible localizations and was recognized on the preoperative x-rays in all 16. Femoral osteolysis was found intraoperatively in 18 of the 50 theoretically possible localizations was only recognized in 6 of the 18. For the ten knees with metallosis, tibial osteolysis was found intraoperatively in 22 of the theoretically possible localizations and was recognized on preoperative x-rays in 10 of the 22. Femoral osteolysis was found intraoperatively in 32 of the 50 theoretically possible localizations but was only recognized preoperatively in 5 of the 32. Comparisons between the two groups showed that femoral osteolysis was significantly more difficult to identify preoperatively than tibial osteolysis irrespective of the type of osteolysis (with or without metallosis). Furthermore, in patients with metallosis, it was significantly more difficult to recognize osteolysis preoperatively in both the tibial and femoral localizations. DISCUSSION: Metallosis can mask the diagnosis of femoral osteolysis and makes it very difficult to recognize tibial osteolysis. Arguments in favor of osteolysis (abnormal skin pigmentation, radio-opaque effusion, abnormal color and density of the joint fluid) are discussed. When the diagnosis of metallosis is established preoperatively, the chances of finding osteolysis intraoperatively are much higher than suggested by the preoperative x-rays.

Arthroplasty, Replacement, Knee↗
PubMed2004

[Total hip arthroplasty for the treatment of septic hip arthritis in adults with sickle-cell disease].

PURPOSE OF THE STUDY: Septic hip arthritis is a recognized complication of sickle-cell disease. The incidence is difficult to assess but is significant since certain authors estimate that 11% of children with sickle-cell disease develop orthopedic complications. We report our experience with hip joint infection in adults with sickle-cell disease. MATERIAL AND METHODS: We diagnosed ten cases of hip joint infection in seven adults with sickle-cell disease. The characteristic feature of the septic arthritis was the development of a septic focus in a zone of osteonecrosis of the femoral head. Diagnosis was difficult due to the presence of prior hip disease and also the circumstances of development: other infectious foci, septicemia, distant osteomyelitis. The diagnosis was confirmed by joint puncture and isolation of the causal germ. Despite adapted antibiotics and immobilization with traction-suspension, hip joint destruction could not be prevented and all patients became bedridden. Surgery was therefore undertaken to remove the head and neck and institute local antibiotic treatment. A total hip prosthesis was implanted in all patients. RESULTS: At 2 to 12 years follow-up, all seven patients had nearly normal hip function (all 10 hips). Recurrent infection nevertheless developed in 2 hips, demonstrating the limitations of this technique.

Adult↗
PubMed2004

Fate of very small asymptomatic stage-I osteonecrotic lesions of the hip.

BACKGROUND: The prognosis for a patient with osteonecrosis of the hip is generally considered to be worse if a large volume of the femoral head is involved, the patient is symptomatic, and the stage of the lesion is advanced. In 1990, we began a prospective study to detect collapse in asymptomatic hips with a very small stage-I osteonecrotic lesion in the femoral head. We hypothesized that such patients would have a favorable prognosis. These hips were followed for a minimum of ten years after the diagnosis. METHODS: A small asymptomatic stage-I osteonecrotic lesion (not seen on plain radiographs) was diagnosed with magnetic resonance imaging in forty patients (forty hips) contralateral to a hip with symptomatic osteonecrosis. The criterion for inclusion in the study was a lesion with a volume of <5 cm(3) involving <10% of the volume of the femoral head. Plain radiographs were made annually in six different projections for all patients. At the most recent follow-up evaluation (average, eleven years), patients with a symptomatic hip but without evidence of collapse on plain radiographs underwent a computerized tomography scan. RESULTS: Thirty-five (88%) of the forty hips became symptomatic, and twenty-nine (73%) demonstrated collapse. The mean interval between the diagnosis and the first symptoms was eighty months. Symptoms always preceded collapse by at least six months. The mean interval between the diagnosis and the collapse was ninety-two months (range, seventy-two to 140 months). The diagnosis of collapse could be made on only one or two of the six radiographic views obtained for each patient at each evaluation. The diagnosis of collapse for two patients was made only on a computerized tomography scan at the most recent follow-up evaluation. At the time of final follow-up, the twenty-nine hips with collapse had symptoms of intractable pain and required surgery. CONCLUSIONS: This study confirms that the diagnosis of collapse is difficult in hips with a very small stage-I osteonecrotic lesion. Multiple radiographic views and computerized tomography scans may be required to demonstrate small areas of collapse. Clinical and radiographic signs of progression of the disease in asymptomatic hips with a very small asymptomatic lesion progress more slowly than do those signs in hips with a large symptomatic stage-II lesion. Because hips with a small area of osteonecrosis do collapse in a large percentage of patients, such patients should be followed carefully over a long period of time. LEVEL OF EVIDENCE: Prognostic study, Level I-1 (prospective study). See Instructions to Authors for a complete description of levels of evidence.

Adult↗