Biomedical subjects

Michel Le Duff

Publications and source records attributed to Michel Le Duff.

6 recordsLinked to original sources

PubMed2006

The value of patient activity level in the outcome of total hip arthroplasty.

Commonly used total hip arthroplasty scores take into account pain, function, walking, and range of motion. The purpose of this study was to evaluate the value of patient activity level as part of the outcome of total hip arthroplasty. Using linear regression analysis, the relationship between patient activity level (University of California Los Angeles activity score), the Harris Hip Score, and the Short Form-12 health survey was evaluated in 152 patients (mean age, 58.7 years) with a mean follow-up 5.2 years (range, 2-21 years). The University of California Los Angeles activity scale had an R(2) value of 0.39 and 0.19 to the Short Form-12 physical and mental components, respectively, and 0.32 to the Harris Hip Score. By evaluating patient activity level, one obtains important qualitative information in assessing the clinical outcome after total hip arthroplasty.

Arthroplasty, Replacement, Hip↗

PubMed2004

Metal-on-metal surface arthroplasty with a cemented femoral component: a 7-10 year follow-up study.

Forty-two McMinn metal-on-metal surface arthroplasties were implanted in 23 males and 16 females, average age 47.5 years old. The overall survivorship at 7 years was 79%; with any reoperation surgery as endpoint, 80%; and 93%; with aseptic loosening of the socket and femoral component, respectively. The average Surface Arthroplasty Risk Index of patients who had failed or were at risk of failing on the femoral side was significantly greater than for the rest of the cohort, 3.9 versus 1.9. The overall survivorship of the McMinn component was unacceptably low, with the majority of failures occurring with the cemented acetabular components. The recent reintroduction of surface arthroplasty of the hip using metal-on-metal bearings and cementless acetabular components may benefit young patients with hip arthritis with appropriate patient selection.

Adult↗

PubMed2004

Surface arthroplasty for osteonecrosis of the hip: hemiresurfacing versus metal-on-metal hybrid resurfacing.

Eighty-four hips with Ficat stage III and IV osteonecrosis were treated: 56 with metal-on-metal surface arthroplasty (MMSA) and 28 with hemi-surface arthroplasty (HSA). Average follow-up was 4.9 years. UCLA hip scores were significantly better for MMSA versus HSA for function and activity as well as Harris Hip scores and physical component of the SF-12 scores. In the MMSA group, 2 hips were revised to total hip arthroplasty for femoral loosening, and 5 hips had adverse radiological changes. In the HSA group, 4 hips were revised (1 sepsis and 3 for pain). There was no evidence of any femoral loosening or neck narrowing in the HSA group. Although the functional clinical outcome of MMSA is superior to HSA, long-term follow up of MMSA will determine the reliability of the femoral fixation.

Adolescent↗

PubMed2004

Cementing a liner into a stable cementless acetabular shell: the double-socket technique.

BACKGROUND: During revision hip replacement surgery, the cementless acetabular shell is often well fixed but the locking mechanism may be ineffective. Cementing a new liner into the existing acetabular shell (the double-socket technique) can provide a simple solution. The purposes of the present study were to review our initial clinical results and to define the potential limitations of this technique. METHODS: Thirty-two hips with a preexisting well-fixed acetabular socket that had been in situ for an average of 8.6 years were treated with the insertion of a new polyethylene liner (seventeen hips) or a metal liner (fifteen hips) with use of cement. The indication for this technique was a deficient locking mechanism in twenty-two hips and the unavailability of a matching liner in ten hips. Anteroposterior radiographs of all hips were analyzed by a single independent reviewer. RESULTS: The mean duration of follow-up was 5.1 years. Six hips required a reoperation after a mean of 29.7 months; the reasons for the reoperations included aseptic failure of the acetabular construct (four hips), instability (one hip), and sepsis (one hip). The University of California at Los Angeles hip scores improved significantly (p < 0.001) compared with the preoperative values; specifically, the mean score improved from 6.2 to 9.1 for pain, from 6.3 to 8.3 for walking, from 6.2 to 7.8 for function, and from 4.7 to 5.8 for activity. The prevalence of dislocation was 22%. Kaplan-Meier analysis with revision as the end point revealed a five-year survival rate of 78% (95% confidence interval, 55% to 91%). CONCLUSIONS: The double-socket technique is a good alternative to acetabular socket removal for suitable candidates who have a well-fixed cementless socket with an inner diameter that is larger than the outer diameter of the cemented liner. This technique preserves acetabular bone stock and permits conversion to alternate bearing surfaces. We believe, however, that removal of a well-fixed acetabular shell or the use of a constrained liner should be strongly considered for patients with a history of hip instability.

Acetabulum↗

PubMed2004

Preservation of bone mineral density of the proximal femur following hemisurface arthroplasty.

Bone mineral density of the proximal femur was measured in six patients who underwent hemisurface replacement for osteonecrosis of the femoral head. Bone mineral density values in operated and contralateral nonoperated hips were compared. In four patients who had sequential examinations, bone mineral density was compared over time. Average patient age was 34.6 years, average follow-up was 9.1 years, and mean follow-up of bone mineral density measurements was 6.6 years. Average bone mineral density variation was 0.0048 to -0.0264 g/cm2 per year in all five regions in nonoperated hips and -0.012 to -0.0300 g/cm2 in operated hips. These results support bone conservation and preservation with hemiresurfacing arthroplasty in young patients with osteonecrosis of the femoral head.

Adolescent↗

PubMed2003

Hemiresurfacing arthroplasty of the hip for failed free-vascularized fibular graft.

Management of Ficat stage III and IV osteonecrosis of the hip remains challenging, with the average patient aged in the mid 30s. Joint- and bone-preserving procedures such as free vascularized fibular graft, redirectional osteotomies, and hemiresurfacing hip arthroplasty are often considered. If these treatments fail, that is, after progression of joint destruction or persistent pain and decreasing function, total hip arthroplasty is often the procedure of choice. We describe the case of a patient with failed bilateral free vascularized fibular graft treated with bilateral hemiresurfacing arthroplasty.

Adult↗