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Biomedical subjects

R Bouvet

Publications and source records attributed to R Bouvet.

6 recordsLinked to original sources

[Implantation of autologous chondrocytes for cartilagenous lesions in young patients. A study of 24 cases].

STUDY AIM: The aim of this study was to describe the treatment of symptomatic knee cartilage defects on young active patients by autologous chondrocyte implantation and to report preliminary results in 24 patients. PATIENTS AND METHODS: Since April 1996, 24 selected patients underwent 25 implantations in five military hospitals. There were 19 men and five women (all of them practicing sports); mean age was 27. Lesions were localized on left (n = 13) and right (n = 12) aligned and stabilized knees. There were 12 isolated cartilage defects (eight OCD and four posttraumatic) and 13 associated with ligament lesions (n = 8) or multiple and severe lesions (n = 3 indication of salvage). Mean surface of cartilage defects was 6 cm2. Mean preoperative evolution was 11 months and stage was grade IV (Outerbridge) for all. The first step was arthroscopy for classification and biopsy. The second one was implantation after a 3-week delay (for the ex vivo culture) through arthrotomy, under a periosteal flap taken from tibia and sutured on the edges of the prepared defect. Weight bearing was allowed after the 6th week; MRI was performed at 6, 12, 18, 24 months. The follow up was evaluated with three scales: Lysholm 2, Tegner Activity, Cincinnati Knee Rating System. RESULTS: Postoperative complications included: algodystrophy (n = 2) and phlebitis (n = 1). Four patients were revised at 6 months, seven between 6 and 12 months, 11 after. The longest follow-up was 26 months. Results were poor in one patient (salvage). For the others, pain and swelling decreased after 6 months and disappeared after 12 months. CONCLUSION: Autologous chondrocyte implantation used in this senes and in a large international ongoing series seems to be the only procedure allowing a true long-term regeneration of cartilage defects. Some questions remain, on the biological level in relation with the use of some growth factors and the risk of chromosomic abnormalities, and on the economical level because of the high cost of this technique.

Adult↗

Asymptomatic cervical haemangioma treated by percutaneous vertebroplasty.

We report a 17-year-old asymptomatic patient with a partially collapsed seventh cervical vertebra due to a haemangioma revealed by conventional radiographs performed for army enrollment. Given radiological evidence of aggressiveness, percutaneous vertebroplasty by injection of methyl methacrylate cement was performed to prevent complications. CT a year later showed no progression of the lesion. The patient remains asymptomatic.

Adolescent↗

[Osteoblastomas of the coccyx. Apropos of a case. Review of the literature].

A 24-year-old man presented with a painful and invalidating coccyx. Exploration revealed a bony lesion involving parts of 2nd and all of the 3rd coccygeal vertebrae. The pathology examination of the surgical specimen revealed the diagnosis of benign osteoblastoma of the coccyx. This exceptional localization required complete surgical resection going into healthy tissues to allow a full histological study and to ensure the absence of relapse. Post-operative follow-up was uneventful and the functional result was excellent.

Adult↗

[Pseudarthrosis of the uncinate process].

Ten cases of nonunion of the hook of the hamate were observed, eight of which had occurred during athletic activity. The mean age was 31.1 years and the mean length of time between the accident and diagnosis was 8.8 months. Diagnosis was most often confirmed by CT scanning, which, represents the examination of choice. In all cases, surgical treatment was applied using the same technique and the same surgeon. Results were evaluated according to resolution of pain, movement, strength of grip and return to former level of athletic activity. Results were very good in six patients and good in two others who returned to previous activity. One patient had only a fair result with resolution of pain. One case was a failure with persistence of pain and ulnar paralysis.

Adult↗

[Darier-Ferrand dermatofibroma. An unusual tumor of the soft tissues].

Darier and Ferrand dermatofibroma is a rare skin tumour arising in the dermal connective tissue. It has a slow course over several years and presents very unusual histological features. It is characterised by a marked potential for local recurrence, frequently multiple due to insufficient primary resection. It has a very low metastatic potential. Its diagnosis is difficult but essential in order to perform an appropriate surgical procedure which ensures its excellent prognosis.

Abdominal Muscles↗