The INCA® implant to treat isolated scaphotrapeziotrapezoid osteoarthritis: Preliminary results at a minimum 2 years' follow-up.

We report results with the INCA® distal scaphoid pole resurfacing implant anchored within the scaphoid for isolated scaphotrapeziotrapezoid osteoarthritis. Thirty-five implants in 27 patients (mean age, 69 years) were retrospectively included with a minimum follow-up of 2 years. Outcome criteria were pain (VAS), PROMs (QuickDASH, PRWE and MMWS), wrist motion, pinch and grip strength, and radiographic assessment. The average follow-up was 4.6 years. There was a significant improvement in pain, PROMs, grip and pinch strength. Radial deviation and wrist extension showed slight but significant postoperative decrease (-4° for both). Dorsal intercalated segment instability (DISI) was significantly improved postoperatively (7 cases versus 21 preoperatively). There were 2 cases of implant loosening (6%) within the first 10 months: 1 keel malpositioning and 1 insufficient postoperative immobilization. These findings suggest that the INCA® implant is an effective and reliable medium-term solution for isolated scaphotrapeziotrapezoid osteoarthritis. By restoring scaphoid length and gliding on the trapeziotrapezoid surface, the implant contributes to restoring normal bone alignment of the wrist.

Trapeziometacarpal prostheses.

In 1970, Jean-Yves de la Caffinière developed the first trapeziometacarpal (TMC) joint prosthesis, a ball-and-socket design based on hip replacement implants. From 1970 to 1990, the first generation of cemented prostheses was developed. At that time, trapeziectomy, with tendon interposition or suspension arthroplasty, and Swanson silastic spacers remained the most widely used surgical procedures for thumb basal joint arthritis. From 1990 to 2010, a second generation of cementless prostheses was developed. The third generation was introduced after 2010 and consisted of dual mobility prostheses. In 2020, TMC arthroplasty (simple or dual mobility) is a reliable option in thumb basal joint arthritis with an implant survival rate of 90% at 10 years of follow-up, while providing pain relief and restoring strength and mobility. Restoration of the thumb's length corrects most thumb Z-deformities, so the TMC joint prosthesis may be a viable alternative surgical solution to trapeziectomy, which remains the gold standard in English-speaking countries. Moreover, trapeziectomy after failed TMC arthroplasty provides outcomes equivalent to those of primary trapeziectomy.

Clinical outcomes after multiligament injured knees: medial versus lateral reconstructions.

PURPOSE: The purpose of this study was to analyse the clinical outcomes of multiligament injured knees with respect to the medial collateral ligament and posteromedial corner (PMC) repair or reconstruction versus the posterolateral corner (PLC) reconstruction in patients operated according to a codified surgical protocol. METHODS: Patients were divided into two groups depending on whether PMC or PLC was injured. Cruciate ligaments as well as PMC or PLC were reconstructed/repaired in a one-stage procedure. At minimum of 1-year follow-up, objective and subjective International Knee Documentation Committee (IKDC) forms, Lysholm score and sports activity level were recorded. RESULTS: Thirty-nine patients with a median follow-up time of 57 months (range 12-129) were reviewed. No significant difference was found for functional scores between acute PMC and PLC subgroups. In Group PLC, subjective outcomes tend to be better in the acute than in chronic reconstruction subgroup. CONCLUSIONS: A one-stage protocol with early surgery rather than delayed reconstruction produced better clinical outcomes whatever the injured collateral ligament, medial or lateral. In the future, early and chronic reconstructions as well as each injury pattern should be considered as separate entities in studies on multiple ligament injured knees to reach a better level of evidence. LEVEL OF EVIDENCE: IV.

Biometry of the calcaneocuboid joint: biomechanical implications.

Precise biometric data of calcaneus, cuboid bones and calcaneocuboid joint are not alluded to in textbooks of anatomy. This study focussed on the biometry of 50 calcanei, 30 cuboid dry bones, and anatomical specimens of 21 transverse tarsal joints. Measurement of the length, width, angular orientation, contact surface and radius of curvature, rolling band of the joints surfaces according to the main axes were performed. The results focussed on biometric variations with several morphological types never identified previously. Measurements obtained on dry bones and anatomical specimens with the functions of ligaments were distinguished. The morphology of the calcaneus could explain the results of osteotomy procedures for the treatment of adult flatfoot. A better knowledge of the joint surfaces and biometric data would generate a modeling of the calcaneocuboid joint and function in locking the transverse tarsal joint.

[Nerve transfer in isolated deltoid palsy: branch of the long head of the triceps to the axillary nerve]. / Neurotisation du nerf du chef long du muscle triceps sur le nerf axillaire, dans les paralysies isolées du deltoïde.

AIM: Nerve transfer of the nerve branch to long head of triceps onto the axillary nerve has joined the therapeutic armamentarium for isolated deltoid paralysis cases. We report our experience in the case of a non-excisable neuroma of the axillary nerve at its origin from the posterior cord. METHODS: Eight patients of average age 28 (15-38) were included in a retrospective study with one operating surgeon. Clinical assessment included analytical testing of the deltoid muscle, pain score (VAS) and a functional assessment. Minimum follow-up was 24 months. RESULTS: Preoperative delay was 10.8 months. In seven cases, recovery was M4 for the posterior deltoid, M3 for the middle deltoid and M2 for the anterior deltoid. The elbow was stable, strong and painless (VAS=2). Cocontraction was found. No morbidity was found at the donor site. The last case was a failure. DISCUSSION: In absence of spontaneous recovery, the surgical treatment of deltoid palsy restores a stable strong shoulder and prevents overloading of the rotator cuff. This nerve transfer initially used in brachial plexus surgery gives results comparable to those using grafts, which is the standard treatment of reference avoiding approach of the plexus. The inconvenience is the persistence of cocontractions and a fatigue phenomenon. CONCLUSION: The nerve transfer of the nerve to the long head of triceps to the axillary nerve is the technique of choice for re-innervation of the deltoid.

Role of haeme oxygenase-1 in resolution of oxidative stress-related pathologies: focus on cardiovascular, lung, neurological and kidney disorders.

The present review examines the role of the cytoprotective enzyme haeme oxygenase-1 (HO-1) in adaptive responses to inflammatory disease and explores strategies for its clinical use, with particular emphasis on use of therapeutic use of the enzyme using phytochemical inducers of HO-1 such as extracts of Ginkgo biloba, curcumin, and flavonoids extracted from seeds of the sour cherry (Prunus cerasus). This laboratory has identified strategies by which combinations of dietary phytochemicals may be configured to synergistically strengthen immunoregulatory mechanisms that normally prevent inflammation from leading to disease. A major focus of this research initiative has been HO-1, which is capable of substantially reducing oxidative stress by several mechanisms. HO-1 metabolizes haeme that accumulates in tissues because of red blood cell turnover. Two products of this degradation - carbon monoxide (CO) and bilirubin - have potent capacity for reducing oxidative stress and for counteracting its effects. A description will be provided of how HO-1 products maintain healthy tissue function and remediate oxidative tissue damage. This will be explored in four major organ systems, including the cardiovascular system, the lungs, the central nervous system and the kidneys. Particular focus will be given to the physiological coordination of cardiovascular functions mediated by CO produced by HO-1 and to nitric oxide (NO), a gaseous second messenger expressed by nitric oxide synthetase. A major unifying theme of the present review is an exploration of the potential use of dietary phytochemical formulations as tools for the clinical application of HO-1 in therapeutic reduction of oxidative stressors, with resultant improved treatment of inflammatory pathologies.

Biometry of bone components in the talonavicular joint: a cadaver study.

INTRODUCTION: Exhaustive biometric data of the talus and the navicular bones have not been reported in the classical anatomy treatises. HYPOTHESIS: The radiographic measurements, being variable according to the X-ray beam inclination, have no real value. This biometric analysis aimed to specify the characteristics of the constitutive bone components of the talonavicular joint. MATERIAL AND METHODS: This anatomic study investigated the biometry of the talus and the navicular bones separated from anatomic specimens with no previous disease history from adult subjects whose sex was unknown. It was completed by in situ dissection and evaluation of talonavicular and talocalcaneal joints conducted to gain an understanding of the bone specimens in three dimensions. The measurements were taken using a highly precise measuring tape and a comparator providing the length and the width of the articular surfaces. The comparator determined the surface pattern and the radii of curvature in the two main axes. RESULTS: The results emphasize the variations in the bone specimens. Three morphotypes emerged, which had never been identified before. DISCUSSION AND CONCLUSION: These biometric data make up a database designed to improve clinical exploration. They can be used as landmarks for fundamental comparative research between all the bone structures of the hindfoot and thus provide a logical classification of the different pathological conditions and a reasoned adaptation of therapeutic protocols. LEVEL OF EVIDENCE: Experimental study, level IV.

Lactic acid bacteria biomass monitoring in highly conductive media by permittivity measurements.

Recent technological improvements have extended the application range of permittivity biomass measurements to bacterial fermentations in highly conductive media. With Lactobacillus casei, the effective biomass detection sensitivity of the FOGALE Biomass System is around 0.2 g/l (0.01 pF/cm). Fermentations growth kinetics of Lactobacillus casei can be recorded with good reproducibility and accuracy despite the high medium conductivity varying between 15 and 75 mS/cm, and the low cell concentration (<6 g/l).