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Elvire Servien - One of the best experts on this subject based on the ideXlab platform.

  • No difference in patellar position between mobile-bearing and fixed-bearing total knee arthroplasty for medial osteoarthritis: a prospective Randomized Study
    Knee Surgery Sports Traumatology Arthroscopy, 2019
    Co-Authors: Elliot Sappey-marinier, Sébastien Lustig, Felipe Galvão A. Abreu, Padhraig O’loughlin, Romain Gaillard, Philippe Neyret, Elvire Servien
    Abstract:

    Purpose Total knee arthroplasty (TKA) is the treatment of choice for severe osteoarthritis of the knee. Many studies have been performed comparing mobile- and fixed-bearing designs; however, there are insufficient data regarding the patellar position in either system. This Study aimed to compare the resultant patellar position with a mobile- versus a fixed-bearing TKA and the influence of both designs on clinical outcomes. Materials and methods In this prospective Randomized Study, between 2007 and 2009, 160 TKA patients were assessed; 79 received a mobile-bearing and 81 received a fixed-bearing implant, for medial compartment osteoarthritis. A posteriorly stabilized, HLS Noetos knee prosthesis (Tornier, Saint-Ismier, France) was used in all cases. The only difference between the groups was whether the tibial component incorporated a fixed or mobile bearing. The patella was resurfaced in all cases. The International Knee Society Score (KSS) and the patellar tilt and translation were compared post-operatively. Patellar translation and patellar tilt analyses were subdivided into two subgroups ( 5 mm and  5°). Results The KSS was not statistically different between the groups at a mean follow-up of 7.4 years (range 5–11 years). Patellar translation and patellar tilt were not statistically different between the groups. When considering the patellar translation subgroup analysis, a significantly increased risk of patellar translation, greater than 5 mm, was found in the mobile-bearing group compared to fixed-bearing group (OR = 2.3; p  = 0.048) without generating any meaningful difference in clinical outcomes. Conclusion The theoretical advantages of mobile-bearing implants compared to fixed-bearing implants were not demonstrated in this Randomized Study, at mid-term follow-up. In daily practice, the choice between mobile-bearing and fixed-bearing designs should be based on the experience and clinical judgment of the surgeon. Level of evidence Prospective Randomized Study, level I.

  • No difference in patellar position between mobile-bearing and fixed-bearing total knee arthroplasty for medial osteoarthritis: a prospective Randomized Study.
    Knee Surgery Sports Traumatology Arthroscopy, 2019
    Co-Authors: Elliot Sappey-marinier, Sébastien Lustig, Felipe Galvão A. Abreu, Romain Gaillard, Padhraig F. O'loughlin, Philippe Neyret, Elvire Servien
    Abstract:

    Total knee arthroplasty (TKA) is the treatment of choice for severe osteoarthritis of the knee. Many studies have been performed comparing mobile- and fixed-bearing designs; however, there are insufficient data regarding the patellar position in either system. This Study aimed to compare the resultant patellar position with a mobile- versus a fixed-bearing TKA and the influence of both designs on clinical outcomes. In this prospective Randomized Study, between 2007 and 2009, 160 TKA patients were assessed; 79 received a mobile-bearing and 81 received a fixed-bearing implant, for medial compartment osteoarthritis. A posteriorly stabilized, HLS Noetos knee prosthesis (Tornier, Saint-Ismier, France) was used in all cases. The only difference between the groups was whether the tibial component incorporated a fixed or mobile bearing. The patella was resurfaced in all cases. The International Knee Society Score (KSS) and the patellar tilt and translation were compared post-operatively. Patellar translation and patellar tilt analyses were subdivided into two subgroups (  5 mm and   5°). The KSS was not statistically different between the groups at a mean follow-up of 7.4 years (range 5–11 years). Patellar translation and patellar tilt were not statistically different between the groups. When considering the patellar translation subgroup analysis, a significantly increased risk of patellar translation, greater than 5 mm, was found in the mobile-bearing group compared to fixed-bearing group (OR = 2.3; p = 0.048) without generating any meaningful difference in clinical outcomes. The theoretical advantages of mobile-bearing implants compared to fixed-bearing implants were not demonstrated in this Randomized Study, at mid-term follow-up. In daily practice, the choice between mobile-bearing and fixed-bearing designs should be based on the experience and clinical judgment of the surgeon. Prospective Randomized Study, level I.

Georg Bartsch - One of the best experts on this subject based on the ideXlab platform.

  • extracorporeal shock wave lithotripsy versus ureteroscopy for distal ureteral calculi a prospective Randomized Study
    The Journal of Urology, 1999
    Co-Authors: Reinhard Peschel, Gunter Janetschek, Georg Bartsch
    Abstract:

    Purpose: We performed a prospective Randomized Study to determine appropriate first line treatment for distal ureteral stones. Material and Methods: Between January 1996 and October 1997, 80 patients with distal ureteral stones (40 smaller than 5 mm. and 40 larger than 5 mm.) were Randomized and treated with extracorporeal shock wave lithotripsy or ureteroscopy with a 9.5 or 6.5F semirigid ureteroscope. Results: Ureteroscopy was significantly better in terms of operative time, fluoroscopy time and time to achieve a stone-free state. The smaller the stones, the greater the difference between the 2 treatment modalities. Conclusions: For distal ureteral stones we recommend ureteroscopy as first line treatment.

Ruben Mühl-benninghaus - One of the best experts on this subject based on the ideXlab platform.

Kathleen F Brookfield - One of the best experts on this subject based on the ideXlab platform.

  • a Randomized Study of closed wound suction drainage for extensive lumbar spine surgery
    Spine, 2004
    Co-Authors: Mark D Brown, Kathleen F Brookfield
    Abstract:

    Study Design. A prospective Randomized Study. Objectives. To Study the risk of infection, hematoma, and neurologic deficits following extensive lumbar spine surgery in patients with or without prophylactic closed wound suction drain placement. Summary of Background Data. One Randomized Study assessing prophylactic drain placement in one-level lumbar spine surgery suggested that the use of a wound drain is not effective at preventing infection and may actually increase the rate of this complication. Our Study was designed to determine the efficacy of closed wound suction drainage in preventing complications after extensive lumbar spine surgery. Methods. Eighty-three consecutive patients undergoing extensive lumbar spine surgery were prospectively Randomized to one of two groups. Forty-two patients had a closed wound suction drain placed before wound closure and 41 patients did not have a drain placed. The two groups were then assessed for differences in postoperative infection rate, incidence of hematoma and neurologic deficits, operating room time, estimated blood loss, hemoglobin and hematocrit values, temperature, dressing drainage, and length of hospital stay. Results. No infections, epidural hematomas, or new neurologic deficits were encountered in either group of patients. The only significant finding was a higher temperature in the “no drain” group the first day after surgery (P = 0.0437). Conclusions. Based on the findings in this and other studies, the decision to use or not use a wound drain following lumbar spine surgery should be left to the surgeon’s discretion.

F A Karlsson - One of the best experts on this subject based on the ideXlab platform.

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