Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Nov 2003
[Long-term results of surgical treatment of lumbar spinal stenosis].
Some discussion remains concerning the quality of the long-term functional outcome after surgical treatment of lumbar spinal stenosis. The purpose of this retrospective observational study was to evaluate outcome ten years after surgical treatment of lumbar spinal stenosis and to determine the rate of reoperation as well as to identify factors influencing outcome at last follow-up. ⋯ For the majority of patients, surgical treatment of lumbar spinal stenosis provides good long-term results and patient satisfaction. At ten years, the risk of reoperation was 10% in this population. Compared with data in the literature, these results are better than with medical treatment. Surgery enables these patients to have a quality of life similar to an age-matched control population.
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Rev Chir Orthop Reparatrice Appar Mot · Nov 2003
[Shoulder arthroplasty for osteoarthritis after prior surgery for anterior instability: a report of 27 cases].
The purpose of this study was to analyze the natural history of shoulder osteoarthritis secondary to prior surgery for anterior instability, to evaluate clinical and radiological results of shoulder prosthesis, and to compare results with reports in the literature. ⋯ Osteoarthritis of the shoulder has a long natural history, 26 years in our patients excepting those whose first dislocation occurred after the age of 60 years. Posterior glenoid wear, described by others, was only found in 24% of the shoulders in this series. Surgical dissection and release of anterior scar tissue was difficult. The overall results of arthroplasty were good and were correlated with fatty degeneration of the rotator cuff muscles, particularly the subscapularis, but not with the type of instability surgery. These results were less satisfactory than reported in series of arthroplasty for primary centred osteoarthritis: complications occurred in 18% of the shoulders with three cases of anterior dislocation. Unlike reports of arthroplasty after instability surgery where many of the patients had several operations, overall results in our series were not compromised by a large number of multiple interventions.
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Rev Chir Orthop Reparatrice Appar Mot · Nov 2003
[Geometrical and mechanical analysis of lumbar lordosis in an asymptomatic population: proposed classification].
The main objective of this study was to describe the morphology and the mechanism underlying the organization of lumbar lordosis in terms of position and shape of the pelvis. A classification of lumbar lordosis was proposed based on the orientation of the sacral plane. ⋯ Regarding sacral slope, lumbar lordosis can be classified into four types. When the sacral slope is low, lumbar lordosis can either be both short and curved with a low apex and a backward tilt (type 1) or both long and flat with a higher position of the apex (type 2). When the sacral slope increases, lumbar lordosis increases in angle and number of vertebrae with an upper apex, with a progressively forward tilt (types 3 and 4). Depending on the shape and position of the pelvis, and because of the relation between sacral slope and pelvic tilt, the morphology of lumbar lordosis could be the main mechanical cause of degenerative diseases of the lumbar spine.