Replacement Arthroplasty: Postel JM

Postel JM, Thoumie P, Missaoui B, Biau D, Ribinik P, Revel M, Rannou F, Anonymous00070. · Clinique Arago, 95, boulevard Arago, 75014 Paris, France. · Ann Readapt Med Phys. · Pubmed #17412445 No free full text.

Abstract: OBJECTIVE: To develop clinical practice guidelines concerning the use of continuous passive motion (CPM) compared with intermittent mobilization after total knee arthroplasty (TKA). METHOD: We used the SOFMER (French Physical Medicine and Rehabilitation Society) methodology, combining systematic literature review and collection of everyday clinical practice concerning postoperative rehabilitation techniques and external review by a multidisciplinary expert panel, to develop the guidelines. RESULTS: The literature contains no evidence of the advantages of CPM over other techniques of mobilization, although CPM could be adjuvant therapy used to accelerate short-term recovery. However, in France, CPM remains widely used after TKA, both in orthopedic surgery units and in physical medicine and rehabilitation services. CONCLUSION: Good methodological quality studies are needed to assess different CPM modalities and compare them to alternative intermittent mobilization techniques, particularly those with therapy starting from a flexed position.

Zilber S, Radier C, Postel JM, Van Driessche S, Allain J, Goutallier D. · Orthopedics and Bone Trauma Unit, Henri Mondor Teaching Hospital, Créteil School of Medicine (Paris XII University), Créteil Cedex, France. · J Shoulder Elbow Surg. · Pubmed #18387316 No free full text.

Abstract: Glenoid component loosening and superior humeral translation are common after Neer II total shoulder arthroplasty using the anterior approach. To determine whether the superior approach reduced these complications, we retrospectively reviewed 20 shoulders in 16 patients. Both components were cemented. Patient satisfaction, unweighted Constant score, and imaging studies were evaluated at a mean of 3.5 years and at a mean of 11.1 years. Fourteen patients were satisfied or very satisfied. The mean unweighted Constant score improved from 25/100 preoperatively to 57/100 after 3.5 years and to 51/100 after 11.1 years. Pain relief contrasted with low strength. Radiolucent lines appeared around 95% of glenoid components and 20% of humeral stems. Computed tomography showed severe glenoid osteolysis in 3 of 13 shoulders. Humeral superior translation did not occur. This study confirms the glenoid component fixation issue. The superior approach may reduce the risk of humeral superior translation and radiologic glenoid component loosening.

Goutallier D, Postel JM, Zilber S, Van Driessche S. · Orthopedics and Trauma Department, Henri Mondor Teaching Hospital, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France. · Joint Bone Spine. · Pubmed #14667550 No free full text.

Abstract: REPAIRING FULL THICKNESS CUFF TEARS.--Despite the sound rationale for repairing full-thickness rotator cuff tears, the procedure may fail to restore cuff integrity, which is indispensable to optimal cuff function. The functional role of each cuff muscle and the factors associated with anatomic failure (particularly those related to the muscles and tendons) provide a basis for rational patient selection and for determination of the best surgical strategy on a case-by-case basis. SHOULDER ARTHROPLASTY IN PATIENTS WITH GLENOHUMERAL JOINT DISEASE.--Total shoulder arthroplasty in patients with glenohumeral joint disease provides better outcomes than humeral hemiarthroplasty. The choice between a semi-constrained total prosthesis and a reverse constrained total prosthesis should be based on the nature of the joint disease (either centered humeral head or normal cuff function or migrated humeral head and abnormal cuff function). At present, only the semi-constrained total prosthesis has been proved effective in the long-term when used in a patient with a centered humeral head and active cuff. This provides additional support for repairing cuff tears whenever possible in patients who are still young.