F. Savoie - Academia.edu (original) (raw)
Papers by F. Savoie
Arthroscopy, Jun 1, 2016
femoral ligament (MQTFL) has been described in the treatment of patellar instability. The purpose... more femoral ligament (MQTFL) has been described in the treatment of patellar instability. The purpose of this study was to identify and describe the anatomic midpoint of the anterior attachment of the combined MPFL and MQTFL (termed the medial patellofemoral complex [MPFC]). Methods: Photographs of 31 cadaveric knee dissections were available for computer-assisted analysis. Using AutoCAD software, a bisecting line was created to identify the midpoint of the MPFC attachment. An anatomic reference point was identified at the intersection of the line along the medial border of the quadriceps tendon and the superior articular border of the patella (P1), and the distance to the midpoint was calculated on the basis of the patellar articular length (PAL). Results: Of the 31 cadaveric knee photographs, 25 had appropriate quality and landmarks for digital analysis. Of these 25 knees, 22 had MPFL and MQTFL fibers, 2 had MQTFL fibers only, and 1 had MPFL fibers only. The midpoint of the MPFC was 3.2 AE 5.9 mm (9.0% AE 16.4% PAL) proximal to P1. After exclusion of the 2 knees with MQTFL fibers only, the MPFC midpoint was 1.9 AE 3.1 mm (5.3% AE 8.6% PAL) proximal to P1. In all knees, the anatomic midpoint of the MPFC was at or proximal to the level of P1. Conclusion: In our anatomic study, the midpoint of the MPFC was found to be at or proximal to the junction of the medial border of the quadriceps tendon and superior pole of the patella. Given the risk of patellar fracture after traditional MPFL reconstruction, further consideration should be given to the analogous MQTFL reconstruction as a potentially safer and more anatomic alternative in the treatment of patellar instability.
Arthroscopy, Jun 1, 2016
Surgeries; 31 pitchers (13.2%) underwent revision surgery. 37% underwent revision within 3 years ... more Surgeries; 31 pitchers (13.2%) underwent revision surgery. 37% underwent revision within 3 years of their index procedure. 26 revisions had more than 2year follow up; 17 pitchers (65.4%) returned to pitch at least one major league game while only 11 pitchers (42.3%) returned to pitch ten or more games. Of those who returned to MLB competition, the average length of recovery was 20.76 months. Compared to age-and position-matched controls, MLB pitchers undergoing revision surgery had a statistically shorter career following revision surgery (4.9 vs 2.6 seasons, p ¼ 0.002), and pitched fewer innings and total pitches per season. Conclusion: The rate of revision Tommy John surgery is substantially higher than previously reported. For MLB pitchers, return to play after revision surgery is much lower than after primary reconstruction. Overall, the durability of MLB pitchers following revision UCL reconstruction decreases significantly compared to age-and position-matched controls.
Southern Medical Journal, 1991
Journal of Shoulder and Elbow Surgery, 1996
Journal of Shoulder and Elbow Surgery, 1995
Orthopedics, 1991
Eighteen consecutive patients with posterior cruciate ligament injury and associated pathology we... more Eighteen consecutive patients with posterior cruciate ligament injury and associated pathology were reviewed. All were re-examined with an average follow up of 5.4 years (range: 3.5 to 7.5). Six posterior cruciate ligaments were repaired to the femur with multiple #2 nonabsorbable suture, and one "mop end" mid-substance tear was repaired with sutures in each stump. Seven mid-substance tears were repaired and augmented with the semitendinosus tendon, while four additional mid-substance tears were repaired and augmented with the semitendinosus tendon and a Dacron stent (Meadox). One medial meniscus was repaired and one was partially excised, and one lateral meniscus tear was partially excised. The anterior cruciate ligament was repaired to the tibia in two knees, left alone (interstitial tear) in two, and excised with extraarticular iliotibial band tenodesis augmentation in five. At follow up, arthrometer readings (Stryker) correlated well with clinical examination. The four...
Clinical Orthopaedics and Related Research, 1993
Forty-three comminuted fractures of the proximal radius and ulna in 34 patients were treated with... more Forty-three comminuted fractures of the proximal radius and ulna in 34 patients were treated with operative stabilization using AO/ASIF techniques. The patients were divided into three groups, according to the type of injury: Group I, isolated comminuted fractures of the olecranon (18 patients); Group 11, isolated fractures of the radial head (eight patientsk Group III, combined olecranon and radial head fractures (eight patients). All fractures were followed until union. The average follow-up period was 18 months (range, 12-48 months). At the time of this review, the average limits of elbow motion were 20" extension, 118" flexion, 65" pronation, and 62" supination. Two patients were unable to return for follow-up examination. Using the functional classification of Broberg and Morrey, results were rated as excellent in nine cases, good in 15, fair in five, and poor in three. The complication rate in this series was 19%: Two patients developed nonunion, and one patient lost reduction during rehabilitation. All of these patients required reoperation, with eventual satisfactory outcome. Three patients developed heterotopic ossification, two of which were minor and one of which produced ankylosis of the elbow joint. Each of these patients had delayed (more than 72 hours postinjury) stabilization. A functional elbow was achieved in 29 of the 32 patients who returned for follow-up examination. Operative stabilition of comminuted fractures of the proximal radius and ulna provides a stable painless joint with a functional, but not full, range of motion.
Archives of Orthopaedic and Trauma Surgery, 2005
Introduction: Numerous operative procedures have been described for the reconstruction of acromio... more Introduction: Numerous operative procedures have been described for the reconstruction of acromioclavicular joint separation; however, the arthroscopic reconstruction has been rarely reported. Therefore, our objective was to propose a new technique of arthroscopic acromioclavicular joint surgery and to evaluate the preliminary results. Materials and methods: Thirteen patients with a mean follow-up of 18 months underwent the arthroscopic acromioclavicular joint reconstruction using suture anchors and small titanium plate. The average age was 40.2 years (range 23-54 years). The shoulders were evaluated using Constant score and radiographs. The indications for surgery included acromioclavicular joint dislocation Rockwood type IV-V. Results: Twelve patients returned to their work without pain within 3 months after operation. The average Constant score at last follow-up was 95. Postoperative radiographs confirmed anatomic reduction in ten patients, residual subluxation in two patients and redislocation of the joint in one patient. One patient had radiographic evidence of coracoclavicular ossification. All patients but one were satisfied with results and cosmetic appearance. Conclusion: Considering its less morbidity, excellent cosmesis, no need of hardware removal, and minimal complications from breakage or migration of metal implants, this new technique offers an attractive alternative in acromioclavicular joint stabilization.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2021
PURPOSE The purpose of this study was to perform a Delphi consensus for the treatment of patients... more PURPOSE The purpose of this study was to perform a Delphi consensus for the treatment of patients with shoulder impingement with intact rotator cuff tendons, comparing North American to European shoulder surgeon preferences. METHODS Nineteen surgeons from North America [NAP] and 18 surgeons from Europe [EP] agreed to participate and answered 10 open-ended questions in rounds 1 and 2. The results of the first two rounds were used to develop a Likert style questionnaire for round 3. If agreement at round 3 was <60% for an item, the results were carried forward into round 4. For round 4 the panel members outside consensus >60%, <80%) were contacted and asked to review their response. The level of agreement and consensus was defined as 80%. RESULTS There was agreement on the following items: impingement is a clinical diagnosis; a combination of clinical tests should be used; other pain generators must be excluded; radiographs must be part of the work up; MR imaging is helpful; the first line of treatment should always be physiotherapy; a corticosteroid injection is helpful in reducing symptoms; indication for surgery is failure of non-operative treatment for a minimum of 6 months. The NAP were likely to routinely prescribe NSAIDs [NA 89%; EU 35%] and consider steroids for impingement [NA 89%. EU 65%]. CONCLUSION Consensus was achieved for 16 of the 71 Likert items: impingement is a clinical diagnosis and a combination of clinical tests should be used. The first line of treatment should always be physiotherapy, and a corticosteroid injection can be helpful in reducing symptoms. The indication for surgery is failure of non-operative treatment for a minimum of 6 months. The panel also agreed that SAD is a good choice for shoulder impingement if there is evidence of mechanical impingement with pain not responding to non-surgical measures.
Morrey's the Elbow and its Disorders, 2018
Journal of shoulder and elbow surgery, 2018
Welcome to the JSES Fellows Issue Many years ago, the American Shoulder and Elbow Surgeons (ASES)... more Welcome to the JSES Fellows Issue Many years ago, the American Shoulder and Elbow Surgeons (ASES) conceived the idea of a symposium in which current ASES fellows would be able to present early, original research. The ASES hoped that all fellows would be able to experience a dedicated shoulder and elbow course, converse with current ASES members and with each other, and be able to obtain a jump start on their shoulder and elbow careers. Through much effort from many members, but especially due to the organization and planning by Jeff Abrams, J.P. Warner, and especially Jim Esch, the idea came to fruition. In 2017, the San Diego Shoulder Institute and ASES were pleased to welcome the graduates of ASES accredited fellowships to present the research completed during their fellowship year. Special thanks go to the San Diego Shoulder Institute Board of Directors and to Ms. Larky Blunk for their gracious help and teamwork.
Journal of the Mississippi State Medical Association, 1993
Six consecutive patients with a stiff, painful, nonfunctional elbow were reconstructed utilizing ... more Six consecutive patients with a stiff, painful, nonfunctional elbow were reconstructed utilizing a semicontrained total elbow prosthetic replacement. All patients had multiple previous surgical procedures with unsuccessful results. The average preoperative flexion (80 degrees) and extension (-60 degrees) improved to 130 degrees to -10 degrees respectively. All patients were able to regain satisfactory use of the elbow without pain.
Orthopedics, 1987
In a retrospective review of 80 tibial plateau fractures, 28 fractures were treated nonoperativel... more In a retrospective review of 80 tibial plateau fractures, 28 fractures were treated nonoperatively with a variety of closed methods and 52 were treated with open reduction and internal fixation using AO technique. At an average follow up of 24 months, a satisfactory result was obtained in 87% of the operatively treated patients and in 66% of those treated nonoperatively. It appears that stable, minimally displaced fractures do equally well with closed or open treatment. Patients with depressed, displaced, or unstable fractures did better with operative treatment. When operative treatment is planned the principles and techniques of internal fixation should be carefully followed.
Orthopedics, 1989
Eleven patients with 12 three-part fractures of the proximal humerus were treated by open reducti... more Eleven patients with 12 three-part fractures of the proximal humerus were treated by open reduction and internal fixation using AO/ASIF buttress plating. All of the fractures healed. There were no failures of fixation. Nine of these patients returned for a follow up of more than 2 years and had a satisfactory rating using Neer's shoulder rating system. Five patients who had an acromioplasty at the time of their initial surgery had slightly better function and range of motion than the remaining patients. Successful operative treatment requires accurate definition of the fracture pattern, careful attention to the details of internal fixation, and supervised postoperative rehabilitation.
Athletic Therapy Today, 2000
Journal of Shoulder and Elbow Surgery, 2019
Clinics in Sports Medicine, 2018
The subscapularis-sparing approach in humeral head replacement, 606-12, Copyright 2015. Disclosur... more The subscapularis-sparing approach in humeral head replacement, 606-12, Copyright 2015. Disclosure Statement: See last page of article.
Instructional course lectures
Instructional course lectures
Arthroscopy, Jun 1, 2016
femoral ligament (MQTFL) has been described in the treatment of patellar instability. The purpose... more femoral ligament (MQTFL) has been described in the treatment of patellar instability. The purpose of this study was to identify and describe the anatomic midpoint of the anterior attachment of the combined MPFL and MQTFL (termed the medial patellofemoral complex [MPFC]). Methods: Photographs of 31 cadaveric knee dissections were available for computer-assisted analysis. Using AutoCAD software, a bisecting line was created to identify the midpoint of the MPFC attachment. An anatomic reference point was identified at the intersection of the line along the medial border of the quadriceps tendon and the superior articular border of the patella (P1), and the distance to the midpoint was calculated on the basis of the patellar articular length (PAL). Results: Of the 31 cadaveric knee photographs, 25 had appropriate quality and landmarks for digital analysis. Of these 25 knees, 22 had MPFL and MQTFL fibers, 2 had MQTFL fibers only, and 1 had MPFL fibers only. The midpoint of the MPFC was 3.2 AE 5.9 mm (9.0% AE 16.4% PAL) proximal to P1. After exclusion of the 2 knees with MQTFL fibers only, the MPFC midpoint was 1.9 AE 3.1 mm (5.3% AE 8.6% PAL) proximal to P1. In all knees, the anatomic midpoint of the MPFC was at or proximal to the level of P1. Conclusion: In our anatomic study, the midpoint of the MPFC was found to be at or proximal to the junction of the medial border of the quadriceps tendon and superior pole of the patella. Given the risk of patellar fracture after traditional MPFL reconstruction, further consideration should be given to the analogous MQTFL reconstruction as a potentially safer and more anatomic alternative in the treatment of patellar instability.
Arthroscopy, Jun 1, 2016
Surgeries; 31 pitchers (13.2%) underwent revision surgery. 37% underwent revision within 3 years ... more Surgeries; 31 pitchers (13.2%) underwent revision surgery. 37% underwent revision within 3 years of their index procedure. 26 revisions had more than 2year follow up; 17 pitchers (65.4%) returned to pitch at least one major league game while only 11 pitchers (42.3%) returned to pitch ten or more games. Of those who returned to MLB competition, the average length of recovery was 20.76 months. Compared to age-and position-matched controls, MLB pitchers undergoing revision surgery had a statistically shorter career following revision surgery (4.9 vs 2.6 seasons, p ¼ 0.002), and pitched fewer innings and total pitches per season. Conclusion: The rate of revision Tommy John surgery is substantially higher than previously reported. For MLB pitchers, return to play after revision surgery is much lower than after primary reconstruction. Overall, the durability of MLB pitchers following revision UCL reconstruction decreases significantly compared to age-and position-matched controls.
Southern Medical Journal, 1991
Journal of Shoulder and Elbow Surgery, 1996
Journal of Shoulder and Elbow Surgery, 1995
Orthopedics, 1991
Eighteen consecutive patients with posterior cruciate ligament injury and associated pathology we... more Eighteen consecutive patients with posterior cruciate ligament injury and associated pathology were reviewed. All were re-examined with an average follow up of 5.4 years (range: 3.5 to 7.5). Six posterior cruciate ligaments were repaired to the femur with multiple #2 nonabsorbable suture, and one "mop end" mid-substance tear was repaired with sutures in each stump. Seven mid-substance tears were repaired and augmented with the semitendinosus tendon, while four additional mid-substance tears were repaired and augmented with the semitendinosus tendon and a Dacron stent (Meadox). One medial meniscus was repaired and one was partially excised, and one lateral meniscus tear was partially excised. The anterior cruciate ligament was repaired to the tibia in two knees, left alone (interstitial tear) in two, and excised with extraarticular iliotibial band tenodesis augmentation in five. At follow up, arthrometer readings (Stryker) correlated well with clinical examination. The four...
Clinical Orthopaedics and Related Research, 1993
Forty-three comminuted fractures of the proximal radius and ulna in 34 patients were treated with... more Forty-three comminuted fractures of the proximal radius and ulna in 34 patients were treated with operative stabilization using AO/ASIF techniques. The patients were divided into three groups, according to the type of injury: Group I, isolated comminuted fractures of the olecranon (18 patients); Group 11, isolated fractures of the radial head (eight patientsk Group III, combined olecranon and radial head fractures (eight patients). All fractures were followed until union. The average follow-up period was 18 months (range, 12-48 months). At the time of this review, the average limits of elbow motion were 20" extension, 118" flexion, 65" pronation, and 62" supination. Two patients were unable to return for follow-up examination. Using the functional classification of Broberg and Morrey, results were rated as excellent in nine cases, good in 15, fair in five, and poor in three. The complication rate in this series was 19%: Two patients developed nonunion, and one patient lost reduction during rehabilitation. All of these patients required reoperation, with eventual satisfactory outcome. Three patients developed heterotopic ossification, two of which were minor and one of which produced ankylosis of the elbow joint. Each of these patients had delayed (more than 72 hours postinjury) stabilization. A functional elbow was achieved in 29 of the 32 patients who returned for follow-up examination. Operative stabilition of comminuted fractures of the proximal radius and ulna provides a stable painless joint with a functional, but not full, range of motion.
Archives of Orthopaedic and Trauma Surgery, 2005
Introduction: Numerous operative procedures have been described for the reconstruction of acromio... more Introduction: Numerous operative procedures have been described for the reconstruction of acromioclavicular joint separation; however, the arthroscopic reconstruction has been rarely reported. Therefore, our objective was to propose a new technique of arthroscopic acromioclavicular joint surgery and to evaluate the preliminary results. Materials and methods: Thirteen patients with a mean follow-up of 18 months underwent the arthroscopic acromioclavicular joint reconstruction using suture anchors and small titanium plate. The average age was 40.2 years (range 23-54 years). The shoulders were evaluated using Constant score and radiographs. The indications for surgery included acromioclavicular joint dislocation Rockwood type IV-V. Results: Twelve patients returned to their work without pain within 3 months after operation. The average Constant score at last follow-up was 95. Postoperative radiographs confirmed anatomic reduction in ten patients, residual subluxation in two patients and redislocation of the joint in one patient. One patient had radiographic evidence of coracoclavicular ossification. All patients but one were satisfied with results and cosmetic appearance. Conclusion: Considering its less morbidity, excellent cosmesis, no need of hardware removal, and minimal complications from breakage or migration of metal implants, this new technique offers an attractive alternative in acromioclavicular joint stabilization.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2021
PURPOSE The purpose of this study was to perform a Delphi consensus for the treatment of patients... more PURPOSE The purpose of this study was to perform a Delphi consensus for the treatment of patients with shoulder impingement with intact rotator cuff tendons, comparing North American to European shoulder surgeon preferences. METHODS Nineteen surgeons from North America [NAP] and 18 surgeons from Europe [EP] agreed to participate and answered 10 open-ended questions in rounds 1 and 2. The results of the first two rounds were used to develop a Likert style questionnaire for round 3. If agreement at round 3 was <60% for an item, the results were carried forward into round 4. For round 4 the panel members outside consensus >60%, <80%) were contacted and asked to review their response. The level of agreement and consensus was defined as 80%. RESULTS There was agreement on the following items: impingement is a clinical diagnosis; a combination of clinical tests should be used; other pain generators must be excluded; radiographs must be part of the work up; MR imaging is helpful; the first line of treatment should always be physiotherapy; a corticosteroid injection is helpful in reducing symptoms; indication for surgery is failure of non-operative treatment for a minimum of 6 months. The NAP were likely to routinely prescribe NSAIDs [NA 89%; EU 35%] and consider steroids for impingement [NA 89%. EU 65%]. CONCLUSION Consensus was achieved for 16 of the 71 Likert items: impingement is a clinical diagnosis and a combination of clinical tests should be used. The first line of treatment should always be physiotherapy, and a corticosteroid injection can be helpful in reducing symptoms. The indication for surgery is failure of non-operative treatment for a minimum of 6 months. The panel also agreed that SAD is a good choice for shoulder impingement if there is evidence of mechanical impingement with pain not responding to non-surgical measures.
Morrey's the Elbow and its Disorders, 2018
Journal of shoulder and elbow surgery, 2018
Welcome to the JSES Fellows Issue Many years ago, the American Shoulder and Elbow Surgeons (ASES)... more Welcome to the JSES Fellows Issue Many years ago, the American Shoulder and Elbow Surgeons (ASES) conceived the idea of a symposium in which current ASES fellows would be able to present early, original research. The ASES hoped that all fellows would be able to experience a dedicated shoulder and elbow course, converse with current ASES members and with each other, and be able to obtain a jump start on their shoulder and elbow careers. Through much effort from many members, but especially due to the organization and planning by Jeff Abrams, J.P. Warner, and especially Jim Esch, the idea came to fruition. In 2017, the San Diego Shoulder Institute and ASES were pleased to welcome the graduates of ASES accredited fellowships to present the research completed during their fellowship year. Special thanks go to the San Diego Shoulder Institute Board of Directors and to Ms. Larky Blunk for their gracious help and teamwork.
Journal of the Mississippi State Medical Association, 1993
Six consecutive patients with a stiff, painful, nonfunctional elbow were reconstructed utilizing ... more Six consecutive patients with a stiff, painful, nonfunctional elbow were reconstructed utilizing a semicontrained total elbow prosthetic replacement. All patients had multiple previous surgical procedures with unsuccessful results. The average preoperative flexion (80 degrees) and extension (-60 degrees) improved to 130 degrees to -10 degrees respectively. All patients were able to regain satisfactory use of the elbow without pain.
Orthopedics, 1987
In a retrospective review of 80 tibial plateau fractures, 28 fractures were treated nonoperativel... more In a retrospective review of 80 tibial plateau fractures, 28 fractures were treated nonoperatively with a variety of closed methods and 52 were treated with open reduction and internal fixation using AO technique. At an average follow up of 24 months, a satisfactory result was obtained in 87% of the operatively treated patients and in 66% of those treated nonoperatively. It appears that stable, minimally displaced fractures do equally well with closed or open treatment. Patients with depressed, displaced, or unstable fractures did better with operative treatment. When operative treatment is planned the principles and techniques of internal fixation should be carefully followed.
Orthopedics, 1989
Eleven patients with 12 three-part fractures of the proximal humerus were treated by open reducti... more Eleven patients with 12 three-part fractures of the proximal humerus were treated by open reduction and internal fixation using AO/ASIF buttress plating. All of the fractures healed. There were no failures of fixation. Nine of these patients returned for a follow up of more than 2 years and had a satisfactory rating using Neer's shoulder rating system. Five patients who had an acromioplasty at the time of their initial surgery had slightly better function and range of motion than the remaining patients. Successful operative treatment requires accurate definition of the fracture pattern, careful attention to the details of internal fixation, and supervised postoperative rehabilitation.
Athletic Therapy Today, 2000
Journal of Shoulder and Elbow Surgery, 2019
Clinics in Sports Medicine, 2018
The subscapularis-sparing approach in humeral head replacement, 606-12, Copyright 2015. Disclosur... more The subscapularis-sparing approach in humeral head replacement, 606-12, Copyright 2015. Disclosure Statement: See last page of article.
Instructional course lectures
Instructional course lectures