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Papers by Philippe Landreau
Orthopaedic Journal of Sports Medicine, 2019
Annals of Translational Medicine, Nov 1, 2018
Orthopaedic Proceedings, Mar 1, 2002
Purpose: Arthroscopic reinsinsertion of rotator cuff tears is an alternative to surgical treatmen... more Purpose: Arthroscopic reinsinsertion of rotator cuff tears is an alternative to surgical treatment, but there is some question as to the reliability of this technique. The purpose of this work was to assess healing with arthroscan, MRI or ultrasonography after arthroscopic reinsertion of the supraspinatus. Material: There were 48 supraspinatus resections in 47 patients (27 men and 20 women), mean age 56 years (range 34–76 years). Thirty patients were active workers (109 manual labourers), seven were sedentary workers, and ten were retired. Mean initial Constant score was 40.56 (range 13–67). Arthroscan or MRI identified 48 full thickness tears of the supraspinatus (41 distal and seven intermediate tears, associated with twenty cleavages of the subspinatus, six cases of biceps tendonitis, and four lesions involving the upper third of the subscapularis. Methods: All patients underwent totally arthroscopic reinsertion of the supraspinatus. One tenotomy of the long biceps and three reinsertions of the upper third of the subscapularis were also performed. All patients were immobilised for six weeks. Passive rehabilitation was started immediately and active work was allowed after six weeks. Results: For this consecutive series of 48 supraspinatus reinsertions with a minimum 12 months follow-up, the Constant score at last follow-up was 76.77 (range 39–99). Arthroscan (n=40), ultrasonography (n=3) and MRI (n=1) were performed at six months to search for leakage and assess healing at the trochiter and cartilage level, aspect of the inferior aspect of the tendon and muscle degeneration. No leakage was observed in 37 cases, the tendon had a normal aspect in 15, with fringes in four cases, and in 12 cases there was a point leakage. Full thickness tear was found in seven cases. Clinical outcome was not correlated with operative technique or preoperative imaging. Discussion: These results in a preliminary series suggest that arthroscopic reinsertion of suprasinatus tears with little retraction is a reliable alternative to surgical reinsertion. The deltoid insertions are not disrupted and adherence phenomena and morbidity are reduced. Arthroscopy also allows complete exploration of the glenohumeral joint. Longer follow-up will be needed to determine the long-term outcome.
Springer eBooks, 2018
For a handball player, an anterior cruciate ligament (ACL) injury does not only represent a caree... more For a handball player, an anterior cruciate ligament (ACL) injury does not only represent a career-threatening injury in the short term but also a potential cause of osteoarthritis in the long term. ACL reconstruction is highly recommended in case of desire to resume handball practice. Many types of surgical techniques are currently available. Arthroscopic intra-articular ACL reconstruction with autologous tendon grafts is the first choice of treatment. In patients with big knee laxities, additional extraarticular stabilization may be required. Meniscus preservation is important for optimal knee function and for the prevention of osteoarthritis in the long term. Although most of the players will be able to return to sports (RTS) after ACL reconstruction, this cannot be guaranteed. RTS can generally be considered after a thorough rehabilitation period of 6–9 months. In young players under the age of 20, the risk of a secondary ACL injury of the contralateral knee or a recurrent graft tear in the operated knee is around 30%. For these reasons, return to sports should be preceded by functional assessments, including strength measurements and hop tests. The development of interdisciplinary strategies to bridge the frequent gap between physiotherapy and return to competition is highly recommended to allow for a safe RTS practice.
Journal De Traumatologie Du Sport, Mar 1, 2009
ABSTRACT Recurrent sprain after ligamentoplasty of the anterior cruciate ligament (ACL) raises th... more ABSTRACT Recurrent sprain after ligamentoplasty of the anterior cruciate ligament (ACL) raises the difficult problem of establishing the etiological diagnosis. Knees with a reconstructed ACL often present residual anterior laxity or an insufficiently controlled rotational stability. Careful examination of the healthy and damaged knee ligaments prior to the second traumatic event provides a double starting point for defining different anatomic and clinical entities. According to the IDKC ligament examination, the threshold of anterior laxity attesting to graft incompetence is 5 mm compared with the healthy side. Traumatic second tears are different, depending on the clinical context, from early anatomic failure or progressive distension. In the event the MRI shows a continuous graft with a low intensity signal, a careful physical examination and instrumental (KT 1000™) and radiographic assessment of laxity are required before confirming the integrity of the graft. Failure after major trauma simply reveals technical errors related to poor position of the bone tunnels. Persistence of intraosseous or meniscal high intensity signals after the first trauma may simulate recent lesions. Certain factors predisposing to recurrent sprains are analyzed in light of the authors’ experience and recent data in the literature.
British Journal of Sports Medicine, Jul 17, 2013
Journal of ISAKOS, Sep 1, 2021
Bony lesions are highly prevalent in anterior shoulder instability and can be a significant cause... more Bony lesions are highly prevalent in anterior shoulder instability and can be a significant cause of failure of stabilisation procedures if they are not adequately addressed. The glenoid track concept describes the dynamic interaction between the humeral head and glenoid defects in anterior shoulder instability. It has been beneficial for understanding the role played by bone defects in this entity. As a consequence, the popularity of glenoid augmentation procedures aimed to treat anterior glenoid bone defects; reconstructing the anatomy of the glenohumeral joint has risen sharply in the last decade. Although bone defects are less common in posterior instability, posterior bone block procedures can be indicated to treat not only posterior bony lesions, attritional posterior glenoid erosion or dysplasia but also normal or retroverted glenoids to provide an extended glenoid surface to increase the glenohumeral stability. The purpose of this review was to analyse the rationale, current indications and results of surgical techniques aimed to augment the glenoid surface in patients diagnosed of either anterior or posterior instability by assessing a thorough review of modern literature. Classical techniques such as Latarjet or free bone block procedures have proven to be effective in augmenting the glenoid surface and consequently achieving adequate shoulder stability with good clinical outcomes and early return to athletic activity. Innovations in surgical techniques have permitted to perform these procedures arthroscopically. Arthroscopy provides the theoretical advantages of lower morbidity and faster recovery, as well as the identification and treatment of concomitant pathologies.
Insights Into Imaging, Jan 8, 2016
Cartilage - Recent Findings and Treatment [Working Title]
Articular cartilage injuries are not uncommon finding in patients with anterior cruciate ligament... more Articular cartilage injuries are not uncommon finding in patients with anterior cruciate ligament (ACL) tear. There are several ways to address the cartilage injuries when encountered during ACL reconstruction. The favorable treatment of cartilage injuries during ACL reconstruction is controversial. Indeed, the treatment of cartilage injuries depends on multiple factors including patient variables and severity of lesion. It is unclear whether cartilage lesions affect the recovery after ACL reconstruction and vice versa. Whether ACL reconstruction has a preventive effect on further progression of cartilage lesions is also unclear. This chapter gives an overview of current literature related to cartilage injuries with ACL tear in terms of epidemiology, clinical presentation, and management.
MUSCULOSKELETAL SURGERY, 2019
Revue de chirurgie orthopédique et réparatrice de l'appareil moteur, 2008
Anterior cruciate ligament (ACL) reconstruction is increasingly proposed for patients aged over 4... more Anterior cruciate ligament (ACL) reconstruction is increasingly proposed for patients aged over 40 years. We report a retrospective analysis of a consecutive series of middle-aged patients who underwent ACL reconstruction surgery in order to analyze the development of meniscal and cartilage lesions and ascertain short-term outcome. Thirty-five patients aged over 40 years (mean 46.1 years) underwent hamstring ACL reconstruction, 19 for persistent instability after functional treatment and 16 after a recent tear in patients who wanted to resume their sports activities. Mean follow-up was 25 months. The IKDC 1993 score was noted as was the Arpege score for sports activity and Telos at 15 and 25kg. At the last follow-up, the IKDC score was A or B in 85% of patients. Among the first intention ligamentoplasties, 94% were scored A or B at last follow-up and all had a single leg jump test greater than 76%. Among patients operated on after failure of functional treatment, 79% were scored A o...
British Journal of Sports Medicine, 2013
Osteoarthritis of the knee
© Authors | Journal of Clinical Orthopaedics | Available on www.jcorth.com | doi:10.13107/jcorth.... more © Authors | Journal of Clinical Orthopaedics | Available on www.jcorth.com | doi:10.13107/jcorth.2021.v06i01.416 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Journal of Clinical Orthopaedics 2021 January-June; 6(1):45-52
Specific Sports-Related Injuries, 2021
Lower Extremity Joint Preservation, 2020
Orthopaedic Journal of Sports Medicine, 2019
Annals of Translational Medicine, Nov 1, 2018
Orthopaedic Proceedings, Mar 1, 2002
Purpose: Arthroscopic reinsinsertion of rotator cuff tears is an alternative to surgical treatmen... more Purpose: Arthroscopic reinsinsertion of rotator cuff tears is an alternative to surgical treatment, but there is some question as to the reliability of this technique. The purpose of this work was to assess healing with arthroscan, MRI or ultrasonography after arthroscopic reinsertion of the supraspinatus. Material: There were 48 supraspinatus resections in 47 patients (27 men and 20 women), mean age 56 years (range 34–76 years). Thirty patients were active workers (109 manual labourers), seven were sedentary workers, and ten were retired. Mean initial Constant score was 40.56 (range 13–67). Arthroscan or MRI identified 48 full thickness tears of the supraspinatus (41 distal and seven intermediate tears, associated with twenty cleavages of the subspinatus, six cases of biceps tendonitis, and four lesions involving the upper third of the subscapularis. Methods: All patients underwent totally arthroscopic reinsertion of the supraspinatus. One tenotomy of the long biceps and three reinsertions of the upper third of the subscapularis were also performed. All patients were immobilised for six weeks. Passive rehabilitation was started immediately and active work was allowed after six weeks. Results: For this consecutive series of 48 supraspinatus reinsertions with a minimum 12 months follow-up, the Constant score at last follow-up was 76.77 (range 39–99). Arthroscan (n=40), ultrasonography (n=3) and MRI (n=1) were performed at six months to search for leakage and assess healing at the trochiter and cartilage level, aspect of the inferior aspect of the tendon and muscle degeneration. No leakage was observed in 37 cases, the tendon had a normal aspect in 15, with fringes in four cases, and in 12 cases there was a point leakage. Full thickness tear was found in seven cases. Clinical outcome was not correlated with operative technique or preoperative imaging. Discussion: These results in a preliminary series suggest that arthroscopic reinsertion of suprasinatus tears with little retraction is a reliable alternative to surgical reinsertion. The deltoid insertions are not disrupted and adherence phenomena and morbidity are reduced. Arthroscopy also allows complete exploration of the glenohumeral joint. Longer follow-up will be needed to determine the long-term outcome.
Springer eBooks, 2018
For a handball player, an anterior cruciate ligament (ACL) injury does not only represent a caree... more For a handball player, an anterior cruciate ligament (ACL) injury does not only represent a career-threatening injury in the short term but also a potential cause of osteoarthritis in the long term. ACL reconstruction is highly recommended in case of desire to resume handball practice. Many types of surgical techniques are currently available. Arthroscopic intra-articular ACL reconstruction with autologous tendon grafts is the first choice of treatment. In patients with big knee laxities, additional extraarticular stabilization may be required. Meniscus preservation is important for optimal knee function and for the prevention of osteoarthritis in the long term. Although most of the players will be able to return to sports (RTS) after ACL reconstruction, this cannot be guaranteed. RTS can generally be considered after a thorough rehabilitation period of 6–9 months. In young players under the age of 20, the risk of a secondary ACL injury of the contralateral knee or a recurrent graft tear in the operated knee is around 30%. For these reasons, return to sports should be preceded by functional assessments, including strength measurements and hop tests. The development of interdisciplinary strategies to bridge the frequent gap between physiotherapy and return to competition is highly recommended to allow for a safe RTS practice.
Journal De Traumatologie Du Sport, Mar 1, 2009
ABSTRACT Recurrent sprain after ligamentoplasty of the anterior cruciate ligament (ACL) raises th... more ABSTRACT Recurrent sprain after ligamentoplasty of the anterior cruciate ligament (ACL) raises the difficult problem of establishing the etiological diagnosis. Knees with a reconstructed ACL often present residual anterior laxity or an insufficiently controlled rotational stability. Careful examination of the healthy and damaged knee ligaments prior to the second traumatic event provides a double starting point for defining different anatomic and clinical entities. According to the IDKC ligament examination, the threshold of anterior laxity attesting to graft incompetence is 5 mm compared with the healthy side. Traumatic second tears are different, depending on the clinical context, from early anatomic failure or progressive distension. In the event the MRI shows a continuous graft with a low intensity signal, a careful physical examination and instrumental (KT 1000™) and radiographic assessment of laxity are required before confirming the integrity of the graft. Failure after major trauma simply reveals technical errors related to poor position of the bone tunnels. Persistence of intraosseous or meniscal high intensity signals after the first trauma may simulate recent lesions. Certain factors predisposing to recurrent sprains are analyzed in light of the authors’ experience and recent data in the literature.
British Journal of Sports Medicine, Jul 17, 2013
Journal of ISAKOS, Sep 1, 2021
Bony lesions are highly prevalent in anterior shoulder instability and can be a significant cause... more Bony lesions are highly prevalent in anterior shoulder instability and can be a significant cause of failure of stabilisation procedures if they are not adequately addressed. The glenoid track concept describes the dynamic interaction between the humeral head and glenoid defects in anterior shoulder instability. It has been beneficial for understanding the role played by bone defects in this entity. As a consequence, the popularity of glenoid augmentation procedures aimed to treat anterior glenoid bone defects; reconstructing the anatomy of the glenohumeral joint has risen sharply in the last decade. Although bone defects are less common in posterior instability, posterior bone block procedures can be indicated to treat not only posterior bony lesions, attritional posterior glenoid erosion or dysplasia but also normal or retroverted glenoids to provide an extended glenoid surface to increase the glenohumeral stability. The purpose of this review was to analyse the rationale, current indications and results of surgical techniques aimed to augment the glenoid surface in patients diagnosed of either anterior or posterior instability by assessing a thorough review of modern literature. Classical techniques such as Latarjet or free bone block procedures have proven to be effective in augmenting the glenoid surface and consequently achieving adequate shoulder stability with good clinical outcomes and early return to athletic activity. Innovations in surgical techniques have permitted to perform these procedures arthroscopically. Arthroscopy provides the theoretical advantages of lower morbidity and faster recovery, as well as the identification and treatment of concomitant pathologies.
Insights Into Imaging, Jan 8, 2016
Cartilage - Recent Findings and Treatment [Working Title]
Articular cartilage injuries are not uncommon finding in patients with anterior cruciate ligament... more Articular cartilage injuries are not uncommon finding in patients with anterior cruciate ligament (ACL) tear. There are several ways to address the cartilage injuries when encountered during ACL reconstruction. The favorable treatment of cartilage injuries during ACL reconstruction is controversial. Indeed, the treatment of cartilage injuries depends on multiple factors including patient variables and severity of lesion. It is unclear whether cartilage lesions affect the recovery after ACL reconstruction and vice versa. Whether ACL reconstruction has a preventive effect on further progression of cartilage lesions is also unclear. This chapter gives an overview of current literature related to cartilage injuries with ACL tear in terms of epidemiology, clinical presentation, and management.
MUSCULOSKELETAL SURGERY, 2019
Revue de chirurgie orthopédique et réparatrice de l'appareil moteur, 2008
Anterior cruciate ligament (ACL) reconstruction is increasingly proposed for patients aged over 4... more Anterior cruciate ligament (ACL) reconstruction is increasingly proposed for patients aged over 40 years. We report a retrospective analysis of a consecutive series of middle-aged patients who underwent ACL reconstruction surgery in order to analyze the development of meniscal and cartilage lesions and ascertain short-term outcome. Thirty-five patients aged over 40 years (mean 46.1 years) underwent hamstring ACL reconstruction, 19 for persistent instability after functional treatment and 16 after a recent tear in patients who wanted to resume their sports activities. Mean follow-up was 25 months. The IKDC 1993 score was noted as was the Arpege score for sports activity and Telos at 15 and 25kg. At the last follow-up, the IKDC score was A or B in 85% of patients. Among the first intention ligamentoplasties, 94% were scored A or B at last follow-up and all had a single leg jump test greater than 76%. Among patients operated on after failure of functional treatment, 79% were scored A o...
British Journal of Sports Medicine, 2013
Osteoarthritis of the knee
© Authors | Journal of Clinical Orthopaedics | Available on www.jcorth.com | doi:10.13107/jcorth.... more © Authors | Journal of Clinical Orthopaedics | Available on www.jcorth.com | doi:10.13107/jcorth.2021.v06i01.416 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Journal of Clinical Orthopaedics 2021 January-June; 6(1):45-52
Specific Sports-Related Injuries, 2021
Lower Extremity Joint Preservation, 2020