Browsing by Author "Lalevee, Matthieu"

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    ItemOpen Access
    An Objective Computational Method to Quantify Ankle Osteoarthritis From Low-Dose Weightbearing Computed Tomography.
    (Foot & ankle orthopaedics, 2022-07) Tazegul, Tutku E; Anderson, Donald D; Barbachan Mansur, Nacime S; Kajimura Chinelati, Rogerio Marcio; Iehl, Caleb; VandeLune, Christian; Ahrenholz, Samuel; Lalevee, Matthieu; de Cesar Netto, Cesar

    Background

    The treatment of ankle osteoarthritis (OA) varies depending on the severity and distribution of the associated joint degeneration. Disease staging is typically based on subjective grading of appearance on conventional plain radiographs, with reported subpar reproducibility and reliability. The purpose of this study was to develop and describe computational methods to objectively quantify radiographic changes associated with ankle OA apparent on low-dose weightbearing CT (WBCT).

    Methods

    Two patients with ankle OA and 1 healthy control who had all undergone WBCT of the foot and ankle were analyzed. The severity of OA in the ankle of each patient was scored using the Kellgren-Lawrence (KL) classification using plain radiographs. For each ankle, a volume of interest (VOI) was centered on the tibiotalar joint. Initial computation analysis used WBCT image intensity (Hounsfield units [HU]) profiles along lines perpendicular to the subchondral bone/cartilage interface of the distal tibia extending across the entire VOI. Graphical plots of the HU distributions were generated and recorded for each line. These plots were then used to calculate the joint space width (JSW) and HU contrast.

    Results

    The average JSW was 3.89 mm for the control ankle, 3.06 mm for mild arthritis (KL 2), and 1.57 mm for severe arthritis (KL 4). The average HU contrast was 72.31 for control, 62.69 for mild arthritis, and 33.98 for severe arthritis. The use of 4 projections at different locations throughout the joint allowed us to visualize specifically which quadrants have reduced joint space width and contrast.

    Conclusion

    In this technique report, we describe a novel methodology for objective quantitative assessment of OA using JSW and HU contrast.

    Clinical relevance

    Objective, software-based measurements are generally more reliable than subjective qualitative evaluations. This method may offer a starting point for the development of a more robust OA classification system or deeper understanding of the pathogenesis and response to ankle OA treatment.
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    ItemOpen Access
    Correction to: Flexor tenodesis procedure in the treatment of lesser toe deformities.
    (Archives of orthopaedic and trauma surgery, 2022-11) de Cesar Netto, Cesar; Schmidt, Eli L; Lalevee, Matthieu; Mansur, Nacime Salomao Barbachan
    The article Flexor tenodesis procedure in the treatment of lesser toe deformities, written by Cesar de Cesar Netto, Eli L. Schmidt, Matthieu Lalevee and Nacime Salomao Barbachan Mansur, was originally published electronically on the publisher’s internet portal on 11 May 2021 without open access. With the author(s)’ decision to opt for Open Choice the copyright of the article changed on 30 June 2021 to © The Author(s) 2021 and this article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/. The original article has been corrected.
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    ItemOpen Access
    Early results and complication rate of the LapiCotton procedure in the treatment of medial longitudinal arch collapse: a prospective cohort study.
    (Archives of orthopaedic and trauma surgery, 2023-05) de Cesar Netto, Cesar; Ehret, Amanda; Walt, Jennifer; Chinelati, Rogerio Marcio Kajimura; Dibbern, Kevin; Dibbern, Kevin; de Carvalho, Kepler Alencar Mendes; Tazegul, Tutku Erim; Lalevee, Matthieu; Mansur, Nacime Salomão Barbachan

    Introduction

    Instability/collapse of the medial column has been associated with many conditions, particularly progressive collapsing foot deformity (PCFD), hallux valgus (HV), and midfoot arthritis (MA). Restoration of first ray length and sagittal plane alignment to restore the foot tripod is essential when treating these deformities. This study aimed to assess early results, healing, and complication rate of a distraction dorsal opening plantarflexion wedge allograft first tarsometatarsal joint fusion (LapiCotton Procedure) in patients with collapse/instability of the medial column.

    Methods

    In this prospective cohort study, we included PCFD, HV, and MA patients that underwent a LapiCotton procedure. Fusion site healing was defined by > 50% bone bridging in both interfaces between allograft wedge and host bone using weight-bearing computed tomography (WBCT) after 3 months. First ray collapse radiographic correction and minor and major complications (deep dehiscence, deep infection, and reoperation) were assessed.

    Results

    A total of 22 patients (22 feet) were included (11 PCFD, 6 MA, and 5 of HV patients). Mean follow-up was 5.9 months (range 3-12) and median allograft size was 8 mm (range 5-19 mm). Bone healing was observed in 91% of cases. Two minor complications (9%, both superficial dehiscence) and one major complication (4.5%, deep infection) were observed. Statistically significant improvement of the sagittal plane talus-first metatarsal angle was observed, with mean improvement of 9.4° (95% CI 6.7-12.1°; p < 0.0001).

    Conclusion

    In this prospective cohort study of 22 patients treated with the LapiCotton procedure for medial longitudinal arch collapse/instability, we observed a low complication rate (9% minor, 4.5% major), high healing rate after 3 months (91%), one clinically stable radiographic non-union (4.5%) and one unstable non-union (4.5%) needing reoperation. Our results demonstrate promising initial results for LapiCotton technique in treating collapse of the medial longitudinal arch in patients with PCFD, MA and HV deformities. Long-term results are needed to confirm these promising results.

    Level of evidence

    Level II, prospective cohort study.
  • Thumbnail Image
    ItemOpen Access
    Flexor tenodesis procedure in the treatment of lesser toe deformities.
    (Archives of orthopaedic and trauma surgery, 2022-11) de Cesar Netto, Cesar; Schmidt, Eli L; Lalevee, Matthieu; Mansur, Nacime Salomao Barbachan
    In this technical report study, we describe the use of a flexor tenodesis procedure in the treatment of lesser toe deformities (LTD). Using a specific implant, both the flexor digitorum longus and brevis tendons are attached to the plantar aspect of the proximal phalanx, allowing dynamic correction of flexible deformities of metatarsophalangeal and interphalangeal joints. Good clinical results and absence of complications were observed in a series of 3 patients, with considerable correction of the LTD, and absence of substantial residual floating toe or metatarsophalangeal joint stiffness. LEVEL OF EVIDENCE: V - Technical Report/Case Report/Expert Opinion.