📇 Rhumatologue · DIEPPE CEDEX · (76) · Salarié

MME MATHILDE OLLIVIER

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Auteur de référence en rhumatologie
23 articles scientifiques publiés — un praticien à la pointe de la recherche
Délais de RDV courts dans la région
119.2 rhumatos / 100 000 hab. — département bien doté

Rhumatologue

📍 DIEPPE CEDEX (76)SalariéRPPS 10101772142

📊 Reconnaissance scientifique : 3/100📝 9 articles publiés🇫🇷 Publications académiques françaises (5)

✨ Génération du profil synthétique IA en cours…

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Indicateurs publics agrégés sur 250 M+ d'œuvres scientifiques (OpenAlex, PubMed). Traduits ici en langage patient.

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Données ANS publiques (Licence Ouverte 2.0) · Enrichissements MonRhumato 100 % opt-in · Toute personne référencée peut demander la suppression ou la rectification.

Top publications · les plus citées

Osteotomy around the painful degenerative varus knee has broader indications than conventionally described but must follow a strict planning process: ESSKA Formal Consensus Part I

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2024

📚 38 citations🎯 RCR 20.66Top 1% NIH🔓 Open Access📄 PDF gratuit ↗

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AbstractPurposeThe European consensus was designed with the objective of combining science and expertise to produce recommendations that would educate and provide guidance in the treatment of the painful degenerative varus knee. Part I focused on indications and planning.MethodsNinety‐four orthopaedic surgeons from 24 European countries were involved in the consensus, which focused on the most common indications for osteotomy around the knee. The consensus was performed according to an established ESSKA methodology. The questions and recommendations made were initially designed by the consensus steering group. And ‘best possible’ answers were provided based upon the scientific evidence available and the experience of the experts. The statements produced were further evaluated by ratings and peer review groups before a final consensus was reached.ResultsThere is no reliable evidence to exclude patients based on age, gender or body weight. An individualised approach is advised; however, cessation of smoking is recommended. The same applies to lesser degrees of patellofemoral and lateral compartment arthritis, which may be accepted in certain situations. Good‐quality limb alignment and knee radiographs are a mandatory requirement for planning of osteotomies, and Paley's angles and normal ranges are recommended when undertaking deformity analysis. Emphasis is placed upon the correct level at which correction of varus malalignment is performed, which may involve double‐level osteotomy. This includes recognition of the importance of individual bone morphology and the maintenance of a physiologically appropriate joint line orientation.ConclusionThe indications of knee osteotomies for painful degenerative varus knees are broad. Part I of the consensus highlights the versatility of the procedure to address multiple scenarios with bespoke planning for each case. Deformity analysis is mandatory for defining the bone morphology, the site of the deformity and planning the correct procedure.Level of EvidenceLevel II, consensus.

Surgical strategy and complication management of osteotomy around the painful degenerative varus knee: ESSKA Formal Consensus Part II

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2024

📚 33 citations🎯 RCR 17.66Top 1% NIH🔓 Open Access📄 PDF gratuit ↗

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AbstractPurposeThe purpose of the European consensus was to provide recommendations for the treatment of patients with a painful degenerative varus knee using a joint preservation approach. Part II focused on surgery, rehabilitation and complications after tibial or femoral correction osteotomy.MethodsNinety‐four orthopaedic surgeons from 24 countries across Europe were involved in the consensus, which focused on osteotomies around the knee. The consensus was performed according to the European Society for Sports Traumatology, Knee Surgery and Arthroscopy consensus methodology. The steering group designed the questions and prepared the statements based on the experience of the experts and the evidence of the literature. The statements were evaluated by the ratings of the peer‐review groups before a final consensus was released.ResultsThe ideal hinge position for medial opening wedge high tibial osteotomy (MOW HTO) should be at the upper level of the proximal tibiofibular joint, and for lateral closing wedge distal femoral osteotomy (LCW DFO) just above the medial femoral condyle. Hinge protection is not mandatory. Biplanar osteotomy cuts provide more stability and quicker bony union for both MOW HTO and LCW DFO and are especially recommended for the latter. Osteotomy gap filling is not mandatory, unless structural augmentation for stability is required. Patient‐specific instrumentation should be reserved for complex cases by experienced hands. Early full weight‐bearing can be adopted after osteotomy, regardless of the technique. However, extra caution should be exercised in DFO patients. Osteotomy patients should return to sports within 6 months.ConclusionClear recommendations for surgical strategy, rehabilitation and complications of knee osteotomies for the painful degenerative varus knee were demonstrated. In Part 2 of the consensus, high levels of agreement were reached by experts throughout Europe, under variable working conditions. Where science is limited, the collated expertise of the collaborators aimed at providing guidance for orthopaedic surgeons developing an interest in the field and highlighting areas for potential future research.Level of EvidenceLevel II, consensus.

A significant rate of tibial overcorrection with an increased JLO occurred after isolated high tibial osteotomy without considering international consensus

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023

📚 27 citations🎯 RCR 9.29Top 3% NIH🔓 Open Access📄 PDF gratuit ↗

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AbstractPurposeThe recent ESSKA consensus recommendations defined indications and outlined parameters for osteotomies around a degenerative varus knee. The consensus collated these guidelines based on the published literature available to answer commonly asked questions including the importance of identifying the site and degree of the lower limb deformity. In the consensus, the authors suggest that a knee joint line obliquity (JLO) greater than 5° or a planned medial proximal tibial angle (MPTA) > 94° preferentially indicates a double level osteotomy (DLO) compared to an isolated opening wedge high tibial osteotomy (OWHTO). This study aimed to analyze the corrections performed on a cohort of isolated opening wedge high tibial osteotomies (OWHTOs) prior to the recent ESSKA recommendations, with a focus on the impact of knee joint line obliquity (JLO) and medial proximal tibial angle (MPTA) on the choice of osteotomy procedure.MethodsThis monocentric, retrospective study included 129 patients undergoing medial OWHTO for symptomatic isolated medial knee osteoarthritis (Ahlbäck grade I or II) and a global varus malalignment (hip–knee–ankle angle ≤ 177°). An automated software trained to automatically detect lower limb deformity was implemented using patients preoperative long leg alignment X‐rays to identify suitability for an isolated HTO in knee varus deformity. Based on the ESSKA recommendations, the site of the osteotomy was identified as well as the degree of correction required. The ESSKA consensus considers avoiding an isolated high tibial osteotomy if the planned resultant knee joint line orientation exceeds 5 ̊ or MPTA exceeds 94°. A preoperative abnormal MPTA was defined by a value lower than 85° and a preoperative abnormal LDFA by a value greater than 90°. The cases of DLO or DFO suggested by the software and the number of extra‐tibial anomalies were collected. Multiple linear regression models were developed to establish a relationship between preoperative values and the risk of being outside of ESSKA recommendations postoperatively.ResultsBased on ESSKA recommendations and on threshold values considered abnormal, the software suggested a DLO in 17.8% (n = 23/129) of cases, a distal femoral osteotomy in 27.9% (n = 36/129) of cases and advised against an osteotomy procedure in 24% (n = 31/129) of cases. The software detected a femoral anomaly in 34.9% (n = 45/129) of cases and an JLCA > 6° in 9.3% (n = 12/129). Postoperatively, the MPTA exceeds 94° in 41.1% (n = 53/129) and the JLO exceeds 5° in 29.4% (n = 38/129).On multivariate analysis, a high preoperative MPTA was associated with higher risk of postoperative MPTA > 94° (R2 = 0.36; p < 0.001). Similarly, the probability of the software advising a DLO or DFO was associated with the presence of an “normal” preoperative MPTA (R2 = 0.42; p < 0.001) or an abnormal preoperative LDFA (R2 = 0.48; p < 0.001) or a planned JLO > 5° (R2 = 0.27; p < 0.001).ConclusionsAnalysis of patients who underwent an isolated OWHTO prior to the ESSKA guidelines, demonstrated a significant rate of post‐operative tibial overcorrection and a resultant increased JLO. Pre‐operative planning that considers the ESSKA guidelines, allows for better identification of those patients requiring a DFO or DLO and avoidance of resultant post‐operative deformities.Level of evidenceIV, case‐series.

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MME MATHILDE OLLIVIER

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Top publications · les plus citées

Publications scientifiques (23) — classées par pathologie

Transversal16

Recommandations4

IRM ostéo-articulaire1

Qualité de vie / PROMs1

Revue / méta-analyse1

Revue générale1

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