Docteur PATRICIA WINKLER

Livres & ouvrages

• 

  Bach-Blütentherapie

  2010 · 96 p.

• 📕

  LES MONOARTHRITES INFLAMMATOIRES DE LA HANCHE OU COXITES

  DIAGNOSTIC, DEVENIR, TRAITEMENT; A PROPOS DE HUIT CAS

  1985 · 146 p.

Source : Google Books — filtre catégories médicales/santé/sciences.

Lieu de consultation

Tarifs & secteur de conventionnement

Secteur de conventionnement non disponible (médecin hospitalier ou non présent dans l'Annuaire santé CNAM des libéraux conventionnés).

Prendre rendez-vous & contact

Lien Doctolib = recherche Google site:doctolib.fr (le 1er résultat est presque toujours le profil correct s'il existe).

Top publications · les plus citées

• 1

  Isolated high tibial osteotomy is appropriate in less than two-thirds of varus knees if excessive overcorrection of the medial proximal tibial angle should be avoided

  Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021

  📚 71 citations🎯 RCR 9.07Top 3% NIH🔓 Open Access📄 PDF gratuit ↗

  Lire l'abstract Crossref ↓

  AbstractPurposeTo perform a detailed deformity analysis of patients with varus alignment and to define the ideal osteotomy level (tibial vs. femoral vs. double level) to avoid an oblique joint line.MethodsA total of 303 digital full‐leg standing radiographs of patients aged 18–60 years and varus alignment [mechanical tibiofemoral varus angle (mFTA) ≥ 3°] were included. All legs were analyzed regarding mFTA, mechanical medial proximal tibia angle (mMPTA), mechanical lateral distal femur angle (mLDFA), and joint line convergence angle. Based on mFTA, varus alignment was categorized as “mild” (3°–5°), “moderate” (6°–8°), or “severe” (≥ 9°). Deformity location was determined according to the malalignment test described by Paley. Two osteotomy simulations were performed with different upper limits for mMPTA: anatomic correction (mMPTA ≤ 90°, mLDFA ≥ 85°) and overcorrection (mMPTA ≤ 95°, mLDFA ≥ 85°). If a single osteotomy exceeded these limits at the intended mFTA of 2° valgus, a double‐level osteotomy was simulated. If even a double‐level osteotomy resulted in deviations from the defined limits, the leg was categorized as “uncorrectable”.ResultsMean mFTA was 6° ± 11° of varus (range 3°–15°). A tibial deformity was observed in 28%, a femoral deformity in 23%, a combined tibial and femoral deformity in 4%, and no bony deformity in 45%. The prevalence of a tibial deformity did not differ between varus severity groups, whereas a femoral and bifocal deformity was significantly more prevalent in knees with more distinct varus (p < 0.001). Osteotomy simulation revealed that isolated high tibial osteotomy (HTO) was appropriate in only 12% for anatomic correction, whereas a double‐level osteotomy was necessary in 63%. If overcorrection of mMPTA was tolerated, the number of HTOs significantly increased to 57% (p < 0.001), whereas the number of double‐level osteotomies significantly decreased to 33% (p < 0.001). Isolated DFO was considered ideal in 8% for both simulations. Significantly more knees were considered “uncorrectable” by simulating anatomic correction (18 vs. 2%; p < 0.001). A double‐level osteotomy was significantly more often necessary in knees with “severe” varus (p < 0.001).ConclusionLess than one‐third of patients (28%) with mechanical varus ≥ 3° have a tibial deformity. If anatomic correction (mMPTA ≤ 90°) is intended, only 12% of patients can be corrected via isolated HTO, whereas 63% of patients require a double‐level osteotomy. If slight overcorrection is accepted (mMPTA ≤ 95°), 57% of patients can be corrected via isolated HTO, whereas 33% of patients would still require a double‐level osteotomy.Level of evidenceIII, cross‐sectional study.

• 2

  High Tibial Osteotomy for Varus Deformity of the Knee

  Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2021

  📚 58 citations🎯 RCR 6.82Top 5% NIH🔓 Open Access

  Lire l'abstract Crossref ↓

  High tibial osteotomy is a powerful technique to treat symptomatic varus deformity of the knee and is successful when properly indicated and performed. Indications include varus deformity with medial compartment osteoarthritis, cartilage or meniscus pathology. Several techniques exist to correct symptomatic varus malalignment along with concomitant procedures to restore cartilage or meniscus injuries. Evidence supporting high tibial osteotomy for symptomatic medial compartment pathology exists, which provides a durable solution for joint preservation. This review will discuss the indications, techniques, and outcomes for high tibial osteotomies used in the treatment of symptomatic varus deformity of the knee.

• 3

  A high tibial slope, allograft use, and poor patient-reported outcome scores are associated with multiple ACL graft failures

  Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022

  📚 46 citations🎯 RCR 7.75Top 4% NIH🔓 Open Access📄 PDF gratuit ↗

  Lire l'abstract Crossref ↓

  AbstractPurposeTo compare clinical outcomes, radiographic characteristics, and surgical factors between patients with single and multiple anterior cruciate ligament (ACL) graft failures. It was hypothesized that patients experiencing multiple ACL graft failures exhibit lower patient‐reported outcome scores (PROs) and a higher (steeper) posterior tibial slope (PTS) than patients with single ACL graft failure.MethodsPatients undergoing revision ACL reconstruction with a minimum follow‐up of 12 months were included in this retrospective cohort study. Based on the number of ACL graft failures, patients were assigned either to the group “single ACL graft failure “or” multiple ACL graft failures “. The PTS was measured on strict lateral radiographs. Validated PROs including the International Knee Documentation Committee (IKDC) subjective knee form, Knee Injury and Osteoarthritis Outcome Score, Lysholm Score, Tegner Activity Scale, ACL‐Return to Sport after Injury Scale, and Visual Analogue Scale for pain were collected.ResultsOverall, 102 patients were included with 58 patients assigned to the single ACL graft failure group and 44 patients to the multiple ACL graft failures group. Quadriceps tendon autograft was used significantly more often (55% vs. 11%, p < 0.001) and allografts were used significantly less often (31% vs. 66%, p < 0.001) as the graft for first revision ACL reconstruction in patients with single versus multiple ACL graft failures. Patients with multiple ACL graft failures were associated with statistically significantly worse PROs (IKDC: 61.7 ± 19.3 vs. 77.4 ± 16.8, p < 0.05; Tegner Activity Scale: 4 (range, 0–7) vs. 6 (range 2–10), p < 0.05), higher PTS (12 ± 3° vs. 9 ± 3°, p < 0.001), and higher rates of subsequent surgery (73% vs. 14%, p < 0.001) and complications (45% vs. 17%, p < 0.05) than patients with single ACL graft failure.ConclusionCompared to single ACL graft failure in this study multiple ACL graft failures were associated with worse PROs, higher PTS, and allograft use. During the first revision ACL reconstruction, it is recommended to avoid the use of allografts and to consider slope‐reducing osteotomies to avoid multiple ACL graft failures and improve PROs.Level of evidenceLevel 3.

Publications scientifiques (32) — classées par pathologie

Source PubMed · Recherche par auteur (homonymes possibles, vérifier l'affiliation).

Partager cette fiche