Activités de recherche et enseignement
En parallèle de son activité médicale, le Dr. Camille Laporte a contribué, tout au long de son parcours, à de nombreuses publications et événements scientifiques dans le domaine de l’imagerie médicale.
Publications scientifiques
Laporte C, Albert J.-D., Duvauferrier R., Bertaud V.,Gouillou M., Guillin R. (2014), « MRI Investigation of Radiating Pain in the Lower Limbs: Value of an Additional Sequence Dedicated to the Lumbosacral Plexus and Pelvic Girdle », American Journal of Roentgenology, 2014; 203: 1280-1285
OBJECTIVE. In some cases, sciatica-like symptoms radiating through the buttock, anterior thigh, or leg result from spinal root compression in an extraspinal location or from injury to the pelvic girdle. It has been suggested that adding a coronal STIR sequence dedicated to the lumbosacral plexus and pelvis to the routine MRI protocol can provide a good depiction of disorders of this type.
MATERIALS AND METHODS. Two hundred nine patients with sciatica-like symptoms of suspected lumbar origin were included in the study. Disorders responsible for symptoms involving extraspinal compression of the lumbosacral plexus or pelvic girdle were retrospectively noted and correlated with age, sex, location of pain, referring physician, presence of discoradicular impingement liable to explain symptoms, and history of neoplasia.
RESULTS. An extraspinal cause of symptoms was depicted in 12 cases (5.7%), including three cases of extraspinal compression and nine differential diagnoses in the pelvic region. Prevalence of an extraspinal cause of pain was significantly correlated with the absence of discoradicular impingement in the spine (p = 0.046). A higher prevalence of extraspinal compression of the lumbosacral plexus (p = 0.029) was seen in patients 60 years old or older, whereas no other feature was statistically associated with an extraspinal cause of pain.
CONCLUSION. Because of its short acquisition time and subsequent low cost, the additional coronal STIR sequence should be performed in the routine MRI investigation of sciatica-like symptoms when no discoradicular impingement is seen in the spine to depict an extraspinal cause of symptoms.
Rochcongar G, Cucurulo T, Ameline T, Potel JF, Dalmay F, Pujol N, Sallé, Chou É, Lutz C, Ehkirch FP, Le Henaff G, Laporte C, Seil R, Gunepin FX, Sonnery-Cottet B et la SFA: « Meniscal survival rate after anterior cruciate ligament reconstruction », Orthopaedics & Traumatology: Surgery & Research, 2015, Vol 101 – N° 8S, p S323-S326.
BACKGROUND. Meniscal suture provides well-documented benefits. Integrity of the cruciate ligaments of the knee is a prerequisite for meniscal healing. Nevertheless, reconstruction of the anterior cruciate ligament (ACL) does not consistently prevent recurrent tearing of a sutured meniscus. We evaluated meniscal survival rates, 5 and 10 years after meniscal suture concomitant with an ACL reconstruction. We compared the outcomes of these repaired menisci to those in which no menisci tears were detected during ACL reconstruction.
METHODS. In this multi-centric retrospective study, we included two groups. One group consists of patients who underwent a meniscal repair. This group was further divided into two subgroups based on whether follow-up was 5 years (n = 76) or 10 years (n = 39). The control group included 120 patients with normal menisci observed during surgery. We studied meniscal survival rates in each group, and we analyzed risk factors associated with the recurrence of meniscal lesions.
RESULTS. The 5-year meniscal survival rate was significantly higher in the control group than in the meniscal-repair group (95% vs. 80%, respectively; P = 0.0029). The controls group also had a higher meniscal survival rate after 10 years, although the difference was not statistically significant (88% vs. 77%, P = 0.07). A difference in knee laxity greater than 4 mm was associated with a 5-fold increase in the risk of recurrent meniscal tears (P = 0.0057). After 5 years, the risk of recurrence was higher for the medial than for the lateral meniscus, whereas after 10 years the difference was no longer statistically significant.
DISCUSSION. Although insufficient healing after meniscal suturing contributes to the risk of further meniscal tears, new lesions can develop in menisci that were undamaged at the time of ACL reconstruction. The risk of a new meniscal lesion is strongly associated with inadequate control of antero-posterior and rotational laxity. Some apparently “new menisci lesions” seems to have been missed during ACL reconstruction.
Lutz C, Dalmay F, Ehkirch FP, Cucurulo T, Laporte C, Le Henaff G, Potel JF, Pujol N, Rochcongar G, Salledechou E, Seil R, Gunepin FX, Sonnery-Cottet B :
« Meniscectomy versus meniscal repair: 10 years radiological and clinical results in vertical lesions in stable knee. », Orthopaedics & Traumatology: Surgery & Research.2015 Dec, Vol 101 (8 Suppl), p S327-31.
INTRODUCTION. Surgical management of meniscal lesion consists of either a meniscectomy or meniscal repair. Although repair offers immediate recovery after surgery, it is also associated with higher rates of revision. A meniscectomy, on the other hand is known to be associated with an early onset of osteoarthritis. The present study compared clinical and radiological results at 10 years between meniscectomy and meniscal repair in isolated vertical lesion in an otherwise stable knee. The hypothesis was that repair shows functional and radiological benefit over meniscectomy.
PATIENTS AND METHOD. A multi-centric retrospective comparative study of 32 patients (24 male, 8 female). Mean follow-up was 10.6 years (range, 10–13 years). There were 10 meniscal repairs (group R) and 22 meniscectomies (group M), in 17 right and 15 left knees. Mean age at surgery was 33.45 ± 12.3 years (range, 9–47 years). There were 28 medial and 4 lateral meniscal lesions; 26 were in the red-red zone and 6 in red-white zone.
RESULTS. Functional score: KOOS score was significantly higher in group R than M on almost all parameters: 98 ± 4.69 versus 77.38 ± 21.97 for symptoms (P = 0.0043), 96.89 ± 7.20 versus 78.57 ± 18.9 for pain (P = 0.0052), 99.89 ± 0.33 versus 80.88 ± 19.6 for daily life activities (P = 0.0002), 96.11 ± 9.83 versus 54.05 ± 32.85 for sport and leisure (P = 0.0005), but 91 ± 16.87 versus 68.15 ± 37.7 for quality of life (P = 0.1048). Radiology score: in group R, 7 patients had no features of osteoarthritis, and 2 had grade 1 osteoarthritis. In group M, 5 patients had grade 1 osteoarthritis, 10 grade 2, 3 grade 3 and 3 grade 4. Mean quantitative score was 0 (mean, 0.22 ± 0.44) in-group R and 2 (mean, 2.19 ± 0.98) in group M (P < 0.0001).
DISCUSSION. At more than 10 year’s follow-up, functional scores were significantly better with meniscal repair than meniscectomy on all parameters of the KOOS scale except quality of life. Functional and radiological scores correlated closely. These results show that meniscal repair for vertical lesions in stable knees protects against osteoarthritis and is therefore strongly recommended.
Sallé de Chou E, Pujol N, Rochcongar G, Cucurulo T, Potel JF, Dalmay F, Ehkirch FP, Laporte C, Le Henaff G, Seil R, Lutz C, Gunepin FX, Sonnery-Cottet B : « Analysis of short and long-term results of horizontal meniscal tears in young adults », Société Française d’Arthroscopie. Orthop Traumatol Surg Res. 2015, Vol 101 (8 Suppl) : S317-22., 2015, Vol 101 – N° 8S, p S323-S326.
INTRODUCTION. Symptomatic horizontal meniscal tears are rare but worrisome lesions in young adults. These are overuse injuries not amenable to the classic arthroscopic sutures. An open meniscal repair allows the meniscal lesion to be suture vertically, perpendicular to its in the vascularized zone. The purpose of this study was to evaluate the short and long-term clinical and radiological outcomes of the aforementioned surgical technique.
MATERIAL AND METHOD. The first cohort consisted of 24 patients operated between 2009 and 2011 (6 women, 18 men; mean age 26years) having 11 lateral and 13 medial meniscal tears. The second cohort was of 10 patients operated between 2001 and 2002 (3 women, 7 men; mean age 24years) having 8 lateral and 2 medial meniscal tears. Patients were reviewed at the last follow-up using the IKDC, Lysholm and KOOS scores. Patients in the first cohort had an MRI, while those in the second cohort had X-rays.
RESULTS. Eighteen patients in the first cohort were reviewed with a mean follow-up of 2 years (12-45 months) and 9 patients from the second cohort were reviewed after 10years (97-142 months). In the first cohort, one patient required secondary menisectomy. The mean Lysholm score was 90 and the subjective IKDC was 85. Every MRI examination found reduced extent and intensity of the hyperintense signal. In the second cohort, no patients required secondary meniscectomy. Two patients had joint space narrowing (less than 50%) on radiographs. The mean Lysholm score was 99 and the subjective IKDC was 91.
CONCLUSION. Open repair of horizontal meniscal tears in young adults leads to good subjective and objective results in the short term, which are maintained in the long-term.
Communications scientifiques
• Communication orale au congrès annuel de la Société Française d’Arthroscopie (Luxembourg, 2015), Symposium réparations méniscales : réparations méniscales, place de l’échographie, désinsertions ménisco-capsulaires postéro-médiales.
• Communication orale aux Journées Francophones de Radiologie 2013 : « MRI investigation of radiating pain in the lower limbs : value of an additional sequence dedicated to the lumbosacral plexus and pelvic girdle.»
Formations scientifiques
Maîtrise de sciences biologiques et médicales, « Immunologie fondamentale et immunopathologie », Université de Brest, juillet 2004.
Maîtrise de sciences biologiques et médicales, « Physiologie et biologie des systèmes intégrés », Université de Brest, juillet 2002.
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© Docteur Camille Laporte-Gladu, Cabinet d’échographie et d’échodoppler, 2026