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A sprain is a traumatic affection of one or more ligaments. This traumatic injury can be a simple stretching of the ligament (mild sprain), a partial tear of some ligament fibers (moderately severe sprain), or total rupture of the ligament (severe sprain).
Ligaments are structures constituting tensioned stay cables on either side of a joint. They allow the articular surfaces to remain in contact during the movements and thus ensure the stabilization of the joint.
After trauma, the joint may undergo excessive torque resulting ligament injury.
There are four main ligaments in the knee, two lateral ligaments (internal and external) on each side of the knee, two in the center of the knee ligaments called cruciate ligaments (anterior cruciate ligament and posterior cruciate ligament)
A knee sprain injury is of one or more ligaments of the knee joint. When certain sports such as football or skiing, trauma torsional and / or rotating on a blocked foot will lead to ligament injuries. In most cases, the sprain is partial and it is a mild sprain of the medial collateral ligament (MCL). However before this type of accident should always be considered a ruptured cruciate ligaments which requires specific therapeutic management. For the achievement of one of two ligaments defines a severe knee sprain because of knee stability is compromised
In the immediate aftermath of a sprained must stop all activities, apply ice if possible, set up a simple bandage or splint. It is necessary to consult in an emergency service in case of severe discomfort, to eliminate a serious pathology (fracture, dislocation ...) In any case, it is advisable to consult a knee specialist in the days following the 'accident.
Medical treatment consists of immobilization in a splint for varying periods depending on the injury, a analgesics and anti-inflammatory, daily icing the knee to reduce pain and hematoma , a rehabilitation through physical therapy; to start quickly to prevent joint stiffness and muscle atrophy. The judgment of the sport depends on the severity of the injury. Except in exceptional cases, there is no rush to make a knee sprain. In severe sprain with ACL lesion surgical intervention may be necessary secondarily.
Knee radiograph can urgently to eliminate a fracture.
An MRI of the knee can be requested without emergency within days or weeks trauma to take stock of the damage.
The rupture of the anterior cruciate ligament increases the risk of recurrent instability of the knee. This instability causes cartilage and meniscal lesions leading to medium term to osteoarthritis. The goal of treatment is to restore knee stability in daily life, professional and sports.
Functional treatment is to compensate for the absence of the anterior cruciate ligament of the knee by muscle and proprioceptive rehabilitation. It is in this case not necessary to operate.
However pivot practice of sports (football, skiing etc ...) or if the knee becomes unstable whatever the sport, recreational or professional, surgical treatment will be offered.
Surgical treatment is to reconstruct the anterior cruciate ligament with a graft by a neighborhood tendon. The tendon that is used is either the patella tendon (KJ) or tendons of the half tendon domestic law goose leg (hamstring). This surgical technique is called a ligament. It allows an anatomical reconstruction of the anterior cruciate ligament and is performed arthroscopically.
In conclusion, the knee sprain is a relatively common injury. The lesion of the anterior cruciate ligament is a serious breach and requires specialized care.
Ligamentoplasty, if necessary, is rarely urgent, gives excellent results and allows a resumption of all sports.
Partial ACL tear
Isolated ruptures of the anterior cruciate ligament (ACL) injuries are the most frequent ligament of the knee. These breaks may be complete or partial. In partial tears, clinical diagnosis is more difficult because the clinical presentation is variable. The diagnosis, evolution in time and treatment its partial tears are still subject to much controversy. The purpose of this article is to clarify the definitions, clinical diagnosis and therapeutic strategies to these partial ACL tears. (read more ...)
Women have four to eight times more likely than men to have a ruptured anterior cruciate ligament (ACL). This risk seems more important during the pre-ovulatory phase of the menstrual cycle than during the post-ovulatory phase. The main objective of the study was to describe the distribution of ACL injuries during the menstrual cycle in a large recreational skiers population.
The main goal of this study Was to compare the results of the GNRB arthrometer To Those of Telos TM in the diagnosis of partial thickness tears of the anterior cru- ciate ligament (ACL). A prospective study Performed January- December 2011 included all patients presenting with a partial or full-thickness tears ACL without ACL recon- struction and with a healthy contralateral knee. Anterior laxity Was Measured in all patients by the Telos TM and GNRB├ĺ devices.
It is necessary to distinguish:
- The fracture lesions which are always found with certainty notion traumatic (new or old)
- Chronic lesions with onset of osteonecrosis subchondral more or less extensive, described in the literature under different terminologies (osteochondrosis, osteochondritis, osteonecrosis).
This distinction seems to us essential because etiology, radiographic appearance, treatment and prognosis of such lesions are sometimes totally different.