Sports clinic Paris
Metro: Saint Marcel
Parking 6 rue test
The information provided on this website is provided by medical professionals: sports doctors, rheumatologists, functional rehabilitation doctors, orthopedic, clinical surgeons sport, podiatrist sports meeting within the group "chirurgiedusport.com"
The use of PRP has become widespread in sports trauma for the last decade, as an alternative to surgery or as a surgical adjuvant. High-profile successes in high-level athletes, and the abolition of the list of substances and methods prohibited by WADA at the end of 2010, have literally sparked the appeal for this technique.
The absence of side effects and excellent tolerance, make the injection of PRP, carried out under rigorous conditions, a technique of great safety .
In our current state of knowledge, the effectiveness of PRP treatment is no longer demonstrated in the treatment of cartilage lesions(7 studies with high level of evidence), superior to hyaluronic acid.
Ultrasound guidance and good pain management (analgesia of pallium 1 or 2, MEOPA) are essential in the injection of tendon and muscular lesions but rarely necessary in the painful joint injection.
Treatments vary greatly from one practitioner to another, in terms of platelet concentration, cell richness (erythrocytes, leukocytes), ultrasound tracking, pain management, number of sessions and accompaniment. It is essential to better define the protocols through comparative studies.
The phase ofRehabilitation and reconditioning to stress is an essential step, often overlooked when PRP is presented as a miracle cure!
Before considering a platelet concentrates processing a visit is required to confirm the indication to define the therapeutic protocol, eliminating against indications and remind the precautions that surround it.
Numerous preparations on the market, variable in terms of platelet concentration, red blood cells and leukocytes, in terms of adjuvants (activator, anticoagulant), in terms of volume. Many protocols exist no scientific consensus on the ideal platelet concentrate, the number and frequency of injections, local anesthesia, the use of anti inflammatories and ice, rehabilitation and return to physical activity.
This technique of reconstruction of the anterior cruciate ligament plasty involving extra and intra-articular fascia lata was described by Hey-Groves in 1917, modified in 1972 and MacIntosh Jaeger recently. This reconstruction is a technique increasingly practiced for controlling the tibial rotation and rotational jump experienced by the patient and the surgeon objectified by clinical examination.
This lateral grafting used in this technique is called the fascia lata is a transplant with high resistance comparable to other biomechanical transplants used. The fascia lata retains its tibial insertion, which is a natural attachment system and therefore superior to any other system used. This technique has the advantages of not having to levy tendon and therefore the hope of postoperative muscle recovery and normalization of the fastest isokinetic tests.
The coracoid bone block screwed in front of the glenoid realized today either open or arthroscopically.
The advantages of arthroscopic abutment technique are:
- Take stock of the damage to the joint, bead, cartilage, loss of bone substance, tendon injuries
- The precise positioning of the stop because under direct control by the camera,
- Of smaller sizes scars,
- The treatment of lesions as lesions of the biceps (SLAP lesion) or lesions of the rotator cuff (tendon rupture) that can be treated in the same operation
- Early functional recovery
Latarjet arthroscopic intervention
The procedure is most often performed under general anesthesia with an inter-scalene block made ??preoperatively by the anesthetist. It involves taking a bone block of about 2 cm at the expense of the coracoid and place it in the anterior and inferior part of the glenoid cavity, passing through the subscapularis muscle. The coracoid can be positioned upright and secured by a screw according to Bristow or lying and fixed by two screws according Latarjet. (read more..)
The shoulder dislocations and recurrent anterior instability is a common problem among young athletes making up 90% of shoulder dislocations. Surgical indication can be provided in these cases of glenohumeral dislocations previous recurrent, but also in cases of painful and unstable shoulders. A question now arises, should we offer it immediately after the first dislocation or should we expect one or more recurrences? (Read more ...)
Patient, 58, sporting good level with chronic tendinitis of the Achilles tendon of the left.
chronic Achilles tendon pain lasting for more than a year after a triathlon.
The patient has received medical treatment (necessary before any surgical decision): rehabilitation, Stanish stretching, shock wave, orthopedic soles. (read more...)
While muscle injuries of the posterior region of the thigh are common in athletes, the proximal hamstring rupture is a rare disease. A study published in 2003  analyzed in a consecutive series of 170 patients, 179 trauma hamstrings occurred over a period of 3 years. MRI and / or ultrasound showed that only 12% of the injuries were fractures of the proximal and 9% complete ruptures. It is also little known, the first cases described in the literature from 1988 . Clinically the patients describe a violent pain in the buttock (stab printing) followed by leg weakness. ( To be continued..)