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The rupture of the anterior cruciate ligament (ACL) in bell clapper is a rare ACL injury often overlooked.
It is the presence of a flexion contracture of the knee (difficulty soft knee) often painful and irreducible. Usually present from the accident but sometimes after a free interval.
It is important to emphasize the role of MRI for radiological diagnosis with an aspect of "clapper" forward in the notch.
The treatment is always surgical. It involves removal of the ACL stump (clapper) by arthrolysis sub-arthroscopy associated with an ACL graft in the same operation (hamstring or KJ).
There is no proper epidemiological factor to damage the anterior cruciate ligament in bell clapper. Few studies in the literature available on the subject. The only epidemiological factor found in the literature is the frequency of partial ACL tears.
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.