Contact us

Make an appointment

our specialists


  01 40 79 40 36






Sports Clinic

36 bd St Marcel

75005 PARIS

Sports clinic Paris

Metro: Saint Marcel

Parking 6 rue test


'Pages chirurgiedusport :


Ce site respecte les principes de la charte HONcode de HON Ce site respecte les principes de la charte HONcode.
Site certifié en partenariat avec la Haute Autorité de Santé (HAS).
Check here


Youtube video

Search results : "" (204 results)

Imaging of the meniscus

Doctor Nicolas LEFEVRE.

The main objective of this study was to present a synthesis of the current literature in order to provide a useful tool for clinicians in radiological analysis of the meniscus. The magnetic resonance imaging (MRI) is the most accurate and least   invasive for the diagnosis of meniscal tears. This technique has revolutionized the imaging of the knee and has become the "gold standard" for imaging the meniscus. It confirms and characterize the meniscal lesion, type, extension, its possible association with a cyst meniscal extrusion,   assessment of cartilage and subchondral bone.   All anatomical descriptions were clearly illustrated in this articleby MRI,   arthroscopic and / or drawings.   We also described   standard radiography   for differential diagnosis as osteoarthritis. Ultrasound is often used as a diagnostic tool for meniscal pathology. CT arthrography with multiplanar reconstructions can detect some cracks not visible meniscus on MRI. CT arthrography is also useful in case of against-MRI in the postoperative evaluation of meniscal sutures or for analysis   cartilage covering the articular surfaces.

MRI is the most accurate and least invasive method for the diagnosis of meniscal tears.New 3D MRI in three dimensions with isotropic resolution   allow   creating multiplanar reformatted images to obtain from an acquisition in one sectional plane, reconstructions in other spatial planes. 3D MRI should further improve the diagnosis of meniscal tears

This article describes MRI imaging of all meniscal lesions.

new ligament chirurgiedusport herman Lefevre burly

A "new" knee ligament?

By Dr. Yoann BOHU , Dr. Nicolas LEFEVRE , Dr. Serge HERMAN .

Focus - A recent article anatomy highlighted the presence of a ligament in the knee. In fact, there is a set of fibers that are called "Kaplan fiber" or "ilio tibial tract" in English ...

Sensitivity and specificity of bell-hammer tear as indirect sign of an anterior cruciate ligament partial rupture on magnetic resonance imaging

Doctor Nicolas LEFEVRE, Doctor Yoann BOHU, Doctor Shahnaz KLOUCHE , Doctor Serge HERMAN.

Injury prevention program and performance improvement: PEP program

By Dr. Yoann BOHU , Dr. Nicolas LEFEVRE , Dr. Serge HERMAN .

An injury prevention exercise program and improve the perforamnce for sports, PEP PROGRAM: Prevention injury and Enhance Performance

Anterior ligament repair crosses: the patellar tendon ligament, technical KJ (Kenneth - Jones)

By Dr. Nicolas LEFEVRE , Dr. Serge HERMAN , Dr. Yoan BOHU .

Surgery: The principle of operation is to repair the anterior cruciate ligament (ACL) with a broken bone autograft bone tendon taken from the patellar tendon. Intervention performed under local or general anesthesia with a tourniquet.

I just learned that I have a complete break from my cruciate ligament (ACL)


SKI ACCIDENT: knee sprain

The diagnosis was made ??by your doctor or mountain already confirmed by MRI, it is not urgent to take a surgical decision.

Knee arthroscopy: treatment of meniscus injury

By Dr. Nicolas LEFEVRE , Dr. Serge HERMAN , Dr. Yoann BOHU

Meniscus - Arthroscopic knee surgery is the gold standard of meniscal lesions of the knee. The goal is to treat meniscal tear (tear, crack, tongue, bucket handle ...) being the least traumatic possible for the knee and the most conservative to the meniscus.


La fiche_de_la_ligamentoplastie_type_KJ_kenneth_jones_chirurgiedusport.jpg

Surgical technique of KJ type of ligament or Kenneth Jones (the image file)

By Dr. Nicolas LEFEVRE , Dr. Serge HERMAN , Dr. Yoann BOHU.

Specifications of the ligament anterior cruciate ligament (ACL) in the kenneth-jones technical or KJ schematic description of this operation is to achieve anatomic ACL reconstruction using autologous (patient's tendon) under arthroscopic control

Lateral collateral ligament of the knee

By Dr. Nicolas LEFEVRE , Dr. Yoan BOHU , Dr. Serge HERMAN .

Lateral collateral ligament (LCL)
Ligament of the outer side of the knee
Short ligament, and tubular end
It is stretched between the femur top
and the fibular head down
It allows external stabilization of the knee

Knee Anatomy, anterior cruciate ligament, internal and external ligament, meniscus knee scheme.

Knee Anatomy, anterior cruciate ligament, internal and external ligament, meniscus knee scheme.

By Dr. Nicolas LEFEVRE , Dr. Serge HERMAN , Dr. Yoan BOHU .

At the top is the femur, the thigh bone. Downstairs there is the tibia, the leg bones. The bottom of the femur is rather round and the top of the tibia appears much flatter. The menisci are small blocks located between the two knee bones.

Treatment of meniscal tab: Image arthroscopic

By Dr. Nicolas LEFEVRE , Dr. Serge HERMAN , Dr. Yoan BOHU .

The regularization of the tongue of the meniscus is performed arthroscopically. This adjustment is done using small instruments.

plug ligament didt system TLS or TLS DT4

Ligamentoplasty anterior cruciate ligament (ACL) using the technique hamstring DT4 TLS or TLS: detail

By Dr. Nicolas LEFEVRE .

The aim of this operation is to achieve anatomic ACL reconstruction using autologous (patient's tendon) under arthroscopic control. The principle of TLS is to use a single hamstring tendon graft in short. Parameters of ACL reconstruction with hamstring TLS.

Anatomie_cheville_ligament_lateral_externe ASTRAGALE calcaneus

Anatomy of the ankle: lateral collateral ligament.

By Dr. Nicolas LEFEVRE , Dr. Serge HERMAN , Dr. Stéphane Cascua .

There are two primary ligaments at the ankle, a lateral collateral ligament (LCL) and a medial collateral ligament (MCL) on each side of the ankle, they are stretched between the tibia / fibula top ....

The bone is strengthened or crack in contact sports

Doctor Stéphane CASCUA.

Each sports movement constitutes a solicitation for the bone structure. At each reception process, the tibia runner undergoes vibratory impacts. Unrolling not, the hiker twists slightly small bone in his foot. Even the body-builders, powerfully contracting its muscles, pulls on his bone.

Each strain injures a little bone of sports. Fortunately, during the rest period, the bone trying to rebuild. If time allows, if they bring him the necessary food, it is repaired! It reconstructs even louder than before as if to prepare for new mechanical attacks. This phenomenon is called by coaches cycle decompensation / overcompensation. This process has been described in many body organs and functions: muscle, stock energy, hormones, etc. It is a key driver of growth.

Thus, it was shown that the well-trained marathoner had stronger bones than sedentary. Indeed, its more dense bone structure, higher in fiber and calcium. In addition, the microscopic architecture of the bone is perfectly oriented along the axis of mechanical stresses.

Indeed, the chemical structure of the bone is comparable to reinforced concrete. The protein network is the steel rods. Calcium is comparable to concrete mired these metal axes. At the hip and pelvis direction of the bone structure is very characteristic. On a radiograph, it is found that the fibers leave the femur, the thigh bone, tilt in, come from hip to withstand the weight of the body resting on the hips. The lines of force from the right leg and left leg meet in the middle of the basin and support each other in the manner of the nave of a church.

Physical activity associated with a sufficiently high protein diet, vitamin D and calcium is a great engine of bone construction. This cocktail is particularly useful to hinge periods of life. During growth, it is necessary to eat 4-5 dairy products every day to build strong bones. It should also move: it is essential to practice a sport requiring the running and jumping at least 3 times a week for 30 minutes. In the absence of impact, bones harden less. It has been shown that a young competitive swimmer had lower bone density than sedentary because he was deprived of gravity during those long hours of pool training. In addition, bone densification stops 25 years. At this age you have made up your bone capital for life!

In adulthood, sport reinforces very hard bone and the amount of calcium necessary for the maintenance of bone is still debated. In case of fracture, the rest of the broken area needed a few weeks to allow to "ensnare" the broken area. In addition, gradually increasing mechanical stress are indispensable to "mechanize" the callus. Again, they help to guide the fabric of the bone in the center of the constraints to prepare him for his mission. An increase in calcium intake in consolidation period is proposed by some doctors without that interest has been really shown.

After menopause, the bone structure is gradually degraded to make the brittle bones is osteoporosis. Ladies, remember, your resistance to hip fracture depends on your diet and your sport for 25 years! If physical activity after menopause can no longer denser bones, reduces the loss of bone tissue. So it is advisable to go see jumping around or jog. It is also good to make the soft gym to maintain bone strength to strength. To make the most of this stimulation, it is again necessary to take 4-5 dairy products daily. It should also go out every day to enjoy the sun and make the vitamin D essential for the absorption and calcium binding. Fresh coordinating sports such as Thai Chi or "balance workshops" have proven effective in reducing the risk of falls and fractures.

If the sporting activity is excessive, the micro-cracks caused by impacts on the bones fail to consolidate over the rest. Rather, these lesions worsen in the next workout. Finally the splits right through bone, it breaks without any violent trauma. It is the stress fracture. In a postmenopausal woman, it was demonstrated that 6 hours of sport load per week may be sufficient to break insidiously bones. Among younger adults, this type of injury is favored by dietary deficiencies and hormonal disorders. Lack of calcium, vitamin D and protein alters the rebuild bone victim of microcracks in the exercise. Insufficiency sex hormones reduces the stimulation microscopic chemical plants be responsible for the synthesis of bone tissue. Functional changes occur when the deep depletion of the body. That kind of burnout is most often diagnosed in women because it causes menstrual irregularities and a cessation of menses. The victim is found in a state of "early menopause". In humans this hormone suffering is more insidious but it exists and its effects on bone density are comparable. The sports overwork cocktail, dietary deficiencies and disappearance of rules typically found in young women anorexic. Faced with a stress fracture, the sports physician must remain vigilant. It should not simply treat a "bone". It has an obligation to support a whole person, he is responsible for seeking overtraining or behavioral disorders.

The Iroman lack of iron, the other sports too!

Doctor Stéphane CASCUA.

Iron is essential to your health and performance. It is a central component of hemoglobin. The latter is contained in red blood cells and gives it color. It is the iron that captures oxygen when blood passes through the lungs. It carries the precious gas to muscles. When they arrived, it drops its cargo which then allows the burning of energy substances and muscle contraction.

When you run or when you jump, your heels hit the ground and the fat pad of the foot of the plant is crushed. It is through many blood vessels. These red blood cells burst and release their hemoglobin. Iron is released into the blood and pass into urine.

Muscle contains a twin sister of hemoglobin, myoglobin. The latter also contains a lot of iron which sets some oxygen. This small local reserve allows starting the contraction before the blood vessels do not provide the necessary complement. When you experience aches, your muscle membranes are victims of micro-fissures. Myoglobin and iron leaves the muscle and gaining the blood. The precious metal is eliminated in the urine.

When you make an effort, the majority of blood flow is directed towards your muscles. There remains very little to the digestive tract and the bladder wall. These organs suffer from lack of oxygen and are shaken with every stride. Small areas are damaged and start to bleed. Red blood cells and iron are lost in the feces and in urine.

You enter the assiduous why athletes often lack iron, especially if they do not take care to concoct "menus and recipes" adapted. Sports are even more concerned since all these iron losses are added the massive elimination of blood during menstruation!

That is why it is good to occasionally perform a blood test to assess the stock in body iron. This levy is necessary when it comes to review a state of fatigue. It unnecessary to dose iron in the blood because the body is able to keep within the limits of normal while the reserves are at their lowest! It is necessary to measure levels of "serum ferritin" because this structure is the storage form of iron.

Technical cruciate ligament

By Dr. Nicolas Lefevre

More videos

Last publications

Feature: knee prosthesis

total knee replacement

Feature: knee ligaments

Dossier: Ambulatory Surgery ACL

Dossier: meniscus


Feature: Shoulder sportsman

Folder: hip prosthesis

Dossier: break hamstring

Dr. Lefevre proximal anatomie_ischio_jambier_rupture chirurgiedusport

Dossier: prosthetic and sports

hip replacement and knee and sports

Dossier: PRP

Chirurgiedusport - Who are we - Contact us - Legal Notice - Web design Digitaline - EMC2 Studio development - Clinique du Sport