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"
independent, randomized single-center, single-blind, single injector with an independent assessor, comparing the Hylan GF 20 (Synvisc) 3 injections versus a sodium hyaluronate (Hyalgan┬«) 5injections. 392 gonarthroses evaluated at 3 months, 6 months and 12 months. The results showed clear superiority of Synvisc┬« both EVA as the WOMAC pain, WOMAC function, the Oxford Knee Scores and scale of quality of life.
6 ml intra-articular in symptomatic knee osteoarthritis, led by Professor Xavier Chevalier de l'Hopital Henri Mondor in Cr├ęteil.
European multicenter, randomized, double-blind, placebo against (saline), including 253 patients evaluated 26 weeks on safety and efficacy. The results showed equivalent tolerability of Synvisc-one┬« to placebo and a few significant efficacy, 160 patients received a second injection at 26 weeks. Pending other more conclusive studies, evaluated over 12 months, I would reserve the mono-injection nomadic patients for whom three injections to 8 days apart is not adapted to their lifestyle.
Very few studies have been conducted, only two were selected by Professor Ren├ę -Marc Flipo the University Hospital of Lille, not independent. The study Altman on Hyalgan┬« and the Franco-German study of Synvisc. In the latter, the best results were observed in the group with a single injection than in group 2 injections!
Very few studies have been conducted with small series and with multiple protocols. A study conducted with Synvisc┬«, of 55 included patients, with osteoarthritis stage 2 Kellgren Lawrence, has shown efficacy at 6 months in 70% of patients who received a single injection against an efficiency of only 30% of patients received a second injection of 1, 2 or month intervals if pain persists. In the current state of knowledge, an injection can be attempted, its repetition in the lack of results is questionable.
Performed under fluoroscopy or under ultrasound, anterior or lateral approach, hip viscosupplementation was not part of the recommendations of the EULAR 2005 (European League Against Rheumatism) but appears in the recommendations of the OARSI (Osteoarthritis Research Society International). 16 studies were identified, to conclude a good safety and potential efficacy to be confirmed by further studies. A single injection may be sufficient, it could be a temporary solution to the implementation of PTH. The interest in osteoarthritis in young patients without malformation deserves to be studied.
iodinated contrast agents can chemically alter the HA molecule. It should be taken into account in clinical studies. Should HA injection is done under radiological identification with contrast or blind with a significant percentage of extra-articular injections? For the hip, echographic identification is it better to guide under fluoroscopy? Regarding the knee, the effectiveness is confirmed by clinical studies without radiological locating the injection site!
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..)
PTG MY KNEE INTERVENTION
A preoperative CT scan is performed 3 weeks before the operative date to carry out the cutting guide on measurement of the prosthesis by printing 3D printer. The various bone cuts are made ??using 3D custom cutting guides, then the instrumentation adapted to the selected prosthesis (ancillary equipment), we must ensure the ligament balance and if necessary make releases (release) rarely ligament retentions. (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..)