Marc Dauty

Change in posture control after recent knee anterior cruciate ligament reconstruction

The aim of this study was to compare statical postures of a knee anterior cruciate ligament reconstruction (ACLR) population with a healthy control population. Thirty‐five patients (age 25·5 ± 5·8 years) were compared at 15 days after an anterior cruciate ligament reconstruction with 35 healthy, age and sex‐matched subjects. Bilateral and unilateral postures were studied according to various stances, knee extension and 20 degrees knee flexion with opened and closed eyes, using a stabilometric platform. A comparison with the non‐ACLR limb and the healthy limbs of the control population was carried out. The ACLR subjects present with the following: (i) a significant change in two‐legged stance, i.e. distances covered by the centre of pressure projection are significantly increased; (ii) a postural alteration during the ACLR one‐legged stance with knee extension and opened eyes in comparison with the non‐ACLR limb; (iii) an incapacity for certain ACLR subjects to perform one‐legged stance on the non‐ACLR limb when there is no visual compensation. Only 11·4% (95% CI: 0·9–21·9%) and 42·8% (95% CI: 26·3–59·3%) of ACLR subjects are capable of maintaining correctly a one‐legged stance posture with closed eyes on both sides (knee extension and flexion, respectively). The identification of the ACLR knee limb is possible from the one‐legged stance postural test in knee extension and opened eyes condition. Because of a change in two‐legged balance and of the incapacity for certain ACLR subjects to maintain one‐legged stance with closed eyes, a central origin explaining the abnormalities of postural control is suggested.

Rééducation des ruptures de coiffe de l’épaule opérées : prise en charge en hospitalisation en internat ou en hospitalisation de jour (à propos de 76 observations)

Resume Objectif. – Degager des criteres d’orientation en hopital de jour ou en internat apres chirurgie de la coiffe des rotateurs d’epaule. Methode. – Population de 71 patients (53,2 ans ± 7) (76 epaules) operes d’une rupture de la coiffe des rotateurs par le meme chirurgien, puis reeduques soit en hospitalisation de jour soit en internat. Evaluation hebdomadaire jusqu’au deuxieme mois postoperatoire en prenant comme criteres : la douleur, les mobilites articulaires passives et actives et les complications. Resultats. – Cinquante-trois epaules ont ete reeduquees en internat et 23 en hospitalisation de jour. Il n’existe pas de difference significative pour les criteres etudies entre les 2 populations sauf pour les douleurs au quinzieme jour postoperatoire. La douleur et la raideur articulaire semblent plus frequentes si la chirurgie est complexe. Discussion. – Les hospitalisations de jour et en internat permettent d’obtenir des resultats equivalents qui s’expliquent par la possibilite de prestations identiques : medicales, de kinesitherapie, d’ergotherapie et de balneotherapie. La connaissance du contexte sociofamilial est importante afin de choisir la structure de reeducation la plus adaptee car le patient doit beneficier d’une aide pour les actes de la vie quotidienne et les tâches menageres. L’hospitalisation en internat permet plus de confort mais implique une rupture familiale.

Effects of running retraining after knee anterior cruciate ligament reconstruction.

OBJECTIVE The aim of this study was to analyze the effect of running retraining on the recovery of the knees functional and muscular properties after anterior cruciate ligament (ACL) reconstruction. METHODS Eighty-five athletes who had undergone ACL reconstruction surgery were selected randomly to receive, or not to receive, controlled running training based on interval training and speed exercises. The effect of retraining was measured by the evolution of the knees isokinetic strength deficit and progress (at angular speeds of 60 and 180 degrees /s), the knee laxity parameters and the score on the Lysholm Knee Scale from the 4th to the 6th month after the surgery. Forty subjects were retrained and compared with 40 control-group subjects. The effect of the retraining program was studied in terms of the type of ACL reconstruction and the effect of time. RESULTS After retraining, no difference was found for isokinetic knee strength deficit and progress, knee laxity and Lysholm Knee Score. The isokinetic strength deficit was influenced mainly by the type of ACL reconstruction. CONCLUSION It would seem that running retraining has an insufficient effect on the muscular and functional recovery after ACL reconstruction, despite the fact that this type of training is well-tolerated.

Bilateral knee arthroplasty infection due to Brucella melitensis : A rare pathology?

Fig. 2. Injection of a contrast agent into the interspinous neoarthrosis: opacification of the interspinous cyst, which is putting pressure on the dural sac. [3]. However, a single case similar to ours has been reported [4]. The patient was a 50-year-old woman with neurogenic claudication and MRI evidence of dural sac compression by a cyst developed from an interspinous neoarthrosis. She underwent surgery for cyst excision and spinal fusion. Our patient probably had a preexisting cyst that migrated into the lumbar canal on two occasions after a physical effort. Needle aspiration established that the interspinous neoarthrosis communicated with the cyst. A glucocorticoid injection improved the neurological abnormalities and alleviated the pain. There was no evidence of a recurrence at the last follow-up 18 months later.

Désentraînement et réentraînement du cycliste de haut niveau immobilisé par blessure

OBJECTIVE To define retraining after injury in a high-level cyclist by taking into account the consequences of detraining. METHOD From three clinical cases and from the analysis of the consequences of detraining, three principles of retraining were determined. RESULTS 1. The high-level cyclist is not protected and loses cycling capacity after four weeks of inactivity. The delay in recovery is longer the higher the adaptations. 2. Recovery of cycling capacity is based on bicycle exercises that are greater in intensity than quantity, taking into account delays in injury consolidation. 3. Retraining requires appreciating the individual physiological level by evaluating force and endurance before envisaging the resumption of training and competition. CONCLUSION The injury of a high-level cyclist is at the origin of detraining, which has been evaluated so that sports rehabilitation may enable the cyclist to find a previous state without relapse, complication or overtraining.

Uncommon external abdominal oblique muscle strain in a professional soccer player: a case report

BackgroundThis is the first report of external abdominal oblique muscle injury occurring in a professional soccer player.Case presentationA 28-year-old Caucasian professional soccer player presented after experiencing a popping sensation associated with strong parietal pain localized between the left 11th and 12th ribs. Ultrasound examination revealed a collection of fluid under the 11th rib, suggesting injury of the left external oblique muscle. Platelet-rich plasma treatment was administered and the soccer player returned to competition on the 21st day after treatment.ConclusionThis rare injury results from a sudden intrinsic eccentric contraction of the internal oblique muscle while in a stretched position. Ultrasound can help to confirm the diagnosis and to monitor clinical follow-up. Platelet-rich plasma treatment could aid recovery in high-level athletes.

Congenital anomalous origin of a single coronary artery and high-level sporting competition.

Using a single clinical case of a professional soccer player presenting an anomalous origin of the right coronary artery, cardiac screening and surgical treatment are described taking into account the recommendations of cardiac and sports societies.

Isolated Rupture of the Teres Major Muscle When Water Skiing: A Case Report and Literature Review

Isolated lesions to the teres major muscle are rare. They generally occur in patients participating in sports such as baseball, tennis, or boxing. We report the case of a sports patient who suffered an isolated injury to the teres major while water skiing. The clinical presentation was confirmed by MRI. Conservative treatment was chosen and consisted of brief analgesic immobilization, followed by rehabilitative treatment. The rapid recovery of this patient with normal isokinetic strength evaluation at 6 months was interesting for objectifying full muscle recovery. Our results and the data from the literature suggest that functional rather than surgical treatment is preferable in isolated lesions to the teres major muscle.

Letter to the editorProsthetic joint infection with pseudo-tumoral aspect due to Mycobacterium bovis infection after Bacillus-Calmette-Guerin therapy

Annals of Physical and Rehabilitation Medicine - In Press. Accepted Manuscript Available online since vendredi 8 septembre 2017

Therapeutic Alternatives: Principles and Results

Muscle injuries are the most common traumas occurring during sports practice. The heterogeneity of the severity of these injuries probably explains the lack of clinical studies on their treatment. Accordingly, treatment principles are derived from empirical tests or from studies with low levels of proof. The RICE protocol (rest, ice, compression and elevation) is universally recognized. The aim is to fight pain and bleeding immediately after injury and during the first 5 days after the initial trauma. Mobilization of the muscle is recommended as soon as possible when pain at rest has disappeared. Muscle strengthening and stretching should be carried out gradually to induce remobilization without re-rupture and to allow return to daily activities. Rehabilitation programs, based on progressive eccentric, agility and trunk stabilization exercises help to organize the muscle scar and to recover full muscle strength and flexibility. Retraining programs can be built around the specific practices of the sport when no pain is present during muscle contraction and stretching. The duration of these phases depends on the type of muscle injury and the individual possibility of scaring. Evaluations using an isokinetic dynamometer or testing on the field can be used to follow and manage treatment before recovery and return to competition. Several therapeutic alternatives are presented to decrease the duration of the muscle treatment but always need to be evaluated in studies with good methodology.