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 effectiveness of the treatment of chronic plantar fasciitis (plantar myoapon├ęvrosite) by extracorporeal shock wave (ODCE) was evaluated in 289 patients between 1996 and 2003, through a randomized, double-blind, placebo and cross.
The three main inclusion criteria were selected failure to at least six months of adequate medical treatment (including minimum physiotherapy, orthotics and various local or systemic anti-inflammatory drugs), pain felt by the patient greater than or equal to 5 on the VAS when the pressure exerted by the examiner on the plantar fascia, a pain felt by the patient than or equal to 5 on the VAS after the first 5 minutes of walking in the morning.
All patients received after anesthetic block 1500 shock waves at an intensity of 18 kv at a frequency of 2 Hz, giving a total of 324.25 Joules energy, applied to the maximum area of ??pain in a radius of 1 cm. For the placebo group, a fluid-filled bag is placed in the probe of the device to absorb the shock waves.
Patients were followed for 12 months. They completed a self-assessment questionnaire: rest pain, pain during daily activities, level of recreational activity and ability to work and were regularly assessed by the examiners. 4 success criteria were used: pressure pain and pain in the early morning not reduced by more than 50%, the pain diminished activity of at least 2 points on the VAS, absence of drug intake. A second application was proposed in case of failure.
The results of the study showed 76.8% good and excellent results at 12 months of treatment, with a significant difference compared to placebo. The average age of patients was 48.6 years, 2 women for every man. A heel spur present in 50-60% of heel pain persists after treatment and does not influence the result. Response to treatment was better in patients with a duration of shorter symptoms. No patient was worse.
In conclusion, the treatment of plantar fasciitis is primarily medical, it is satisfactory in 90% of cases. The following regimen may be adopted: first-line orthotics, Stout, to a relaxation of the plantar fascia, associated with NSAID therapy; second-line local infiltration, after eliminating other causes of heel pain and a corrected hyperuricemia; third for the ODCE, one or two sessions with a specialized therapist. Many devices on the market delivering different types of shock waves: infrared, acoustic, radial, electro hydraulic. Only the latter, used in lithotripsy, delivers ODCE of "high energy".
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 in short graft (transplant economy). The half tendon tendon is one of two hamstring tendons (hamstring). It is thin (3-4 mm) and long (about 25 cm). It is the termination of the semitendinosus that ends on the bridle. The harvesting the graft is carried out by a short nearly horizontal incision of 2 cm to the surface of the tibia, is removed only the semitendinosus tendon over its entire length with a stripper. He bent over backwards to get a transplant ACL bundles 4 or 4 strands with diameters ranging from 7 to 9 mm. It's ashort 50 mm average length graft (Fig.8). At both ends of the graft are passed two textile strips for fixing the graft in tunnels. A traction table is used to make a claim to the graft to 500 Newtons
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 ...)
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.
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..)
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.