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".
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..)