Resultats a long terme de la reeducation fonctionnelle dans le traitement du syndrome femoro-patellaire. A propos des 63 patients

Rehabilitation plays a primordial role in the treatment of the patellofemoral syndrome. We wanted to seek in a sample of population suffering from this problem, the factors favoring the occurrence of this syndrome, the rehabilitation result and the continuation of exercises patients and methods: Prospective descriptive study on the rehabilitated patients in a questionnaire form divided in two parts. The first one seeks the information of the patients file demographical, social and professional data, risk factors, clinical assessment and imaging, medical treatment, immediate rehabilitation results. The second part seeks the long-term effect of rehabilitation, the perseverance to exercises and the resumption of professional and sports activities. 78 patients, feminine prevalence 59%; average age: 32.7 years [between 12 and 60 years]. Occurrence favoring factors found: intensive sports 47.4%, profession presenting a risk 14%, traumatism 24.5%, hypermobility 30,7%.Etiology: patellar instability 18/78, dysplasia 2, chondromalacia 14, femoropatellar osteoarthritis 4, non-marked 40. Previous treatment AINS: 45%, efficient in third of cases; previous physical therapy 9/78 [50% failure]. The evaluated results of short-term rehabilitation according to Ficat criteria, regardless of etiology, were satisfying [good or very good] in 77% of cases. Very good: 20.5%; good: 56.5%; acceptable: 19.2%] and bad 3.8%.At long term on 63 patients with an average recession of 18 months [6 months to 3 years] we had very good 22.2%, good: 55.5%, acceptable 20.6% and bad 1.7%. Average duration of carry on of exercises: 4 months. The functional rehabilitation has confirmed its efficiency in the treatment of young patients suffering from patellofemoral syndrome. The education, the life hygiene, the preparation to sports as well as carry on of exercises prevent recurrences

Is MRI effective in detecting interaarticular abnormalities of the injured knee?

Background data Magnetic resonance imaging [MRI] is widely used for the diagnosis of intraarticular anomalies of the knee. Its reliability is controversial mainly in the pediatric population, and its results may vary from one center to the other. The PURPOSE of this study was to assess the validity of MRI in detecting intraarticular abnormalities in patients who sustained an injury of their knee, by comparing its findings to those of arthroscopy. Material and methods: Two hundred and seventeen traumatic knees underwent MRI followed by arthroscopy. Findings of MRI and arthroscopy were statistically compared. Results: Accuracy of MRI was 95.39% and 99.08% for anterior and posterior cruciate ligament ruptures respectively, 85.25% and 90.78% for medial and lateral meniscal tears respectively, and 91.24% for injury of the articular cartilage. There was not a significant difference between the pediatric and the adult populations, except for a greater sensitivity to detect lateral meniscal tears and a better specificity and accuracy to identify chondral lesions in the first group. Variability between centers was significant for the diagnosis of chondral defects. Conclusion The good MRI reliability in detecting intraarticular abnormalities as demonstrated in this report, underlines its importance in the assessment of the injuried knee before arthroscopy

Popliteal cyst in a patient with total knee arthroplasty. A case report and review of the literature

We report a case of total knee arthroplasty [TKA] failure presenting initially as a large popliteal cyst without bony destruction in a 66-year-old woman. A foreign body gigantocellular inflammatory reaction against polyethylene wear particles was found on histology.The size of the cyst and the absence of bony destruction can be due to an exclusive early intramuscular granulomatous reaction. Progressive loosening of the femoral component and narrowing of the joint space heralded the TKA failure