The anterior cruciate ligament (ACL) rupture is a frequent lesion in athletes. It is incompatible with the practice of high-level sport, especially pivot and contact-pivot ones. The purpose of the ACL reconstruction is to allow the athlete to resume the practice of same sport at the same level.The study involved 51 sports patients operated for ACL reconstruction at the Order of Malta's Hospital center in Dakar during the period from 1 January 2011 to 31 May 2014. The average age of patients was 26.3 years with a male predominance (92.15%). These were professional athletes in 37.25%, amateur in 31.37%, and leisure in 31.37% of the cases. The sport was contact-pivot in 96.6% of the cases, mainly football. The objective functional evaluation was performed using the Lysholm-Tegner scale and laximetry using the GNRB arthrometer. The overall sporting recovery rate was 96% with 54.9% recovery in the same sport at the same level. Professional athletes were 42 times more likely to resume the same sport at the same level as amateurs. Recovery times were 4.7 months for line sports, 9.2 months for pivot / contact-pivot and 11.3 months for the resumption of competition. These delays were shorter for professionals with a return to pivot sport at 8 months.Apprehension and fear of a new injury were the main reason for sport's downtime or decline. Functional and anatomical results were good with a mean Lysholm score of 91% and a GNRB differential of 2.87. No independent factor was predictive of returning to sport at the same level.Returning to sports activity is very likely after an ACL ligamentoplasty, but the return to the same sport at the same level is more uncertain, in the order of 55% despite satisfactory anatomical and functional results, confirming the important role of other factors such as psychological coaching and sport-specific rehabilitation.
The anterior cruciate ligament (ACL) rupture is a frequent lesion in athletes. It is incompatible with the practice of highlevel sport, especially pivot and contact-pivot ones. The purpose of the ACL reconstruction is to allow the athlete to resume the practice of same sport at the same level.The study involved 51 sports patients operated for ACL reconstruction at the Order of Malta's Hospital center in Dakar during the period from 1 January 2011 to 31 May 2014. The average age of patients was 26.3 years with a male predominance (92.15%). These were professional athletes in 37.25%, amateur in 31.37%, and leisure in 31.37% of the cases. The sport was contact-pivot in 96.6% of the cases, mainly football. The objective functional evaluation was performed using the Lysholm-Tegner scale and laximetry using the GNRB arthrometer. The overall sporting recovery rate was 96% with 54.9% recovery in the same sport at the same level. Professional athletes were 42 times more likely to resume the same sport at the same level as amateurs. Recovery times were 4.7 months for line sports, 9.2 months for pivot/contact-pivot and 11.3 months for the resumption of competition. These delays were shorter for professionals with a return to pivot sport at 8 months.Apprehension and fear of a new injury were the main reason for sport's downtime or decline. Functional and anatomical results were good with a mean Lysholm score of 91% and a GNRB differential of 2.87. No independent factor was predictive of returning to sport at the same level.Returning to sports activity is very likely after an ACL ligamentoplasty, but the return to the same sport at the same level is more uncertain, in the order of 55% despite satisfactory anatomical and functional results, confirming the important role of other factors such as psychological coaching and sport-specific rehabilitation.
Osteo-articular complications of sickle cell disease are multiple but mostly dominated by epiphyseal aseptic necrosis.Conservative at the beginning, the surgical treatment becomes radical in the last stage with the performance of a total hip arthroplasty (THA). We report the case of total hip arthroplastyin a patient with sickle cell traitSSat Ordre de Malte Hospital (CHOM) in Dakar, focusing on the peri-operative complications encountered in this particular case in order to prevent them or to treat them if necessary. This is a retrospective, mono-centric study including 15 total hip arthroplasty (THA) performed in 14 SS sickle cell patients over a 66-month period. The postero-lateral Moore mini open approach was used exclusively. The clinical evaluation was based on the Aubigné Postel-Merle (PMA) and Harris (HHS) scores and the radiographic score on the Ficat and Arlet classification. The corticodiaphyseal index as well as the Noble flare index channel made it possible to appreciate the medullary congestion and the shape of the femur.All together, THA in Sickle Cell Disease represented 7.57% of all hip prosthetic activity during the period. The average age of patients (10 women and 4 men) was 29.06 years (18-50). The overall functional result was good and very good in 77% of cases. We observed 4 femoral fissures, an early vesicular lithiasis infection with psoas syndrome and acetabular loosening in the same patient and one death at 5 days postoperatively.
Introduction:The management of traumatic lesions of the menisci is an up to date topic. The treatment has for long remained mutilating and the evolution towards osteoarthritis inevitable. In the light of the original work, important progress has been noted, which now allows conservative arthroscopic treatment in about 20% of cases. The scarcity of data in the West African literature on this topic and the need for a retrospective look at such a treatment which has been practiced at Ordre de Malte Hospital since 2012, motivate this study. Material and Method:This is a retrospective study from 2012 to 2015. A series of 13 meniscal sutures or 10.5% of 124 lesions explored and treated arthroscopically. This exclusive male series whose mean age is 28 years (20 -49) was followed with a average follow-up of 38 months (23 -62). Results:The average consultation time was 2 years and for 11 times (85%) the lesion had occurred following an accident during sport, of a contact + / pivot type . The lesions being found 11 times on the right, 9 times on the medial meniscus, 10 times on the posterior segment, and 9 times on the average segment. It was a bucket handle in 9 cases including 4 dislocated cases. The suture was performed "from outside to inside" and was made stable with an average of 2 points with Prolene 2/0. In 3 cases, this suture was associated with ACL DIDT Ligamentoplasty. We noted as complications: a case of intraoperative failure that led to partial regulation, an early superficial infection of the operative site and a thromboembolic event that had evolved well under treatment. At the last follow-up, 11 patients were satisfied or very satisfied compared to 2 disappointed. The average Lysholm score was 94.7 / 100 with 12 good or excellent results; the IKS score was 100% in all patients and the average knee IKS was 95.6 / 100. IKDC clinical evaluation of 10 patients seen at last follow-up reported 07 patients ranked "A" and 03 ranked "B". Anatomically, the MRI and the Arthro-CT found Research Article
The Anterior Cruciate Ligament (ACL) rupture constitutes the main injury in modern sport. We have been interested in an arthroscopic reconstruction of the ACL using hamstring tendons. This is a prospective study covering a period of 58 months. Eighty-one patients aged 28.60 ± 8.77 years were included. The objective functional evaluation was performed using the IKDC and Lysholm scales; radiographic evaluation using the Aglietti method and laximetry using the GNRB® arthrometer. The mean follow-up for the evaluation was 12.80 ± 3.27 months.The anatomo-clinical results obtained were very satisfactory and allow us to conclude that this is a reliable, low-iatrogenic technique with low morbidity and rapid functional recovery, compatible with the requirements of high-level sports.
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