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See detailTendinopathies et plasma riche en plaquettes (PRP) : applications cliniques. Revue de la littérature
Kaux, Jean-François ULg; Crielaard, Jean-Michel ULg

in Journal de Traumatologie du Sport (2012), 3(29), 174-178

Tendinopathies are common and frequently resisting to actual conservative measures. The aim of this review was to gather the actual knowledge concerning the platelet-rich plasma (PRP) treatment in tendon ... [more ▼]

Tendinopathies are common and frequently resisting to actual conservative measures. The aim of this review was to gather the actual knowledge concerning the platelet-rich plasma (PRP) treatment in tendon lesion. However, given the relative recent knowledge about PRP in sports medical, the studies could not yet reproduce the beneficial effects obtained in-vitro. Most studies about the subject indeed show an improvement in symptoms after PRP treatment but, the few studies of high level of evidence are contradictory. Therefore, there is no evidence of formally advise the use of PRP in the treatment of tendinopathy. So the main research field in the close future will have to determine a standard for the manufacture of PRP and the protocols of the future studies in order to be able to compare them. [less ▲]

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See detailL’appareillage orthétique distal du membre inférieur chez le patient neurologique
DOUCHAMPS, Frédéric ULg; Kaux, Jean-François ULg; WANG, François-Charles ULg

in Lettre du Neurologue (La) : le Courrier du Spécialiste (2012), XVI(8), 268-274

La prescription d’une orthèse doit tenir compte: • de la spasticité des muscles tibial postérieur et triceps sural (échelle d’Ashworth) ; • de la force des releveurs (échelle de Lovett) ; • de la statique ... [more ▼]

La prescription d’une orthèse doit tenir compte: • de la spasticité des muscles tibial postérieur et triceps sural (échelle d’Ashworth) ; • de la force des releveurs (échelle de Lovett) ; • de la statique plantaire (pied varus et/ou talus en phase d’appui) ; • de l’âge et du niveau d’activité (sédentaire, sportif) ; • de l’attente des patients. [less ▲]

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See detailUne infiltration de plasma riche en plaquettes (PRP) améliore les symptômes des tendinopathies patellaires supérieures
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; Rodriguez de la Cruz, Carlos ULg et al

in 5ème Congrès Commun SFMES & SFTS (2012, October)

Introduction : Le plasma riche en plaquettes (PRP) aurait des effets bénéfiques sur les symptômes des tendinopathies grâce à la libération locale de leurs nombreux facteurs de croissance. Le but de cette ... [more ▼]

Introduction : Le plasma riche en plaquettes (PRP) aurait des effets bénéfiques sur les symptômes des tendinopathies grâce à la libération locale de leurs nombreux facteurs de croissance. Le but de cette étude est d’évaluer les résultats d’une injection de PRP sur la symptomatologie des patients présentant une tendinopathie patellaire supérieure. Matériels et Méthodes : Vingt patients atteints d’une tendinopathie patellaire supérieure, rebelle aux traitements conservateurs classiques depuis au moins 3 mois, ont bénéficié d’une évaluation du statut algo-fonctionnel (EVA, algomètre de pression, VISA-P et IKDC) et des performances physqiues (isocinétique et optojump), ainsi que d’un bilan d’imagerie (échographie et IRM). Ces analyses ont été réalisées en pré-injection ainsi qu’aux 6èmeet 12èmesemaines post-injection. Le test isocinétique évaluait la force des quadriceps et des ischios-jambiers des deux membres suivant différentes modalités (C60°/sec, C240°/sec et E30°/sec). Le test Optojump évaluait la détente et la puissance musculaire par la mesure de la hauteur de saut via deux modalités («Counter Movement Jump » et « Drop Jump »). Le PRP est obtenue à l’aide d’une machine d’aphérèse (COM.TEC, Fresenius-Kabi), permettant d’obtenir une concentration plaquettaire reproductible d’un patient à l’autre, en l’absence quasi totale de globules rouges et blancs. L’infiltration intratendineuse de PRP (6mL) est réalisé à la pointe de la rotule in loco dolenti sans anesthésie locale. Résultats : Les résultats de notre expérimentation démontrent qu’une seule injection locale de PRP accompagnée d’un programme de rééducation excentrique améliore significativement la cicatrisation du tendon patellaire au niveau du score EVA, de l’algomètre de pression, des scores VISA-P et IKDC. Lors du test isocinétique, seuls l’augmentation du MFM des ischios jambiers en C240°/sec, de la différence bilatérale des ischios jambiers en C60°/sec ainsi que de l’EVA en E30°/sec était significative. Les résultats optojump en terme de détente et puissance musculaire ne montrent pas d’amélioration des performances. Néanmoins, l’EVA du « Counter Movement Jump » se voit significativement diminuée après l’infiltration. Enfin, les résultats de l’imagerie (échographie et IRM) ne démontrent pas de modification significative du tendon. Conclusions : L’injection locale de PRP dans le cadre de tendinopathies patellaires supérieure permet une diminution de la symptomatologie douloureuse à 6 semaines, se poursuivant à 12 semaines. La performance fonctionnelle et l’imageries, quant à elles, ne sont pas modifiées. [less ▲]

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See detailTendinopathies et plasma riche en plaquettes : applications cliniques
Kaux, Jean-François ULg

in 5ème Congrès Commun SFMES & SFTS (2012, October)

Les lésions tendineuses représentent au sein d’une population sportive ou de travailleurs de force une proportion élevée des lésions de surcharge. Leur incidence atteint 30% des pathologies musculo ... [more ▼]

Les lésions tendineuses représentent au sein d’une population sportive ou de travailleurs de force une proportion élevée des lésions de surcharge. Leur incidence atteint 30% des pathologies musculo-squelettiques ; la douleur limite régulièrement les capacités fonctionnelles et athlétiques (1). Actuellement, ces tendinopathies demeurent un défi thérapeutique car certaines évoluent selon un mode désespérément chronique en raison de leur caractère rebelle aux différentes thérapeutiques conservatrices classiques (anti-inflammatoires, rééducation, ondes de choc...). Les infiltrations de plasma riche en plaquettes (PRP) pourraient représenter une alternative espoir thérapeutique suite aux résultats de diverses expérimentations in vitro et animales (2). Les résultats favorables relatés par les médias sportifs contrastent parfois singulièrement avec les études cliniques. Le PRP ne figure plus sur la liste des produits dopants depuis janvier 2011 (www.wada-ama.org) contrairement aux produits sanguins labiles (3).Cette revue actualise le traitement des lésions tendineuses (épicondylite, tendinopathies de coiffe, patellaire et calcanéenne) ainsi que les fasciites plantaires par plasma riche en plaquettes (3). Etant donné le caractère récent de ce traitement dans le domaine médico-sportif, les études cliniques réalisées à ce jour n’ont pas confirmé les effets bénéfiques obtenus in vitro. Certaines études démontrent une amélioration de la symptomatologie suite au traitement par PRP, mais d’autres études apparaissent contradictoires. Cependant, il est communément admis qu’après l’infiltration, une (auto-)rééducation excentrique sous-maximale progressive améliore la qualité de la cicatrisation tendineuse. Le PRP initie un processus cicatriciel, secondairement développé par le vecteur des forces excentriques (4). L’avenir du PRP nécessite une standardisation de la procédure de recueillement permettant d’éviter la collecte des globules rouges et blancs pouvant être délétères au processus cicatriciel (chaque technique produit un PRP différent (5)), ainsi que la réalisation de protocoles standardisés permettant de comparer les futurs travaux. De plus, le type de tendon exercerait-il un effet sur la réponse de guérison ? Celle-ci serait-elle différente entre certains tendons volumineux (calcanéen, patellaire) et les autres (épicondyliens, coiffe des rotateurs...) ? Références: Kaux et al. Current opinion on tendinopathy. Journal of Sports Sciences and Medicine, 2011; 10:238-253. Kaux et al. Effects of platelet-rich plasma (PRP) on the healing of Achilles tendons of rats. Wound Repair and Regeneration, 2012 ; 5: 748-756. Smets et al. Applications cliniques du plasma riche en plaquettes (PRP) dans les lésions tendineuses : revue de la littérature. Science & Sport, 2012; 27:141-153 Kaux et al. Eccentric training improves tendon biomechanical properties: a rat model. Journal of Orthopaedic Research, 2012; DOI: 10.1002/jor.22202 Kaux et al. Etude comparative de cinq techniques de préparation plaquettaire (platelet-rich plasma). Pathologie-Biologie, 2011; 59: 157-160. Plus de références sur orbi.ulg.ac.be [less ▲]

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See detailLe dosage des acides gras érythrocytaires : comparaison entre une population de référence et des sujets ayant présenté un infarctus aigu du myocarde.
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; Leroy, Ludovic et al

in Immuno-Analyse & Biologie Spécialisée [=IBS] (2012), 27(5), 237-243

The aim of our study was to compare reference values for these FA with data obtained in a population of acute myocardial infarction patients. We performed the quantification of different FA by gas ... [more ▼]

The aim of our study was to compare reference values for these FA with data obtained in a population of acute myocardial infarction patients. We performed the quantification of different FA by gas chromatography associated with flame ionization detector ( FA determination is a new tool we are able to use and to process in our laboratory which can help the clinician to screen patients with the highest cardiovascular risks because of the implication of FA in the etiopathogeny of atherosclerosis. [less ▲]

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See detailEffects of platelet-rich plasma (PRP) on the healing of Achilles tendons of rats
Kaux, Jean-François ULg; Drion, Pierre ULg; Colige, Alain ULg et al

in Wound Repair & Regeneration : Official Publication of the Wound Healing Society and the European Tissue Repair Society (2012), 20(5), 748-756

Platelet-Rich Plasma (PRP) contains growth factors involved in the tissular healing process. The aim of the study was to determine if an injection of PRP could improve the healing of sectioned Achilles ... [more ▼]

Platelet-Rich Plasma (PRP) contains growth factors involved in the tissular healing process. The aim of the study was to determine if an injection of PRP could improve the healing of sectioned Achilles tendons of rats. After surgery, rats received an injection of PRP (n=60) or a physiological solution (n=60) in situ. After 5, 15 and 30 days, 20 rats of both groups were euthanized and 15 collected tendons were submitted to a biomechanical test using cryo-jaws before performing transcriptomic analyses. Histological and biochemical analyses were performed on the 5 remaining tendons in each group. Tendons in the PRP group were more resistant to rupture at 15 and 30 days. The mechanical stress was significantly increased in tendons of the PRP group at day 30. Histological analysis showed a precocious deposition of fibrillar collagen at day 5 confirmed by a biochemical measurement. The expression of tenomodulin was significantly higher at day 5. The mRNA level of type III collage, matrix metalloproteinase 2, 3 and 9 was similar in the 2 groups at all time points whereas type I collagen was significantly increased at day 30 in the PRP group. In conclusion, an injection of PRP in sectioned rat Achilles tendon influences the early phase of tendons healing and results in an ultimate stronger mechanical resistance. [less ▲]

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See detailPlatelet-rich plasma (PRP) to treat patellar tendinopathy: preliminary results
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; SIMONI, Paolo ULg et al

in Regional Anesthesia & Pain Medicine (2012, September), 37(5 - Suppl 1), 216

Introduction: Patellar tendinopathy, often remain rebel to conservative treatments. Researches have specifically demonstrated the platelets action as mediator and/or enhancer of tissue healing. The aim of ... [more ▼]

Introduction: Patellar tendinopathy, often remain rebel to conservative treatments. Researches have specifically demonstrated the platelets action as mediator and/or enhancer of tissue healing. The aim of our study was to investigate the effect of 1 injection of PRP in patients suffering from chronic patellar tendinopathy. Methods: Patients performed imaging (US and MRI) and functional assessments, and a clinical examination using an algometer, before treatment and 6 weeks after PRP treatment. They were also invited to answer to questionnaire relative to pain and functional status. PRP was obtained from autologous blood using an apheresis system (COM.TEC, Fresenius). The injection of 6mL of PRP was realised without local anaesthesia into the proximal insertion of the patellar tendon. A 48h rest-time was recommended after infiltration. Afterwards, a submaximal eccentric reeducation was initiated 1 week after infiltration 3 times a week during 5 weeks. In case of pain, anti-inflammatory drugs were prohibited and patient were encouraged to take class I or II painkillers. Results: At this time, 10 patients with patellar tendinopathy were included in our study. Pre-injection tests revealed pain of the upper part of the patellar tendon just below the patella, associated with loss of function. Imaging exams confirmed diagnosis. Six weeks post-injection, the clinical status was improved in all patients, with a significant decrease of algo-functional scores. The pain reported during functional assessments was decreased (in particular for the eccentric actions), yet no significant improvement of physical performances was observed. We found no significant differences between imaging exams before and 6 weeks after PRP injection. Conclusion: One in situ injection of PRP clinically improved patients with patellar tendinopathy 6 weeks after treatment. All the 10 patients reported a decrease of pain during day-life and through physical activities. However nor functional performances neither imaging were improved. [less ▲]

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See detailCurrent evidence and indications for Prolotherapy with Platelet Rich Plasma in chronic musculoskeletal conditions
Kaux, Jean-François ULg; Crielaard, Jean-Michel ULg

in Regional Anesthesia & Pain Medicine (2012, September), 37(5 - Suppl 1), 104-106

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See detailImpact of extracorporeal shock wave therapy in the treatment of chronic lateral epicondylitis
Deroanne, Adrien; Deroanne, Didier; Florkin, Marc et al

in Regional Anesthesia & Pain Medicine (2012, September), 37(5 - Suppl 1), 263

Background and aim: radial shock wave therapy (RSWT) is a relatively new way to treat chronic tendinopathies, such as lateral epicondylitis. However, very few studies have been realized on this subject ... [more ▼]

Background and aim: radial shock wave therapy (RSWT) is a relatively new way to treat chronic tendinopathies, such as lateral epicondylitis. However, very few studies have been realized on this subject, and the results are very divergent. We aimed to observe the impact of this technique on chronic lateral elbow pain. Method: fifteen subjects who had a lateral epicondylitis for at least 3 months were included in the study. Two groups were formed: experimental (10 subjects) who received 6 sessions of physiotherapy and RSWT, and the control group (5 subjects) who received exclusively physiotherapy. Physiotherapy sessions were composed of massage, stretching, diacutaneous fibrolysis, and a muscular eccentric program of the wrist extensor muscles. We evaluated the subjects before the first session, and after 6 weeks of treatment with a pain visual analog scale (VAS), the painless wrist flexion amplitude, ant the “Patient-Rated Tennis Elbow Evaluation” (PRTEE) questionnaire. Results: the difference between initial and final evaluations was significant (regarding to the wilcoxon test) for all of the parameters studied (p=0,028 for the VAS, p=0,005 for the wrist flexion amplitude, and p=0,005 for the PRTEE) in the experimental group. It wasn’t significant in the control group (VAS p=0,144128, wrist flexion amplitude p=0,079617, and PRTEE p=0,067890). The comparison between the two groups was not significant, neither in the beginning, nor in the end of the treatment (regarding to the Umann and Whitney test) Conclusions: RSWT associated to physiotherapy is a more effective treatment for lateral epicondylitis than physiotherapy alone. [less ▲]

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See detailRace cycling: biological evolution
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; Goffaux, Sébastien et al

in Meeusen, R; Duchateau, J; Roelands, B (Eds.) et al Book of Abstracts of the 17th annual Congress of the ECSS (2012, July)

Introduction: The metabolic and cardiac impact of a cycling effort on blood biology is not very well described in the literature. We aimed to measure the concentration of different biomarkers (cardiac and ... [more ▼]

Introduction: The metabolic and cardiac impact of a cycling effort on blood biology is not very well described in the literature. We aimed to measure the concentration of different biomarkers (cardiac and metabolic) released during an international cycling race. Materials and methods: Venous blood samples of 15 young men (25.1 ± 6.4 y.o.) were collected just before (T1), just after (T2), 3 hours (T3) after an international cycling race of 179.6 kilometers in Belgium for the determination of cardiac and metabolic biomarkers: red blood cell (RBC), haemoglobin (HgB), creatinin (Cr), highly sensitive troponin T (hsTnT), myoglobin (MYO) and NT-proBNP. All automated assays were performed according to the manufacter’s specifications. For the statistical analysis, an Anova calculated with the Statistica Software version 9.1 was used. Results and discussions: RBC and HgB levels varied significantly between T0 and T3 (respectively p=0.0026, and p=0.002). Cr concentration also varied significantly between all times (T0-T1:p<0.0001, T1-T3:p=0.0326 and T0-T3 p=0.0001). These changes might be related to renal flow depletion during exercice. MYO increased significantly between T0 and T1 (p<0.0001), but quickly decreased between T1 and T3, however the T3 level stay higher than T0 (p=0.014). The stress delivered from the physical activity performed during the race induced a significant variation of hsTnT which increased significantly between T0 and T1 (p<0.0001) and stayed higher 3 hours after the end of the exercise (T0-T3: p<0.0001). The intense exercise delivery by the race induced a significant variation of NT-proBNP, that followed the same kinetic of hsTnT but in smaller proportion. We noticed variations statistically significant between T0 and T1 and between T0 and T3 for NT-proBNP. These increases of cardiac biomarkers were significant but reasonable and could not allow us to talk about cellular necrosis or irreversible injury. Conclusion: Our results show that stress generated by a cycling race could be the cause for the different metabolic variations observed. Troponin T stays without a doubt the most specific marker for stress related to myocardial tissue. Its increase can then be considered as being of interest. [less ▲]

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See detailImpact of strenous exercise on the release of cardiac biomarkers
LE GOFF, Caroline ULg; MELON, Pierre ULg; Kaux, Jean-François ULg et al

in Meeusen, R; Duchateau, J; Roelands, B (Eds.) et al Book of Abstracts of the 17th annual Congress of the ECSS (2012, July)

Background: Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury and NT-proBNP as the best for the cardiac insufficiency. In this study, cTnT was measured ... [more ▼]

Background: Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury and NT-proBNP as the best for the cardiac insufficiency. In this study, cTnT was measured by new commercially available high-sensitive methods in subjects undergoing the Maasmarathon. Our aim was to compare cTnT and NT-proBNP levels in sportive subjects before and after a strenuous exercise. Materials and Methods: Twenty eight subjects (26 ♂, 42.5±11yo) underwent a race of 42.195 kilometers between Visé (Belgium) and Maastricht (The Netherlands). We drowned blood samples before (T0), just after (T1) and three hours after the race (T3). For all patients, cTnT concentrations were measured by high sensitive methods (hsTnT, Roche Diagnostics) on heparin plasma. The NT-proBNP was also determined with the kit Roche on heparin plasma. The protocol was approved by the ethics committee of the University of Liège (Belgium). All subjects gave their informed consent. All statistical analyses were performed using Medcalc version 8.1 for Windows. p-value <0.01 was regarded as statistically significant. Results and discussion: A significant difference between hsTnT concentrations at T0 and T1 (p<0.0001) was measured as well as between T0 and T3 (p<0.001) for NT-proBNP, but not between T1 and T3. This observation appeared only after a strenuous exercise but today this type of exercise is not reproduce easier in a laboratory of sport. Moreover, at this moment, nobody knows if these observations would have cardiac consequences at long terms. Conclusions: Measurement of cardiac troponins by high sensitive methods allows detecting significant release of biomarkers from the heart during exercise. The levels of NT-proBNP were found significantly increased but in less extent than TnThs. We think that the TnThs could be an interesting marker in the future to help sport medicine to detect risk of developing a cardiac problem. [less ▲]

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See detailInfluence of type of contraction upon tendinous tissue during training: animal model
Kaux, Jean-François ULg; Drion, Pierre ULg; Croisier, Jean-Louis ULg et al

in Meeusen, R; Duchateau, J; Roelands, B (Eds.) et al Book of Abstracts of the 17th annual Congress of the ECSS (2012, July)

Introduction: The treatment of choice for tendinopathies is eccentric reeducation. Although the clinical results appear favourable, the biomechanical changes to the tissue are not yet clear. Materiel and ... [more ▼]

Introduction: The treatment of choice for tendinopathies is eccentric reeducation. Although the clinical results appear favourable, the biomechanical changes to the tissue are not yet clear. Materiel and methods: This study compared the effects of two methods of training (eccentric (E) training and concentric (C) training) with untrained (U) rats. The animals underwent training over a period of five weeks. The tricipital, patellar and Achilles tendons were subsequently removed to perform a traction test to the point of tendon rupture, and a histological analysis was performed. Results: There was a significant improvement in the rupture force of the patellar and tricipital tendons between the U and E groups. The tricipital tendons in the control group presented a significantly smaller cross-section than the E- and C-trained groups. No significant difference was observed for the constraints between the three groups for all three tendons. However, a tendency towards improvement was observed between the trained and the U groups for the patellar tendon. Histological studies demonstrated the development of a greater number of blood vessels and a larger quantity of collagen in the eccentric group. Discussion and conclusion: The mechanical properties of tendons in rats improve after specific training, especially following eccentric training. [less ▲]

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See detailPlatelet-rich plasma (PRP) to treat upper patellar tendinopathies
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; SIMONI, Paolo ULg et al

in Meeusen, R; Duchateau, J; Roelands, B (Eds.) et al Book of Abstracts of the 17th annual Congress of the ECSS (2012, July)

Introduction: Tendinopathies, especially upper patellar tendinopathy also known as jumper’s knee, often remain rebel to conservative treatments. Several experimental studies have shown the healing ... [more ▼]

Introduction: Tendinopathies, especially upper patellar tendinopathy also known as jumper’s knee, often remain rebel to conservative treatments. Several experimental studies have shown the healing properties of platelet and their growth factors. These factors have the potentiality to improve healing of different tissues: bones, muscles, tendons... Researches have specifically demonstrated the platelets action as mediator and/or enhancer of tissue healing. On the other hand, such treatment has been totally removed of list of doping treatments. The aim of our study was to investigate the effect of 1 injection of PRP in patients suffering from chronic jumper’s knee. Methods: Patients performed imaging (US and MRI) and functional assessments, and a clinical examination using an algometer, before treatment and 6 weeks after PRP treatment. They were also invited to answer to questionnaire relative to pain and functional status. PRP was obtained from autologous blood using an apheresis system (COM.TEC, Fresenius). The injection of 6mL of PRP was realised without local anaesthesia into the proximal insertion of the patellar tendon. A 48h rest-time was recommended after infiltration. Afterwards, a submaximal eccentric reeducation was initiated 1 week after infiltration 3 times a week during 5 weeks. In case of pain, anti-inflammatory drugs were prohibited and patient were encouraged to take class I or II painbrakers. Our protocol was approved by Ethic Committee of University and University Hospital of Liège. Results: Eighteen patients with jumper’s knee were included in our study. Pre-injection tests revealed pain of the upper part of the patellar tendon just below the patella, associated with loss of function. Imaging exams confirmed diagnosis. Six weeks post-injection, the clinical status was improved for the majority of the patients, with a significant decrease of algo-functional scores. The pain reported during functional assessments was decreased (in particular for the eccentric actions), yet no significant improvement of physical performances was observed. We found no significant differences between imaging exams before and 6 weeks after PRP injection. Conclusion: One in situ injection of PRP clinically improved patients with jumper’s knee 6 weeks after treatment. Most patients reported a decrease of pain during day-life and through physical activities. However nor functional performances neither imaging were improved. A followup at 3 months is actually in process to evaluate more long term efficacy of PRP treatment. [less ▲]

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See detailApplications cliniques du plasma riche en plaquettes (PRP) dans les lésions tendineuses : revue de la littérature
Smets, Fanny; Croisier, Jean-Louis ULg; Forthomme, Bénédicte ULg et al

in Science & Sports (2012), 27(3), 141-153

Tendinopathies are common and frequently resisting to actual conservative measures. The aim of this review was to gather the actual knowledge concerning the platelet-rich plasma (PRP) treatment in tendon ... [more ▼]

Tendinopathies are common and frequently resisting to actual conservative measures. The aim of this review was to gather the actual knowledge concerning the platelet-rich plasma (PRP) treatment in tendon lesion. The interest of this well-known technique, applied since almost 15 years in facial and dental surgery, is growing in the sports world because of its potential ability to treat refractory tendinopathies and to get back quickly a functional use. However, given the relative recent knowledge about PRP in sports medical, the studies could not yet reproduce the beneficial effects obtained in-vitro. Most studies about the subject indeed show an improvement in symptoms after PRP treatment but, because of the many biases introduced, such as the lack of population, the lack of control group or the many different kind of PRP used, the studies cannot be conferred a high level of evidence. Therefore, there is no evidence of formally advise the use of PRP in the treatment of tendinopathy. So the main research field in the close future will have to determine a standard for the manufacture of PRP and the protocols of the future studies in order to be able to compare them. [less ▲]

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See detailL'épaule du sportif : Evaluation fonctionnelle et réadaptation
Forthomme, Bénédicte ULg; Kaux, Jean-François ULg; Crielaard, Jean-Michel ULg et al

in Ortho-Rhumato (2012), 10(3), 46-50

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See detailCes tendinopathies qui nous submergent
Kaux, Jean-François ULg

Conference (2012, May 05)

Des traitements conservateurs classiques ( AINS, infiltrations, rééducation excentrique) aux nouveaux traitements ( ondes de choc, concentrés plaquettaires, …) . Chirurgie. Particularités de l’épaule.

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See detailActualités sur l'emploi du PRP dans les tendinopathies
Kaux, Jean-François ULg

in 31ème Séminaire AMDTS de Traumatologie du Sport (2012, May)

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See detailEffects of platelet-rich plasma on the healing of tendons: animal model
Kaux, Jean-François ULg; Drion, Pierre ULg; Colige, Alain ULg et al

in Biomedica 2012 (2012, April)

Introduction: Platelet-Rich Plasma (PRP) contains lot of growth factors which could enhance the healing process of different tissues. We aimed to determine if a single injection of PRP could improve the ... [more ▼]

Introduction: Platelet-Rich Plasma (PRP) contains lot of growth factors which could enhance the healing process of different tissues. We aimed to determine if a single injection of PRP could improve the cicatrisation of ruptured Achilles tendons of rats. Material and Methods: A 5mm defect was surgically made in the Achilles tendon of 120 rats. A few hours after surgery, 45 rats received a PRP or PBS injection in situ. After 5, 15 and 30 days, 20 rats of both groups were euthanized and 15 collected tendons were immediately submitted to a biomechanical tensile strength test until rupture using a “cryo-jaw” device. After, theses samples were used for transcriptomic analyses. Histological and biochemical analyses were performed on the five remained tendons in each group. Results: Tendons in the PRP group were more resistant to rupture at 15 and 30 days than those in the control group. The transverse area of tendons in the PRP group was significantly higher at day 5 and 15. The constraint was significantly increased in tendons of the PRP group in the late phase of the healing (day 30). Histological and immunohistological analysis showed an increased staining for fibrillar collagen at day 5 confirmed by a biochemical analysis showing an increased collagen concentration in the callus. The expression of tenomodulin, a tenocyte differentiation marker, was significantly higher in the PRP-treated tendons at day 5. No significant difference in terms of mRNA for type III collagen and matrix metalloproteinase 9 was observed at any time between the 2 groups. Conclusion: A single injection of PRP in sectioned Achilles tendon of rats few hours after surgery influences the early phase of tendons healing, resulting in an ultimate stronger mechanical resistance. [less ▲]

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See detailPlatelet-rich plasma to treat jumper’s knee: preliminary results
Kaux, Jean-François ULg; CROISIER, Jean-Louis ULg; SIMONI, Paolo ULg et al

in Biomedica 2012 (2012, April)

Introduction: Tendinopathies, especially jumper’s knee, often remain rebel to conservative treatments. Several experimental studies have shown the healing properties of platelet and their growth factors ... [more ▼]

Introduction: Tendinopathies, especially jumper’s knee, often remain rebel to conservative treatments. Several experimental studies have shown the healing properties of platelet and their growth factors. Researches have specifically demonstrated the platelets action as mediator and/or enhancer of tissue healing. The aim of our study was to investigate the effect of 1 injection of PRP in patients suffering from chronic jumper’s knee. Our protocol was approved by Ethic Committee of University and University Hospital of Liège. Methods: Patients performed imaging (US and MRI) and functional assessments, and a clinical examination using an algometer, before treatment and 6 weeks after PRP treatment. They were also invited to answer to questionnaire relative to pain and functional status. PRP was obtained from autologous blood using an apheresis system (COM.TEC, Fresenius). The injection of 6mL of PRP was realised without local anaesthesia into the proximal insertion of the patellar tendon. A 48h rest-time was recommended after infiltration. Afterwards, a submaximal eccentric reeducation was initiated 1 week after infiltration 3 times a week during 5 weeks. In case of pain, anti-inflammatory drugs were prohibited and patient were encouraged to take class I or II painbrakers. Results: At this time, 10 patients with jumper’s knee were included in our study. Pre-injection tests revealed pain of the upper part of the patellar tendon just below the patella, associated with loss of function. Imaging exams confirmed diagnosis. Six weeks post-injection, the clinical status was improved in all patients, with a significant decrease of algo-functional scores. The pain reported during functional assessments was decreased (in particular for the eccentric actions), yet no significant improvement of physical performances was observed. We found no significant differences between imaging exams before and 6 weeks after PRP injection. Conclusion: One in situ injection of PRP clinically improved patients with jumper’s knee 6 weeks after treatment. All the 10 patients reported a decrease of pain during day-life and through physical activities. However nor functional performances neither imaging were improved. [less ▲]

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See detailBiological variations during a race cycling
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; Goffaux, Sébastien et al

in Biomedica 2012 (2012, April)

Background: The metabolic and cardiac impact of a cycling effort on blood biology is not very well described in the literature. We aimed to measure the concentration of different biomarkers (cardiac and ... [more ▼]

Background: The metabolic and cardiac impact of a cycling effort on blood biology is not very well described in the literature. We aimed to measure the concentration of different biomarkers (cardiac and metabolic) released during an international cycling race. Materials and Methods: Venous blood samples of 15 young men (25.1 ± 6.4 y.o.) were collected just before (T1), just after (T2), 3 hours (T3) after an international cycling race of 176 kilometers in Belgium for the determination of cardiac and metabolic biomarkers: red blood cells (RBC) haemoglobin (HgB) creatinin (Cr) highly sensitive troponin T (hsTnT) myoglobin (MYO) NT-proBNP All automated assays were performed according to the manufacter’s specifications. For the statistical analysis, an Anova calculated with the Statistica Software version 9.1 was used. Results: •RBC and HgB levels varied significantly between T0 and T3 (respectively p=0.0026, and p=0.002) (Fig. 1 and 2). • Cr concentration also varied significantly between all times (T0-T1:p<0.0001, T1-T3:p=0.0326 and T0-T3 p=0.0001)(Fig.3). These changes might be related to renal flow depletion during exercise. •MYO increased significantly between T0 and T1 (p<0.0001), but quickly decreased between T1 and T3, however the T3 level stay higher than T0 (p=0.014) (Fig.4). •The stress delivered from the physical activity performed during the race induced a significant variation of hsTnT which increased significantly between T0 and T1 (p<0.0001) and stayed higher 3 hours after the end of the exercise (T0-T3: p<0.0001) (Fig.5) . •The intense exercise delivery by the race induced a significant variation of NT-proBNP, that followed the same kinetic of hsTnT but in smaller proportion. We noticed variations statistically significant between T0 and T1 and between T0 and T3 for NT-proBNP (Fig.6). •These increases of cardiac biomarkers were significant but reasonable and could not allow us to talk about cellular necrosis or irreversible injury. Conclusions: Our results show that stress generated by a cycling race could be the cause for the different metabolic variations observed. Troponin T stays without a doubt the most specific marker for stress related to myocardial tissue. Its increase can then be considered as being of interest. [less ▲]

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