References of "DANIEL, Christophe"
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See detailQuality of life benefits of knee arthroplasty for osteoarthritis
NEUPREZ, Audrey ULg; François, Garance ULg; KURTH, William ULg et al

in Osteoporosis International (2014), 25(2), 40

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See detailCritères de retour sur le terrain après plastie LCA chez le footballeur professionnel
Croisier, Jean-Louis ULg; Rochcongar, Pierre; Bruyère, Olivier ULg et al

in European Journal of Sports Medicine (2013, September), 1(1),

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See detailHazard factors of ACL rupture: Neuromuscular factors
Kaux, Jean-François ULg; Delvaux, François ULg; MASSART, Nicolas ULg et al

in European Journal of Sports Medicine (2013, September), 1(supplement 1), 50-51

Injuries to the anterior cruciate ligament (ACL) of the knee are disabling, often associated with other intra-articular damages and increase the risk of early onset of osteoarthritis. It is very probable ... [more ▼]

Injuries to the anterior cruciate ligament (ACL) of the knee are disabling, often associated with other intra-articular damages and increase the risk of early onset of osteoarthritis. It is very probable that multiple risk factors act in combination to influence injury risk. It is important to have a comprehensive understanding of these ACL risk factors, whose neuromuscular factors, even if investigations on neuromuscular factors reported to date do not provide a complete understanding of ACL injury risk. According to several recent studies, the neuromuscular control of joint biomechanics during a specific activity seems to represent a predicting factor of an ACL injury, by quantifying the intersegmental forces and moments generated about the tibio-femoral joint. Laboratory studies have shown that landing from a jump performs cutting and pivoting maneuvers with less knee and hip flexion, increases knee valgus and internal rotation of the hip coupled, with increased external rotation of the tibia and quadriceps muscle activation (especially in women). It has been hypothesized that these movement patterns increase the strain in the ACL during activity and that the large difference in knee injury incidence rates between males and females (1/4.5) may be attributed to neuromuscular differences and resultant mechanics. Although studies have shown that the position of the knee and the magnitude and sequence of muscle contraction can increase ACL strain values, it is hard to exactly correlate these movements to what occurs during activity and sport and at the time of ACL injury. Recently, a simpler assessment tool has been validated and is able to be administered in a clinic-based testing environment Consequently, the screening for ACL injury risk could be performed on a more widespread population. Athletes who went on to a primary ACL injury also demonstrated significant side to side differences in lower extremity biomechanics as well as reduced relative lower extremity flexor activation relative to an uninjured control population during the vertical drop jump. Similar mechanisms of injury risk have been identified in athletes medically cleared to return to sport after ACL reconstruction. These seminal findings indicate that these abnormal and asymmetrical biomechanical and neuromuscular control profiles are likely both residual to, and exacerbated by, the initial injury. A study revealed that a fatigue-induced protocol altered the latency as well as the magnitude of reflex responses of the hamstring muscles and the tibial translation only in women. The authors of various studies have suggested that the hamstring muscles play an important role in maintaining knee stability and that they protect the ACL during movements of the tibia relative to the femur. Therefore, decreased reflex responses of the hamstring muscles and in turn an increased the tibial translation might contribute to the pathomechanics of the ACL injuries. It is therefore conceivable that the fatigue-induced decrease of the hamstring neuromuscular function may increase the tibial translation and probably contributes to the higher incidence of ACL injuries, especially in women. A preventive approach to decrease ACL injuries could integrate muscle imbalances as a risk factor. If it has been scientifically validated than the muscle strength profile determined by an isokinetic testing offers a predictive value on the hamstring lesion occurrence, similar studies have not permitted such a conclusion about ACL injury. The isokinetic assessments after ACL reconstruction have allowed us to observe, on the healthy contralateral knee, a higher frequency of reduced hamstring/quadriceps ratios. A possible pre-existing weakness in the hamstring and the occurrence of an ACL injury is therefore possible but only a difficult prospective approach due to the multifactorial nature of ligament injuries could clarify that point. In conclusion, a functional analysis of the landing of a jump and an isokinetic muscle strength assessment have been suggested to represent predictive elements of an ACL rupture, but further studies are needed to have a stronger evidence of their predictive qualities of injury. [less ▲]

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

in British Journal of Sports Medicine (2013, July), 47(10 (e3)), 15

Background: Upper patellar tendinopathies remain often chronic and rebel to a thorough conservative treatment. Moreover, the option of a surgical treatment could be disappointing. New treatments are being ... [more ▼]

Background: Upper patellar tendinopathies remain often chronic and rebel to a thorough conservative treatment. Moreover, the option of a surgical treatment could be disappointing. New treatments are being developed. Injection of PRP is one of these. Platelets contain lot of growth factors which would have the potentiality to enhance the healing process of tendons. Even if in vitro and animal experiments have demonstrated this stimulation of tendon healing process1, clinical series are subject to controversy2. Methods: Twenty patients with chronic upper patellar tendinopathy were enrolled. Assessments [VAS, clinical examination with an algometer, algofunctional scores (IKDC and VISA-P), functional assessments (isokinetic and Optojump) and imagery (ultrasounds and MRI)]were made before infiltration of PRP, and 6 weeks and 3 months after. The PRP was obtained by an apheresis system (COM.TEC, Fresenius). Six millilitres of PRP were injected without local anaesthetic. One week after infiltration, patients started a 6-week standardised sub-maximal eccentric reeducation. Results: We observed a very significant improvement of the algofunctional status as soon as 6 weeks after the infiltration of PRP, and continued to a lesser extent up to 3 months. During functional evaluation, pain decreased as well, but without significant improvement of performances. No significant improvements in the imagery were observed. Interestingly, patients who had a VAS equal or below 1 after 3 months post-infiltration were younger (24.7 vs 32.2 y.o.). Moreover, these younger patients had a significant increase of the IKDC score (p=0.003), a significant improvement of pain during isokinetic evaluations (p<0.05), and during Optojump assessments (p=0.01). Seventy-five percent of subjects were able to return to sport, even if only half of these patients recovered the same level than before the tendinopathy. Discussion / Conclusions: This study demonstrates that a local infiltration of PRP associated with a submaximal eccentric protocol is efficient to improve symptoms of chronic upper patellar tendinopathies, non-responsive to classical conservative treatments. However, up to now, there is no consensus on the method to prepare the PRP. Indeed, each technique could provide a very different PRP (variations in the platelet concentrations and of the amount of red and white cells). [less ▲]

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See detailReturn-To-Play criteria after hamstring injury: actual medicine practice in professional soccer
Delvaux, François ULg; Rochcongar, Pierre; Bruyère, Olivier ULg et al

Poster (2013, April 25)

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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 detailAssessment of quality of life in patients undergoing total joint replacement for OA of the lower limb
Neuprez, Audrey ULg; François, Garance ULg; Bruyère, Olivier ULg et al

in Annals of the Rheumatic Diseases (2012, June), 71(Suppl.3), 693

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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 detailInfiltration de concentré plaquettaire dans le traitement des tendinopathies rotuliennes : résultats préliminaires
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; SIMONI, Paolo ULg et al

in 4ème Congrès commun SFMS & SFTS (2011, September)

Introduction : L’évolution de certaines tendinopathies, et plus particulièrement, les tendinopathies rotuliennes aussi appelées Jumper’s knee demeurent relativement rebelles aux traitements ... [more ▼]

Introduction : L’évolution de certaines tendinopathies, et plus particulièrement, les tendinopathies rotuliennes aussi appelées Jumper’s knee demeurent relativement rebelles aux traitements «conservateurs». Divers travaux expérimentaux ont souligné les propriétés réparatrices des plaquettes et de divers facteurs de croissances libérés localement. Ceux-ci peuvent effectivement accélérer la cicatrisation de certains tissus : os, muscles et tendons. Ces recherches ont permis de comprendre l’action plaquettaire en qualité de médiateur et/ou activateur de la cicatrisation tissulaire. Depuis janvier 2010, ce traitement des lésions tendineuses n’est plus repris sur la liste des méthodes dopantes. Matériel et méthodes : Le but de l’étude est de réaliser une injection locale de concentré plaquettaire (PRP) chez des patients présentant une tendinopathie rotulienne supérieure rebelle, évoluant depuis plus de 3 mois, n’ayant plus bénéficié de traitement physique (programme excentrique, ondes de choc) depuis 4 semaines. Les patients bénéficient d’un bilan d’imagerie (échographie et IRM), un bilan fonctionnel ainsi qu’un test clinique algique palpatoire à l’aide d’un algomètre avant le traitement et à 6 semaines. Ils sont également invités à répondre à un questionnaire relatif à l’importance de la douleur et de la situation médico-sportive et fonctionnelle. Le PRP est prélevé à partir de sang autologue par l’intermédiaire d’un système d’aphérèse. L’injection de PRP (± 6 mL) est réalisée, sans anesthésie locale, de manière stérile au niveau de l’insertion proximale du tendon rotulien. Un repos relatif 48 heures après l’infiltration est préconisé. Une rééducation excentrique complémentaire est initiée 1 semaine après l’injection. Un repos sportif spécifique de 6 semaines est maintenu. En cas de douleur, le patient ne peut pas prendre d’anti-inflammatoire mais bien un antidouleur de classe I ou II. Notre protocole a été examiné et approuvé par le Comité d’Ethique Hospitalo-Facultaire Universitaire de Liège. Résultats et discussion : Dix patients présentant une tendinopathie rotulienne supérieure chronique sont actuellement inclus dans l’étude. Les tests et évaluation pré-injection révèlent une douleur persistante à la pointe de la rotule associée généralement à une perte de fonction. L’imagerie permet de confirmer le diagnostic. A 6 semaines de l’injection de PRP, l’évolution clinique est globalement favorable, avec une diminution significative des scores algo-fonctionnels (questionnaires et EVA lors des tests fonctionnels), mais sans amélioration significative des performances physiques. Il n’y a pas non plus de différence significative quant aux explorations d’imagerie médicale 6 semaines après l’injection de PRP. Conclusion: Une injection de PRP in situ semble améliorer cliniquement les patients atteints d’une tendinopathie rotulienne supérieure, à 6 semaines post-infiltration. Cependant, celle-ci ne semble pas avoir de répercussion sur les performances fonctionnelles ni sur l’imagerie médicale après 6 semaines. Un suivi sur une période plus importante est nécessaire pour en apprécier les effets à long terme. [less ▲]

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See detailCritères de retour sur le terrain
Delvaux, François ULg; Rochcongar, P.; Bruyère, Olivier ULg et al

in Abstract book du 7ème Congrès du GIBL (2010, November 27)

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