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See detailEccentric training improves tendon biomechanical properties: a rat model
Kaux, Jean-François ULg; Drion, Pierre ULg; Libertiaux, Vincent et al

in British Journal of Sports Medicine (2014, April), 48(7), 155

Background: Even if eccentric exercises appear favourable in primary prevention of tendons lesions and, especially, in secondary prevention after tendinopathy, the biomechanical changes to the tissue are ... [more ▼]

Background: Even if eccentric exercises appear favourable in primary prevention of tendons lesions and, especially, in secondary prevention after tendinopathy, the biomechanical changes to the tissue are not yet clear. Objective: We aimed to better define the biomechanical changes that affect healthy tendon after eccentric and concentric training. Design: Randomised controlled trial. Participants: Eighteen Sprague-Dawley rats of 2 months. Interventions: The six rats in the control group (U) were not subjected to physical exercise. The 12 remaining rats (6 in each group) ran on a treadmill set at a +15° incline for concentric training (C) or a -15° incline for eccentric training (E), at a speed of 17 m/min for 1 h, three times per week for 5 weeks. Main Outcome Measurements: The tricipital, patellar and Achilles tendons were subsequently removed to perform a traction test until 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, but none between E and C groups. No significant difference was observed for the mechanical stress at rupture per surface unit between the three groups for all three tendons. However, a tendency towards improvement these values was observed between the trained and the U groups for the patellar tendon. Histological studies demonstrated the tendency of the development of a greater number of blood vessels and a larger quantity of collagen in the eccentric group. Conclusions: The mechanical properties of tendons in rats improve after specific training, especially following eccentric training. Our results partly explained how mechanical loading, especially in eccentric mode, could improve the tendon structure. [less ▲]

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See detailRevue épidémiologique des blessures lors de la pratique du rugby à XV
Kaux, Jean-François ULg; Julia, Marc; Chupin, Marie et al

in Journal de Traumatologie du Sport (2014), 31(1), 49-53

Rugby is an increasingly popular sport. Full contact being a major characteristic of rugby, injuries are not uncommon. The incidence of injury in Rugby Union reaches 30–91 per 1,000 hours of game time ... [more ▼]

Rugby is an increasingly popular sport. Full contact being a major characteristic of rugby, injuries are not uncommon. The incidence of injury in Rugby Union reaches 30–91 per 1,000 hours of game time. This epidemiological review of injuries in rugby players reports their localization, nature, causes, moment of occurrence in matches and seasonal trends as well as the influence of the player’s position, field conditions, and duration of off time after injury. [less ▲]

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See detailExuberant inflammatory reaction as a side effect of platelet-rich plasma infiltration for treating one case of tendinopathy
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; LEONARD, Philippe ULg et al

in Clinical Journal of Sport Medicine (2014), 24(2), 150-152

Platelet-rich plasma (PRP) contains a large quantity of growth factors, which may enhance tendon healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To ... [more ▼]

Platelet-rich plasma (PRP) contains a large quantity of growth factors, which may enhance tendon healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To date, no side effects have been reported after infiltration of PRP to treat tendinopathy. We reported a case of exuberant inflammatory reaction after one infiltration of PRP to treat jumper’s knee in a type 1 diabetic patient who was 35 years old. Injections of PRP must be proposed after careful consideration for patients with morbidity risks linked to insulin-dependent diabetes. [less ▲]

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See detailVascular Endothelial Growth Factor-111 (VEGF-111) and tendon healing: preliminary results in a rat model of tendon injury
Kaux, Jean-François ULg; Janssen, Lauriane ULg; Drion, Pierre ULg et al

in Muscle, Ligaments and Tendons Journal (2014), 1(5), 25-28

Tendon lesions are among the most frequent musculoskeletal pathologies. Vascular endothelial growth factor (VEGF) is known to regulate angiogenesis. VEGF-111, a biologically active and proteolysis ... [more ▼]

Tendon lesions are among the most frequent musculoskeletal pathologies. Vascular endothelial growth factor (VEGF) is known to regulate angiogenesis. VEGF-111, a biologically active and proteolysis-resistant splice variant of this family, was recently identified. This study aimed at evaluating whether VEGF-111 could have a therapeutic interest in tendon pathologies. Surgical section of one Achilles tendon of rats was performed before a local injection of either saline or VEGF-111. After 5, 15 and 30 days, the Achilles tendons of 10 rats of both groups were sampled and submitted to a biomechanical tensile test. The force necessary to induce tendon rupture was greater for tendons of the VEGF-111 group (p<0.05) while the section areas of the tendons were similar. The mechanical stress was similar at 5 and 15 days in the both groups but was improved for the VEGF-111 group at day 30 (p <0.001). No difference was observed in the mRNA expression of collagen III, tenomodulin and MMP-9. In conclusion, we observed that a local injection of VEGF-111 improves the early phases of the healing process of rat tendons after a surgical section. Further confirmatory experimentations are needed to consolidate our results. [less ▲]

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See detailVitamien D et pahtologies cardiovasculaires
LE GOFF, Caroline ULg

Scientific conference (2013, November 16)

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See detailTechnical and clinical evaluation of the VITROS Immunodiagnostic Products 25-OH Vitamin D Total Assay - comparison with marketed automated immunoassays and a liquid chromatography - tandem mass spectrometry method
CAVALIER, Etienne ULg; ROUSSELLE, Olivier ULg; FERRANTE, Nunzio ULg et al

in Clinical Chemistry & Laboratory Medicine (2013), 51(10), 1983-1989

Background: The study was conducted to evaluate the technical and clinical performance of the VITROS ® Immunodiagnostic Products 25-OH Vitamin D Total Assay, and compare it with the performance of five ... [more ▼]

Background: The study was conducted to evaluate the technical and clinical performance of the VITROS ® Immunodiagnostic Products 25-OH Vitamin D Total Assay, and compare it with the performance of five marketed automated assays and a liquid chromatography/mass spectrometry reference method (LC-MS/MS). Methods: Three hundred patient serum samples were used to compare the correlation of the VITROS ® 25-OH Vitamin D Total Assay with both the other immunoassays and the LC-MS/MS method, using Passing-Bablok regression and Bland-Altman analyses. Concordance of the diagnosis of vitamin D status was calculated to test the agreement between the different assays. In addition, samples containing vitamin D2 were used to test the assay ’ s ability to detect the D2 form of the vitamin. Results and conclusions: These results from the VITROS ® 5-OH Vitamin D Total Assay generally correlated well with those from most of the marketed immunoassays. Cross-reactivity of the D2 form was calculated as being close to 100%. Additionally, we found substantial variability in performance amongst the various assays, which suggests the need for optimisation and recalibration of commercial methods. [less ▲]

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See detailRéaction inflammatoire exubérante comme effet secondaire d’une infiltration de PRP
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; LEONARD, Philippe ULg et al

in Annals of Physical and Rehabilitation Medicine (2013, October), 56(Sup 1), 068

Introduction : Infiltrations of plasma rich platelets (PRP) represent a new treatment of tendinopathies. Currently, no side effects were reported in this indication. Case report: We report the case of a ... [more ▼]

Introduction : Infiltrations of plasma rich platelets (PRP) represent a new treatment of tendinopathies. Currently, no side effects were reported in this indication. Case report: We report the case of a 35-year-old type 1 diabetic patient with right upper patellar tendinopathy that had persisted for more than 6 months. The patient benefited from an intratendinous infiltration of 6 mL of PRP (8.105 platelets/mm3, almost no red or white blood cells) after a carefully disinfection but without local anesthesia. Typically, a standardized program of sub-maximal eccentric rehabilitation should be started 1 week after infiltration. However, the patient experienced local swelling with erythema, increased heating and pain, which appeared just underneath the patella, without biological inflammatory syndrome. In absence of septic general symptoms, no blood or wound culture were made. At 2 weeks post-infiltration, a greatly increased Doppler signal in a thicker tendon was observed by ultrasounds compared to that before infiltration, but there was no sign of infection demonstrated by either MRI or CT. However, the local inflammation did not decrease after a 3-week treatment of local cryotherapy, local and oral NSAID, and adjunct use of colchicine 1 mg. Thus, an insidious infection was suspected, even though there was no evidence of biological inflammatory syndrome or sign of infectious lesion on imagery examination. Antibiotic therapy (rifampicine 600 mg + minocycline 100 mg), was initiated for three months. Due to a lack of improvement via imaging and clinical examination, a 3-phase bone scintigraphy was performed. The results suggested the presence of a complex regional pain syndrome type 1. The patient benefited from classical physical therapy and concomitant pain killers. The evolution was favorable after 6 months of treatment. Discussion : Even though PRP infiltration represents a new and promising treatment for tendinopathy, more studies are needed both to verify its clinical efficacy. Moreover, implementing this innovative treatment requires caution because of potential adverse events. Thus, the balance between benefits and risks must be carefully evaluated before using this treatment, especially in patients with type 1 diabetes. [less ▲]

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See detailUne infiltration de plasma riche en plaquettes (PRP) pour traiter les tendinopathies rotuliennes supérieures chroniques
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; Bruyère, Olivier ULg et al

in Annals of Physical and Rehabilitation Medicine (2013, October), 56(Sup 1),

Objective: Jumper’s knee is a frequent chronic overuse syndrome of the upper part of the patellar tendon. Platelets contain lots of growth factors which could enhance the healing process of tendons ... [more ▼]

Objective: Jumper’s knee is a frequent chronic overuse syndrome of the upper part of the patellar tendon. Platelets contain lots of growth factors which could enhance the healing process of tendons. Infiltration of platelet-rich plasma (PRP) could be a new therapy for such chronic tendinopathies. Materiel and methods: Twenty patients with chronic upper patellar tendinopathy were enrolled. Assessments were made before infiltration of PRP, and 6 weeks and 3 months after the infiltration, using a 10-point Visual Analogic Scale, clinical examinations with a pressure algometer, algofunctional scores (IKDC and VISA-P), functional assessments (isokinetic and optojump evaluations) and imagery (ultrasounds and MRI). The PRP was obtained with an apheresis system (COM.TEC, Fresenius). Six millilitres of PRP were injected without local anaesthetic. One week after infiltration, patients started a standardised sub-maximal eccentric reeducation. Results: Pain during daily activities significantly decreased with time (especially after 6 weeks and continued to a lesser extend up to 3 months). During functional evaluation, it decreased as well, but without significant functional improvement. No improvements in the imagery measurements were observed. Younger patients seemed to be more susceptible to have an improvement of pain by the PRP infiltration. Discussion: This study demonstrates that a local infiltration of PRP associated with a submaximal eccentric protocol is efficient to improve symptoms of chronic jumper’s knee in patients non-responsive to classical conservative treatments. [less ▲]

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See detailDosage des catécholamines et métabolites par LCMS-MS
LE GOFF, Caroline ULg

Conference (2013, September 25)

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See detailFatty acids and associated cardiovascular risk
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; Leroy, Ludovic et al

in Food and Nutrition Sciences (2013), 4(9A), 188-194

Background: A fatty acid (FA) is a carboxylic acid with a long aliphatic chain, which is either saturated or unsaturated. Recently, the role of FA and particularly omega-3 and -6 has emerged as ... [more ▼]

Background: A fatty acid (FA) is a carboxylic acid with a long aliphatic chain, which is either saturated or unsaturated. Recently, the role of FA and particularly omega-3 and -6 has emerged as cardiovascular risk factor in the literature. The aim of our study was to establish reference values for these FA and to compare them with data obtained in a population of acute myocardial infarction (AMI) patients. Materials and methods: Hundred thirty five healthy subjects (59.38 ± 27.12 yo, 75 men) were selected as reference population. We also evaluated FA in thirty three patients (55 ± 9 yo, 23 men) admitted in the Emergency Department of our Institution for AMI. The fasting whole blood was drawn in vacutainer containing EDTA. Before analysis, samples were washed and transmethylated. We performed the quantification of different FA by gas chromatography associated with flame ionisation detector (GCFID). Results: We obtained results in control healthy patients to be used as reference values. In the AMI group, levels of omega-6 were significantly higher (p<0.05) for C18:2n6 and C18:3n6 than the reference population and omega-3 values were significantly lower (p<0.01) compared to reference value for C22:6n3. The omega-3 index was lower and the ratio omega-6/omega-3 was higher in AMI group compared to reference values. Conclusions: We have established reference value for FA and have compared these values with the results obtained in AMI population. 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 detailRunning races: study of the stress and cardiac biomarkers
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; MELON, Pierre ULg et al

in European Journal of Sports Medicine (2013, September), 1(Supplement 1), 212

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 a marathon and an ultra-trail. Our aim was to compare cTnT and NT-proBNP levels before and after the stress tests, in sportive subjects. Materials and Methods: Twenty eight subjects (26 men, 42.5 ± 11 yo) ran the Maasmarathon (42.195 kilometers) between Visé (Belgium) and Maastricht (The Netherlands) and 33 subjects (33 men, 45.7±9.3yo) ran the Ultratour of Liège (Belgium ; 67 km). We took blood sample before (T0), just after (T1) and 3 hours after the race (T3). In all the 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), and between T0 and T3 (p<0.001) for NT-proBNP have been observed, but not between T1 and T3. This observation appeared only after a strenuous exercise. However, up to now this type of exercise is not reproducible easily in a laboratory. Moreover, 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 value of NT-proBNP are also significant but less than TnThs. We think that the TnThs could be an interesting tool in the future to help sport medicine to detect risk of developing a cardiac problem in the future or a sudden death. [less ▲]

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See detailRéaction inflammatoire exubérante suite à une infiltration de PRP
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; LEONARD, Philippe ULg et al

in European Journal of Sports Medicine (2013, September), 1(Supplement 1), 278-279

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively ... [more ▼]

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To date, no side effects have been reported after infiltration of PRP to treat tendinopathy. Case report: A 35-year-old patient had a right upper patellar tendinopathy which was resistant to all conservative treatments for more than 6 months. The patient was a type 1 diabetic (well controlled). He had an intratendinous infiltration of 6 mL of PRP (8.105 platelets/mm3, almost no red or white blood cells) after disinfection but without local anaesthetic. Immediately following the infiltration, local cryotherapy was performed for 15 minutes. NSAIDs were avoided, but class-1 or -2 pain-killers were authorised if necessary. A standardised sub-maximal eccentric rehabilitation should have been started 1 week after. However, the patient experienced local swelling with erythema, increased heating and pain which appeared just underneath the patella, but without biological inflammatory syndrome. A great Doppler signal in a thicker patellar tendon was observed by US, but there was no sign of local infectious disease demonstrated by either CT or MRI. However, the local inflammation did not decrease after a progressive 3-week treatment of local cryotherapy, local and oral NSAIDs and colchicine 1 mg. Thus, an insidious infection was suspected, even though there was neither evidence of biological inflammatory syndrome nor sign of infectious lesion on imagery examination. An antibiotic therapy (rifampicine 600 mg + minocycline 100 mg) was initiated for 3 months. Finally, a 3-phase bone scintigraphy suggested the presence of a complex regional pain syndrome type 1 treated by a classical physical therapy and concomitant class-2 pain killers. The evolution was favourable after 6 months of symptomatic treatment, and the pain decreased to a level similar to that before the infiltration of PRP. Discussion/Conclusions: This case report draws attention to potential side effects that are linked to this new therapy by infiltration of platelet rich plasma in case of tendinopathy, in particular when used in patients with type 1 diabetes. Thus, the balance between benefits and risks must be carefully evaluated before using this treatment in patients with type 1 diabetes. [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 detailImpact de l'effort physique intense: avancées en biologie clinique
LE GOFF, Caroline ULg

Scientific conference (2013, June 17)

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See detailExuberant inflammatory reaction after an infiltration of platelet-rich plasma to treat tendinopathy
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; LEONARD, Philippe ULg et al

in Book of abstracts of 18th Annual Congress of the ECSS (2013, June)

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively ... [more ▼]

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To date, no side effects have been reported after infiltration of PRP to treat tendinopathy. Case report: A 35-year-old patient had a right upper patellar tendinopathy which was resistant to all conservative treatments for more than 6 months. The patient was a type 1 diabetic (well controlled). He had an intratendinous infiltration of 6 mL of PRP (8.105 platelets/mm3, almost no red or white blood cells) after disinfection but without local anaesthetic. Immediately following the infiltration, local cryotherapy was performed for 15 minutes. NSAIDs were avoided, but class-1 or -2 pain-killers were authorised if necessary. A standardised sub-maximal eccentric rehabilitation should have been started 1 week after. However, the patient experienced local swelling with erythema, increased heating and pain which appeared just underneath the patella, but without biological inflammatory syndrome. A great Doppler signal in a thicker patellar tendon was observed by US, but there was no sign of local infectious disease demonstrated by either CT or MRI. However, the local inflammation did not decrease after a progressive 3-week treatment of local cryotherapy, local and oral NSAIDs and colchicine 1 mg. Thus, an insidious infection was suspected, even though there was neither evidence of biological inflammatory syndrome nor sign of infectious lesion on imagery examination. An antibiotic therapy (rifampicine 600 mg + minocycline 100 mg) was initiated for 3 months. Finally, a 3-phase bone scintigraphy suggested the presence of a complex regional pain syndrome type 1 treated by a classical physical therapy and concomitant class-2 pain killers. The evolution was favourable after 6 months of symptomatic treatment, and the pain decreased to a level similar to that before the infiltration of PRP. Discussion/Conclusions: This case report draws attention to potential side effects that are linked to this new therapy by infiltration of platelet rich plasma in case of tendinopathy, in particular when used in patients with type 1 diabetes. Thus, the balance between benefits and risks must be carefully evaluated before using this treatment in patients with type 1 diabetes. Reference: Platelet-rich plasma application in the management of chronic tendinopathies. Acta Orthop Belg 2013; 79: 10-15. [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 Book of abstracts of 18th Annual Congress of the ECSS (2013, June)

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 detailComparison of the Heart-type fatty acid-binding protein (H-FABP) with the high sensitive cardiac troponin T in healthy runners
LE GOFF, Caroline ULg; MELON, Pierre ULg; BREVERS, Eric ULg et al

in Book of abstracts of 18th Annual Congress of the ECSS (2013, June)

Background: Heart-type fatty acid-binding protein (H-FABP) is a low molecular weight protein involved in the intracellular uptake and buffering of long chain fatty in the myocardium. It is an early marker ... [more ▼]

Background: Heart-type fatty acid-binding protein (H-FABP) is a low molecular weight protein involved in the intracellular uptake and buffering of long chain fatty in the myocardium. It is an early marker for acute coronary syndrome. Troponin T (TnT) is a component of the contractile apparatus of the striated musculature. Cardiac TnT is a cardio-specific, highly sensitive marker for myocardial damage. The aim of our study was to compare the results obtained with the H-FABP and the highly sensitive cardiac troponins (hsTnT) and to test their cardiospecificity in healthy runners. Methods: Twenty three runners (marathon) were enrolled. We drowned samples at three times: just before (T0), just after (T1), and three hours after the end of the race (T3). H-FABP was determined with a Randox immunoturbidimetric assay and hs-TnT with a Roche electrochemiluminescence immunoassay, both on Cobas 6000. A linear regression was calculated to observe if there is any correlation between the two biomarkers. Values above the 95th percentile for H-FABP (2.5ng/mL) and the 99th percentile for hsTnT (14ng/L) were considered as positive. Results: At T0, none of the subjects were positive for hsTnT but 35% were positive for H-FABP; at T1, 83% for hsTnT and 100% for H-FABP; at T3, 83% for hsTnT and 96% for H-FABP. At T0, the regression equation was H-FABP T0 = 3.9454 – 0.1001 x hsTnT T0; at T1: H-FABP T1 = 51.838 – 1.7026 x hsTnT T1; at T3: H-FABP T3 = 47.977 – 1.6193 x hsTnT T3. No correlation was observed between the two biomarkers at the different time. Conclusions: We observed a significant increase of H-FABP and hsTnT in runners. These markers are independent to each other. These values could biologically correspond to a heart ischemia. However, we suggested that exercise-induced cardiac hsTnT and H-FABP release is not a marker of exercise-induced pathology but likely a physiologic response to effort or an exercise-induced cardiac remodelling. [less ▲]

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See detailImpact of different endurance races on the heart: the point of view of the biologist
LE GOFF, Caroline ULg; MELON, Pierre ULg; Thébault, Jérémie et al

in Book of abstracts of 18th Annual Congress of the ECSS (2013, June)

Objective The aim of this study was to investigate the impact of intense exercise, represented by different endurance races, in relationship with oxidative stress and cardiac markers. In a second time, we ... [more ▼]

Objective The aim of this study was to investigate the impact of intense exercise, represented by different endurance races, in relationship with oxidative stress and cardiac markers. In a second time, we tried to demonstrate if oxidative stress induced by physical activity is a physiological or pathological process, and to establish some issues to diagnose the risk of sudden death in athletes. Methods Four populations were compared, a control group of 16 participants “sedentary” (37 ± 4,39 years old), a group of 24 semi-marathon runners (41 years ± 8,76 years old), a group of 28 marathon runners (44,1 ± 8,37 years old) and a group of 33 ultra-trail runners (45,8 ± 8,7 years old). Three blood tests were drowned, one just before, one just after, and the last three hours after the end of the race.Different oxidative and stress and cardiac biomarkers were measured. The ultra-trail runners will be subject to an echocardiography and an ECG pre- and post-race. For statistical analysis, STATISTICA 10 software was used. We performed a non-parametric test of Kruskal-Wallis for independent sample and a Friedman ANOVA for paired samples. Results Myeloperoxydase increased during exercise, but the release is less important according to the level of training of the runners. GSH/GSSG ratio seems to remain stable during the race but it could increase during the 24 hours post-race. There is a decrease in lipidic peroxidation during exercise. But, we note an increase of creatine kinase, isoform MB, myoglobin and C-reactive protein during the race. We observe an increase of troponin T and natriuretic peptide but with a different kinetic than the kinetic obtained for a myocardial infarction. Medical imaging in ultra-trail runners present cardiac adaptations to endurance training, as left ventricular hypertrophy (LVH) and incomplete right bundle branch block (IRBBB). A decrease of systolic and diastolic volumes of the left ventricle and a decrease of longitudinal strain were observed by echocardiography at the end of the race. Conclusion Endurance races induce the income of oxidative stress objectified by different biomarkers increase, but a cell necrosis is not specially observed. In fact, the increase of the cardiac markers during endurance races but may be explained by a transient modification of myocyte permeability, with a release of pool cytosolic. These races may induce micro-muscle damages causing the appearance of an inflammatory process explaining our observations of markers of inflammation. For the medical imaging, it was observed a myocardial adaptation to training and a transient impairment of ventricular function due to dehydration. [less ▲]

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See detailExuberant inflammatory reaction after an infiltration of platelet-rich plasma (PRP)
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; LEONARD, Philippe ULg et al

in British Journal of Sports Medicine (2013, June), 47(10 (e3)), 92

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively ... [more ▼]

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To date, no side effects have been reported after infiltration of PRP to treat tendinopathy. Case report: A 35-year-old patient had a right upper patellar tendinopathy which was resistant to all conservative treatments for more than 6 months. The patient was a type 1 diabetic (well controlled). He had an intratendinous infiltration of 6 mL of PRP (8.105 platelets/mm3, almost no red or white blood cells) after disinfection but without local anaesthetic. Immediately following the infiltration, local cryotherapy was performed for 15 minutes. NSAIDs were avoided, but class-1 or -2 pain-killers were authorised if necessary. A standardised sub-maximal eccentric rehabilitation should have been started 1 week after. However, the patient experienced local swelling with erythema, increased heating and pain which appeared just underneath the patella, but without biological inflammatory syndrome. A great Doppler signal in a thicker patellar tendon was observed by US, but there was no sign of local infectious disease demonstrated by either CT or MRI. However, the local inflammation did not decrease after a progressive 3-week treatment of local cryotherapy, local and oral NSAIDs and colchicine 1 mg. Thus, an insidious infection was suspected, even though there was neither evidence of biological inflammatory syndrome nor sign of infectious lesion on imagery examination. An antibiotic therapy (rifampicine 600 mg + minocycline 100 mg) was initiated for 3 months. Finally, a 3-phase bone scintigraphy suggested the presence of a complex regional pain syndrome type 1 treated by a classical physical therapy and concomitant class-2 pain killers. The evolution was favourable after 6 months of symptomatic treatment, and the pain decreased to a level similar to that before the infiltration of PRP. Discussion/Conclusions: This case report draws attention to potential side effects that are linked to this new therapy by infiltration of platelet rich plasma in case of tendinopathy, in particular when used in patients with type 1 diabetes. Thus, the balance between benefits and risks must be carefully evaluated before using this treatment in patients with type 1 diabetes. Reference: Platelet-rich plasma application in the management of chronic tendinopathies. Acta Orthop Belg 2013; 79: 10-15. [less ▲]

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