Tesis sobre el tema "Ligament croisé antérieur du genou – Chirurgie"
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Albisson, Franck. "Les problèmes du vissage d'interférence dans la ligamentoplastie du ligament croisé antérieur selon la technique du tunnel fémoral borgne : à propos de 52 dossiers". Bordeaux 2, 1994. http://www.theses.fr/1994BOR2M165.
Texto completoGunepin, François-Xavier. "Positionnement isométrique des plasties du ligament croisé antérieur : de la théorie à la pratique (à propos de 24 cas)". Bordeaux 2, 1992. http://www.theses.fr/1992BOR2M141.
Texto completoLutz, Christian. "Analyse, stratégie thérapeutique et innovations technologiques lors de la stabilisation rotatoire du genou dans les reconstructions du ligament croisé antérieur". Electronic Thesis or Diss., Strasbourg, 2024. http://www.theses.fr/2024STRAJ009.
Texto completoTreatment of the rotational instability induced by rupture of the anterior cruciate ligament is a major challenge in knee ligament surgery. Combining lateral tenodesis with anterior cruciate ligament reconstruction improves this control compared to isolated intra-articular plasty. However, the orthopaedic community is not unanimous about the use of lateral tenodesis. Their interest was at the origin of this anatomical, biomechanical and clinical research project. Anatomically and biomechanically, rotational control of the knee is ensured by the anterior cruciate ligament and the anterolateral ligament. Technically, lateral tenodesis must respect precise criteria to restore the function of the anterolateral ligament, via the concept of favorable anisometry. Clinically, this additional lateral plasty enhances rotational stability.This association of ligament reconstructions has increased the complexity of surgical procedures and spurred further research using innovative technologies to enhance accuracy and a more personalizated surgery
Bernez, Jean. "Plastie du ligament croisé antérieur renforcée sous contrôle endoscopique (Technique de Th. D. Rosenberg modifiée), à propos d'une étude prospective de 25 cas avec 2 ans de recul". Bordeaux 2, 1996. http://www.theses.fr/1996BOR23055.
Texto completoFossat, Sébastien. "Plasties du ligament croisé antérieur (technique de Th. D. Rosenberg modifiée) rapport préliminaire à un an : à propos de 34 patients opérés dans le service de chirurgie orthopédique et traumatologique de l'H.I.A. Robert Picqué". Bordeaux 2, 1992. http://www.theses.fr/1992BOR2M188.
Texto completoRebai, Haithem. "Réhabilitation des muscles de la cuisse après reconstruction du ligament croisé antérieur au niveau du genou : évaluation de deux programmes de stimulation électrique par IRM et isocinétisme". Clermont-Ferrand 1, 2002. http://www.theses.fr/2002CLF1MM04.
Texto completoElmansori, Ashraf. "L'effet de la pente tibiale postérieure accrue sur l'intégrité du ligament croisé antérieur et des patrons de lésions méniscales : une approche méthodologique". Thesis, Lyon, 2019. http://www.theses.fr/2019LYSE1062/document.
Texto completoThe aim of this work was to report a comprehensive literature review comparing the different methods and techniques of measurement of the posterior tibial slope (PTS) among the conventional radiograph, computed tomography (CT), and magnetic resonance imaging (MRI) in order to help the orthopedic surgeons to establish a standard and reliable measurement method. The work also includes two retrospective studies measuring the tibial slope using different modalities. It has been reported that the PTS has an influence on the kinematics of the knee notably the anterior cruciate ligament (ACL). A better understanding of the significance of the PTS could improve the development of ACL injury screening and prevention programmes, and might serve as a basis for individual adapted rehabilitation programmes after ACL reconstruction. Additionally, in several orthopedic interventions such as high tibial osteotomy, the tibial slope can result in altered knee mechanics. Therefore, an exact preoperative measurement of the posterior tibial slope is mandatory. Several methods are used on conventional radiographs, CT and MRI, but until now there is no standard validated method. The first part of this work was a general introduction about the anatomical structures of interest involved in this study, namely the knee joint, the anterior cruciate ligaments, the menisci, and the tibia, this introduction part included the gross anatomy, the microscopic structure, function, and some clinical considerations. The second part of the work is dedicated to a systematic review of the available modalities and techniques in the literature. Information regarding methods of measurement of the tibial slope in normal and ACL-injury subjects was extracted from all the studies in a systematic fashion and classified according to the measurement technique and used modalities. The most common used axis was the proximal tibial anatomical axis (PTAA), and the midpoint method is the most frequently used method for calculating the PTAA. By direct comparison, the greatest value of the medial tibial slope (MTS) for the pathological knee was achieved by the radiological studies, while the MRI studies presented the smallest values. Consequently, for the pathological lateral tibial slope (LTS), the MRI values were smaller than that of the CT studies. The greatest values of the MTS and LTS were obtained by the anterior tibial cortex axis, while the minimum values were achieved by the tibial diaphyseal axis.This third part of the work was a case-control study, by using MRI, the bony slopes as well as the lateral and medial meniscal slopes (LMS, MMS) were compared in 100 patients with isolated ACL injury and a control group of 100 patients with patello-femoral pain and an intact ACL. The most important finding of this study is that the increased tibial slopes, both bony and meniscal, are risk factors for ACL injury. As the meniscus tends to correct the observed slope towards the horizontal, loss of the posterior meniscus may potentiate this effect by increasing the functional slope. The fourth part of the work is aimed to evaluate the effects of the patient characteristics, time from injury (TFI), and PTS on meniscal tear patterns. In the 362 ACL-injured analyzed patients; the most common tear location was the posterior horn (PH) of the medial meniscus (MM), followed by tear involving the whole MM. Patient age, BMI, and TFI were significantly associated with the incidence of MM tear. An increase in the tibial slope, especially of the lateral plateau, seems to increase the risk of tear of the lateral meniscus (LM), and of both menisci
Brune, Thierry. "Ingénierie tissulaire du ligament antérieur croisé du genou". Lyon 1, 2008. http://www.theses.fr/2008LYO10197.
Texto completoTears of the anterior cruciate ligament (ACL) are frequent. In absence of spontaneous healing, it is necessary to perform an autologous graft. In spite of clinical good results, some limitations remain. Within the framework of this project, we developed an new kind of tissue-engineered implant. The first part deals with the characterization of the cells extracted from the disrupted ACL. Then we present two models of ligament made of “small intestinal submucosa” (SIS), an acellular material of animal origin. The use of various cellular populations and several versions of SIS is discussed in the third part. Our results show that the cells of the disrupted ACL behave in vitro like those of the intact ACL. In addition, a hydrated form of SIS makes it possible to obtain a model with a morphology close to that of the ACL. The fourth part is devoted to an animal test which aimed to validate for the ACL a new protocole of implantation allowing a quicker integretion of the implant
Moreira, Pereira Jadson. "Production de substituts du LCA de seconde génération par génie tissulaire". Doctoral thesis, Université Laval, 2019. http://hdl.handle.net/20.500.11794/66674.
Texto completoJouve, Michel. "Rééducation après ligamentoplastie du croisé antérieur au dacron sous arthroscopie : à propos de 116 cas". Montpellier 1, 1989. http://www.theses.fr/1989MON11111.
Texto completoBoudenot, Arnaud. "Caractérisation de l'os sous chondral : du traumatisme du genou à la gonathrose : étude chez l’homme et dans un modèle expérimental : effets de l’activité physique". Thesis, Orléans, 2013. http://www.theses.fr/2013ORLE2072/document.
Texto completoKnee injuries, such as anterior cruciate ligament rupture, occur frequently in sport or exercise. Mid-term or long-term consequence is an early osteoarthritis. If physical activity can be indirectly the cause of development of this disease, it is also a form of non-pharmacological therapy. The effects of exercise will be studied both in humans and animals at different osteoarthritis severity stages on various parameters. Knee osteoarthritis is a disease that is characterized by many changes in the structure of the joint. Thus, the subchondral bone is particularly involved in the initiation or progression of osteoarthritis. Diagnostic methods usually employed, will be complemented by the analysis of trabecular bone organization, analysis of bone mineral density, microscopic analysis of osteocytes and their lacunae in which they are embedded. Our results show that exercise has positive effects on subchondral bone with better control of the mineralization probably through an increase in the viability of osteocytes
Bouafia, Abdelkrim. "Contribution à l'étude cinématique et dynamique d'un genou en charge sur simulateur : effet d'une pathologie simulée : rupture du ligament croisé antérieur et pose d'une prothèse". Lyon 1, 1995. http://www.theses.fr/1995LYO10265.
Texto completoLessim, Soucounda. "Comportement de cellules humaines sur un ligament synthétique en polyéthylène téréphtalate". Paris 13, 2013. http://www.theses.fr/2013PA132015.
Texto completoLaurent, Cédric. "Vers un nouveau biosubstitut pour l'ingénierie tissulaire du ligament croisé antérieur : approche biomécanique". Thesis, Université de Lorraine, 2012. http://www.theses.fr/2012LORR0073/document.
Texto completoTissue engineering, which consists in replacing an injured tissue with a biodegradable scaffold seeded with cells, has the potential to overcome the limitations associated with current reconstructions strategies of the Anterior Cruciate Ligament (ACL). However, no relevant solution has been proposed yet, especially due to the variety of scientific fields involved in this approach. In the current study, the key requirements for the design of a new scaffold have been listed from the current state of art. A scaffold based on P(LL85/CL15) fibers arranged into a multilayer braided structure has been proposed, and the tools needed to process this scaffold have been developed. Dedicated numerical tools have been proposed in order to predict the morphological and multiscale biomechanical behavior of the scaffold. These simulation tools have enabled to optimize the scaffold geometry in order to match the selected key requirements for ACL tissue engineering. Moreover, preliminary biological assessments have shown that the scaffold was suited for the culture of stem cells and for tissue formation. In addition, a dedicated bioreactor has been developed in order to prescribe tension-torsion cycles within a controlled environment. The use of local information issued from the biomechanical simulations open large perspectives as far as the optimization of culture conditions and the understanding of mechanisms that govern the formation of a ligamentous tissue are concerned. As a conclusion, the present study is likely to enable a new solution for ACL tissue engineering to emerge in the next years
Blanck, Richard. "Etude prospective sur le devenir des lésions non opérées du ligament croisé antérieur du genou : à propos de 65 cas". Université Louis Pasteur (Strasbourg) (1971-2008), 1985. http://www.theses.fr/1985STR1M109.
Texto completoShabani, Bujar. "Gait knee kinematics of patients with ACL rupture : a 3D assessment before and after the reconstruction". Thesis, Lyon 1, 2015. http://www.theses.fr/2015LYO10021/document.
Texto completoBecause of the role of the ACL in knee joint’s biomechanics, it is essential to quantify the kinematics of ACL deficient and ACL reconstructed knee. In-vitro models bare the handicap of limited muscle simulation, while static, one-dimensional testing cannot predict the behavior of these groups of patients under realistic loading conditions. Currently, the most widely accepted method for assessing joint movement patterns is gait analysis. Respectively, 3D motion analysis is necessary to provide high reliability movement analysis. The purpose of the study was in-vivo evaluation of the behavior of the anterior cruciate ligament deficient (ACLD) and anterior cruciate ligament reconstructed (ACLR) knees during walking, using 3D, real-time assessment tool. Significant alterations of joint kinematics in the ACLD knee were revealed in this study by manifesting a higher flexion gait strategy and excessive internal tibial rotation during walking that could result in a more rapid cartilage thinning throughout the knee. In the other hand, even though ACLR knees showed some improvements in sagittal plane compared to ACLD knees, in axial plane there still exists difference compared to healthy control knees. These kinematic changes could lead to abnormal loading in knee joint and initiate the process for future chondral degeneration. However, the post-operative kinematic data were collected 10 months after surgery, so a longer follow-up is needed to evaluate if these kinematic changes persist in time, and their effects in joint degeneration
Zhou, Jie. "Evaluation d’une nouvelle prothèse ligamentaire du genou biointégrable en PET : la réponse fibroblastique in vitro et la réponse de l’hôte in vivo". Paris 13, 2010. http://www.theses.fr/2010PA132011.
Texto completoThe grafting was performed on PET surface by ozonation and radical polymerization of a monomer, sodium styrene sulfonate (NaSS). Characterization of the samples by various techniques has highlighted the success and the reproducibility of the grafting. The in vitro study was performed with primary fibroblasts cultured on grafted and non grafted PET fabrics and fibers. Significant differences of the cell response were systematically observed between the grafted and non grafted surfaces. The grafted and non grafted PET ligament prostheses were implanted in sheep. A clinical and biological monitoring was performed during the first 3 months after the surgery. The results showed that no additional chronic inflammatory response can be attributed the grafting. Molecular biological analyses by real time RT-PCR were performed on explanted ligament prostheses one year after surgery. Results showed that an improvement of the cell signal transduction
Morin, Hélène. "Efficacité de la réadaptation musculaire à la suite d'une reconstruction du ligament croisé antérieur du genou et d'une discoïdectomie chez l'humain". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/mq33721.pdf.
Texto completoBoulocher, Caroline. "La mesure de l'arthrose : imagerie des lésions d'arthrose du genou induite par section du ligament croisé crânial chez le lapin". Lyon 1, 2008. http://www.theses.fr/2008LYO10037.
Texto completoOsteoarthritis (OA) results from articular cartilage degenerative changes and is a painful and invalidating disease. Experimental OA in the rabbit model shows close similarity with human disease. Such studies are essential for facilitating development of therapies and early diagnostic methods. Diagnostic imaging allows for non-invasive in-vivo evaluation of OA but is technically challenging in the rabbit. After reviewing human and animal OA, this thesis illustrates the development of in vivo diagnostic imaging methods in the rabbit model of osteoarthritis after cranial cruciate ligament transection. A micro-MRI protocol was created for quantitative in vivo cartilage thickness measurements in a 7T magnet and sensitivity to change was correlated with final macroscopic and histological evaluations. A protocol for knee joint ultrasonography in the rabbit model was developed and was both specific and sensitive in detecting meniscal lesions and cranial cruciate ligament transection. We created a standardized radiographic procedure with a semi-quantitative grading scale and an atlas which could be used as a template. A new automatized method for radiographic OA grading is presented
Peultier-Celli, Laetitia. "Facteurs prédictifs de la qualité du contrôle postural et de sa compensation dans les pathologies traumatiques et dégénératives du genou". Thesis, Université de Lorraine, 2017. http://www.theses.fr/2017LORR0150/document.
Texto completoThe knee can suffer damage from either traumatic or degenerative pathology. Anterior cruciate ligament (ACL) injuries frequently occur, especially in activities that including rotational stresses. Degeneration of the articular cartilage of the knee can subsequently result in osteoarthritis. The aim of this study was to analyze the predictive factors of postural control and recovery in traumatic injuries and also in degenerative pathologies of the knee. The effects of an innovative rehabilitation protocol combining reduced conventional rehabilitation with aquatic rehabilitation were compared with conventional rehabilitation defined by the National French Health Authority on the kinetics of recovery of proprioceptive skills and functional improvement. Postural control and motor control using clinical tests were quantified in 67 patients with ACL surgery before and up to six months after surgery. The effects of meteorological parameters on postural control and pain in knee osteoarthritis were evaluated in 113 patients, using posturography and also a pain scale. Six months after knee ligament surgery, both groups attained the same quality of postural control. However, patients who followed the innovative protocol made more used of proprioceptive inputs compared to the group who underwent conventional rehabilitation who made more use of a compensation mechanism. In patients following the innovative protocol proprioception was improved two months after surgery compared to before surgery. Muscle strength was higher in patients who followed the innovative rehabilitation protocol at one, two and six months after surgery. One month after surgery, the walking distance traveled was higher in patients who underwent innovative rehabilitation than in patients who had undergone conventional rehabilitation. In patients with knee osteoarthritis, degradation of postural control was observed when atmospheric pressure and maximum humidity decreased during the morning and when atmospheric pressure decreased during the entire day. Increased pain was correlated with increased temperature in the morning and with increased temperature and humidity during the entire day. The environment in which evolves the subject (aquatic, climatic) thus has an influence on postural control performance. A better management in post-ligamentoplasty rehabilitation of the knee would reduce the need for compensation using the contralateral limb, by better use of somesthesia. This could prevent the occurrence of osteoarthritis and a contralateral ACL injury, which would also reduce costs to the society and health care
Pairot, de Fontenay Benoît. "Récupération après reconstruction du ligament croisé antérieur et prévention des ruptures : étude biomécanique d'un mouvement pluri-articulaire". Thesis, Lyon 1, 2014. http://www.theses.fr/2014LYO10212/document.
Texto completoSurgical reconstruction is the common treatment after Anterior Cruciate Ligament (ACL) injury in athletes. It usually requires a long period of rehabilitation and the results in terms of return to sport and re-injury rates are not fully satisfactory. The present work has two aims: the enhancement of recovery after ACL tear and the prevention of initial injury. Firstly, we assessed the kinematic and kinetic alterations during a jump task in patients 7 months after ACL reconstruction. Our findings highlight both a lower jumping performance, and greater asymmetries in patients, particularly considering the total joint mechanical work. The operated leg presents deficits at the knee, hip and ankle joints on parameters such as joint range of motion, joint moments and powers. In addition, changes are also found on the non-operated leg, characterized by a modification of the knee and ankle joint angles, and by a lower total joint moment. Secondly, we focused on ACL injury prevention in female athletes. We determinate a way to detect and reduce the neuromuscular risk factors, including “dynamic valgus”, while increasing jumping performance in young basketball female players. In conclusion, maximizing the recovery after ACL tear requires, in the rehabilitation protocol and the patients follow-up, a particular emphasis on the quality of execution of multi-joint task, on each of both lower limbs. Moreover, the detection and management of the neuromuscular risk factors should be systematized in sports or public at risk in order to prevent ACL injury
Napa, Ioana Diana. "Development of new biocompatible scaffolds for human ACL substitutes". Thesis, Université Laval, 2008. http://www.theses.ulaval.ca/2008/25098/25098.pdf.
Texto completoGillot, Timothée. "Étude des risques de lésion du ligament croisé antérieur chez la joueuse de sports pivot Effect of fatigue on functional stability of the knee : particularities of female handball players". Thesis, Normandie, 2019. http://www.theses.fr/2019NORMR105.
Texto completoACL injuries are severe and highly prevalent in female handball and basketball players. The increasing participation of women in multidirectional sports conduces to a better understand the mechanism and causes of the injury. The aim of this thesis is to investigate anterior cruciate ligament injury risk among female players in multidirectional sports and its workload-induced changes. The first part is a narrative review about the dynamic process of sports injury. Epidemiologic and biomechanic approaches were used to explain the complexity of risk factors and injury mechanism interaction. These data showed the key role of neuromuscular risk factors in building the incitative event of anterior cruciate ligament injuries. The lack of knowledge about the impact of an acute workload on those risk factors in female multidirectional sports needs to be addressed.The second part is an experimental report, including two prospective studies and a systematic review using muscular assessment, systematic tools for literature review and biomechanical analysis (kinetics, kinematics and laximetry). The results showed the specificity of female handball players when performing an isokinetic fatigue protocol. The jump landing kinetic was the most impacted by a fatigue protocol. Cutting techniques were the less impacted. The analysis of 766 side-step-cutting showed that knee joint loading is anticipated (46 to 48 ms after initial contact) in female handball and basketball players. It was also shown that women performed side-step-cutting with similar knee amplitude than the injury mechanism, a less flexed trunk position and a highest angle-velocity than men.The third part of this work proposes a discussion of those results in relation to their perspectives for the prevention of anterior cruciate ligament injury risk in female handball and basketball players
Haida, Amal. "Blessure, environnement et performance de haut niveau". Rouen, 2014. https://hal-insep.archives-ouvertes.fr/tel-01788566.
Texto completoThe thesis deals with the epidemiology and physiopathology of performance in elite sport. The objective is to analyze the impact of two parameters that can affect performance and its development during a sports career: injury and environmental factors. At first, we study the impact of the Anterior Cruciate Ligament (ACL) rupture on the performance of the best alpine skiers (1st decile of performance) in the French Team since 1980. Through a transversal study, we analyze the return to performance after an ACL injury and evaluate whether the injury is a handicap in post-rupture performance. It is also an opportunity to demonstrate and compare the performance of the best skiers who had a torn ACL with those who never suffered this injury during their career. Secondly, a second longitudinal study analyses the performance development of the entire alpine skiers in the French Team during their career in injured and non injured athletes since 1980. Moreover, in alpine skiing the environment plays a role in the occurrence of injuries. The snow conditions, weather conditions and temperature are all factors that influence the prevalence of injuries, including the ACL rupture. Thus, in a third study we evaluated the impact of seasonality and environment in the sprint and middle distance. This study was conducted in athletics because it represents one of the oldest Olympic sports with sufficient data available allowing a substantial historical perspective of performance. Our studies describe the importance of taking into account the injury and the environment, particularly temperature, in the multifactorial context of performance optimization in elite sport
Leroy, Adrien. "Ingénierie tissulaire du ligament : association de copolymères dégradables et de cellules souches mésenchymateuses". Phd thesis, Université Montpellier II - Sciences et Techniques du Languedoc, 2013. http://tel.archives-ouvertes.fr/tel-01022842.
Texto completoSangeux, Morgan. "Modélisation mécanique in vivo personnalisée du genou via l’Imagerie par Résonance Magnétique". Compiègne, 2006. http://www.theses.fr/2006COMP1643.
Texto completoThis work concerned the mechanical behavior of the knee. A numerical 3D model in vivo has been developed derived from MRI images. The first part of the work was the development and the use on 11 normal subjects of a movement analysis protocol based on MRI data. The results allowed to provide a quantitative evaluation of an external marker set system. Ln the second part, the computation of the contact pressure areas on the cartilage and the meniscus during the personalized knee movement was performed. A method to determine the cartilage thickness map and the building of a personalized finite element model of the knee has been developed. The last part of the work concerned the in vivo determination of the mechanical properties of the Anterior Cruciate Ligament derived from the Lachman test reproduced in the MRI environment. The results of the work are of interest for the quantitative evaluation of pathological knee and in the development of numerical models for testing knee implants
Jied, Alexandre. "Étude cinématique et dynamique des groupes articulaires du membre inférieur au cours de la phase d'appui de la marche, à partir de marqueurs externes : étude comparative entre des sujets normaux et des sujets souffrant d'une laxité du ligament croisé antérieur". Lyon 1, 1997. http://www.theses.fr/1997LYO1T152.
Texto completoCaumeil, Benjamin. "Etude des déterminants de l'anxiété de re-blessure chez le sportif : Identification de profils psychologiques et étude de l'efficacité d'une intervention d'imagerie mentale auprès de sportifs blessés au ligament croisé antérieur". Thesis, Bordeaux, 2020. http://www.theses.fr/2020BORD0082.
Texto completoAbstract : When returning to sports, athletes are exposed to specific negative cognitions and emotions. One of these negative emotions was named re-injury anxiety. The consequences of re-injury anxiety could lead to an impact on performance and physical well-being, increasing the risk of re-injury. The psychological aftermath of re-injury anxiety have been depicted with increasing interest in literature, and interventions decreasing this specific emotion, many gaps in literature remain to be developed. The purpose of this doctoral work, with published scientific articles, will study the concept of re-injury anxiety in reference to five complementary objectives. The first chapter of the thesis will present a systematic review of the literature, highlighting the factors of re-injury anxiety and other close concepts. This review of literature will demonstrate the importance in prioritising the concept of re-injury anxiety to describe psychological reactions when an athlete return to sport after an injury. The second chapter will focus on the adaptation and a validation in French language of a measuring tool for re-injury anxiety. Exploratory and confirmatory factorial analysis allowed us to identify three subscales of this specific anxiety : the latter will be named : fear of re-injury, performance anxiety and signs of anxiety. The third chapter will propose the study of the factors of re-injury anxiety with regression analysis, mediation and moderation models. The results showed that stress, anxious symptomatology and gender were directly predicting re-injury anxiety, and also indirectly with mediating and moderating effects, describing their interactions with other psychological characteristics. Using cross-lagged models allowed us to identify the signification of stress in predicting re-injury anxiety in a longitudinal perspective. In the fourth chapter, we will investigate the psychological cluster related to re-injury anxiety. Cluster analysis highlighted four different profiles with 2 specific profiles characterised by high level of re-injury anxiety and other negative emotions (i.e., one with moderate level, and one with very high level of re-injury anxiety). An other profile was characterised by a low re-injury anxiety level, and the last profile was characterised with average re-injury anxiety especially with very low knee confidence. Finally, the fifth chapter will discuss the psychological interventions which can be proposed to athletes expressing re-injury anxiety. The fifth part of this work will present the implementation in a rehabilitation center of a controlled randomised interventional protocol based on mental imagery like Visuo-Motor Behavior Rehearsal (VMBR) on athletes who injured at anterior cruciate ligament. The intervention turns out to be efficient on the reduction of negative effects caused by the injury such as re-injury anxiety, stress but also pain. Besides, it allows the increased mobilisation of protective factors such as optimism and social support seeking. Resorting to a VMBR-like intervention also allows athletes to return to sport faster than those who didn’t. The general synthesis of this thesis will offer to generalise the principal results obtained while identifying the perspectives of application of the results in other types of interventions, contexts, or in other populations
Leroux, Amélie. "Implant ligamentaire bioactif et biodégradable : élaboration, fonctionnalisation et étude des mécanismes". Thesis, Sorbonne Paris Cité, 2019. http://www.theses.fr/2019USPCD054.
Texto completoThe rupture of the anterior cruciate ligament of the knee is a common affection which mainly occurs in young and active population. Because of its joint location and its poor vascularization, this ligament does not heal spontaneously. The “gold-standard”, consisting of using autograft, has many disadvantages and the research focuses on the development of synthetic ligament implants. In this context, this thesis studies and evidences the possibility of a new ligament with bioactive and biodegradable features, made of polycaprolactone (PCL) grafted with poly(sodium styrene sulfonate) (pNaSS). The results presented in this manuscript evaluate the initial choice of raw PCL, its characterization, its functionalization, its mechanical properties after processing, its degradation mechanism and its in vitro and in vivo biological impact. At the interface of engineering, chemistry, mechanics and biology fields, we demonstrated that: the pNaSS grafting accelerates the PCL degradation while protecting the surface during the first six months; the mechanical properties of PCL are adapted to the ligament application; in vitro the pNaSS grafting promotes cell growth, cell distribution, cell density, cell spread, growth factor production, and maintenance of gene expression; and finally that in vivo the pNaSS grafting allows to reduce joint inflammation and postoperative osteoarthritis while promoting tissue recolonization
Drigny, Joffrey. "Intérêt de l'évaluation isocinétique en traumatologie sportive : de la prévention primaire à la réhabilitation". Electronic Thesis or Diss., Normandie, 2023. http://www.theses.fr/2023NORMC295.
Texto completoObjective: Isokinetic testing of muscle function in sports traumatology is often limited to the measurement of muscle strength with restricted clinical applicability. The purpose of this work is to study the use of isokinetic dynamometry for measuring parameters of muscle function (strength, passive properties, and proprioception) in sports traumatology. We propose the study of two common clinical situations from primary to tertiary prevention.The theoretical framework reviews anatomical basics and properties of the muscle-tendon complex and their assessment, with a focus on isokinetic testing. Then, we present how isokinetic testing of muscle functions is of interest in sports traumatology.The first part examines the validity of isokinetic testing of shoulder rotator muscles in the prevention of shoulder injuries in two «overhead» sports, one bilateral and the other unilateral, characterized by different biomechanical demands: swimming and badminton. In these sports, a functional ratio < 2:3 measured during preseason assessment is associated with a 2 to 4.5 times higher risk of injury during the sports season. The use of fast angular velocity is more discriminating than slower velocities in identifying the risk of shoulder injury in badminton. The functional ratio decreases with the number of years of sports practice in these two sports, thus increasing the risk of injury.The second part addresses isokinetic testing conducted in the follow-up of anterior cruciate ligament reconstruction (ACL-R) to optimize the analysis of muscle function. Firstly, for the strength analysis, our work validates decision criteria for the assessment at the 4th month. A symmetry index ≥60% for knee extensors and >72% for flexors is associated with optimal symmetry at the 8th month, return to sports performance at 2 years, and the risk of a new serious knee injury (operated and contralateral sides) with an average follow-up of 3 years. Next, we demonstrate that the analysis of the force-velocity profile using a 2-point method is feasible, sensitive, and applicable in the decision-making process for returning to sports without adding measurements to the usual isokinetic testing. A study of the passive parameters of knee flexors using isokinetics shows a decrease in muscle-tendon stiffness on the operated side compared to the contralateral side and a control group. This could be associated with an alteration of the biomechanical and proprioceptive properties of the operated knee. Finally, two studies evaluate proprioceptive properties. One methodological study identifies proprioception parameters associated with knee functional tests performance and symmetry in a healthy population, while a prospective study in the follow-up of ACL-R shows that limb dominance influences knee proprioception at the 4th postoperative month, itself associated with the athlete's psychological status.Conclusion: Our results show that isokinetic testing has clinical relevance in assessing muscle function, beyond the sole measurement of strength, in primary/secondary/tertiary prevention of common sports injuries
Pinese, Coline. "Conception d’une structure composite à base de polymères synthétiques et naturels résorbables : application à la ligamentoplastie". Thesis, Montpellier 1, 2014. http://www.theses.fr/2014MON13504.
Texto completoFollowing accidents, anterior cruciate ligament (ACL) damages are increasingly becoming a common public health problem. To comply with the demand for alternatives to current surgical treatments, we have developed ligament reinforcement with degradable biomaterials. To meet the requirement of ligament regeneration, ligament reinforcement must be strong enough to support knee physiological strains, and must degrade while allowing the new ligament regeneration. Novel block copolymers PLA- and poloxamer or poloxamine based have been synthesized which were then spun for designing a tubular knitted fabric. The tubular fabric has interesting mechanical characteristics for ligament replacement. In parallel, a collagen and glycosaminoglycans porous three-dimensional matrix has been developed. This matrix is able to promote cell adhesion and proliferation. The knitted reinforcement associated with the collagen matrix has been implanted in vivo for 3 months. Fully integrated, the composite structure allows néo-tissue formation while gradually losing its mechanical properties after 3 months
Montreuil, Julien. "Évaluation tridimensionnelle de la reconstruction du ligament croisé antérieur". Thesis, 2019. http://hdl.handle.net/1866/24714.
Texto completoThe anterior cruciate ligament (ACL) remains one of the most injured ligament of the knee. Mispositioning the tunnels remains a common cause of ACL reconstruction failure. A better biomechanical description of this phenomenon is therefore essential. Using the low irradiation biplanar stereoradiographic EOStm imaging system, our group developed a 3D reconstruction method allowing a precise morphologic description of the knee. With this system, the tridimensional positioning of the femoral tunnel can be evaluated in a novel, computerized, precise and reproducible coordinate system. With this referential, our group wish to assist orthopedic surgeons in the restoration of optimal biomechanics in ACL reconstructions.
Fuentes, Alexandre. "Apport d’une évaluation biomécanique 3D du genou dans la prise en charge orthopédique de patients ayant une rupture du ligament croisé antérieur". Thèse, 2010. http://hdl.handle.net/1866/4764.
Texto completoThe anterior cruciate ligament (ACL) is involved in approximately 20% of all sports-related knee injuries. An injury to the ACL, the primary stabilizer of the knee, will lead to knee joint instability and functional impairment. Unfortunately, current clinical assessments of ACL-deficient patients present limitations with respect to the investigation of the impact of the injury on knee function. A 3D knee biomechanical assessment could provide innovative information to overcome these drawbacks. The main objective of the doctoral theses is to demonstrate the role of biomechanics in (1) the investigation of the impact of the injury on knee function and in (2) the diagnostic process. Twenty-nine ACL-deficient patients and a control group of fifteen healthy participants took part in a 3D knee biomechanical assessment during treadmill walking. By assessing the 3D knee biomechanical patterns of each group we observed that ACL-deficient patients adopted a gait compensatory mechanism: the Pivot-shift avoidance gait. The explanation for this adaptative strategy is to avoid placing the knee in a position biomechanically favorable to anterolateral rotatory instability during gait. Furthermore, an automatic classification method capable of distinguishing ACL deficient patients from an asymptomatic population was developed. Features were extracted from the 3D knee biomechanical patterns using a wavelet decomposition method and then classified by the nearest neighbour rule. The proposed classification method obtained a level of accuracy, sensitivity and specificity of 88%, 90% and 87% respectively. This method shows great potential as a diagnostic aid in a clinical setting. This thesis demonstrates that biomechanics plays a substantial role in the management of ACL injuries by improving the understanding of the impact of the injury on knee function and by its capacity to serve as a diagnostic aid.
Fuentes-Dupré, Alexandre. "Apport d’une évaluation biomécanique 3D du genou dans la prise en charge orthopédique de patients ayant une rupture du ligament croisé antérieur". Thèse, 2010. http://hdl.handle.net/1866/4764.
Texto completoThe anterior cruciate ligament (ACL) is involved in approximately 20% of all sports-related knee injuries. An injury to the ACL, the primary stabilizer of the knee, will lead to knee joint instability and functional impairment. Unfortunately, current clinical assessments of ACL-deficient patients present limitations with respect to the investigation of the impact of the injury on knee function. A 3D knee biomechanical assessment could provide innovative information to overcome these drawbacks. The main objective of the doctoral theses is to demonstrate the role of biomechanics in (1) the investigation of the impact of the injury on knee function and in (2) the diagnostic process. Twenty-nine ACL-deficient patients and a control group of fifteen healthy participants took part in a 3D knee biomechanical assessment during treadmill walking. By assessing the 3D knee biomechanical patterns of each group we observed that ACL-deficient patients adopted a gait compensatory mechanism: the Pivot-shift avoidance gait. The explanation for this adaptative strategy is to avoid placing the knee in a position biomechanically favorable to anterolateral rotatory instability during gait. Furthermore, an automatic classification method capable of distinguishing ACL deficient patients from an asymptomatic population was developed. Features were extracted from the 3D knee biomechanical patterns using a wavelet decomposition method and then classified by the nearest neighbour rule. The proposed classification method obtained a level of accuracy, sensitivity and specificity of 88%, 90% and 87% respectively. This method shows great potential as a diagnostic aid in a clinical setting. This thesis demonstrates that biomechanics plays a substantial role in the management of ACL injuries by improving the understanding of the impact of the injury on knee function and by its capacity to serve as a diagnostic aid.
De, Oliveira Junior Eros. "Évaluation de la reconstruction des ligaments croisés post luxation aiguë du genou avec l’utilisation des ligaments synthétiques". Thèse, 2012. http://hdl.handle.net/1866/8511.
Texto completoKnee dislocation, although very rare, remains a devastating injury with many complications because of the complex nature of this trauma. This uncommon injury can result from either a high or low energy trauma. The severe damage to the knee’s ligaments and associated structures render this injury at high potential for functional impairment. Non operative treatment which was once deemed acceptable, is now reserved for very low demand patients. Surgical reconstruction is now the standard of care for most patients, however many options exist but the optimal surgical treatment remains controversial. Some surgeons advocate early complete reconstruction of all damaged ligaments, whereas others who fear arthrofibrosis, limit the immediate surgery to reconstruction of the posterior cruciate ligament and the posterolateral corner. Because of the multiple structures damaged by knee dislocations, surgeons have been successfully using combinations of autografts and allografts for complete knee ligament reconstruction. Complications associated with graft harvesting, graft elongation and early weakness as well as risks for disease transmission has pushed surgeons to look for different options. The use of synthetic material for ligament replacement was proposed in the 1980’s. After an initial wave of enthusiasm, poor long term results and high rates of failure diminished its popularity. Since then, a new generation of artificial ligaments has emerged, the Ligament Advanced Reinforced System (LARS) has shown promising results. It recently has been used in isolated anterior cruciate ligament and posterior cruciate ligament reconstruction and has shown good short to medium term results. The purpose of this retrospective study was to evaluate the knee function and stability after acute knee dislocation reconstructed with LARS artificial ligaments. This study assessed the results of 71 patients with knee dislocations who underwent acute combined repair and reconstruction of anterior cruciate ligament and posterior cruciate ligament using LARS artificial ligaments. After the surgery all patients followed the same intensive rehabilitation protocol. Progressive weight bearing was permitted over 6 weeks as muscle strength and dynamic stability were regained. The outcome measures used were the Lysholm score, the International Knee Documentation Committee form, the Short Form-36, clinical knee stability testing, a goniometer to mesure the range of motion and Telos stress radiography at 30° and 90° of knee flexion. The non-operated knee of the patient was used as a baseline for the operated knee. The subjective and objective findings from this study are satisfactory and suggest that acute combined repair and reconstruction with LARS ligaments is a valid alternative for treating acute knee dislocations. These findings demonstrate sustained results in terms of function and revealed durability of LARS artificial ligaments at long-term. Patients seem to get more autonomous and satisfied with time even though acute knee dislocation is seen as a catastrophe when it happens. Randomised, prospective trials are now needed to compare graft selection and timing of the surgical reconstruction.
Décary, Simon. "Validité et fidélité de la combinaison de l’anamnèse et de l’examen physique pour le diagnostic des pathologies communes au genou". Thèse, 2017. http://hdl.handle.net/1866/20276.
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