The hamstrings are more impacted than the quadriceps after severe ankle sprain

International audienceAnkle sprains (AS) are common in the military population, with a prevalence 5 to 8 times higher than that for civilians. The aim of this study was to evaluate in patients with severe AS the impact of disuse on thigh muscle induced by unloading and immobilization due to care. This study focused on muscle trophicity and dynamometric strength. In this observational prospective study, assessments were repeated at 3 visits: close to injury, 15 and 30 days following the sprain. The injured limb was compared to the contralateral limb. A dynamometer assessment was used to monitor changes in strength and fatigue of the thigh muscles of both limbs. Isometric and isokinetic concentric evaluation of peak torque (PTiso and PTdyn), total work (Wt), and peak torque time integral (IPT) of thigh muscles. Full follow-up was obtained in 30 subjects. The injured limbs showed significant deficits in the mean (SD). The quadriceps PTiso and IPT deficits were −12.6% ± 1.9% ( P < .0001) and −13.27% ± 1.8% ( P < .0001), respectively. The quadriceps PTdyn showed a significant deficit since V2 (−12.2.5% ± 2.0). The quadriceps Wt presented a significant deficit of −4.2% ± 2.4 ( P < .0007) at 1 month. The hamstring PTdyn deficit presented a mean loss of −16.5% ± 2.4% ( P < .0001). The hamstring Wt deficit was −13.7% ± 2.3% ( P < .001). The analysis of variance showed that the grade of the sprain had a significant effect on the quadriceps PTq deficit ( P < .016) but not the type of discharge. Our study showed that disuse leads to a significant deficit in the strength of knee muscles within 1 month. It is noteworthy that the hamstrings are more affected than the quadriceps. The rehabilitation protocol to prevent the risk of iterative ankle injuries and secondary knee injuries should incorporate early training of both quadriceps and hamstrings

Excellent outcomes for lateral unicompartmental knee arthroplasty: Multicenter 268-case series at 5 to 23 years&apos; follow-up

Introduction: Isolated lateral compartment osteoarthritis of the knee (LCOA) is 10 times less frequent than medial compartment involvement. Long-term assessments of unicompartmental knee arthroplasty (UKA) in this indication are rare, with small series. Hypothesis Survival and functional outcome of lateral UKA in a large series are quite acceptable; the strategy is suited for isolated LCOA. Material and method A multicenter retrospective study in 6 French health establishments included all lateral UKAs performed between January 1988 and September 2014. Clinical data (range of motion, International Knee Society (IKS) knee and function scores, satisfaction), paraclinical data (radiologic angles) and complications were prospectively entered in medical files during follow-up and analyzed retrospectively at end of follow-up. Results During the study period, 311 lateral UKAs were performed in 295 patients, using 5 fixed-bearing implant models. Twenty-eight patients died within 5 years, and 15 (4.8%) were lost to follow-up. The series thus comprised 268 lateral UKAs in 63 male and 205 female patients, with a mean age of 68.8±10.5 years, including 7 cases of post-traumatic osteoarthritis and 4 of aseptic osteonecrosis. Mean follow-up was 9.1 years (range, 5-23 years), implant survivorship with failure defined as all-cause revision surgery was 85.4% at 10 years and 79.4% at 20 years. At last follow-up, IKS knee score was 87.0 and IKS function score 80.2. Maximal flexion was 125°. 94.3% of patients were satisfied or very satisfied. The main cause of revision surgery was osteoarthritis in another knee compartment (66,7%, n=26). Conclusion: Lateral UKA showed good survivorship, comparable to medial UKA, with good functional results and excellent long-term satisfaction. Level of evidence IV, retrospective cohort study

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