Ben Salah, F.Z.

Dziri, C.

Faiez, M.

Ghidaoui, L.

Herchi, W.

Lebib, S.

Miri, I.

Sbabti, R.

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w/ Annals of Physical and Rehabili
nd observation.– 62-year-old male admitted for a left knee operated on
9/09/2010 for tibial osteotomy, the radiographs of the knee after 6 months sho-
ed late healing with bone demineralization (CRPS type I). The two patients
eceived treatment with bisphosphonates: intravenous Ibondronate (two cures
mg in 200 cc of serum to 1 month apart), they also received calcium and vita-
in D supplementation. The outcome was favorable after 1 month with bone
ealing.
onclusion.– Whatever the supportive care, the type of treatment used, and des-
ite the measures of prevention, delayed healing is common after fractures of
he tibia, the increased density of bone mineralization is proved after adminis-
ration of bisphosphonates by inhibition of osteoclasts, but their effectiveness is
nproven on bone healing.
our en savoir plus
. Obert, A. Couesmes, D. Lepage, J. Pauchot, P. Garbuio, Y. Too
uch And Consolidation bone nonunion of long bones: the contri-
ution of BMP: Department of Traumatology, Orthopaedic and Plas-
ic Surgery Hospital Main Support Minjoz Bd Jean Fleming 25000
esanc¸on.
. Chiron 1, A. Brouchet 2. Bone healing of bone adaptation to stress fundamen-
als, 1 orthopedic CHU Rangueil, 2 Pathology Rangueil.
oi:10.1016/j.rehab.2011.07.957
051 EN
he course of adhesive capsulitis in physical medecine and
ehabilitation
. Sbabti ∗, S. Lebib , M. Faiez , W. Herchi , L. Ghidaoui , I. Miri , F.Z. Ben
alah , C. Dziri
Médecine physique et rééducation fonctionnelle, institut d’orthopédie
ohamed-Kassab-Ksar-Said, 2010 Manouba, Tunisia
Corresponding author.
eywords: Adhesive Capsulitis; Arthrodistention; Intraarticular infiltration
bjective.– The aim of our study was to assess the contribution of different thera-
eutic modalities in Physical Medicine and Rehabilitation for rapid improvement
f adhesive capsulitis
aterials and methods.– This is a retrospective study conducted during the
eriod from January 2009 to March 2011 in the service of Physical Medi-
ine and Rehabilitation in the Institute of Orthopaedics Kassab. Twenty-one
ases of adhesive capsulitis, primitive (two cases) or secondary (four cases
fter shoulder trauma, one case after surgery of the rotator cuff, 11 cases
ue to diabetes, one case post-stroke and two cases of post-injury cap rota-
ors) were included. The management has consisted in an intensive program
f rehabilitation for two weeks, usually associated with complementary the-
apy by capsular distension or articular injection of corticosteroid. Treatment
fficacy was assessed by VAS pain and the degree of joint mobility of the
houlder
C
s
c
dMedicine 54S (2011) e180–e183 e183
esults.– It was found a significant improvement in VAS pain and range of
otion particularly in abduction from 71◦ to 119◦ and external rotation of 29◦
o 43◦ between the beginning and end of hospitalization
iscussion.– The natural history of adhesive capsulitis, whether idiopathic or
econdary, is not always favorable. There are no international recommendations
or the management of adhesive capsulitis. Intensive rehabilitation or not coupled
ith other treatment such as distension or infiltration of articular corticosteroid is
n effective especially at the intermediate stage to increase joint mobility to limit
he risk of sequelae, and reduce the duration of disease of adhesive capsulitis
oi:10.1016/j.rehab.2011.07.958
052 EN
easurement of therapeutic effect of ultrasound on knee
steoarthritis; double blind study
. Kapidzic
UKC Clinic for Physical Medicine and Rehabilitation, University Clinical
enter Tuzla Trnovac, 75000 Tuzla, Bosnia and Herzegovina
herapeutic ultrasound is often used in the treatment of knee osteoarthritis (OA),
owever sufficient evidence of its effect is lacking. More scientific evidence is
eeded to confirm its effect.Aim.– The aim of this work is to determine the effect
f ultrasound therapy on pain, stiffness and functional ability of patients with
nee OAExaminees and methods.– This was randomized, double blind, placebo
ontrolled study of continuous effects of ultrasound on knee OA conducted in
ut-patients clinic for physical medicine and rehabilitation
xamination was conducted on 80 patients with knee OA, mean age of 60
ears and average duration of clinical difficulties of 8.3 years. Physical therapy
PT) lasted for three weeks. All patients also had thermotherapy and exercises.
dditional therapy with continuous ultrasound, with 0.8 W/cm2 that lasted for
ve minutes was applied to 40 patients (group A) and 50 patients had placebo
ltrasound (group B). For objectification of difficulties we used Lekrt’s scale
or pain evaluation, and Lequesne index and Womac scale with subscales for
ain, stiffness and functional disability evaluation. We measured joint circum-
erence, joint movement, and brute muscle strength with manual muscle test
efore and after PT. Test- retest examination was conducted.Results.– In both
roup there was significant reduction of pain and improvement of functional
bility (p < 0.0001). Difference in pain evaluation before and after treatment
as in group A 1.6 ± 0.70, and in group B 1.0 ± 0.71. Reduction in Lequesne
ndex was 4.36 ± 1.75 in group A and 3.43 ± 1.74 in group B. Womac for pain
as reduced in group A for 0.83 ± 0.51 and in group B 0.53 ± 0.40; for stiff-
ess in group A 0.83 ± 0.46, and in group B 0.49 ± 0.44; for function in group A
.61 ± 0,55 and in group B 0.38 ± 0.70. All differences were significantly better
n group A. There were no changes in joint circumference and muscle strength
as remotely improved, in average for half score in both groups
onclusion.– Therapy with continuous ultrasound in comparison with placebo
howed significant efficacy in treatment of knee OA, because it leads to signifi-
ant reduction of pain, stiffness and improvement of functional status
oi:10.1016/j.rehab.2011.07.959


The course of adhesive capsulitis in physical medecine and rehabilitation 

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The course of adhesive capsulitis in physical medecine and rehabilitation

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