[fr] L’ostéochondrite disséquante est une nécrose de l’os sous-chondral et du cartilage sus-jacent. Dans les stades avancés, un fragment peut se détacher et se retrouver libre dans l’articulation, responsable alors de blocages. Cette pathologie touche davantage les adolescents, surtout de sexe masculin ; une notion d’activité physique intense est souvent retrouvée. L’articulation la plus concernée est le genou, notamment le condyle fémoral interne. Les symptômes (douleurs, blocages) et signes cliniques (œdème, crépitations) s’aggravent lors des sollicitations. La prise en charge débute par un examen clinique exhaustif ; s’en suit le bilan iconographique (radiographies standard, IRM). Le traitement sera adapté à chaque patient. Les modalités conservatrices priment généralement sur les techniques chirurgicales. Ces dernières sont parfois inévitables. La rééducation est essentielle et doit être parfaitement menée afin d’éviter toute impotence fonctionnelle résiduelle. Dans ce cadre, nous suggérons la réalisation d’un test isocinétique permettant de personnaliser la prise en charge et d’adapter la rééducation aux besoins de chacun. Le suivi à long terme est indispensable pour surveiller et prévenir les lésions arthrosiques. [en] Osteochondritis dissecans is a necrosis of the subchondral bone and the overlying cartilage. In the advanced stages, a fragment can detache and can be found free in intra-articular, responsible for blockages. This pathology affects adolescents, especially men; a notion of intense physical activity is often found. The most interested joint is the knee, especially the medial femoral condyle. Symptoms (pain, blockages) and clinicals signs (edema, crepitations) worsen during physical activity. The treatment begins with an exhaustive clinical examination, follows the iconographic assessment (standard radiographs, MRI), conservatives treatments generally predominate surgicals techniques. But, these last are sometimes inevitables. Rehabilitation is essential in order to avoid residual functional impotence. In this context, we propose the use of an isokinetic test, which makes it possible to personalize the management and adaptation of the rehabilitation to the needs of each one. The long term follow-up is essential to monitor and prevent osteoarthritis.
Disciplines :
Orthopédie, rééducation & médecine sportive
Auteur, co-auteur :
Maillard, Bérengère ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service de médecine de l'appareil locomoteur
Delvaux, François ; Université de Liège - ULiège > Département des sciences de la motricité > Médecine physique, réadaptation et traumatologie du sport
Croisier, Jean-Louis ; Université de Liège - ULiège > Département des sciences de la motricité > Kinésithérapie générale et réadaptation
DESPRECHINS, Brigitte ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiodiagnostic
FERRARA, Marie-Antoinette ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiodiagnostic
SIMONI, Paolo ; Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Département de Physique Médicale
Kaux, Jean-François ; Université de Liège - ULiège > Département des sciences de la motricité > Médecine physique, réadaptation et traumatologie du sport
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