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We aimed to evaluate the clinical outcomes after surgical repair of patellar tendon rupture (PTR) and compare the evolution of 2 types of rupture (acute and chronic) after the same rehabilitation protocol.This was a prospective cohort study of patients with PTR treated between January 2006 and January 2014 in the department of trauma surgery, Ibn Rochd university hospital, Casablanca.We evaluated 25 patients (21 men) after a median follow-up of 75 months (range 29-120). The mean age was 34.7±8.59 years. Overall, 17 patients had acute rupture and 8 chronic rupture. Fifteen healthy volunteers (13 men) were recruited as a control group. Mean Knee Society Score (KSS) knee score was significantly higher after than before surgery (82.28±12.297 vs 20.64±7.6; P0.0001) as was KSS function score (88.40±17.483 vs 23.40±8.98; P0.0001). Pain measured on a visual analog scale was significantly lower after than before surgery (1.96±1.24 vs 6.60±1.26; P0.0001). ROM and KSS knee and function scores were significantly lower on the operated than non-operated side after surgery. For both types of PTR, only knee extensor muscle strength was significantly lower on the operated than non-operated side and as compared with healthy volunteer knees.Surgical repair of PTR with reinforcement and an early rehabilitation program demonstrate good results after a long follow-up. However, chronic PTR may need longer or a different rehabilitation protocol of the knee-extensor apparatus.

Objectives The aim of this retrospective study was to evaluate the long-term clinical and radiological results in a continuous series of total hip arthroplasties performed for aseptic necrosis of the femoral head and discuss the therapeutic indications. Patients and methods The series included 88 arthroplasties performed between January 1992 and December 2008 in 79 patients with a mean age of 43, 5 years. Functional evaluation was made according to the Postel-Merle d’Aubigne (PMA) score. The preoperative PMA score averaged 8. According to the classification of Ficat and Arlet, 60 hips were classified as stage IV and 28 hips as stage III. The implants used were a total hip prosthesis in 90.9% of cases; cemented in 55 cases, uncemented in 22 cases and hybrid in 3 cases. Bipolar hemiarthoplasty was made in 8 patients. Postoperative analysis and at follow-up was looking for local or systemic complications. Radiographic analysis radiolucent lines around the implants. Finally, the causes of re interventions were studied. Results Functional and radiological results were established 5.1 years mean follow. The mean PMA score was of 15, 8. Radiographic inspection showed that the loosening rate was 3.4% of acetabular implants and 2.27% of the stems. The rate of periarticular ossification was 9%, of which 1.5% were in stage 3 or 4 of Brooker's score. Discussion-conclusion Some pathologies (haematological disorders, renal failure) have received considerable therapeutic progress resulting from both an increase in the life of patients and an increase in the prevalence of osteonecrosis of the femoral head. Necrosis may also be the result of the treatments themselves (corticosteroids, immunosuppressants, allografts). The results of arthroplasty in this indication are demonstrative in terms of level of activity and PMA score. The results of this series conclude that arthroplasty remains the treatment of choice for advanced stages of necrosis.

Objectives The subject of this work is to clarify the epidemiological, clinical, therapeutic and prognostic of neglected rupture of the patellar tendon. Patients and methods A retrospective study of 24 cases of neglected rupture of patellar tendon, treated between June 2000 and June 2012. Results Our patients were 13 men and 10 women. The average age was 33 years, ranging from 21 to 52 years. Eight patients were followed for systemic diseases. The mean time to consultation was 52 days (28 days to three months). The diagnosis was done through imaging. Surgical exploration specified that the rupture was total in 19 cases, partial in five cases and located at the infra-patella in fourteen cases. All patients were operated. The repair of the lesions were made by using a fascial flap from quadriceps in 19 cases and a plasty with the semitendinosus tendon in five cases. In all cases, the tendon was put to rest and protected by a metal framing for a period. Distant results were evaluated after a mean of 27 months by Kelly and Dubourg clinical and radiological criteria. The result was fair in 18 cases and poor in 5 cases. Discussion-conclusion The results of our work allowed us to conclude that the neglected rupture of the patellar tendon was the prerogative of the young and active adult. The only treatment is surgical. The major prognosis factor is the length of duration of the lesion. Early postoperative rehabilitation is of a great interest and determines the functional prognosis.