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Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_II | Pages 99 - 99
1 Apr 2005
Ammari T Zrig M Annabi Chérif M Trabelsi M M’Barak M Essadem H Ben Hassine H Mongi M
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Purpose: First described in 1699, hydatid cyst in a muscle is extremely rare today, even in endemic areas.

Material and methods: We report a retrospective series of nine cases of primary hydatid cyst observed between 1985 and 1998. The patients were predominantly women living in a rural area (mean age 37 years), who consulted for an isolated tumefaction of the thigh (left side in 7/9 cases) which had evolved for twelve months on the average without affecting the general health status. Ultrasonography was highly contributive, suggesting the diagnosis in all cases. Hydatic serology was positive in five cases. Computed tomography (n=3) and magnetic resonance imaging (n=2) provided supplementary information. Hydatid cysts were identified in the adductors (n=4), the quadriceops (n==3) and the three compartments (n=1).

Results: Surgical treatment was performed in eight patients; en bloc resection of the hydatid cyst with peripheral muscle tissue in six cases and subtotal pericystectomy in two. Clinical and anatomic results are presented at mean six years follow-up.

Discussion: We discuss the role of each radiographic examination for the diagnosis and search for extension of hydatid cysts as well as the therapeutic options depending on the clinical course and soft tissue involvement.


Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_II | Pages 129 - 129
1 Apr 2005
Zrig M Ammari T Annabi H Chérif M Trabelsi M M’Barek M Ben Hassine H Mongi M
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Purpose: Patellar tendinopathy is a frequent pathology which generally heals well after functional treatment if managed early.

Material and methods: We report a retrospective analysis of thirteen high-level athletes who underwent surgery for chronic patellar tendinopathy. The disease was demonstrated by ultrasound, MRI, and plain radiographs. Four patients had insertion tendiopathies and nine had tendinopathies involving the tendon body. Six patients also presented a femoropatellar impingement demonstrated by arthroscan. The indication for surgery was total sports disability (Blazina stage III-b) after failure of functional treatment. Surgery consisted in systematic combing of the tendon after resection of degenerative tissue. Resection of the patellar apex was performed in the four patients with insertion tendinopathy. Lateral release was performed in patients with femoropatellar impingement and one patient with severe impingement required advancement of the anterior tibial tuberosity.

Results: Outcome was very good in eight patients and good in five at 36 months (mean follow-up).

Discussion: Ultrasonography was often the only exploration performed for chronic patellar tendinopathy. It is essential for diagnosis and postoperative surveillance. MRI should be reserved for surgical cases or if the diagnosis is doubtful. The beneficial effect of surgical treatment is undeniable if the indication is well founded. For us it is logical and necessary to treat any femoropatellar impingement during the same operation.