Nicolas Bouguennec

• Clinique du Sport Bordeaux-Merignac

The anterior cruciate ligament (ACL) plays a crucial role in knee stability and function, with its injuries posing challenges across the domains of prevention, treatment, and rehabilitation [...]

Background The co-occurrence of anterior cruciate ligament (ACL) rupture with medial collateral ligament (MCL) rupture is a compound injury that can be associated with meniscal tears. Purpose To report the characteristics of meniscal tears in knees with isolated ACL versus combined ACL and MCL injuries, analyzing their frequency, distribution by s...

Background/Objectives: After anterior cruciate ligament reconstruction (ACLR), a 6-month composite test is recommended during rehabilitation before the return to sport, and the influence of a meniscal tear is not known. The hypothesis was that the location and treatment of meniscus injuries could influence the results of the composite test. Methods...

Purpose This study aimed to evaluate which preoperative patient, injury or clinical factors were associated with the anterior cruciate ligament (ACL) remnant volume in patients undergoing ACL surgery. It was hypothesized that the main factors determining an insufficient ACL remnant volume at the time of surgery were younger age and longer time to s...

Computed tomography arthrography (CTA) highly correlates with arthroscopy in detecting labral tears, especially in patients with positive impingement tests. CTA enables the acquisition of isotropic datasets with high spatial resolution within a single acquisition. However, the hip is a close-fitting, congruent, and nearly spherical joint, with rela...

Background/Objectives: Evaluations allowing patients to return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR) should be multimodal, including a psychological evaluation. The goal of this study was to determine if there is a correlation between the ACL–return to sport after injury (ACL-RSI) score at 6 months post-ACLR and mid-...

Purpose The study aimed to estimate the prevalence of ramp lesions among patients undergoing anterior cruciate ligament (ACL) reconstruction and identify risk factors associated with these lesions. Methods A retrospective, multicentre cohort study was conducted using data from the Francophone Arthroscopic Society's registry, including 5359 patient...

Objective This study aimed to assess the performance of dynamic MRI in Chronic Groin Pain (CGP) related to the inguinal region, comparing it with surgery as the gold standard. Materials and methods A cohort of 25 consecutive patients exhibiting persistent clinical inguinal-related CGP underwent a pre-surgical pelvis MRI. Imaging encompassed strictl...

Background Chronic combined medial collateral ligament (MCL) and anterior cruciate ligament (ACL) injuries are frequent. Medial residual laxity is a risk factor for ACL rerupture. It should be treated at the same time as the ACL reconstruction (ACLR) if necessary, but there are still questions surrounding the indications for abstention or surgery o...

Purpose: The purpose of this study was to analyze the clinical outcomes and radiologic position of the knee in two groups of patients after medial unicompartmental knee arthroplasty (UKA): one group with residual varus axis (RVA) alignment and other one with neutral mechanical axis (NMA) of the lower limb. Methods: All patients who underwent UKA...

Background The risk of cyclops syndrome increases significantly after anterior cruciate ligament (ACL) reconstruction (ACLR) if complete extension is not recovered before the sixth postoperative week. The lockdown in France due to the COVID-19 pandemic led to an absence of supervised rehabilitation, requiring unexpected self-rehabilitation in patie...

Purpose This study evaluates the use of the needle arthroscopy in anatomical reconstruction of the lateral ankle. We hypothesized that the needle arthroscopy would allow anatomical reconstruction to be performed under arthroscopy. Methods Three patients underwent treatment of chronic ankle instability. The comparative procedure was performed in th...

Introduction La SFA a décidé de mettre en place un registre des ruptures du LCA intégré à sa plateforme de registres-SFA Datalake. Cette étude présente les résultats de l’évaluation du registre par les utilisateurs à 1 an afin d’identifier les points forts et faibles pour améliorer la participation. Matériel et méthode Un questionnaire contenant 1...

Introduction The high tibial osteotomy (HTO) survival rate is strongly correlated with surgical indications and predictive factors. This study aims to assess HTO survival in the long term, to determine the main predictive factors of this survival, to propose a predictive score for HTO based on those factors. Methods This multicentric study include...

Résumé Le SFA Datalake est la plateforme des registres appartenant à la Société francophone d’arthroscopie (SFA). Il a été conçu pour collecter et stocker les données de résultats relatifs à la chirurgie orthopédique arthroscopique ou la chirurgie articulaire conservatrice dans les pays francophones. Le registre des ruptures du ligament croisé anté...

Introduction: Anterior cruciate ligament (ACL) reconstruction is a frequent procedure, with room for improvement by rehabilitation measures and associated peripheral and meniscal surgeries that are currently under assessment, requiring follow-up. Outside France, there have been ACL registries for 20 years now. The French Arthroscopy Society (SFA) d...

SFA Datalake is the registry platform of the French Society of Arthroscopy (SFA). It was designed to collect and store data on arthroscopic orthopedic surgery and joint-sparing surgery in French-speaking countries. The anterior cruciate ligament (ACL) tear registry is the first registry to be set up based on SFA Datalake. Registries are intended to...

Résumé Introduction La reconstruction du ligament croisée antérieur (LCA) est une intervention fréquente dont les résultats restent améliorables avec des procédures de rééducation et des gestes associés périphériques ou méniscaux en cours d’évaluation justifiant la nécessité d’un suivi. Les registres du LCA existent depuis 20 ans à l’étranger. La...

Purpose: Anterior cruciate ligament reconstruction (ACLR) using a short, quadrupled semitendinosus (ST-4) autograft, fixed with an adjustable suspensory fixation (ASF), has several potential advantages. However, the construct is suspected to generate micromotion, tunnel widening and poor graft maturation. The aim of this study was to evaluate post...

We present a surgical technique to reconstruct the deep portion of the medial collateral ligament (MCL) when associated with an injury of the anterior cruciate ligament (ACL). Patients could benefit from this procedure in cases of ACL reconstruction and persistent laxity at 20° of flexion of the MCL without any laxity in extension. This surgery use...

Purpose: Graft failure and secondary meniscal tears are major concerns after anterior cruciate ligament (ACL) reconstruction in young athletes. The aim was to evaluate the link between ACL reconstruction with and without anterolateral ligament (ALL) reconstruction and outcomes in young patients participating in pivoting sports. Methods: This was...

Introduction L’évaluation avant reprise du sport à 6 mois d’une reconstruction du LCA est multimodale et comprend une évaluation clinique, fonctionnelle mais aussi psychologique avec le questionnaire ACL-RSI. L’hypothèse de cette étude était que le moment de réalisation du test lors de la consultation influençait le résultat du questionnaire. Maté...

Aims: MRI has been suggested as an objective method of assessing anterior crucate ligament (ACL) graft "ligamentization" after reconstruction. It has been proposed that the MRI appearances could be used as an indicator of graft maturity and used as part of a return-to-sport assessment. The aim of this study was to evaluate the correlation between...

MRI has been suggested as an objective method of assessing anterior crucate ligament (ACL) graft "ligamentization" after reconstruction. It has been proposed that the MRI appearances could be used as an indicator of graft maturity and used as part of a return-to-sport assessment. The aim of this study was to evaluate the correlation between MRI gra...

Anterior cruciate ligament ruptures are commonly associated with ramp lesions of the medial meniscus. These posterior longitudinal peripheral tears induce medial meniscus instability and increase the anteroposterior and rotational knee laxity. We divided ramp lesions in 3 types: meniscocapsular ligament tears, meniscotibial ligament tears, and a co...

Objectives The rate of repeat graft ruptures in young athletes is a major concern after ACL reconstruction. Our objective was to evaluate the association between two reconstruction techniques and repeat ruptures, repeat surgery, return to sports and complications in center playing sportspersons younger than 20 years of age. Methods A prospective s...

Résumé Introduction L’ostéotomie tibiale de valgisation (OTV) et la prothèse uni-compartimentale (PUC) sont deux solutions chirurgicales en cas de gonarthrose fémorotibiale médiale isolée. Le résultat de ces interventions dépend de critères préopératoires et de la sélection des patients mais aussi de facteurs postopératoires (positionnement des im...

Résumé Introduction La planification préopératoire d’une ostéotomie tibiale de valgisation (OTV) est une étape capitale afin d’obtenir la correction souhaitée et un résultat clinique satisfaisant. La technique radiographique conventionnelle, la navigation et les guides de coupe sur-mesure (PSI) sont les 3 méthodes qui permettent cette planificatio...

Introduction: Cyclops syndrome is a classic complication after anterior cruciate ligament (ACL) reconstruction and usually manifests as an extension deficit. A presentation dominated by recurrent hemarthrosis has never been reported. Case report: We report the cases of two patients who underwent ACL hamstring reconstruction and whose post-operat...

Introduction: Preoperative planning in high tibial osteotomy (HTO) is a critical step for achieving the desired correction and a clinically satisfactory outcome. Conventional radiography, navigation assistance and patient-specific instrumentation (PSI) are the 3 means of planning, but no prospective studies have compared precision between the 3. T...

Purpose: To evaluate return to sport and clinical outcomes with at least 2 years followup after arthroscopic reconstruction ACL in population over 50 years-old. Methods: eighty-one patients aged 50 years or older underwent isolated, primary ACL reconstruction with hamstring autograft between 2014 and 2016. In all patients, a period of conservati...

PurposeThe purpose of this study was to systematically assess the possibility for a patient younger than 15 to return to a competitive level of sport following an ACL injury.Methods Four databases were analyzed (PubMed, MedLine, Cinahl, Cochrane Library and LISTA). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guid...

Introduction High tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are two surgical solutions for isolated medial tibiofemoral osteoarthritis. Results depend on preoperative criteria and patient selection, but also on postoperative factors: implant positioning, limb alignment. Factors for HTO survival need identifying to reduce r...

Résumé Introduction Les résultats à 20 ans de recul après ligamentoplastie du croisé antérieur sont rares. Cette étude a été réalisée afin d’étudier la prévalence de la gonarthrose à plus de 20 ans de recul d’une ligamentoplastie du croisé antérieur et de déterminer les facteurs de risque. Hypothèse : Les lésions méniscales, le niveau d’activité,...

Background: Few data are available on the 20-year outcomes of anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to assess the prevalence and risk factors of knee osteoarthritis at least 20 years after ACL reconstruction. Hypothesis: Factors associated with progression to knee osteoarthritis include meniscal lesions,...

Anterior cruciate ligament (ACL) reconstruction using an autograft gives good results that could provide improved failure rates. ACL augmentation saving the remnant has demonstrated advantages, such as saving vascular supply and nerve receptors, which could be useful for healing. Conversely, isolated repair techniques are gaining interest but do no...

Success of ACL reconstruction requires Graft healing in the joint and a solid graft incorporation within the tunnels. Resorbable interference screws (RIS) provide limited tendon-bone contact because much of the tunnel circumference is occupied by the screw itself, while adjustable suspensory fixation (ASF) systems provide larger contact zones and s...

Introduction Lors d’une reconstruction du Ligament Croisé Antérieur (LCA), l’autogreffe aux ischio-jambiers (IJ) va passer par une phase de transformation et de maturation pour acquérir sa résistance définitive. Des études entre la maturation, le signal IRM et les résultats fonctionnels ont été rapportées mais aucune étude n’a analysé l’effet de l’...

Résumé Introduction Le syndrome du Cyclope, après reconstruction du ligament croisé antérieur (LCA), est caractérisé par un flessum irréductible du genou dû à la formation d’un nodule fibreux à la partie antérieure de l’échancrure intercondylienne. L’objectif de cette revue systématique était d’évaluer l’incidence clinique du syndrome du Cyclope a...

Background: Cyclops syndrome after anterior cruciate ligament (ACL) reconstruction is due to a fibrous nodule that develops in the anterior part of the intercondylar notch and prevents full knee extension. The primary objective of this systematic literature review was to evaluate the incidence of symptomatic cyclops lesion after ACL reconstruction...

Chronic patellar tendon rupture is a rare injury; extensor mechanism impairment leads to great disability in daily life. The delayed diagnosis and reconstruction of chronic patellar tendon ruptures are technically challenging. Numerous surgical procedures have been described with bone-tendon-bone graft, hamstring graft, artificial ligament, and all...

Allergy to metal, especially to titanium, is a poorly known subject in orthopedic surgery and is mostly found after arthroplasty. Here, we describe an original case of titanium allergy that developed after an anterior cruciate ligament (ACL) reconstruction of the left knee in a patient with a history of severe atopic dermatitis. Three years after t...

Introduction La fixation par endoboutons réglables fémoral et tibial des reconstructions du LCA par DT4 est une technique récente. Peu de publications rapportent les complications. Nous présentons une série continue prospective de 1148 patients en rapportant les complications, échecs et ré-interventions. Matériel et méthode Mille cent quarante-hui...

Introduction La reconstruction combinée du ligament croisé antérieur (LCA) et du ligament antéro-latéral (LAL) pourrait permettre dans certaines indications de diminuer les taux de re-rupture par un meilleur contrôle rotatoire. Nous présentons une technique originale de reconstruction en cadre du LCA au demi-tendineux (DT) et du LAL au gracilis (G)...

Background The success of anterior cruciate ligament (ACL) reconstruction requires reliable and rigid graft fixation. Cortical suspensory fixation (CSF) devices have become an acceptable alternative to interference screws for soft tissue ACL grafts. However, CSF devices have been reported to be associated with tunnel widening and increased postoper...

Chronic rupture of the patellar tendon is a severe injury that leads to dramatic functional consequences including lack of extension and walking difficulty. Surgery is the gold standard to treat this type of injury, but revision reconstructions are problematic because an ipsilateral graft was often harvested for the initial surgery. Because fibroti...

Background: Femoral malposition is the first cause for graft rupture during ACL reconstruction. Arthroscopic landmarks can be difficult to identify. So, landmark has to be found for reliable tunnel placement. A proximal-distal reference was described as "Apex reference" reported by Hart et al. but no posterior/anterior reference exists in the lite...

Introduction La réussite d’une reconstruction du ligament croisé antérieur (LCA) nécessite des repères fiables pour le positionnement des tunnels, surtout pour le tunnel fémoral dont la malposition est la première cause d’échec. L’amélioration de la connaissance de l’anatomie du LCA a conduit à la recherche de nouveaux repères pour obtenir une posi...

Introduction Le taux d’échec des reconstructions du LCA utilisant les ischio-jambiers est important, de 1,4 % à 15,3 % selon les séries (moyenne à 7,4 %). Parmi les causes d’échec, les systèmes de fixation ont leur part de responsabilité. Notre hypothèse était que les greffes DT4 fixées par suspension réglable des deux côtés, ont un résultat cliniq...

Good to excellent results at long-term follow-up have been published for bone–patellar tendon–bone (BTB) graft anterior cruciate ligament reconstruction. Fixation using screws historically has been the most common choice for femoral and tibial bone blocks, but screws present several disadvantages, which include the risk of blowout (for which preven...

PurposeThe role of lateral extra-articular tenodesis (LEAT) as an augment to primary anterior cruciate ligament reconstruction (ACLR) remains controversial. However, concerns exist regarding the risk of development of osteoarthritis due to over constraint of the knee. To systematically review the literature to analyse the long-term incidence of ost...

Introduction Un mauvais positionnement du tunnel fémoral est la première cause d’échec identifiée lors d’une reconstruction du ligament croisé antérieur (LCA). La position « idéale » ne fait pas consensus avec des variations d’interprétation des paramètres anatomiques et biomécaniques. Nous avons comparé le positionnement et les repères lors de la...

Classifications of meniscal lesions in children are interesting from several points of view: diagnostic, prognostic, and therapeutic. The presence or absence of an abnormality of the meniscus is the main parameter: some of the classifications are the same as for adults (traumatic lesions with normal aspect of the meniscus) and others are specific t...

To evaluate and treat a pathology of a meniscus, the normal anatomy and the normal aspect of each structure during an arthroscopic surgical procedure have to be known. Indeed, a bad analysis leads to mistreatment, and for the exploration of the entire meniscus, either medial or lateral, several portals will be needed and the surgeon will know how t...

Introduction La ligamentoplastie anatomique a prouvé sa supériorité à long terme dans les lésions ligamentaires latérales sévères de la cheville. Le repérage sous arthroscopie de l’insertion calcanéenne du ligament fibulocalcanéen (LFC) reste techniquement difficile, agressif et approximatif. Basée sur une étude cadavérique préliminaire, nous propo...

Introduction La ligamentoplastie anatomique a prouvé sa supériorité à long terme dans l’instabilité chronique cheville. Le développement des techniques arthroscopiques a pour but de restituer plus précisément l’anatomie de l’insertion distale du ligament fibulo-calcanéen (LFC). Mais cette restitution est encore difficilement fiable et reproductible...

Résumé Introduction Le TELOS™ est une référence pour la mesure instrumentale de la translation antérieure du tibia dans le bilan et le suivi des lésions du ligament croisé antérieur. Le GNRB®, non irradiant mais de développement récent, a été moins étudié. Hypothèse Le GNRB® est plus reproductible que le TELOS™ pour la mesure de la translation an...

Background: TELOS™ is among the reference tools for the instrumental measurement of anterior tibial translation during the initial work-up and follow-up of patients with injuries to the anterior cruciate ligament (ACL). GRNB(®) is a non-irradiating but recently developed tool for which only limited data are available. Hypothesis: The GRNB(®) off...

The localized form of pigmented villonodular synovitis of the knee is a rare condition with non-specific symptoms. This makes diagnosis especially difficult when the meniscus is affected. A full assessment with several imaging modalities can help support the preoperative diagnosis. But in the case reported here, the full clinical and paraclinical a...

La synovite villo-nodulaire pigmentée localisée est une pathologie rare dont les symptômes non spécifiques rendent le diagnostic difficile, en particulier en cas de syndrome méniscal. L’imagerie complémentaire peut aussi être trompeuse mais permet d’évoquer le diagnostic en préopératoire lorsque le bilan est complet. L’ensemble du bilan complet cli...

Les lésions du labrum glénoïdien supérieur sont souvent retrouvées associées aux lésions de la coiffe du sujet de plus de 45 ans dans un cadre dégénératif, ou associées aux lésions d'instabilité chez les patients jeunes et sportifs dans un contexte plus volontiers traumatique. Elles peuvent cependant exister de façon isolées et ont alors été décrit...

Background: Performing a single-bundle anterior cruciate ligament (ACL) reconstruction within the femoral footprint is important to obtain a functional graft and a stable knee. Hypothesis: There will be a significant difference in the ability of 3 ACL reconstruction techniques to reach and cover the native femoral footprint. Study design: Cont...

Les luxations de l’articulation sacro-iliaque rentrent fréquemment dans le cadre des polytraumatismes avec cinétique lésionnelle importante. Une rupture de l’anneau pelvien suppose une double lésion de celui-ci, soit une lésion associée de l’arc antérieur et de l’arc postérieur, soit une lésion bilatérale. L’os coxal est le plus souvent luxé vers l...

Sacroiliac joint dislocations frequently occur in a context of high-energy polytrauma. When there is disruption of the pelvic ring, sacroiliac joint displacements are more often posterior and combine two lesions: either lesions of the pubic arch as well as the posterior arch or bilateral lesions. The case we report here lacks these two characterist...