[Total knee replacement without patellar resurfacing: about 60 cases]. / Prothèse totale du genou sans resurfaçage de la rotule: à propos de 60 cas.

During total knee replacement, one of the main problems of surgeon is to choose between preservation of the patella or resurfacing with prosthetic replacement of patellar cartilage. This issue continues to be a subject of controversy within the orthopaedic community. There is no clear consensus on the optimal approach to the patella during total knee arthroplasty (TKA). We conducted a retrospective study of 60 patients undergoing total knee replacement without resurfacing of the patella. These procedures were performed in the Department of Orthopedics and Trauma-Surgery (B) at the University Hospital Hassan II, Fez, since January 2009 to December 2015. The average age of patients was 58 years, ranging between 20 years and 80 years. Female prevalence was clear (41 women, 72% and 16 men, 28%). Clinically, the majority of patients had mechanical pain and all patients underwent clinical and radiological examination. The IKS score was used to assess knee condition before and after surgery. The surgical procedure was based on total knee arthroplasty without patellar resurfacing. Post-operative complications included 7 cases of anterior knee pain, 2 cases of infection of superficial skin treated with appropriate antibiotic therapy and 3 cases of stiffness. No cases of hematoma, phlebitis or sepsis were reported. Clinical results after a follow-up period of 18 months were satisfactory. Given these results, the preservation of the patella allowed for very satisfactory middle term results regarding pain relief and restoration of function. In addition, potential complications of patella prosthesis were avoided. One limitation of these replacements without resurfacing is the occurrence, or sometimes the persistence, of anterior knee pain; hence the need for secondary resurfacing. Current data from the literature show that there is no consensus on the approach to the patella during total knee replacement. Finally, patella resurfacing is an approach that the surgeon should choose on the basis of current data. This said, the debate can continue focusing on a single issue: which approach should be used to the patella.

[Emergency coverage of post-traumatic losses of cutaneous substances of the anterior face of the knee using proximally based sural fasciocutaneous flap: about 4 cases of articular wounds]. / La couverture en urgence des pertes de substances cutanées d'origine traumatique de la face antérieure du genou par lambeau fascio-cutané sural à pédicule proximal: à propos de 4 cas de plaies articulaires.

Our study reports 4 cases of male patients with wounds on the anterior face of the knee loosing cutaneous substance after motorcycle accident. The patients had undergone surgery involving the debridement and the application of four proximally based sural fasciocutaneous flaps since 2012. The average age of patients ranged from 28 to 42 years. The highest loss of cutaneous substance measured 14 x 10 cm. The average pedicle length was 14 cm. The post-operative suites were uneventful with a satisfactory wound healing. From a functional point of view the knee and the ankle were completely mobile. This study shows the effectiveness and reliability of proximally based sural fasciocutaneous flap in the coverage of post-traumatic losses of cutaneous substances of the anterior face of the knee, and allows for limit the indications for heads of the gastrocnemius muscle flaps.

[Patella cubiti detected after a trauma: about a case and literature review]. / La patella cubiti découverte à la suite d'un traumatisme: à propos d'un cas et revue de la littérature.

Patella cubiti is a very rare anomaly characterized by the non-union of olecranon and proximal ulna. We here report the case of a 27-year old patient admitted with a trauma of the elbow. Diagnostic examination revealed patella cubiti mimicking olecranon fracture. The patient underwent excision of bone fragment. Three months after surgery, the patient was satisfied because the foreign body that he felt at the level of the elbow had disappeared.

[Triplane fracture of the proximal end of the tibia: a rare lesion (case study and literature review)]. / Fracture triplane de l'extrémité supérieure du tibia: une lésion rare (étude d'un cas et revue de la littérature).

We here report the case of a 16-year old patient with triplane fracture of the proximal end of the tibia due to a sporting accident occurred during a cycling race. CT scan (CT) was performed to assess the fracture with a high level of accuracy. After identification of all fragments requiring osteosynthesis, closed reduction was performed with fixation of fracture fragments using cannulated screws. At the last follow-up visit, radiological and functional results were excellent.

[Hip arthroscopy in patients with femoroacetabular impingement: about 2 cases]. / L'arthroscopie de la hanche dans le conflit fémoro-acétabulaire: à propos de 2 observations.

Femoroacetabular impingement (FAI) can causes hip pain in young subjects and in athletes. His diagnosis is based on clinical and radiological examinations. Surgical treatment is based on conventional surgery or on arthroscopy. Arthroscopy proves to be a reliable technique in the treatment of FAI. It is effective on the pain and improves performances of athletes in order to enable them to resume their activities within a very short space of time. We here report our experience within our Department in treating 2 patients with FAI with arthroscopy. Modified Harris score significantly improved at the last follow-up (24 and 18 months).

[Spontaneous simultaneous bilateral rupture of the quadriceps tendon in patients with parathyroid adenoma: case report and literature review]. / Rupture bilatérale spontanée et simultanée du tendon quadricipital dans l'adénome parathyroïdien: à propos d'un cas et revue de la littérature.

Spontaneous as well as bilateral and simultaneous rupture of the quadriceps tendon is rare. We report the case of a 53-year old patient followed up for parathyroid adenoma complicated by renal failure, admitted for spontaneous bilateral rupture of the two quadriceps tendons. He underwent surgical repair allowing him to maintain his autonomy.