list of speakers

Transcription

list of speakers

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CONTENT
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Edito ...........................................................................................................................................................5
Forewords .................................................................................................................................................7
Program.....................................................................................................................................................11
Organising Committee ..............................................................................................................................12
List of speakers .........................................................................................................................................15
Abstracts ...................................................................................................................................................21
1.
The role of imaging in the orthopaedic screening of Thoroughbred racehorses.
Sarah Powell ................................................................................................................................23
2.
How do tendons work, and how do they fail; what is the future potential of imaging for detection of earliest pathology?
Peter Clegg ...................................................................................................................................26
3.
Diagnostic imaging of the knee in the preparticipation screening of soccer players
Jan L. Gielen .................................................................................................................................28
4.
Mesenchymal stem cells in rheumatology: an update
Christian Jorgensen ......................................................................................................................31
5.
Mesenchymal stem cells in the treatment of tendon injuries in racing Thoroughbreds and sports horses
Roger K.W. Smith ........................................................................................................................32
6.
Current knowledge on the use of Platelet-Rich Plasma in sports medicine
Jamie Textor .................................................................................................................................33
7.
Strategic management of a rugby player during a world cup tournament
Jean-Philippe Hager .....................................................................................................................35
8.
Governance and management of the organizational structure of professional sports: from global to local, from elite to sport for all
Thierry Zintz .................................................................................................................................37
9.
The anti-doping program of the FEI: Clean Sport
Harald Müller ...............................................................................................................................38
10.
Doping prevention in human sports
Denis Hauw ..................................................................................................................................44
11.
Anti-doping in equestrian sports, from regulation to implementation
Charles Troillet and Jacques Nardin ............................................................................................46
This Symposium is supported by
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Monument to Dr. Charles Mérieux recalling his involvement in comparative pathobiology.
Veterinary Campus of Lyon (VetAgro Sup, Marcy l’Etoile, France)
Monument au docteur Charles MERIEUX rappelant son implication en biopathologie comparée.
Campus vétérinaire de Lyon (VetAgro Sup, Marcy l’Etoile, France)
EDITO
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Sylvie Robert
Equestrian events Director,
President of Equita’Concours
Dear friends,
It is an immense pleasure to play host to the international
scientific community for this first European equine and human comparative sports medicine symposium presented by
Merial, as part of these FEI World Cup™ Finals. The GL events
Group, Merial, the Equine Health Centre of Expertise of the
VetAgro Sup Veterinary Campus in Lyon and the whole team
which surrounds me, would like to welcome you to Lyon, in
this city which was a natural choice to welcome this first symposium. Indeed Lyon is closely linked to comparative medicine
between humans and animals. Great names of this discipline
come to mind here, such as Claude Bernard, Auguste Chauveau and Etienne-Jules Marey, who, since the 18th century, were aware that links between the study of
human and animal anatomy and the care given to both species should be explored. This is the first time
that a sport-themed comparative medicine symposium has been organised. I hope you have many enriching, passionate and enlightening discussions.
I wish you all an enjoyable symposium.
Sylvie Robert,
Equestrian events Director,
President of Equita’Concours
Chers amis,
C’est un immense plaisir que d’accueillir la communauté internationale scientifique à l’occasion de ce premier Symposium européen de médecine du sport comparée équine et humaine présenté par Merial, dans
le cadre de ces FEI World Cup™ Finals. Le groupe GL events, la société Merial, le Pôle de compétences en
santé équine du Campus vétérinaire de VetAgro Sup à Lyon, et toute l’équipe qui m’entoure vous souhaitent la bienvenue à Lyon, dans cette ville qui se devait d’accueillir ce premier Symposium. Lyon est en effet
intimement liée à la médecine comparée entre humains et animaux. De grands noms de cette discipline
résonnent ici, comme ceux de Claude Bernard, d’Auguste Chauveau, d’Etienne-Jules Marey, qui depuis
le XVIIIe siècle, ont su que des passerelles devaient être tendues entre l’étude de l’anatomie humaine et
de l’anatomie animale, entre les soins apportés à l’ensemble des espèces. C’est la première fois qu’un
Symposium de médecine comparée est organisé sur le thème du sport. Je vous souhaite alors de riches
échanges, passionnants et porteurs de nombreux enseignements.
Très bon symposium à tous.
Sylvie Robert
Directeur des événements équestres,
Présidente d’Equita’Concours
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FOREWORDS
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Dear Colleagues and friends of sports medicine,
“We have come to realize the intimate similarities that exist between the human and the animal machine;
this relationship is such that both human and veterinary medicine will mutually enlighten and improve
each other…“ (Claude Bourgelat, founder of Veterinary Schools and pioneer of Comparative Pathobiology, at Lyon in 1761). Today’s unique European Comparative Symposium on Equine and Human Sports
Medicine, Rehabilitation and Traumatology is a meeting point for people from different backgrounds
working or interested in this subject.
It should be recognized that comparative medicine and pathology is a concept that has resulted in major
advances, especially in physiology and infectious diseases, as “between animal and human medicine,
there is no dividing line, nor should there be” (Rudolf Virchow ~1850). And this concept has always been
relevant in Lyon, the home of Bourgelat and other veterinarians but also of Claude Bernard and the Merieux dynasty who founded the SANOFI group, which includes its company MERIAL, a world leader in
veterinary pharmaceuticals, to whom I am very grateful for their strong support of this meeting.
Even though comparative medicine has more frequently resulted in fundamental research, why should
we not be able to apply this concept to answer some of the multiple clinical questions that arise from
sports activities at the highest level in both equine and in human athletes? Subjects of discussion at this
Symposium encompass some of these clinical aspects, in order to prioritise our understanding of the
well-being of our athletes, be it human or equine, by sharing our specialized expertise.
As a consequence of new collaborations between veterinary and human specialists, not only should the
horse and the rider benefit but potentially also the entire sports industry. Our distinguished invited
speakers, from all over Europe and the United States, will outline the latest developments in clinical and
basic science, and formulate their recommendations during the closing round table discussion on Saturday evening.
On behalf of the Scientific Program Committee I wish to take this opportunity to thank all of you sincerely
for your presence here in Lyon, and extend these thanks to the European Society of Veterinary Orthopedic and Traumatology for their patronage, and to the students of the Veterinary Campus of Lyon (VetAgro
Sup), who are here to welcome each one of you attending this conference. Finally I would like to make
special mention of Ms Sylvie Robert and the GL Events Group, without whose vision of combining a major
sports event with a medical symposium, this meeting would not have been possible.
Warmest Regards,
Prof. Olivier M. Lepage
Chair Scientific Program Committee
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AVANT-PROPOS
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Chers collègues et amis de la médecine sportive,
Nous avons connu l’intimité des rapports qui existent entre la machine humaine et animale; rapports qui
sont tels que l’une et l’autre médecine s’éclaireront et se perfectionneront mutuellement... (Claude Bourgelat, fondateur des Ecoles vétérinaires et précurseur de la biopathologie comparée, à Lyon en 1761).
Aujourd’hui, le Symposium en médecine du sport, réadaptation et traumatologie auquel vous assistez est
un point de rencontre pour les personnes de différents horizons de la médecine humaine ou équine ayant
un intérêt commun pour le sport.
Il faut reconnaître que la médecine et la pathologie comparées est un concept qui a offert des progrès
importants en particulier dans l’étude de la physiologie et des maladies infectieuses « entre médecine
humaine et animale, il n’y a pas de frontières, et il ne devrait pas y en avoir» (Rudolf Virchow ~ 1850).
Ce concept a toujours été d’actualité en région lyonnaise avec Bourgelat et d’autres vétérinaires, mais
aussi avec Claude Bernard et la dynastie Mérieux à l’origine du groupe SANOFI qui comprend la Société
MERIAL, un groupe au leadership fort dans le secteur de la pharmaceutique vétérinaire que je tiens à
remercier pour leur soutien à cette réunion.
Si la médecine comparative a conduit, le plus souvent, à des recherches fondamentales, pourquoi ne pouvons- nous pas appliquer ce concept pour répondre aux interrogations multiples qui découle de pratiques
sportives au plus haut niveau autant chez les chevaux que chez l’homme? Les sujets qui seront discutés
lors du colloque porteront donc sur un aspect plus clinique, et doivent favoriser, par le partage d’une expertise spécialisée, les connaissances sur la santé des athlètes qu’ils soient humains ou équin.
En ce qui concerne les nouvelles collaborations entre les spécialistes des deux médecines, le bénéfice ne
sera pas seulement pour le cheval ou le cavalier mais il retombera sur l’ensemble de l’industrie du sport.
Nos conférenciers invités, provenant de toute l’Europe ou des Etats-Unis, présenteront les derniers développements de la science fondamentale et de la clinique, et suggéreront des idées pour la table ronde de
clôture du samedi soir.
Au nom du Comité en charge du programme scientifique, je tiens à profiter de l’occasion pour remercier
sincèrement de votre présence ici, à Lyon, et pour étendre ces remerciements à la Société Européenne
d’Orthopédique et de Traumatologie vétérinaire pour son patronage, ainsi que les étudiants du Campus
vétérinaire de Lyon (VetAgro Sup) en charge de vous accueillir. Enfin, je voudrais faire une mention spéciale à Madame Sylvie Robert du groupe GLevents, car ce Symposium n’aurait pas été possible sans leur
vision de combiner un événement sportif majeur avec un colloque médical.
Bon congrès,
Prof. Olivier M. Lepage
Chair Scientific Program Committee
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Crédit photo : O. Lepage
PROGRAM
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Friday April 18th 2014
13.00 - 13.45 Registration
13.45 – 14.00 Word of welcome
Session 1
What is the role of diagnostic imaging in the screening of upper level athletes for purchase transactions and injury prevention?
Chair: Professor Michael Schramme
Moderator: Dr Jean-Philippe Hager
14.00 - 14.45
The role of imaging in the orthopaedic screening of Thoroughbred
racehorses
Dr Sarah Powell MA VetMB, Assoc. (LA) DipECVDI, Head of Diagnostic Imaging, Beaufort Cottage Equine Hospital, Newmarket, United
Kingdom
14.45 – 15.30
Session 3
Contributions of sports medicine to the high-level human
athlete
Chair: Jean-Marc Gentil
Moderator: Professor Jan Gielen
13.30 - 14.00
Strategic management of a rugby player during a world cup
tournament
Dr Jean-Philippe Hager, Médecin de l’Equipe de France de
Rugby, Centre Orthopédique Paul Santy, Lyon, France
14.00 – 14.30
Governance & management of the organizational structure
of professional sports: from global to local, from elite to
sport for all
Professor Thierry Zintz, Dean Faculté des Sciences de la
Motricité, Titulaire de la Chaire Olympique Henri de Baillet
Latour & Jacques Rogge en Management des Organisations
Sportives, Université catholique de Louvain, Louvain-laNeuve, Belgium
14.30 – 15.00 Discussions
15.00 – 15.30 Break
Professor Peter Clegg MA Vet MB, PhD, DipECVS, Professor of Surgery, University of Liverpool, United Kingdom
15.30 Break
16.15 – 17.00
Diagnostic imaging of the knee in the preparticipation screening of
soccer players
Professor Jan Gielen MD, PhD, Vice-head Department of radiology,
Coordinator Department of Sports Medicine, Faculty of Medicine,
University of Antwerp, Belgium
18.00 – 19.00 Welcome Reception
Saturday April 19th 2014
Session 2
Regenerative medicine in the rehabilitation of high level athletes
Chair: Regis Steinberg
Moderator: Professor Olivier Lepage
08.30 – 09.15
Prof. Christian Jorgensen, MD, PhD, Head Clinical Unit for osteoarticular diseases, Inserm U 844, University Hospital of Montpellier,
France.
09.15 – 10.00
Mesenchymal stem cells in the treatment of tendon injuries in racing
Thoroughbreds and sports horses
Prof. Roger K.W. Smith, MA Vet MB, DEO, PhD, FHEA DipECVS, Professor of Equine Orthopaedics, The Royal Veterinary College, Department of Veterinary Clinical Sciences and Services, UK.
10.00 Break
10.30 – 11.15
Dr Jamie Textor, DVM, PhD, DipACVS, Total Performance Equine
Sports Medicine & Surgery, Martinez CA (USA)
Session 4
Veterinarians and Doctors for clean sport: doping and banned substances
Chair: Professor Olivier Lepage
Moderator: Professor Thierry Zintz
15.30 – 16.00
Dr Harald Müller, Fédération Equestre Internationale, Executive Director Education & Standards, Switzerland
16.00 – 16.30
Professor Denis Hauw, PhD, Université de Lausanne, Institut
des Sciences du Sport, Switzerland
16.30 – 17.00
Charles Troillet, méd vét. Président de la Fédération Suisse
de Sports Equestre, Switzerland
Jacques Nardin, Dr vét, Medication Control Program FEI,
France
General round table
4 sessions - 4 questions – 4 answers
Rapporteur: Professor Jean-Luc Cadoré
17.30 - 18.30
Question 1 : S. Powell, P. Clegg, J. Gielen, M. Schramme
Question 2 : C. Jorgensen, R. Smith, J. Textor, R. Steinberg
Question 3 : P. Hager, J. Gielen, T. Zintz, JM Gentil
Question 4: H. Müller, D. Hauw, C. Troillet, J. Nardin
18.30 End of the Symposium
ORGANIZING COMMITTEE
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Scientific Program Committee Chair
Olivier Lepage (Chair)
Professor of Equine Surgery, DMV, MSc, PD, HDR, DES, DipECVS
Head Equine Department
University of Lyon, VetAgro Sup,
Veterinary Campus, F-69280 Marcy l’Etoile, France
olivier.lepage@vetagro-sup.fr
Olivier Lepage qualified as a veterinarian at the University of Liège, Belgium, he
obtained a Master of Science from the University of Montreal (Canada), became
Privat Dozent in 1998 from the University of Berne (Switzerland) and received his
Habilitation to direct research from the University of Lyon (France). These postgraduate degrees concentrated on research of noninvasive assessment of equine
bone. Presently he works at the ICE-GREMERES Research Unit where he developed an original equine model of osteoarthritis for assessment of various joint
regenerative medicine treatments in both horses and humans. His clinical career
started as a private practitioner before being accepted for an Internship at the
University of Montreal followed by a Residency in large animal surgery. He holds the Diploma of the European College of Veterinary Surgeons. In Academics he has occupied the positions of: Equine Surgery Clinician (University of Montreal), Head of the
equine surgery (University of Bern) and since 1998, Director of the Equine Center on the Veterinary Campus of Lyon (France).
As a full Professor in equine surgery, he has served the European Society of Veterinary Orthopaedics and Traumatology as
President and he is presently Board member of the European College of Veterinary Surgeons.
Olivier Lepage est docteur vétérinaire diplômé de l’Université de Liège en Belgique. Il a obtenu une Maîtrise en Sciences de
l’Université de Montréal (Canada), est devenu en 1998 Privat Dozent de l’Université de Berne (Suisse) et a ensuite obtenu son
Habilitation à Diriger des Recherches de l’Université de Lyon (France). La thématique principale pour l’ensemble de ces travaux
est l’évaluation non invasive du système osseux des équidés. Actuellement il travaille au sein de l’Unité de recherche ICE-GREMERES où il a développé un modèle original d’ostéoarthrite du cheval afin d’évaluer différentes options thérapeutiques de
médecine régénérative autant pour l’homme que les équidés. Sa carrière clinique a commencé comme praticien généraliste
avant d’être accepté pour un Internat à l’Université de Montréal qui se poursuivra par une résidence en chirurgie des grands
animaux dans la même Institution. Diplômé du Collège Européen des chirurgiens vétérinaires il occupe successivement les
postes académiques de clinicien en chirurgie équine (Université de Montréal), Responsable du Service de chirurgie équine (Université de Berne), et depuis 1998 il dirige le Pôle de compétences en santé équine de VetAgro Sup - Campus Vétérinaire de Lyon.
Professeur titulaire en chirurgie équine il a été Président de la Société Européenne d’orthopédie et de traumatologie vétérinaire
(ESVOT) et est actuellement membre du Conseil de direction du Collège Européen des chirurgiens vétérinaires.
Scientific Meeting Rapporteur
Jean-Luc Cadoré
Dr Med vét, PhD, HDR, DipECVIM-CA,
Professor of Internal medicine,
University of Lyon, VetAgro Sup, Veterinary Campus, F-69280
Marcy l’Etoile, France
jean-luc.cadore@vetagro-sup.fr
Jean-Luc Cadoré is Professor of Internal medicine at the University of Lyon, where
he divides his time between small animal practice, equine practice and research
in retrovirology and pulmonary diseases. Dr Cadoré is a veterinary graduate from
the University of Lyon in 1981 and has been an academic in that Institution since
1983. He is presently member or President of multiple organizations involved in
equine research: member of the scientific committee of IFCE, co-President of INRA equine research section, scientific Director
of Hippolia Fondation.
Jean-Luc Cadoré est professeur de médecine interne à l’Université de Lyon, où il partage son temps entre pratique des petits
animaux, pratique équine et recherche en rétrovirologie et maladies pulmonaires. Le Docteur Cadoré est diplômé vétérinaire
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de l’Université de Lyon en 1981 et occupe une position académique dans cette institution depuis 1983. Il est actuellement
membre ou président de plusieurs organisations impliquées dans la recherche équine: membre du Conseil scientifique de
l’IFCE, co-président du Groupe Filière Équine de l’INRA et Directeur scientifique de la Fondation Hippolia.
Scientific Program Committee Members
Jean-Marc Gentil
Kinésithérapeute - préparateur physique
12 rue Claude Jusseaud, 69110 Sainte-Foy-les-Lyon, France
gentilj@wanadoo.fr
Jean-Marc Gentil is Physiotherapist and Osteopath DE. He is expert in preventive
medicine and specialized in sports physiotherapy. Jean-Marc carries out comparative studies of various techniques, including shock waves therapy, laser and TECAR
therapy. Mr Gentil is also involved in teaching veterinarians and farriers to prevent
back problems and he was involved in monitoring professional athletes in Rugby
Pro and cyclists in the Tour de France competition. He is also developing a specific
activity in physical preparation and follow up for professional riders during the international competitions in dressage and CSO at Equitalyon.
Jean-Marc Gentil est Masseur Kinésithérapeute D.E et ostéopathe. C’est un expert spécifique en prévention santé, spécialisé en
kinésithérapie du sport. Il effectue des études comparatives concernant diverses techniques dont les ondes de choc, le laser et
la TECAR thérapie. Mr Gentil enseigne l’Ecole du dos aux vétérinaires et aux maréchaux-ferrant. Il est intervenu dans le suivi
de sportifs professionnels en Rugby pro et de cyclistes dans le Tour de France. Il développe une activité plus spécifique pour les
cavaliers professionnels en préparation physique et en suivi dans le cadre des compétitions internationales en dressage et CSO
d’Equitalyon.
Michael Schramme
Professor of Equine Surgery, DrMedVet, CertEO, PhD, DipECVS/
ACVS, Associate LA-ECVDI
University of Lyon, VetAgro Sup, Veterinary Campus, F-69280 Marcy l’Etoile, France
michael.schramme@vetagro-sup.fr
Michael Schramme qualified as a veterinarian from the University of Ghent, Belgium, in 1985. He has since worked as a resident, lecturer, senior lecturer or associate professor in equine surgery at the University of Ghent, the Royal Veterinary
College (London), the Animal Health Trust (Newmarket), Cornell University (New
York) and North Carolina State University (USA). In 2011, Dr. Schramme was appointed Professor in Equine Surgery at the Veterinary Campus of Lyon, VetAgro Sup in France. Professor Schramme holds the
Certificate in Equine Orthopaedics, the Diploma of the European College of Veterinary Surgeons, the Diploma of the American
College of Veterinary Surgeons, associate Diplomate status of the European College of Veterinary Diagnostic Imaging and a
PhD in equine rheumatology. He is treasurer of the European College of Veterinary Surgeons and ex-President of the European
Society of Veterinary Orthopaedics and Traumatology. He has an interest in all aspects of large animal surgery, lameness and
diagnostic imaging with special emphasis on MRI. He is presently active as a member of the Research Unit ICE-GREMERES.
Michael Schramme est diplômé comme vétérinaire de l’Université de Gand, en Belgique (1985). Depuis, il a travaillé en tant
que résident, chargé de cours, maître de conférences ou professeur agrégé en chirurgie équine a l’Université de Gand, au Royal
Veterinary College (Université de Londres), à l’Animal Health Trust (Newmarket), à l’Université de Cornell (New York, USA) et
de Caroline du Nord (USA) . En 2011, le Dr Schramme a été nommé professeur en chirurgie équine à l’École Nationale Vétérinaire de Lyon en France. Le Professeur Schramme détient le certificat en orthopédie équine, le diplôme du Collège européen
des chirurgiens vétérinaires, le diplôme du Collège Américain des chirurgiens vétérinaires, le statut de Diplomate associé du
Collège Européen d’imagerie diagnostique vétérinaire et un PhD en rhumatologie équin. Il est trésorier du Collège européen
des chirurgiens vétérinaires et ex-président de la Société Européenne d’orthopédie et traumatologie vétérinaire. Il a un intérêt
particulier dans la boiterie et l’imagerie diagnostique avec un accent sur l’IRM. Il est membre actif de l’Unité de Recherche
ICE-GREMERES.
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Regis Steinberg
PhD, Senior Scientist in Exploratory Unit,
Pharmacology group, Sanofi research, Montpellier, France.
regis.Steinberg@sanofi-aventis.com
Regis Steinberg is an industrial pharmacologist with strong expertise in the Neuropsychiatric and Neurologic Therapeutic Area. Regis carried out his doctoral thesis at
the University of Lyon; he works on the validation of a specific Biomarker of neuronal
damage. After his PhD, Regis has been working as researcher in the pharmaceutical
industry. He has extensive management experience of multidisciplinary pharmacology
research with particular emphasis in neurotransmission and neurodegenerative mechanisms involved in psychiatric and neurologic disorders. Since several years, he has
managed a regenerative medicine project in the Exploratory Unit, a department which develops innovative programs in translational research dedicated to transfer of basic research into therapeutic use. He is particularly interested in new technologies
based on cellular therapy for animal and human world.
Regis Steinberg est un chercheur pharmacologue de l’industrie possédant une grande expertise dans les domaines de la neuropsychiatrie et neurologie. Régis a effectué sa Thèse de doctorat à l’Université de Lyon dont le sujet était la validation d’un bio
marqueur spécifique des dommages neuronaux. Il a ensuite intégré l’industrie, supervisé des projets et manager des équipes
de recherche pluridisciplinaires dans les domaines de la neurotransmission et les mécanismes neurodégénératifs impliqués
dans les troubles psychiatriques et neurologiques. Depuis plusieurs années, il a gère un projet de médecine régénératrice au
sein de l’Unité Exploratoire, un département qui développe des programmes novateurs dont les objectifs sont de transférer
les nouveaux concepts vers la clinique. Plus particulièrement, il s’intéresse aux nouvelles techniques basées sur la thérapie
cellulaire applicable en clinique humaine et animale.
LIST OF SPEAKERS
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Peter Clegg
MA Vet MB, PhD, DipECVS, Professor of Surgery
University of Liverpool, UK
P.D.Clegg@liverpool.ac.uk
Peter Clegg is Professor of Musculoskeletal Biology at the University of Liverpool,
where he divides his time between running a large research group, and undertaking
duties as a veterinary clinician specializing in equine surgery. Peter is a veterinary
graduate from the University of Cambridge and initially spent 4 years in equine veterinary practice. He then undertook a residency in equine surgery at the Royal Veterinary College, University of London and then a PhD in cartilage biochemistry at the
University of Liverpool. Since 1997 he has had a number of academic posts at the
University of Liverpool. His research group investigates aspects of the cell and matrix biology of cartilage and tendons in health and disease. Furthermore the group has a growing interest in the relationship
between the structure and composition of musculoskeletal tissues and their biomechanical properties; specifically how this
relationship alters during healthy ageing, and how this can be determined in-vivo.
Peter Clegg est Professeur de Biologie Musculo-squelettique a l’Université de Liverpool en Angleterre. Il partage son temps
entre la direction d’un groupe de recherche important et son rôle de chirurgien spécialiste en équine a l’hôpital d’enseignement équine de l’École Vétérinaire de Liverpool. Le Professeur Clegg est un vétérinaire diplômé de l’Université de Cambridge,
qui a passé 4 ans dans la pratique vétérinaire équine privée. Il a ensuite entrepris une résidence en chirurgie équine au Royal
Veterinary College, de l’Université de Londres, puis un PhD en biochimie du cartilage articulaire à l’Université de Liverpool. Depuis 1997, il a maintenu un nombre de différentes positions académiques à l’Université de Liverpool. Son groupe de recherche
étudie les aspects de la biologie des cellules et de la matrice du cartilage et des tendons dans la santé et la maladie. En outre,
son groupe dispose d’un intérêt croissant dans la relation entre la structure et composition des tissus musculo-squelettiques et
leurs propriétés biomécaniques; précisément comment cette relation modifie au cours du vieillissement, et comment cela peut
être déterminée in vivo.
Jan L. Gielen
MD, PhD
Professor Department Morphology Medical School and advanced ultrasound,
Department Biomedicine. University of Antwerp, Belgium,
jan.gielen@uza.be
Jan Gielen is graduate from the Catholic University of Leuven in Belgium where he was
lecturer in radiology at the medical school and postgraduate lecturer sports medicine,
(sports radiology) and physiotherapists. He was concomitantly full time radiologist at
the Leuven University Hospital responsible for musculoskeletal imaging. Jan Gielen is
presently Professor at the Department Morphology Medical School and advanced ultrasound, Department Biomedicine (University of Antwerp), Visiting Professor Master
Degree physiotherapy and Sports Physiotherapy (Artesis University College), Medical coordinator Department of Sports Medicine (University of Antwerp). Teacher and, or organiser of musculoskeletal radiology courses, MRI and Ultrasound, recognised
for the European Society of Radiology in the Netherlands and in Belgium.
Jan Gielen est diplômé de l’Université catholique de Louvain en Belgique où il a été chargé de cours en radiologie à la faculté
de médecine et conférencier aux étudiants de troisième cycle en médecine du sport, (radiologie de sport) et aux physiothérapeutes. Il était en même temps radiologue à temps plein à l’hôpital universitaire de Louvain responsable de l’imagerie musculo-squelettique. Jan Gielen est actuellement professeur dans les Départements de morphologie et d’échographie avancée et de
biomédecine de l’Université d’Anvers, professeur invité d’un Master en physiothérapie du sport (Artesis University College) et
coordinateur médical du Département de médecine du sport de l’Université d’Anvers. Jan est aussi enseignant et, ou organisateur de cours (reconnus pour la Société européenne de radiologie) de radiologie du système musculo-squelettiques, d’IRM et
d’échographie aux Pays-Bas et en Belgique.
LIST OF SPEAKERS
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Jean-Philippe Hager
MD, Médecin du Sport, Responsable médical du LOU Rugby
Centre Orthopédique Paul Santy, Lyon, France
hagerjp@free.fr
Dr. Jean-Philippe Hager is a sports physician in Lyon. He is a founding member of the
Orthopaedic Centre Santy, the first French medical “FIFA medical center of excellence”
since 2013. Former high level rugby player (B and international university) and captain
of the LOU Rugby, he is since 1994 in charge of the medical aspect of this team. Since
1995, he has been a physician for France University Rugby teams (world champion 1996
and 2000) and the U21 and U20 teams (2006 world champion). He was team physician
for French senior team from 2007 to 2011 and was responsible for the implementation
of the proposed medical and physiological monitoring of players during the World Cup 2011 (Vice World Champion). Dr Hager
is currently a member of the medical committee and medical director of the scientific center of the FFR and medical representative of this Federation to the IRB. Lecturer at the University of Lyon 1 (coordinator IUD locomotor pathology related to
sport) he created a University Diploma in Pathology related to rugby in 2010.
Le Dr Jean-Philippe Hager est médecin du sport à Lyon. Il est membre fondateur du Centre Orthopédique Santy, premier centre
Français de médecine du sport agréé «FIFA médical center of excellence» depuis 2013. Ancien joueur de rugby de haut niveau
(international B et universitaire) et capitaine du LOU, il est responsable médical du LOU Rugby depuis 1994. Depuis 1995, il a
été médecin des équipes de France universitaire (champion du monde 1996 et 2000) puis U21 et U20 (champion du monde
2006). Il a été nommé médecin de l’équipe de France de 2007 à 2011 et a été chargé de la mise en place du projet de suivi
médical et physiologique des joueurs pour la coupe du monde 2011 (vice-champion du monde). Le Dr Hager est actuellement
membre du comité médical et responsable médical du pôle scientifique de la FFR ainsi que représentant médical de cette Fédération à l’IRB. Chargé d’enseignement à l’université Lyon 1 (coordinateur du DIU de pathologie locomotrice liée à la pratique
du sport), il a créé le Diplôme Universitaire de pathologie du rugby en 2010.
Denis Hauw
Professor of sports psychology, PhD,
Université de Lausanne, Institut des Sciences du Sport, Switzerland
Denis.Hauw@unil.ch
Denis Hauw is Professor of sport psychology at the Institute of Sport Sciences of the University of Lausanne. His research focuses on doping and substances usages in sport, and
also on the development of athletes’s performances. He has published several articles in
leading journals in sport performance studies. He was the president of French National
call centre « Ecoute dopage » and also sports psychologist consultant for diverse elite
teams and athletes.
Denis Hauw est Professeur de psychologie du sport à l’Institut des Sciences du Sport de l’Université de Lausanne. Ses recherches
portent sur le dopage et la consommation de substances en sports mais aussi sur le développement de la performance sportive.
Il a publié de nombreux articles dans des revues scientifiques en sciences du sport. Il a été le Président du numéro vert Ecoute
Dopage en France et aussi consultant en psychologie du sport auprès de nombreuses équipes et athlètes de haut niveau.
Denis Hauw
Professor of sports psychology, PhD,
Denis.Hauw@unil.ch
Christian Jorgensen is Professor at the Faculty of Medicine Montpellier-Nimes and expert
for Biologics at the French National Authority of Health (HAS). His clinical interest lie in
stem cell, immunology and rheumatology. He is head of the clinical unit, «Immuno-therapy
Rheumatology”, University Hospital “Lapeyronie” (Montpellier). He leads the Institute IRMB
dedicated to regenerative medicine, and the clinical department of immunotherapy with 20
beds dedicated to biotherapy applied to Rheumatoid Arthritis and other autoimmune diseases. Pr Christian Jorgensen, specialist in Therapeutics and Rheumatology, is head of research INSERM unit U844 (“mesenchymal stem cells, joint environment
and immunotherapy of Rheumatoid arthritis”). He animates this group composed of 35 permanent researchers dedicated to
therapeutic innovation in the field of arthritis and diseases of cartilage. He has over 170 publications in the field of immuno-
LIST OF SPEAKERS
17
logy and stem cell therapy and has a strong track record for competitive research grants from EU and ANR.
Christian Jorgensen est professeur à la Faculté de médecine de Montpellier - Nîmes et expert des produits biologiques à l’Autorité nationale française de santé. Son intérêt clinique concerne les cellules souches, l’immunologie et la rhumatologie. Il est
chef d’unité clinique à l’hôpital universitaire «Lapeyronie» à Montpellier (France). Il dirige l’Institut IRMB dédié à la médecine
régénérative, et le département clinique d’immunothérapie avec 20 lits dédiés à la biothérapie appliquée à la polyarthrite rhumatoïde et d’autres maladies auto-immunes. Le Prof. Christian Jorgensen, est également chef de l’unité de recherche INSERM
U844 « cellules souches mésenchymateuses, environnement articulaire et immunothérapie lors de polyarthrite rhumatoïde ».
Il anime ce groupe, composé de 35 chercheurs permanents, dédié à l’innovation thérapeutique dans le domaine de l’arthrite et
les maladies du cartilage. Il a publié plus de 170 publications dans le domaine de l’immunologie et de la thérapie par cellules
souches et a une solide expérience dans le développement de projets de recherche au niveau ANR et UE.
Harald Müller,
PhD
FEI Director, Education & Standards
Lausanne, Switzerland
Harald.Muller@fei.org
Dr Harald Müller graduated from the German Sport University in Cologne (DSHS)
in 1988 and received his doctorate in sociology from the Eberhard-Karls University
Tübingen (Germany) in 2004. His major research focus is on the interdependency of
sport and developing societies. Dr Müller has written several technical publications
in the area of training theory, didactics and biomechanics. At the DSHS he was senior
lecturer in athletics and weightlifting. Harald worked for many years as head of education at the International Association of Athletics Federations (IAAF) in Monaco before
joining the FEI in 2007.
Dr Harald Müller est diplômé en 1988 de l’Université allemande du sport à Cologne (DSHS) et a reçu son doctorat en sociologie
de l’Université de Tübingen Eberhard-Karls (Allemagne) en 2004. Son travail de recherche majeur est sur l’interdépendance du
sport et le développement des sociétés. Le Dr Müller a écrit plusieurs publications techniques dans le domaine de la théorie de
la formation, de la didactique et de la biomécanique. Au DSHS il était maître de conférences en athlétisme et en haltérophilie.
Le Dr Müller a travaillé pendant de nombreuses années à la tête de l’éducation à la Fédération internationale des fédérations
d’athlétisme (IAAF) à Monaco avant de rejoindre la FEI en 2007.
Jacques Nardin
Dr med vét, approved FEI testing veterinarian
29 rue des Etables, Signes - France
nardin@free.fr
Jacques NARDIN is a private practitioner in a rural area and an approved testing veterinarian for the French Anti-Doping Agency, the French Sleddog Federation, the French
Horse Racing Federation and the Fédération Equestre Internationale (FEI) with more than
15 years’experience. He is an expert-consultant on anti-doping and is in charge of lecturing
a module about “Doping, anti-doping and medication control at the Equine Department of
VetAgro Sup – Veterinary Campus of Lyon.
Jacques Nardin est praticien privé en zone rurale et vétérinaire agréé par l’Agence française de lutte contre le dopage, la
Fédération Française de chiens de traîneaux, la Fédération française de cheval de course et par la Fédération Equestre Internationale (FEI) avec une expérience de 15 ans. Il est aussi un expert-conseil sur la lutte contre le dopage et est en charge d’un
module d’enseignement sur «le dopage, l’anti-dopage et le contrôle des médicaments au Département Hippique du Campus
Vétérinaire de Lyon (VetAgro Sup).
LIST OF SPEAKERS
18
Sarah Powell
MA VetMB, Assoc. (LA) DipECVDI
Head of Diagnostic Imaging, Beaufort Cottage Equine Hospital, Newmarket, United Kingdom
sarah.powell@rossdales.com
Sarah graduated from Cambridge Veterinary School in 2002. After a Canadian internship and 2 years of first opinion practice in rural England, Sarah joined Rossdale
& Partners, Newmarket as an orthopaedic assistant in 2005. Sarah is now managing
partner of Rossdales Equine Diagnostic Centre and head of diagnostic imaging. Sarah
lectures and publishes widely and her main interest is comparative imaging of subchondral bone injury in the racing Thoroughbred. Sarah is a large animal associate member
of the European College of Veterinary Diagnostic Imaging.
Sarah Powell est diplômée de l’Ecole Vétérinaire de Cambridge en 2002. Après un stage au Canada et 2 ans de pratique privée
comme généraliste en zone rurale d’’Angleterre, Sarah rejoint une Clinique spécialisée en équine (Rossdale & Partners), située
à Newmarket. Elle débute d’abord comme assistant en orthopédie (2005) et elle est maintenant directrice associée du Centre
de Diagnostique en Equine chez Rossdale et directrice du département d’imagerie médicale. Sarah donne des conférences
scientifiques et publie de nombreux articles scientifiques. Son intérêt principal est l’imagerie comparative de lésion osseuse
sous-chondrale chez les galopeurs. Sarah est un membre associé du Collège Européen d’Imagerie Diagnostique Vétérinaire.
Roger Smith
MA, VetMB, PhD, DEO, FHEA, DipECVS
Professor of Equine Orthopaedics
The Royal Veterinary College, University of London, Department of Veterinary Clinical Sciences, UK
rksmith@rvc.ac.uk
Roger Smith is Professor of Equine Orthopaedics at the Royal Veterinary College, London,
UK. He qualified as a veterinary surgeon from Cambridge University in 1987, having obtained a First for his undergraduate degree and a Cambridge Blue at swimming. After 2
years in practice, he returned to academia to undertake further clinical training as a Resident in Equine Studies at the Royal Veterinary College. Following his residency, he undertook a 3 year research project culminating in the award of a PhD for his studies on the extracellular matrix of equine tendon.
He remained at the Royal Veterinary College, first as a Lecturer in Equine Surgery, then as Senior Lecturer before his appointment to Professor in Equine Orthopaedics. He holds the Diploma of Equine Orthopaedics from the Royal College of Veterinary
Surgeons, and is both a Diplomate of the European College of Veterinary Surgeons and a Royal College of Veterinary Surgeons
Specialist in Equine Surgery. He currently divides his time equally between running a specialist orthopaedic service and continuing to direct research into equine tendon disease. His principal research interests are understanding the pathogenesis of
tendon disease, developing a serological assay for tendonitis, and stem cell therapy for tendons in both horses and humans.
Roger Smith est professeur d’orthopédie équine au Royal Veterinary College de Londres (Royaume-Uni). Il est gradué en tant
que vétérinaire de l’Université de Cambridge en 1987. Après 2 années de pratique, il est retourné à l’enseignement universitaire pour suivre une formation de résident en équine au Royal Veterinary College. Il a entrepris un projet de recherche de
3 ans, sanctionné par l’attribution d’un doctorat pour ses études sur la matrice extracellulaire du tendon équin. Il est resté à
Londres, d’abord comme chargé de cours en chirurgie équine, puis comme maître de conférences avant sa nomination comme
professeur en orthopédie équine. Il est titulaire des diplômes d’orthopédie et de spécialiste en chirurgie équine du Royal Veterinary College ainsi que du diplôme du Collège européen des chirurgiens vétérinaires. Il partage actuellement son temps à parts
égales entre l’exécution d’un service orthopédique spécialisé et la recherche sur les maladies du tendon équin. Ses principaux
intérêts de recherche sont la compréhension de la pathogenèse des pathologies tendineuses, le développement d’un test sérologique pour la tendinite, et la thérapie par cellules souches pour les tendons aussi bien chez les chevaux que chez les humains.
LIST OF SPEAKERS
19
Jamie Textor
DVM, PhD, DipACVS,
Total Performance Equine Sports Medicine & Surgery,
Martinez, California (USA)
jamietextor@gmail.com
Dr. Textor graduated from Colorado State University in 1998, after having spent 2 student externships in France (Neuilly-sur-Seine and Chantilly). Her primary mentor during
veterinary school research and clinical work was Dr. Eric Monnet, a small animal soft
tissue surgeon from France. After graduation she completed an internship in equine
medicine and surgery at Peterson & Smith Equine Hospital in Ocala, Florida, and was
then awarded a residency position in Large Animal Surgery at Cornell University. Her
mentors there included Drs. Alan Nixon, Norm Ducharme, and Susie Fubini. She became a Diplomate of the American College of Veterinary Surgeons in 2003. From 2002-2008 she worked in academic practice
in New Zealand, Australia, and California. She performed research on PRP and completed her PhD at UC Davis in 2012. Dr.
Textor recently launched her own private ambulatory practice in northern California, focusing on equine sports medicine &
surgery. She is in preparation to sit the exam for the American College of Veterinary Sports Medicine and Rehabilitation, and
if successful, will become a Diplomate of that college later this year.
Dr Textor est diplômé de l’Université d’État du Colorado en 1998, après avoir passé deux externats comme étudiant en France
(Neuilly-sur- Seine et Chantilly). Son premier mentor en recherche et en clinique à l’école vétérinaire a été le Dr Eric Monnet,
un chirurgien des tissus mous en petits animaux d’origine Française. Après ses études, elle a effectué un stage en médecine et
chirurgie équine à la Clinique Peterson & Smith d’Ocala, en Floride, et elle a ensuite obtenu un poste de résidence en chirurgie
des grands animaux à l’Université Cornell. Ses encadrants étaient les docteurs Alan Nixon, Norm Ducharme, et Susie Fubini.
Elle est devenue Diplomate de l’American College of Veterinary Surgeons en 2003. Durant la période 2002-2008, elle a travaillé
en milieu académique en Nouvelle-Zélande, en Australie et en Californie. Elle a effectué des recherches sur PRP et a obtenu
son doctorat (PhD) à l’UC Davis en 2012. Dr Textor a récemment lancé son propre cabinet de clinique ambulatoire dans le nord
de la Californie, en mettant l’accent sur la médecine sportive équine et la chirurgie. Elle est actuellement en préparation pour
passer l’examen de l’American Veterinary College of Sports Medicine afin d’obtenir le diplôme dans cette spécialité.
Charles Troillet, méd vét.
Président de la Fédération Suisse de Sports Equestre, (Switzerland)
trolliet@swissonline.ch
Charles TROLLIET from Seigneux in Switzerland obtained the degree in veterinary medicine
in 1977 from the University of Berne. He was then a clinician at the Horse Clinic of the
same University, before becoming an independent practitioner. From 2005 to 2012 Charles
Troillet was President of the Society of Swiss Veterinarians. He is also an FEI (Federation
Equestre Internationale) veterinarian, and member of numerous boards and committees
related to the veterinary and the equestrian world. He is currently President of the Swiss
Federation for Equestrian Sports (FSSE) and member of the IENA Board (Institut Equestre
National Avenches) and Chairman of the Board of Directors of FIRST Industries.
Charles TROLLIET est originaire de Seigneux en Suisse et il obtient le Diplôme de vétérinaire
en 1977 de l’Université de Berne. Il est ensuite assistant à la Clinique pour Chevaux de l’Hôpital Vétérinaire de cette même
Université avant de devenir praticien indépendant, seul puis en association. De 2005 à 2012 Charles Troillet est Président de
la Société des Vétérinaires Suisses. Il est aussi Vétérinaire de concours FEI (Fédération Equestre Internationale) et membre de
nombreux conseils ou comités en relation avec le monde vétérinaire et équestre. Il est actuellement Président de la Fédération
Suisse des Sports Equestres (FSSE) et membre du Conseil de Gérance de l’IENA (Institut Equestre National Avenches) et Président du conseil d’administration de FIRST Industries.
LIST OF SPEAKERS
20
Thierry Zintz
Dean Faculté des Sciences de la Motricité, Titulaire de la Chaire Olympique Henri de Baillet Latour & Jacques Rogge en Management des
Organisations Sportives
Université catholique de Louvain, Louvain-la-Neuve, Belgium
thierry.zintz@uclouvain.be
Since 2005 Thierry Zintz is a professor of Sports Organisations Management at the
Faculty of Sports Sciences of the Université catholique de Louvain, Belgium. He is the
Dean of the Faculty since February, 23, 2010. He is in charge of the Olympic Chair
Henri de Baillet Latour – Jacques Rogge in Management of Sport Organisations at
the same university. In this framework, he works closely with the Louvain School of
Management as a senior researcher and member of the Center for Research in Entrepreneurial Change and Innovation Strategies (CRECIS). He holds a PhD from the
University of Louvain in 2004 with a thesis on the management of change in European National Sports Governing Bodies. He
is also Vice-President of the Belgian Olympic and Interfederal Committee since 2001. From 2006 to 2012, he was Secretary
General of the European Observatory of Sport and Employment (EOSE) and is now chairing this organisation. Since May 2010,
he is the director of the MEMOS in English and coordinator of MEMOS (English, French and Spanish versions). The MEMOS
is an Executive Master in Management of Sport organisations, organised by the International Olympic Committee and twelve
universities in the world.
Depuis 2005, Thierry Zintz est professeur en Management des Organisations Sportives à la Faculté des Sciences de la Motricité de l’Université catholique de Louvain (Belgique). Il en est le Doyen depuis le 23 février 2010. Il y est titulaire de la Chaire
Olympique Henri de Baillet Latour – Jacques Rogge en Management des Organisations Sportives. Dans ce contexte, il collabore
étroitement avec la Louvain School of Management comme chercheur senior et membre du Center for Research in Entrepreneurial Change and Innovation Strategies (CRECIS). Il a obtenu son doctorat à l’Université catholique de Louvain, en 2004,
avec une thèse sur le management du changement dans les fédérations sportives nationales en Europe. Il est vice-président du
Comité Olympique et Interfédéral Belge depuis 2001. De 2006 à 2012, il a été secrétaire général de l’ European Observatory
of Sport and Employment (EOSE) ; il en est le président depuis 2012. Depuis mai 2010, il est le directeur du MEMOS en Anglais
et coordonne les MEMOS en Anglais, en espagnol et en Français. Ce programme est un Executive Master en Management des
Organisations Sportives, organisé par le Comité International Olympique et douze universités dans le monde
ABSTRACTS
21
1.
The role of imaging in the orthopaedic screening of Thoroughbred racehorses.
Sarah Powell ................................................................................................................................23
2.
Peter Clegg ...................................................................................................................................26
3.
Diagnostic imaging of the knee in the preparticipation screening of soccer players
Jan L. Gielen .................................................................................................................................28
4.
Christian Jorgensen ......................................................................................................................31
5.
Mesenchymal stem cells in the treatment of tendon injuries in racing Thoroughbreds and sports horses
Roger K.W. Smith ........................................................................................................................32
6.
Jamie Textor .................................................................................................................................33
7.
Strategic management of a rugby player during a world cup tournament
Jean-Philippe Hager .....................................................................................................................35
8.
Governance and management of the organizational structure of professional sports: from global to local, from elite to sport for all
Thierry Zintz .................................................................................................................................37
9.
Harald Müller ...............................................................................................................................38
10.
Denis Hauw ..................................................................................................................................44
11.
Charles Troillet and Jacques Nardin ............................................................................................46
22
THE ROLE OF IMAGING IN THE ORTHOPAEDIC SCREENING OF RACEHORSES
23
Dr Sarah Powell MA VetMB, Assoc. (LA) DipECVDI, Head of Diagnostic Imaging,
Beaufort Cottage Equine Hospital, Newmarket, United Kingdom
There is no unanimously accepted definition of ‘screening’ in veterinary medicine, medicine or healthcare
but it is taken to refer to a method or filtering device to sort out those who have disease, or are prone
to disease, from a larger group. It differs from clinical or diagnostic testing in that there are no history
or signs (or in the case of humans, symptoms) of disease. A working definition for human screening is:
“The use of a medical investigation or testing method for investigating the health status of an individual
with the aim of selecting some of these for possible further treatment from a larger group with no previously recognized symptom of the disease(s)”
There has been a controversial evolution into the private health care market for screening healthy individuals for disease and it has become a separate discipline in medical ethics to ensure screening programs
are justifiable.
For screening of humans to be deemed ethical evidence that effective treatments are available to those
found to have disease or that the test leads to physiologic or psychological health improvements have to
be proven. This is not so in the equine world but there are important parallels. The potential to cause
anxiety in the horse owner is a real one, and – as our understanding of disease progression remains incomplete – there is potential for unnecessary wastage and economic loss of animals.
Whilst we do not necessary have to offer an effective management strategy for those found to carry signs
of disease, as clinicians offering an equine screening program we do have to ensure:
•
•
•
The screen has the potential to do more good than harm.
The screening process can be done quickly and relatively cheaply to make it acceptable to clients.
The screening will be delivered as part of a good quality service with a high level of interpreta-
tion by clinicians familiar with athletic horses.
The rationale is driven by a number of equine orthopaedic conditions, which we can consider prevalent
and significant enough to screen for. Those that we know, if detected, have at least the potential to have
a negative effect on the future soundness of the horses, therefore it’s athletic potential and future resale
value. Screening for potential orthopaedic disease in horses is common but can be a controversial issue. Traditional technologies have proven record to assist in the diagnosis and prognosis in lame horses;
their use as a screening tool also has been validated where a proven link between the radiographic (for
example) appearance and a known pathologic process has been established.
THE ROLE OF IMAGING IN THE ORTHOPAEDIC SCREENING OF RACEHORSES
24
MRI as a tool for equine screening:
This is beginning to evolve further from the relatively common use of radiography, endoscopy and ultrasonography as ancillary aids to the pre-purchase examination towards more complex techniques such as
standing MRI.
MRI could be considered the gold standard screening tool for certain conditions but it can allow us to
make general statements about a sample of the population. Our knowledge of the natural history of
some diseases is too embryonic to allow us to make specific judgments about individuals and this is perhaps more true when assessing equine athletes than horses used for low level endeavors. Certain athletic horses have ability to function despite the presence of orthopaedic disease and it is not clear what
other factors contribute to loss of performance.
We do however have a duty to the vendor to only carry out meaningful tests considered likely to give clinically relevant information and we can’t relate MRI findings to future performance and soundness of an
individual. There is potential for litigation using ‘novel’ technology in this context the potential for mis/
inappropriate diagnoses is considerable.
LE RÔLE DE L’IMAGERIE DANS LE DEPISTAGE DES AFFECTIONS LOCOMOTRICES CHEZ LES CHEVAUX
DE COURSE
25
Dr Sarah Powell MA VetMB, Assoc. (LA) DipECVDI, Head of Diagnostic Imaging,
Beaufort Cottage Equine Hospital, Newmarket, United Kingdom
Il n’existe pas de définition unanimement acceptée de «screening» en médecine vétérinaire, mais elle se
réfère à une méthode ou un dispositif de filtrage pour trier ceux qui ont la maladie, ou sont sujettes à la
maladie, à partir d’un groupe plus large. Cela diffère de l’essai clinique ou diagnostique dans le fait qu’il
n’existe pas de symptômes de la maladie. Une définition de travail pour le dépistage humain est :
« L’utilisation d’un examen médical ou d’une méthode d’évaluation dans le but d’étudier l’état de santé
d’un individu et de sélectionner, pour d’éventuels traitements, certains individus provenant d’un grand
groupe n’ayant montré aucun symptôme connu de cette maladie».
HOW DO TENDONS WORK, AND HOW DO THEY FAIL; WHAT IS THE FUTURE POTENTIAL OF IMAGING
FOR DETECTION OF ERLIEST PATHOLOGY ?
26
Professor Peter Clegg MA Vet MB, PhD, DipECVS, Professor of Surgery,
University of Liverpool, United Kingdom
Understanding how a tissue functions is essential for prevention of injury and development of rationale
treatments. Further understanding how tendons may initially fail, allows targeting and developing imaging modalities to identify when this pathology can be first recognised.
As a hierarchical fibrocomposite material, strain transfer through tendon is complex, with data showing
that tendon extension is governed by sliding between collagenous components throughout the structural hierarchy. With cells located between the collagen fibres, sliding behaviour is likely to have substantial
effects on cell mechanobiology and their resulting phenotype. However it has also been shown that tendons of varying functions have very different compositional and mechanical behaviour (Birch et al. 2008;
Thorpe et al. 2010). Based on these data, our recent studies have focused on elucidating micromechanical distinctions between differing functional tendons.
Recently we have discovered a number of distinct mechanisms involved in tendon extension and recoil.
In the equine it has been demonstrated that fascicles have a helical structure, which will lead them to
act as small springs, enabling efficient elastic extension and recoil (Thorpe et al, 2013a). Furthermore in
these tendons there is considerable interfascicular sliding, facilitating the large strain requirements of
this tissue without overloading the collagen components (Thorpe et al, 2012). In contrast in the low strain
stiffer positional tendons, more viscoelastic and less fatigue resistant behaviour is governed by fibre and
fibril sliding (Thorpe et al, 2012).
Recognition of these contrasting mechanisms allows novel insights into how tendons optimize their
structure and function to effectively manage their loading without failure. Indeed, from a materials perspective, a fibre composite material will initially fail at its weakest point, which is likely to be the non-collagenous matrix in tendon. Identifying the weakest structural level in different tendon types will allow
identification of the early failure events which may occur in those tissues. Thus, with fascicle sliding proposed to be key in high strain tendons, understanding how the non-collagenous matrix between fascicles
mediates sliding mechanics may be key to preventing failure, as well as identifying the earliest changes
associated with pathology. It is uncertain what are the molecular mediators within the non-collagenous
matrix for this mechanism; however, it is likely that molecules such as elastin, elastic fibres, lubricin and
a variety of proteoglycans will have key roles (Thorpe et al. 2013b).
This has clear implications for tendon physiology and pathology. Failure at the non-collagenous interface
will firstly, alter load on the cell, and through mechanotransduction will potentially alter cell phenotype
to a more degradative state. Secondly, failure of the non-collagenous matrix will propagate through the
tissue hierarchy ultimately resulting in both biochemical and mechanical failure of the structure.
It is well recognized that risk of tendon injury increases with ageing. Collagen turnover in mature tendon
is extremely low, with a half-life of approximately 250 years, whilst non-collagenous matrix has much
more rapid turnover in energy storing tendons (Thorpe et al. 2010). Furthermore, there is alteration in
the collagenous matrix with increasing cross-links and retention of collagen degradation products within
the ageing matrix (Thorpe et al. 2010). Such changes may have implications for the mechanobiology of
the ageing tendon. Indeed, as the SDFT ages the effectiveness of the fascicular spring reduces, and there
is a stiffening of the interfascicular matrix (Thorpe et al, 2012a, Thorpe et al, 2013c). These changes will
result in localized stiffening within the hierarchy and likely alterations in cell loading.
Using ex-vivo models of tendon fatigue injury, we have identified differing mechanisms predominate
in early fatigue damage depending on age. Throughout life, it is likely that failure of the interfascicular
matrix is a key early event in tendinopathy. Further in young tendons, failure occurs by initial unwinding
of the fascicular helical structure, whilst in older tendons it is sliding between fascicular collagen fibrils
which are the earliest events in pathology (Thorpe et al. 2014).
HOW DO TENDONS WORK, AND HOW DO THEY FAIL; WHAT IS THE FUTURE POTENTIAL OF IMAGING FOR DETECTION OF ERLIEST PATHOLOGY ?
27
There have been a number of recent advances in tendon imaging and diagnosis, including the use of elastography, ultrasonographic tissue characterisation, fluid biomarkers and MRI. Whilst all these approaches
are of interest, they are going to have some limitations in the identification of the earliest pathologies.
Recent research interest in our group has focussed on imaging the earliest changes in tendon structure
and function through the use of contrast computed tomography, dynamic ultrasonography and tissue
biomarkers. Research data on these techniques will be presented and discussed.
A limitation of our approaches is that we are interested in determining the earliest fatigue mechanisms in
tendon failure; it is likely that the changes we are determining may be common in elite athletes. The key
issues will be then to identify why such pathologies progress in some and not in other athletes.
Acknowledgements
Our tendon studies are supported through funding from BBSRC, Wellcome Trust, Arthritis Research UK,
MRC and the Horserace Betting Levy Board. Practical work on these projects was undertaken by Chavaunne Thorpe, Mandy Peffers, Othman Ali, Ewa Spiesz and Alan Mueller. The work is undertaken in
collaboration with Dr Hazel Screen (Queen Mary University of London) and Dr Helen Birch (University
College London).
References
Birch, HL., Worboys, S., Eissa, S., Kackson, B., Strassburg, S. and Clegg, PD (2008) Matrix metabolism rate
differs in functionally distinct tendons. Matrix Biology 27(3):182-9
Thorpe, C., Streeter, I., Pinchbeck, G.L., Goodship A.E., Clegg, P.D., and Birch, H.L. (2010) Aspartic acid
racemization and collagen degradation markers reveal an accumulation of damage in tendon collagen
which is enhanced with ageing J. Biol. Chem. 285, 15674-15681
Thorpe, CT, Udeze, CP, Birch, HL, Clegg PD and Screen HR (2012) Specialisation of tendon mechanical
properties results from interfascicular differences J R Soc Interface 9, 3108-3117
Thorpe, C., Klemt, C., Riley, G.P., Birch, H.L., Clegg, P., and Screen, H.R. (2013a) Helical sub-structures in
energy-storing tendons provide a possible mechanism for efficient energy storage and return. Acta Biomaterialia, 7, 7948-7956
Thorpe, C., Birch, H.L., Clegg, P., and Screen, H.R (2013b) The role of the non-collagenous matrix in tendon function. Int. J. exp. Pathol. 94, 248-259
Thorpe, C., Udeze, C.P., Birch, H.L., Clegg, P., and Screen, H.R. (2013c) Capacity for sliding between tendon fascicles decreases with ageing in injury prone equine tendons: a possible mechanism for age-related tendinopathy? European Cells and Materials 8, 48-60
Thorpe, C., Riley, G.P., Birch, H.L., Clegg, P., and Screen, H.R. (2014) Fascicles from energy-storing tendons
show an age-specific response to cyclic fatigue loading. J R Soc Interface 11, 20131058
DIAGNOSTIC IMAGING OF THE KNEE IN THE PREPARTICIPATION SCREENING OF SOCCER
PLAYERS
28
Professor Jan L. Gielen MD, PhD, Vice-head Department of radiology,
Coordinator Department of Sports Medicine, Faculty of Medicine, Antwerp University, Belgium
Preparticipation orthopedic evaluation of applicant human athletes serves as an entry point status, may
detect conditions that predispose the athlete to increased risk of injury and may be required to fulfill legal, administrative, and insurance requirements. Indeed professional athletes with a history of orthopedic injury and especially surgery have decreased career lengths and are at a greater risk for re-injury compared with their peers. Imaging procedures, plain MRI in particular, are used by premier league soccer
and football clubs as part of the preparticipation screening of the knee in the evaluation of applicant elite
professional players. MRI of other joints is less frequently used for preparticipation evaluation; this is
related to the epidemiology of the injury and related to the lack of diagnostic accuracy numbers of plain
MRI or to the low diagnostic accuracy of plain MRI compared to MR-arthrography.
Even in the knee the use of plain MRI in preparticipation evaluation is prone to specific pitfalls.
Most published accuracy numbers of the knee are available on not surgically treated lesions of the anterior cruciate ligament, the meniscus and cartilage.
Prospective plain clinical MRI studies of the knee performed in our institution and published accuracy
numbers of meniscus and anterior cruciate ligament lesion detection are good to very good. Medial meniscus lesions are more accurately detected compared to lateral meniscus lesions. The accuracy is not
statistically significantly different when 1.5T and 3T examinations were compared, Table 1.
On the other hand MRI is a poor performer in the detection of cartilage lesions. The published accuracy
for cartilage lesions is very low. In our comparative study 3T MRI showed statistic significantly better results compared to 1.5T but with still low accuracy for superficial lesions (grade 1 and 2), Table 2. In the
preparticipation screening it is important to recognize that most of the grade 2 cartilage lesions are not
detected on plain MRI.
Despite the lack of published scientific evidence it is very likely that the overall accuracy of preparticipation MRI is lower compared to clinical MRI as it is not achieved in the acute clinical status ie. without bone
and soft tissue edema or fluid on T2 weighted imaging with fat suppression. Indeed these edematous
area’s provide diagnostic “light bulbs” that attract attention of the radiologist and improve diagnostic
conspicuity.
To improve lesion conspicuity clinical findings and history are required to execute and report MRI examinations. On the other hand MRI diagnostic findings should always be interpreted in relation with clinical
findings and history as for instance rupture of a ligament is not synonymous with instability or the stability of a not displaced meniscus tear is poorly predicted on MRI.
PLAYERS
29
Table 1, Meniscus lesions, sensitivity, specificity and accuracy of 1.5 and 3T plain MRI
1,5T 3T N= 200 P Medial meniscus Sens 93% 96% Spec 90% 88% Lateral Meniscus Sens 77% 82% Spec 99% 98% ACL Sens 78% 80% Spec 100% 100% Interreader agreement Kappa 0.82 1.00 Table 2, Cartilage lesions, sensitivity, specificity and accuracy of 1.5T and 3T plain MRI
Cartilage lesions 1,5T 3T N= 600 Detection Sens 60% 69% P = 0,001 Spec 96% 96% P = 0,470 Acc Grade 3 lesions Sens 91% 94% P = 0,335 Grade 2b Sens 29% 43% P = 0,021 Grade 2a Sens 39% 54% P = 0,002 Grade 1 Sens 9% 7,5% P = 0,423 87% 90% P = 0,998 References.
von Engelhardt LV, Schmitz A, Pennekamp PH, Schild HH, Wirtz DC, von Falkenhausen F Diagnostics of
degenerative meniscal tears at 3T MRI compared to arthroscopy as reference standard ARCHIVES ORTHOPEDIC TRAUMA AND SURGERY, 2008
Van Dyck P et al Arch Orthop Trauma Surg 2007
Van Dyck P et al JBJS Am 2013;95(10):916-924
Rugg CM, et al. Effects of Prior Knee Surgery on Subsequent Injury, Imaging, and Surgery in NCAA Collegiate Athletes. Am J Sports Med. 2014 Feb 11
Ramnath RR. 3T MR Imaging of the MSK system. Considerations, coils and challenges. Magnetic Reson
Imaging Clin N Am 2006;27-40
PLAYERS
30
Link TM, Steinbach LS, Ghosh S, et al. Osteoarthritis: MR imaging findings in different stages of disease
and correlation with clinical findings. Radiology 2003;226(2):373–381
Suh JS, Cho JH, Shin KH. Chondromalacia of the knee: evaluation with a FS 3D SPGR after iv contrast . J
Magn reson Imaging 1996;6:884-8
Bredella MA, Tirman PF, Peterfy CG, et al. Accuracy of T2-weighted fast spin-echo MR imaging with fat
saturation indetecting cartilage defects in the knee: comparison with arthroscopyin 130 patients. AJR Am
J Roentgenol 1999;172(4):1073–1080
Disler DG, McCauley TR, Kelman CG, et al. Fat-suppressed three-dimensional spoiled gradient-echo MR
imaging ofhyaline cartilage defects in the knee: comparison with standard MR imaging and arthroscopy.
AJR Am J Roentgenol 1996;167(1):127–132
Potter HG, Linklater JM, Allen AA, Hannafin JA, Haas SB.Magnetic resonance imaging of articular cartilage
in the knee.An evaluation with use of fast-spin-echo imaging. J BoneJoint Surg Am 1998;80(9):1276–1284
Brittberg M, Winalski CS, et al. Evaluation of cartilage injury and repair. Journal of Bone and Joint Surg
2003;85:58-69
Notohamiprodjo M, Horng A, Pietschmann MF, Muller PE et al. 3T MRI of the knee: first clinical results
with an isotropic FS PD TSE sequence. Invest Radiol (2009);44(9):585-597
Yoshioka H, Stevens K, Genovese M, Dillingham MF, LangP. Articular cartilage of knee: normal patterns at MR imaging that mimic disease in healthy subjects and patients with osteoarthritis. Radiology
2004;231(1):31–38
Gold GE, Hargreaves BA, Beaulieu CF. Protocols in sports magnetic resonance imaging. Top Magn Reson
Imaging2003;14(1):3–23
Rubin DA, Harner CD, Costello JM. Treatable chondral injuries in the knee: frequency of associated focal
subchondral edema. AJR Am J Roentgenol 2000;174(4):1099–1106
Messner K, Maletius W. Eighteen- to twenty-five-yearfollow-up after acute partial anterior cruciate ligament trupture. Am J Sports Med 1999;27(4):455–459
Finsterbush A, Frankl U, Matan Y, Mann G. Secondary damage to the knee after isolated injury of the
anteriorcruciate ligament. Am J Sports Med 1990;18(5):475–479
Verstraete KL, Almqvist F, Verdonk P, et al. MR imaging of cartilage and cartilage repair. Clin Radiol
2004;59:674-89
MESENCHYMAL STEM CELLS IN RHEUMATOLOGY : AN UPDATE
31
Prof. Christian Jorgensen, MD, PhD, Head Clinical Unit for osteoarticular diseases,
Inserm U 844, University Hospital of Montpellier, France.
Among the degenerative diseases associated with aging, osteoarthritis is the most common pathology
and affects 16% of the female population over 65 years. The ADIPOA project started in January 2010 with
the goal to develop a new cell based strategy for patients suffering from knee osteoarthritis (OA). Up
to now, no therapeutic option exists to obtain a sustainable improvement of joint function beside knee
arthroplasty. This prompted us to propose adipose derived stem cells as a possible cell therapy.
Adipose derived mesenchymal stromal cells (ASC) are adult stem cells exhibiting functional properties
that have open the way for cell-based clinical therapies. Primarily, their capacity of multilineage differentiation has been explored in a number of strategies for skeletal tissue regeneration. More recently,
MSCs have been reported to exhibit immunosuppressive as well as healing capacities, to improve angiogenesis and prevent apoptosis or fibrosis through the secretion of paracrine mediators. We performed
2 pre-clinical models of osteoarthritis, and showed that a local injection of ASC showed a reduction of
synovitis, reduction of osteophytes, joint stabilization, reducing the score of cartilage lesions. This work
was completed by toxicology data showing the excellent tolerance of the local injection of ADSC and biodistribution showing the persistence of cells after 6 months in murine models. In addition, quality control
and tolerability of the injection of adipose derived mesenchymal cells led to the approval by AFSSAPS in
France and in Germany by the PEI to conduct the clinical trial phase I.
In this open-label phase 1 trial we included 18 patients with severe osteoarthritis of the knee in failure
of conventional therapies (62.5% were KL IV) at two sites, Montpellier and Wurzburg. Mean age was 61
years, with a 10 years history of knee OA. The patient received a single injection of autologous ASC 15
days after lipoaspiration (2.106 , 107 or 5.107) through intra-articular injection. The primary outcome
measure of effectiveness was patient-reported WOMAC pain subscores by VAS in the affected knee at
week 12. Secondary outcome measures included Outcome Measures in Rheumatology Clinical Trials and
Osteoarthritis Research Society International (OMERACT OARSI) responses. We observed a decrease of
the VAS Pain (73±11 mm day 0 to 32±23 month 3), and of WOMAC (50±18 to 25±7 month 3). This study
confirms the feasibility and safety of local injection of autologous cells from adipose tissue and suggested
that the most effective dose was 107 autologous cells.
The ADIPOA research teams performed successfully the phase 1 clinical trial is in France and Germany. A
phase 2B controlled trial is scheduled to confirm the clinical benefit of this strategy.
ADIPOA: MSC based therapy for severe osteoarthritis of the knee. A phase 1 dose escalation trial. C. Jorgensen on behalf of ADIPOA consortium.
MESENCHYMAL STEM CELLS IN THE TREATMENT OF TENDON INJURIES IN
RACING THOROUGHBREDS AND SPORT HORSES
32
Prof. Roger K.W. Smith, MA Vet MB, DEO, PhD, FHEA, AssocECVDI, DipECVS, MRCVS
Professor of Equine Orthopaedics,
The Royal Veterinary College, Department of Veterinary Clinical Sciences and Services, UK
Tendon naturally heals (repairs) well but the scar tissue formed in this repair is functionally deficient
compared to normal tendon, which has important consequences for the animal in terms of reduced
performance and a substantial risk of re-injury, in spite of a multitude of treatments that have been
proposed. Regenerative medicine offers the prospect of restoring normal structure and function to an
injured organ and thereby resulting in a successful restoration of activity without the risk of re-injury.
For a number of years we have been investigating the efficacy of bone marrow-derived MSCs (BM-MSCs)
implanted into naturally-occurring over-strain injury of the equine superficial digital flexor tendon (SDFT).
We hypothesised that autologous implanted MSCs would induce normalization of the tendon matrix and
reduce re-injury rates.
1) Tissue effects
In a controlled experimental study of naturally-occurring SDFT injuries (n=12), MSC treatment appeared
to ‘normalise’ the tissue parameters so that they were closely to the contralateral, relatively normal and
untreated tendons than saline-injected controls. Specifically, in comparison to saline-treated tendons,
treated tendons had lower structural stiffness (p=0.061) although no significant difference in calculated
modulus of elasticity, lower (improved) histological scoring of organisation (p<0.003) and crimp pattern
(p<0.05), lower cellularity from histological scoring (p<0.007) and DNA content (p<0.05), reduced vascularity (p<0.03), water content (p<0.05), and GAG content (p=0.055). Total collagen content was unaltered between groups and interestingly, while tissue-linked fluorescence (indicates age of collagen) was
similar between treatment and control groups, both were significantly lower than the contralateral limb
(p<0.014), which suggested similar amounts of new collagen in the injured limbs. A higher remodelling
rate, exemplified by increased MMP-13 activity, was also demonstrated for the control group compared
to the treated group and contralateral limbs (p<0.02).
2) Clinical outcome
In 113 MSC-treated racehorses with SDFT over-strain injury, the re-injury percentage was 27.4%, which
was a significantly reduced re-injury rate (approximately one half) compared with two other studies in
racehorses where the inclusion and follow-up criteria were identical (p<0.05 versus 56%[1]; p<0.01 versus 50%[2]).
Outcome has also been analysed for SDFT injuries in sports horses treated with MSCs (n=68). 85% returned to competitive exercise, with 76% returning to their previous level of activity. The re-injury rate was
only 19% which was also approximately one half that previously documented for sports horses [1]. The
re-injury rate increased with increasing interval between injury and implantation but was not affected by
severity of injury.
These findings suggest that treatment with MSCs appear to have beneficial effects on the healing tendon
matrix and also reduce re-injury rates in two different equine athletic disciplines.
References:
[1]
Dyson, S.J. Medical management of superficial digital flexor tendonitis: a comparative study in
219 horses (1992-2000). Equine Vet J, 2004. 36(5): p. 415-9.
[2]
O’Meara, B., et al. An investigation of the relationship between race performance and superficial
digital flexor tendonitis in the Thoroughbred racehorse. Equine Vet J, 2010. 42(4): p. 322-6.
Acknowledgements:
J. Dudhia, S. Dakin, N. Werling - Department of Clinical Sciences and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, UK.
A.E. Goodship - Institute of Orthopaedics, University College London, Royal National Orthopaedic Hospital, Stanmore, Middlesex. HA7 4LP. UK.
J. Miller - VetCell
Funding: Horserace Betting Levy Board and VetCell.
CURRENT KNOWLEDGE ON THE USE OF PLATELET-RICH PLASMA IN
SPORTS MEDICINE
33
Dr Jamie Textor, DVM, PhD, DipACVS,
Total Performance Equine Sports Medicine & Surgery, Martinez CA (USA)
Platelet-rich plasma (PRP) is an autologous biological therapy used in human and veterinary sports medicine since approximately 2004. During its first decade in use for these applications, PRP has been a
contentious topic ---it has simultaneously elicited considerable enthusiasm from its proponents (professional human athletes and sports medicine physicians alike) while drawing equal skepticism from its
detractors. PRP preparation and administration methods are widely variable, and it has been applied to
many diverse lesions and tissues. As a result, it has been historically difficult to draw conclusions about
PRP’s efficacy.
More recently, large, well-designed, favorable clinical studies have been reported in the human literature. Mechanisms for both anti-inflammatory and analgesic properties of PRP have been elucidated by
benchtop research over the past year. The product can be affordably produced and safely administered,
and is usually provided by percutaneous injection into the lesion site in tendon, ligament, muscle or joint.
This talk will review the pertinent literature on PRP, briefly discuss the variables involved in preparation
and administration, and will emphasize PRP use in equine sports medicine.
LES CONNAISSANCES ACTUELLES SUR L’UTILISATION DE PLASMA RICHE
ENRICHI EN PLAQUETTES DANS LA MEDECINE DU SPORT
34
Dr Jamie Textor, DVM, PhD, DipACVS,
Total Performance Equine Sports Medicine & Surgery, Martinez CA (USA)
Le plasma riche en plaquettes (PRP) est une thérapie biologique autologue utilisée en médecine sportive
humaine et vétérinaire depuis environ 2004. Au cours de sa première décennie d’utilisation, le PRP a été
un sujet controversé et il a en même temps suscité beaucoup d’enthousiasme de ses partisans (des athlètes humains professionnels et des médecins) tout en attirant également le scepticisme de ses détracteurs. Les méthodes de préparation et d’administration du PRP sont très variables, et il a été utilisé dans
le traitement de nombreuses lésions dans des tissus divers. En conséquence, il a toujours été difficile de
tirer des conclusions sur l’efficacité du PRP.
Plus récemment, des études cliniques de bonne qualité scientifique montrant un effet favorable du PRP
ont été rapportées dans la littérature humaine. De plus des mécanismes pour des propriétés anti-inflammatoires et analgésiques du PRP ont été élucidés par la recherche fondamentale pendant l’année
écoulée. Le produit peut être fabriqué à moindre coût et administré en toute sécurité. Il est généralement
administré par injection percutanée dans le site de lésion d’un tendon, d’un ligament, d’un muscle ou
d’une articulation. L’exposé examinera la documentation pertinente sur le PRP, discutera brièvement des
variables impliquées dans la préparation et l’administration, et il mettra l’accent sur l’utilisation du PRP
dans la médecine sportive équine.
STRATEGIC MANAGEMENT OF A RUGBY PLAYER DURING A WORLD CUP
TOURNAMENT
35
Dr Jean-Philippe Hager (1) & J. Piscione (2).
(1) Centre Orthopédique Paul Santy, Lyon, France ; (2) Pôle Scientifique FFR, Marcoussy, France
Introduction: Following disappointing sports scores at the 2007 World Cup, the French Rugby Federation
wished to reorganize the medical care and physiological monitoring players XV of France.
The 2011 World Cup project was developed through close collaboration between the technical and medical staff of the XV of France, national technical management and scientific center. We propose to expose
the scientific path set up around the team of France to the 2011 World Cup .The project involved the
development of a science center whose three axes are working performance , prevention and development. It was also necessary to reorganize the medical commission of the FFR and establish a federal
medical plan and a medical project XV of France.
Material and Methods: The medical and physiological monitoring XV of France was facing two priorities:
quantifying workload and monitoring the state of form. Due to the complexity of our sport it took to
develop and validate some innovative technologies: GPS, monitoring heart rate in real time, use of monitoring variability of nocturnal heart rate...
Results: The evolution of the results of medical and physiological monitoring of a national team is difficult and subjective. We propose a feedback from all innovative technologies for team sports, used in the
preparation phase and competition.
Conclusion: The evaluation of a proposed medical and physiological monitoring of a high-level team
sports should not be linked solely to sports performance , but also its scientific validation.
SUIVI STRATEGIQUE D’UN JOUEUR DE RUGBY DANS LE CADRE D’UNE COUPE DU
MONDE
36
Dr Jean-Philippe Hager (1) & J. Piscione (2).
(1) Centre Orthopédique Paul Santy, Lyon, France ; (2) Pôle Scientifique FFR, Marcoussy, France
Introduction : Suite à des résultats sportifs décevants lors de la coupe du monde 2007, la Fédération Française de Rugby a souhaité réorganiser la prise en charge médicale et le suivi physiologique des joueurs du
XV de France.
Le projet Coupe du monde 2011 a été développé grâce à la collaboration étroite entre le staff technique
et médical du XV de France, la direction technique nationale et le pôle scientifique. Nous proposons d’exposer le cheminement scientifique mis en place autour de l’équipe de France jusqu’à la coupe du monde
2011. Le projet a nécessité le développement d’un pôle scientifique dont les trois axes de travail sont la
performance, la prévention et le développement. Il a fallu également réorganiser la commission médicale
de la FFR et établir un projet médical fédéral ainsi qu’un projet médical du XV de France.
Matériel et Méthodes : Le suivi médical et physiologique du XV de France a été orienté vers deux priorités
: la quantification de la charge de travail et le suivi de l’état de forme. En raison de la complexité de notre
sport il a fallu développer et valider certaines technologies innovatrices : GPS, suivi de la fréquence cardiaque en temps réel, utilisation du suivi de la variabilité de la fréquence cardiaque nocturne…
Résultats : L’évolution des résultats d’un suivi médical et physiologique d’une équipe nationale est difficile
et subjective. Nous proposons un retour d’expérience de toutes les technologies novatrices pour un sport
collectif, utilisées dans la phase de préparation et de compétition.
Conclusion : L’évaluation d’un projet de suivi médical et physiologique d’une équipe sportive de haut
niveau ne doit pas être uniquement liée aux performances sportives, mais surtout à sa validation scientifique.
GOVERNANCE AND MANAGEMENT OF THE ORGANIZATIONAL STRUCTURE OF PRO- 37
FESSIONAL SPORTS : FROM GLOBAL TO LOCAL, FROM ELITE TO SPORT FOR ALL
Professor Thierry Zintz, Dean Faculté des Sciences de la Motricité, Titulaire de la Chaire Olympique Henri
de Baillet Latour & Jacques Rogge en Management des Organisations Sportives,
Université catholique de Louvain, Louvain-la-Neuve, Belgium
Professionalized sport organizations have to develop proper governance and management since the autonomy of sport is challenged by its commercialization and by public authorities. Corporate governance
involves “a set of relationships between a company’s management, its board, its shareholders and other
stakeholders. Corporate governance also provides the structure through which the objectives of the company are set, and the means of attaining those objectives and monitoring performance are determined”
The definition of corporate governance cannot apply as such to sport organizations. The Olympic Charter
gives a clear view of the main challenges of governance in sport organizations. It states that “recognizing
that sport occurs within the framework of society, sports organizations within the Olympic Movement
shall have the rights and obligations of autonomy, which include freely establishing and controlling the
rules of sport, determining the structure and governance of their organizations, enjoying the right of
elections free from any outside influence and the responsibility for ensuring that principles of good governance be applied». (Olympic Charter, 2011). National and international sport organizations are encouraged to endorse the Basic Universal Principles of Good Governance for the Sport Movement. These
principles were adopted by the Olympic Congress in Copenhagen 2009 and incorporated in the Ethical
code of IOC in 2010 and in the Olympic Charter in 2011.
President Jacques Rogge (IOC, 2013) stated that “the IOC and the sports movement in general have a
social responsibility - to provide access to sports practice, and in so doing to spread the values of sport
to all sections of society.»
In this presentation we underline the architecture and positive drivers of governance and social responsibility in Olympic sport organizations. Failures in the process are the other side of the coin. A day to day
fight against corruption, gigantism in mega sport events, doping, (illegal) betting, match fixing, violence,
racism and all form of harassment is requested. We give some perspectives and examples on how to
engage national and international sport organizations in this process from a global to a local perspective,
from Elite level to Sport for All level.
THE ANTI-DOPING PROGRAM OF THE FEI : CLEAN SPORT
Dr Harald Müller, Executive Director education & standards,
Fédération Equestre Internationale, Lausane, Switzerland
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43
DOPING PREVENTION IN HUMAN SPORTS
44
Professor Denis Hauw, PhD,
The purpose of this presentation is to review the different approaches of interventions to prevent human
doping. In line of educational research, the examination of the various programmes in different countries
that received a form of assessment resulted in four approaches of learning. The cognitive approach describes interventions directed at individuals’thoughts (athletes or athletes support personal) in which the
principle is to receive, store, and recall information that determine an antidoping behaviour. The programmes focus on the knowledge, attitudes and moral stance in reference to the the theory of planned
behaviour. Wada’s play true quiz, the FEI clean sport videoclip or CNOSF ‘s online test are well-known
examples of such programmes. The constructivist approach describes interventions aimed at generate
a process of assimilation and accomodation of antidoping informations. Several mechanisms could be
involved in the process of internalization such as reflexive practice, focus group, collaborative learning,
scenario etc. Athletes Training and Learning to Avoid Steroids (ATLAS) or Being a real sportman programs
are examples of such types of learning. The situated approach corresponds to interventions that take into
account the specificity of the individual situation in lifelong education persspective in order to avoid the
emergence of potential vulnerability to doping (or substance abuse) and to reduce the tension of a critical situation. Hotlines and E-Suivi Program are typical of such prevention. The socio-cultural approaches
are programs that considered the prevention into a system gathering economical, environmental, institutional etc… factors. The main principle is to prevent doping by shaping the interactions between those
factors in an ethical ways offering antidoping socialization. For example the status of professional cyclist
should be considered in relation to the load of training and the calendar of competition in order to provide an ethical culture of practice. In conclusion, a reflexion on the best practice of prevention should
consider a balanced contribution to these four approaches distributed among the different levels of sport
organizations.
Indicative references.
Ajzen, I., & Madden, T. J. (1986). Prediction of goal-directed behaviour: Attitudes, intentions, and perceived
behavioural control. Journal of Experimental and Social Psychology, 22(5), 453-474. doi:10.1016/00221031(86)90045-4
Bilard, J., Ninot, G., & Hauw, D. (2011). Motives for illicit use of doping substances among athletes calling a national anti-doping phone-help service: An exploratory study. Substance Use and Misuse, 46(4),
359–367. doi:10.3109/10826084.2010.502553
Donovan, R.J., Egger, G., Kapernick, V., & Mendoza, J. (2002). A conceptual framework for achieving performance enhancing drug compliance in sport. Sports Medecine, 32(4), 269-284. doi:10.2165/00007256200232040-00005
Goldberg, L., Elliot, DL., Clarke, GN., MacKinnon, DP., Zoref,L., Moe, E., Green, C., Wolf, SL., Greffrath, E.,
Miller, DJ. & Lapin, A. (1996). Effects of a multidimensional anabolic steroid prevention intervention - The
Adolescents Training and Learning to Avoid Steroids (ATLAS) prevention program. Journal of the American Medical Association, 276(19), 1555-1562.
Hauw, D. & Bilard, J. (2012). Situated activity analysis of elite track and field athletes’ use of prohibited performance-enhancing substances. The Journal of Substance Use, 17(2), 183-197. doi:
10.3109/14659891.2010.545858
Hauw, D. & Mohamed, S. (In Press). Patterns in the situated activity of substance use in the careers of
elite doping athletes. Psychology of Sport and Exercise. doi : 10.1016/j.psychsport.2013.09.005
Melzer, M., Elbe, A.-M., & Brand, R. (2010). Moral and ethical decision-making: A chance for doping prevention in sports? Nordic Journal of Applied Ethics, 4, 69-85.
Ohl, F., Fincoeur, B., Lentillon-Kaestner, V., Defrance, J., Brissonneau, C. (2013). The socialization
of young cyclists and the culture of doping. International Review for the Sociology of Sport. doi:
10.1177/1012690213495534
Piaget, J. (1976). Le comportement, moteur de l’évolution. Gallimard : Paris
LA PREVENTION DU DOPAGE CHEZ L’HOMME
45
Professeur Denis Hauw, PhD,
Université de Lausanne, Institut des Sciences du Sport, Suisse
Cette présentation propose une revue des différents types d’intervention visant la prévention du dopage
chez l’homme. En relation avec les recherches en sciences de l’éducation, l’examen des différents programmes d’éducation existants dans différents pays et ayant reçu une validation scientifique fait apparaître quatre approches de l’apprentissage. L’approche cognitive décrit les interventions visant les
système de pensée des individus (athlètes or entourage) avec le principe selon lequel le comportement
antidopage est déterminé par la capacité à recevoir, stocker et se rappeler l’information utile relative à
l’antidopage. Les programmes sont focalisés sur les connaissances, les attitudes et les postures éthiques
en référence aux théories de l’action planifiée. Le Quiz « Jouer Franc Jeu » de l’AMA, le vidéo clip de la FEI
ou le test en ligne « Valider vos connaissances antidopage » du CNOSF sont des exemples illustratifs de ces
programmes. L’approche constructiviste décrit les interventions visant à générer un processus d’assimilation et d’accommodation de ces informations sur l’anti-dopage. Plusieurs mécanismes d’appropriation
peuvent être engagés comme la pratique réflexive, les groupes de paroles, l’apprentissage collaboratif
ou l’examen des scénarii. Le programme « Athletes Training and Learning to ovoid Steroids » (ATLAS) ou
le programme « Etre un sportif respectable » sont des exemples de ce type d’approche. Les approches situées correspondent aux interventions qui prennent en compte la spécificité de la situation individuelle de
l’athlète dans une perspective d’apprentissage tout au long de la vie dans le but d’éviter l’émergence d’une
vulnérabilité au dopage (ou à l’abus de substances) et de réduire les tensions lors de situations critiques.
Les Hot-lines and le programme « E-Suivi » sont des exemples typiques de tels programmes de prévention.
Enfin, les approches socio-culturelles considèrent la prévention dans un système rassemblant des facteurs
institutionnels, économiques, environnementaux, culturels, etc. Le principe général est que la prévention
du dopage tient dans la constitution d’une configuration entre ces facteurs qui aboutit par socialisation
à un comportement éthique. Par exemple, le statut des cyclistes professionnels peut être considéré en
relation avec les charges d’entrainement et le calendrier des compétitions dans le but de promouvoir une
culture et des comportements éthiques en référence avec cette pratique. Pour conclure, une réflexion sur
les bonnes pratiques en matière de prévention suggère qu’un équilibre entre ces formes d’apprentissage
à travers les différents niveaux de la performance sportive devrait être trouvé et constituer un indicateur
précis d’une réelle prise en charge de la prévention du dopage dans et par les organisations sportives.
Références indicatives
Ajzen, I., & Madden, T. J. (1986). Prediction of goal-directed behaviour: Attitudes, intentions, and perceived
behavioural control. Journal of Experimental and Social Psychology, 22(5), 453-474. doi:10.1016/00221031(86)90045-4
Bilard, J., Ninot, G., & Hauw, D. (2011). Motives for illicit use of doping substances among athletes calling a
national anti-doping phone-help service: An exploratory study. Substance Use and Misuse, 46(4), 359–367. do
i:10.3109/10826084.2010.502553
Donovan, R.J., Egger, G., Kapernick, V., & Mendoza, J. (2002). A conceptual framework for achieving performance enhancing drug compliance in sport. Sports Medecine, 32(4), 269-284. doi:10.2165/00007256200232040-00005
Goldberg, L., Elliot, DL., Clarke, GN., MacKinnon, DP., Zoref,L., Moe, E., Green, C., Wolf, SL., Greffrath, E., Miller,
DJ. & Lapin, A. (1996). Effects of a multidimensional anabolic steroid prevention intervention - The Adolescents
Training and Learning to Avoid Steroids (ATLAS) prevention program. Journal of the American Medical Association, 276(19), 1555-1562.
Hauw, D. & Bilard, J. (2012). Situated activity analysis of elite track and field athletes’ use of prohibited performanceenhancing substances. The Journal of Substance Use, 17(2), 183-197. doi: 10.3109/14659891.2010.545858
Hauw, D. & Mohamed, S. (In Press). Patterns in the situated activity of substance use in the careers of elite
doping athletes. Psychology of Sport and Exercise. doi : 10.1016/j.psychsport.2013.09.005
Melzer, M., Elbe, A.-M., & Brand, R. (2010). Moral and ethical decision-making: A chance for doping prevention in sports? Nordic Journal of Applied Ethics, 4, 69-85.
Ohl, F., Fincoeur, B., Lentillon-Kaestner, V., Defrance, J., Brissonneau, C. (2013). The socialization of young cyclists
and the culture of doping. International Review for the Sociology of Sport. doi: 10.1177/1012690213495534
Piaget, J. (1976). Le comportement, moteur de l’évolution. Gallimard : Paris
ANTI-DOPING IN EQUESTRIAN SPORTS, FROM REGULATION TO IMPLEMENTATION
46
Charles Trolliet, veterinary surgeon, FEI veterinary delegate, President of the Swiss Equestrian Federation
Jacques Nardin, veterinarian, EADMCP Testing Veterinarian FEI, France
The fight against doping and medication is a central concern of all sports federations. The general framework of this struggle is defined by the Code of World Anti-Doping Agency (WADA). The FEI ratified this
Code as a member of the Association of Summer Olympic International Federations (ASOIF).
In equestrian sports -in the equine athlete- the fight against doping is special because, besides the
concept of sporting fairness, it is also important in terms of animal welfare. Policy against doping and
medication of the FEI has been redesigned after the Olympic Games in Beijing-Hong Kong and was embodied in detailed regulations, known as the Equine Anti-Doping and Controlled Medication Regulations
(EADCM Regulations). This regulatory basis is undoubtedly good quality and is subject to regular updates
and / or improvements, but it remains that it is only the regulatory aspect of the anti-doping and his
implementation at any level whatsoever, is critical to the ultimate effectiveness of the said fight. In this
paper, we try to identify some of the factors likely to influence the quality of the fight against doping and
to propose some solutions to optimize the accuracy of the EADCM Regulations.
A major limiting factor is financial. Costs of anti-doping, which consist of analysis costs, fees of the veterinary samplers, cost of equipment and ancillary costs, are high. The financing of these costs is provided in
groups I and II of the FEI (Europe) by a levy on the prize money respectively a «tax» charged to the rider.
At present, competitions from other groups, which are not subject to the Medication Control Program,
does not directly, contribute to this funding. The financial aspect requires making choices, both in the
number of controlled horses than the number of sampling events.
On the other hand the number and availability of MCP testing veterinarians, which operate in the groups
I and II on behalf of the FEI, must also be taken into consideration. In the other groups, the samplings are
made directly by the veterinary delegate, so that control of the FEI on this activity is significantly reduced.
The choice of controlled competition, which depends, among other financial contingencies and geographical availability as mentioned above, is also connected with sports aspects (relevant of the discipline,
nature / importance of the competition). It might be interesting to elaborate objective criteria to ensure
a large and representative as possible control, ideally in all FEI groups.
Besides choosing competitions, choice of horses sampled is also a factor to consider. The designation
by chance, if it appears to offer advantages, is probably not very effective due to the low percentage of
horses tested (average of 5% in the groups subjected to MCP). The levy winners or podium has a limited
sense, insofar as, in most FEI disciplines, prohibited substances are only marginally effective to gain an
advantage as it ensures victory. These samples were especially meaningful in major competitions, where
titles and medals are at stake, to ensure that the victory was obtained in accordance with the rules and
the spirit of sport. The third way of selecting horses is probably the most interesting: the target control.
But this control requires intense collaboration between the jury, stewards, the veterinary delegate and
the MCP vet. If in certain constellations, this collaboration works well, this is unfortunately not always
the case; the MCP vet in particular is frequently perceived as disruptive rather than a link in the sports
as well as other stakeholders. When the above mentioned collaboration works, it becomes possible to
optimize the choice of horses taken, taking into account information and observations held or made by
all stakeholders.
If sampling conditions are regulated, facilities provided are not always optimal. This can lead to various
problems, and these suboptimal conditions easily opening the door to formal objections to a possible
positive outcome. On the other hand, the staff made available to the MCP vet (usually one or stewards)
is not always sufficient, either by number or availability, given the many tasks to be completed as part of
a competition.
ANTI-DOPING IN EQUESTRIAN SPORTS, FROM REGULATION TO IMPLEMENTATION
47
On the level of analysis, we know that great work of harmonization has been undertaken in recent years
between the FEI approved laboratories. However we are still surprised at the negativity of some of the
results, while clear indications were assumed the presence of prohibited substances. Again, better collaboration between veterinary delegates, MCP veterinary and -which is not the case at that day- laboratories might improve the results, as it is true that the search for an alleged substance in a sample is more
effective than blind search.
Without wishing to interfere in the disciplinary procedures of the FEI or CAS, it seems that in some
positive cases, the veterinary expertise of cases remains superficial and that the allegations of the responsible person may not always be evaluated with sufficient medical perspective.
In conclusion, we formulate some ideas to optimize the implementation of EADCM Regulations of the
FEI:
•
•
•
•
•
•
•
•
•
Establishment of a system to insure the funding of the anti-doping, in order to intensify the num
ber of controlled events and the number of tested horses
MCP extension to all FEI groups, in order to ensure uniform application of the regulations and, indirectly, to improve funding for anti-doping
Establishment (or, if existing, improvement) of a concept of choice from the controlled events to ensure the most uniform possible coverage of all disciplines and at all levels (educative target)
Study of a more effective system of collaboration between jury, stewards, veterinary delegate and MCP Vet
Reflexion and recommendations to the various stakeholders in the choice of tested horses
Awareness by the organizers of the importance of infrastructure in relation to the control of me
dication
Increase if necessary, the number of stewards and improvement of their training in knowledge in the anti-doping
Reflection on the possibilities from improvement of collaboration between treating veterina-
rians, vet delegate, MCP veterinarians and laboratory
Improvement of awareness of responsible persons, their staff and veterinarians practitioners, of the importance, not only for the individual but also for the whole of the equestrian sports («Clean Sport») and a very simple and practical explanations of possibilities, limitations and constraints associated with them.
LA LUTTE ANTIDOPAGE CHEZ LE CHEVAL DE SPORT : DE LA REGLEMENTATION A SA MISE
EN PLACE
48
Charles Trolliet, médecin-vétérinaire, vétérinaire délégué FEI, président de la Fédération Suisse des Sports
Equestres
Jacques Nardin, docteur vétérinaire, Testing Veterinarian EADMCP FEI
La lutte contre le dopage et la médication constitue une préoccupation centrale de toutes les fédérations
sportives. Le cadre général de cette lutte est défini par le Code de l’Agence Mondiale Antidopage (AMA /
WADA ), code que la FEI a ratifié en tant que membre de l’Association des fédérations Internationales de
Sports Olympiques d’Eté (ASOIF).
Dans les sports équestres –en ce qui concerne l’athlète équin- la lutte contre le dopage revêt un caractère
particulier puisque, outre la notion d’équité sportive, elle a également une importance en matière de
protection des animaux. La politique de lutte contre le dopage et la médication de la Fédération Equestre
Internationale a été repensée après les Jeux olympiques de Pékin-Hongkong et a été concrétisée dans une
réglementation détaillée, connue sous le nom d’Equine Anti-Doping and Controlled Medication Regulations (EADCM Regulations). Si cette base réglementaire est sans aucun doute de bonne qualité et qu’elle
est soumise régulièrement à des actualisations et/ou des améliorations, il n’en reste pas moins qu’elle ne
représente que le volet réglementaire de la lutte anti-dopage et que sa mise en application, à quelque
niveau que ce soit, est déterminante pour l’efficacité finale de la dite lutte. Dans le présent exposé, on
cherche à identifier certains des éléments susceptibles d’influencer la qualité de la lutte anti-dopage et à
proposer quelques pistes de solutions visant à optimiser la mise en applications des EADCM Regulations.
Le coût financier est un des principaux facteurs limitants. Les coûts de la lutte anti-dopage, qui se composent de frais d’analyse, d’honoraires des vétérinaires préleveurs, de coûts de matériel et de frais annexes, est élevé. Le financement de ces coûts est assuré, dans les groupes I et II de la FEI (Europe), par un
prélèvement sur la dotation du concours respectivement par une « taxe » facturée au cavalier. A l’heure
actuelle, les compétitions des autres groupes, qui ne sont pas soumis au Medication Control Program, ne
contribuent pas directement à ce financement. L’aspect financier oblige à effectuer des choix, tant dans le
nombre de manifestations contrôlées que dans le nombre de prélèvements.
D’autre part le nombre et la disponibilité des vétérinaires MCP, qui agissent dans les manifestations des
groupes I et II sur mandat de la FEI, sont également à prendre en considération. Dans les autres groupes,
les prélèvements sont effectués directement par le délégué vétérinaire, de sorte que le contrôle de la FEI
sur cette activité est nettement plus réduit.
Le choix des compétitions contrôlées, qui dépend donc entre autre des contingences contraintes financières et géographiques ainsi qu’aux disponibilités évoquées précédemment, est aussi lié à des notions
sportives (discipline concernée, nature/importance de la compétition). Il pourrait être intéressant de réfléchir à des critères objectifs permettant d’assurer un choix aussi large et représentatif que possible des
compétitions contrôlées, idéalement dans tous les groupes de la FEI.
Outre le choix des compétitions, le choix des chevaux prélevés est également un facteur à prendre en
compte. La simple désignation par le hasard, si elle semble offrir des avantages, est probablement peu efficace vu le faible pourcentage de chevaux contrôlés (en moyenne 5% dans les groupes soumis au MCP).
Le prélèvement des vainqueurs ou des podiums n’a qu’un sens limité, dans la mesure où, dans la plupart
des disciplines FEI, les pratiques interdites ne sont que peu efficaces pour obtenir un avantage tel qu’il
assure la victoire. Ces prélèvements ont surtout un sens dans les grandes compétitions, où des titres et
des médailles sont en jeu, pour assurer que la victoire a été obtenue en conformité avec les règlements et
l’esprit du sport. La troisième voie de sélection des chevaux prélevés est probablement la plus intéressante
: le contrôle ciblé. Mais ce contrôle nécessite une collaboration intense entre le jury, les stewards, le délégué vétérinaire et le vétérinaire MCP. Si dans certaines constellations, cette collaboration fonctionne bien,
ce n’est malheureusement pas toujours le cas, le vétérinaire MCP en particulier étant fréquemment perçu
comme un élément perturbateur plutôt que comme un maillon du sport au même titre que les autres
intervenants. Lorsque la collaboration mentionnée ci-dessus fonctionne, il devient possible d’optimiser le
LA LUTTE ANTIDOPAGE CHEZ LE CHEVAL DE SPORT : DE LA REGLEMENTATION A SA MISE
EN PLACE
49
choix des chevaux prélevés, en tenant compte des informations et des observations détenues ou faites
par tous les protagonistes.
Si les conditions de prélèvement sont bien réglementées, les infrastructures mises à disposition ne sont
pas toujours optimales. Cela peut amener à divers problèmes, qu’ils soient de nature directement pratique ou plus juridique, ces conditions sub-optimales ouvrant facilement la porte à des contestations formelles d’un éventuel résultat positif. D’autre part, le personnel mis à disposition du vétérinaire MCP (en
principe un ou des stewards) n’est pas toujours suffisant, que ce soit en nombre ou en disponibilité, au vu
des nombreuses tâches à remplir dans le cadre d’un concours.
Au niveau de l’analyse, on sait qu’un grand travail d’harmonisation a été entrepris ces dernières années
entre les laboratoires agréés par la FEI. Toutefois on s’étonne encore de la négativité de certains résultats, alors que des indices clairs laissaient présumer la présence de substances prohibées. Là aussi une
meilleure collaboration entre délégué vétérinaire, vétérinaire MCP et- ce qui n’est pas le cas à ce jourlaboratoires serait susceptible d’améliorer les résultats, tant il est vrai que la recherche d’une substance
supposée présente dans un échantillon est plus efficace qu’une recherche à l’aveugle.
Sans vouloir interférer dans les procédures disciplinaires de la FEI ou du TAS, il semble bien que, dans un
certain nombre de cas positifs, l’expertise vétérinaire des cas reste superficielle et que les allégations de
la personne responsable ne soient pas toujours évaluées avec assez de recul médical.
En conclusion, nous formulons quelques pistes visant à optimiser la mise en application des EADCM Regulations de la FEI :
•
Mise en place d’un système de financement de la lutte anti-dopage permettant d’intensifier le nombre de compétitions contrôlées ainsi que le nombre de chevaux testés
•
Extension du MCP à l’ensemble des groupes de la FEI, afin d’assurer une mise en application uni
forme des règlements et, indirectement, d’améliorer le financement de la lutte anti-dopage
•
Mise en place (ou, dans la mesure où il existe déjà, amélioration) d’un concept de choix des
manifestations contrôlées, afin d’assurer la couverture la plus uniforme possible de toutes les dis
ciplines et à tous les niveaux (rôle éducatif)
•
Etude d’un modèle plus efficace de collaboration entre jury, stewards, délégué vétérinaire et vété
rinaire MCP
•
Réflexion et recommandations aux divers intervenants quant au choix des chevaux testés
•
Sensibilisation des organisateurs à l’importance des infrastructures en relation avec le contrôle de médication
•
Augmentation, là où cela est nécessaire, du nombre de stewards et amélioration de leur forma
tion quant à leur rôle dans la lutte anti-dopage
•
Réflexion sur les possibilités d’amélioration de collaboration entre les vétérinaires traitants, les délégués vétérinaires, les vétérinaires MCP et les laboratoires d’analyse
•
Amélioration de la prise de conscience par les personnes responsables, leur entourage et les vé-
térinaires praticiens, de l’importance, non seulement pour l’individu mais aussi pour l’ensemble des sports équestres, d’un sport propre (« Clean Sport ») et explications très simples et concrètes des possibilités, limites et contraintes qui y sont liées.
GENERAL ROUND TABLE
50
4 sessions - 4 questions – 4 answers
Rapporteur: Professor Jean-Luc Cadoré
Session 1
What is the role of diagnostic imaging in the screening of upper level athletes for purchase transactions
and injury prevention?
Participants - Peter Clegg, Jan Gielen, Sarah Powell, Michael Schramme
Question 1:
GENERAL ROUND TABLE
51
Session 2
Regenerative medicine in rehabilitation of high level athletes
Participants - Christian Jorgensen, Roger Smith, Régis Steinberg and Jamie Textor,
Question 2:
GENERAL ROUND TABLE
52
Session 3
Contributions of sports medicine to the high-level human athlete
Participants - Philippe Hager, Jean-Marc Gentil, Jan Gielen, Thierry Zintz
Question 3:
GENERAL ROUND TABLE
53
Session 4
Veterinarians and Doctors for clean sport: doping and banned substances
Participants - Harald Müller, Denis Hauw, Charles Troillet, Jacques Nardin
Question 4:
ESVOT_2014 pagina A4
2-04-2014
12:50
Pagina 1
AND ALDO VEZZONI
EQUINE PROVISIONAL PROGRAMME
MAIN CONGRESS SEMINARS
FRIDAY, OCTOBER 2nd
• Lame or ataxic?
• What’s the current opinion?
• Racetrack orthopedics
SATURDAY, OCTOBER 3rd
• Modern diagnostic techniques
• Fracture treatment/Regenerative medicine
AGENDA & SOCIAL
PROGRAMME
FRIDAY, OCTOBER 3rd
5:30 pm - Opening
ceremony
SATURDAY, OCTOBER 4th
12:30 pm - ESVOT General meeting
5:30 pm - Poster session
8:30 pm - Banquet
Deadline for abstract submission: MAY 15th, 2014 - Early Registration deadline: JULY 31st, 2014

list of speakers

Transcription

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