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Shuichi Chida, Hitoshi Suzuki, Moto Kobayashi, Tsutomu Sakuraba, Hideji Kura, Naohisa Miyakoshi, Yoichi Shimada
BACKGROUND: We reconstructed a chronically ruptured Achilles tendon and the associated scar tissue using braided polyblend polyethylene sutures (FiberWire; Arthrex Inc.; Naples, FL, USA) and anchors. CASE PRESENTATION: A 68-year-old Japanese man, who was being treated for right Achilles tendinosis, felt pain in his Achilles tendon when walking and started to find plantar flexion of his ankle joint difficult. As his symptoms persisted, he visited us after 4 weeks...
March 2, 2018: Journal of Medical Case Reports
Oliver Nickolaas Schipper, Robert Bentley Anderson, Bruce E Cohen
BACKGROUND: Achilles tendon insertional sleeve avulsions occur when the Achilles distal tendon sleeve ruptures off of its insertion into the calcaneal tuberosity, sometimes with a small bony fragment from calcific tendinosis. Little evidence exists describing the outcomes and rerupture rate after operative management of Achilles tendon sleeve avulsions. METHODS: A retrospective chart review was performed to identify patients who sustained an Achilles sleeve avulsion injury treated with operative repair between October 2005 and July 2014...
February 1, 2018: Foot & Ankle International
Manusak Boonard, Sermsak Sumanont, Alisara Arirachakaran, Punyawat Apiwatanakul, Artit Boonrod, Wichan Kanchanatawan, Jatupon Kongtharvonskul
BACKGROUND: In symptomatic tendinosis, a corticosteroid injection into the subacromial space is a palliative treatment option. This study compares high volumes (10 cc) of local anesthetic (LA) combined with triamcinolone acetate (TA) with low volumes (4 cc) of LA combined with TA to see whether the latter would provide similar pain, function and complication outcomes for subacromial injections in patients with impingement syndrome. MATERIALS AND METHODS: This single-center, randomized, single-blind, non-inferiority trial included patients with shoulder pain and positive multiple clinical tests supporting the diagnosis of impingement syndrome...
February 8, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Håkan Alfredson, Christoph Spang
BACKGROUND: Non-invasive treatment is not always successful in patients with Achilles tendon disorders, and surgical treatment is instituted as the next step. There is sparse knowledge about the diagnoses, pain levels before surgery, surgically confirmed pathologies and postoperative complications in large patient groups. AIMS: To study the diagnoses, pain scores before surgery, macroscopic surgical findings and postoperative complications in a series of patients treated for Achilles disorders...
June 12, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Elisabeth R Garwood, Christopher J Burke, Laith M Jazrawi, Ronald S Adler
Emerging musculoskeletal applications for local administration of autologous bone marrow aspirate concentrate (BMAC) include treatment of fractures, osteonecrosis, osteochondral injuries, osteoarthritis, ligament injury, tendon injury, and tendonopathies. Ultrasound-guided technique for various BMAC injection sites is detailed in this technical report and our preliminary clinical experience outlined.Five patients, 1 woman and 4 men, were treated with 6 peri/intratendinous (n = 4) or intraarticular (n = 2) BMAC injections between July 5, 2015 and December 31, 2016 for the clinical indications of common hamstrings origin tendinosis (n = 4), hip labral tear (n = 1), and osteochondral lesion of the talus (n = 1)...
January 23, 2018: Ultrasound Quarterly
Mitsunori Kaya
PURPOSE: For patients who have anterior hip pain evaluated by Patrick's test and tenderness at Scarpa's triangle, we perform periarticular debridement based on the hypothesis that extra-articular pathologies are responsible for the hip pain. The purpose of this study was to categorize the endoscopic extra-articular findings and to evaluate the clinical significance of periarticular pathologies in anterior hip pain. METHODS: Arthroscopic findings of 77 patients who underwent periarthritic debridement were evaluated...
2018: PloS One
Ana Torres, Mariano Fernández-Fairen, José Sueiro-Fernández
Greater trochanteric pain syndrome (GTPS) affects 10-25% of people in developed countries. The underlying etiology for GTPS is most commonly the tendinosis or a tendon tear of the gluteus medius, minimus or both at the greater trochanter; the inflammation of the tendon is not a major feature. We critically evaluated conservative treatment, for which we reviewed 76 publications, grading them according to four levels of evidence. We identified a wide variety of conservative treatment options: home therapy (insoles, walking sticks/crutches, orthotic devices, stretching exercises and preventive measures); physiotherapy (massage and stretching exercises); infiltrations (corticosteroids and local anesthetics); image-guided infiltrations (fluoroscopy and ultrasound); shockwave therapy; platelet-rich plasma injection; and drug therapy...
January 2018: Pain Management
Elisabeth Kvalvaag, Masoud Anvar, Anna Cecilia Karlberg, Jens Ivar Brox, Kaia Beck Engebretsen, Helene Lundgaard Soberg, Niels Gunnar Juel, Erik Bautz-Holter, Leiv Sandvik, Cecilie Roe
BACKGROUND: Previous studies on shoulder patients have suggested that the prevalence of rotator cuff or bursa abnormalities are weakly related to symptoms and that similar findings are often found in asymptomatic persons. In addition, it is largely unknown whether structural changes identified by magnetic resonance imaging (MRI) affect outcome after treatment for shoulder pain. The purpose of this study was therefore to evaluate the presence of structural changes on MRI in patients with subacromial pain syndrome and to determine to what extent these changes are associated with symptoms and predict outcome after treatment (evaluated by the Shoulder Pain and Disability Index (SPADI))...
November 21, 2017: BMC Musculoskeletal Disorders
Amol Saxena, Deann Hofer
We present a case report with 1-year follow-up data of a 57-year-old male soccer referee who had sustained an acute triple Achilles tendon rupture injury during a game. His triple Achilles tendon rupture consisted of a rupture of the proximal watershed region, a rupture of the main body (mid-watershed area), and an avulsion-type rupture of insertional calcific tendinosis. The patient was treated surgically with primary repair of the tendon, including tenodesis with anchors. Postoperative treatment included non-weightbearing for 4 weeks and protected weightbearing until 10 weeks postoperative, followed by formal physical therapy, which incorporated an "antigravity" treadmill...
March 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Nahum Michael Beard, Robert Patrick Gousse
This article is a comprehensive review of the current utilizations of ultrasound in the treatment of orthopedic conditions of the foot and ankle. It reviews the diagnostic and interventional applications to commonly encountered lower-extremity ailments, including plantar fasciosis, tendinosis, and peripheral nerve disorders. It also outlines minimally invasive ultrasound-guided procedures and emerging therapies as alternatives to current treatments. These emerging therapies can be used to assist surgeons and provide options for patients needing intervention...
January 2018: Orthopedic Clinics of North America
Massimiliano Leigheb, Giuseppe Guzzardi, Francesco Pogliacomi, Luca Sempio, Federico A Grassi
BACKGROUND AND AIM OF THE WORK: Achilles tendon rupture is frequent and can result in a disabling condition. The ideal method of management remains a matter of debate. We aimed to compare the clinical outcome of patients who underwent surgical repair of Achilles tendon rupture with Silfverskiöld augmentation technique with gastrocnemius fascia flap versus Krackow end-to-end stitching technique. METHODS: We retrospectively studied all patients that were surgically treated for Achilles tendon rupture at our institution, between January 2000 and December 2015, using either Silfverskiöld or Krackow technique...
October 18, 2017: Acta Bio-medica: Atenei Parmensis
James W Brodsky, Jacob R Zide, Justin M Kane
A high clinical suspicion and greater understanding of the anatomy and pathophysiology of lateral ankle injuries have enabled early diagnosis and treatment-improving outcomes of acute peroneal tendon tears. Multiple conditions can be the cause of lateral ankle pain attributed to the peroneal tendons: tenosynovitis, tendinosis, subluxation and dislocation, stenosing tenosynovitis, abnormality related to the os peroneum, as well as tears of the peroneal tendons. It is imperative for the clinician to maintain a high suspicion for peroneal tendon abnormality when evaluating patients with lateral ankle pain...
December 2017: Foot and Ankle Clinics
Elizabeth Harkin, Michael Pinzur, Adam Schiff
Tibialis anterior (TA) tendon rupture is a rare injury that has been described and studied in orthopedic literature through case reports and low-volume case studies. This article reviews the current literature on TA tendinosis and acute and chronic ruptures. It discusses the patient presentation, physical examination, nonoperative management, surgical treatment options, and outcomes.
December 2017: Foot and Ankle Clinics
Avreeta Singh, Arash Calafi, Chris Diefenbach, Chris Kreulen, Eric Giza
Noninsertional Achilles tendinosis is differentiated from insertional Achilles tendinosis based on anatomic location. Tendinosis, as opposed to tendonitis, is primarily a degenerative process and the role of inflammation is believed limited. The etiology of Achilles tendinopathy may include overuse leading to repetitive microtrauma, poor vascularity of the tissue, mechanical imbalances of the extremity, or combination of these elements. There is evidence to support eccentric exercise nonoperative management for patients with noninsertional Achilles tendinopathy...
December 2017: Foot and Ankle Clinics
Ahmed M Elsaman, Ehab Saad Mostafa, Ahmed R Radwan
Ankle joint evaluation is underestimated in many clinical and sonographic scores used for evaluation and follow-up of rheumatoid arthritis (RA) patients. Agreement on examination parameters is poor among sonographic scores that include the ankle joint. More effort is needed to detect the value of ankle joint examination in RA and assessment of ultrasonographic signs according to frequency, disease duration and activity. The objective of this study was to use ultrasound (US) to detect ankle involvement in active RA and to compare findings with disease duration, disease activity and assessment of ankle bone erosion...
December 2017: Ultrasound in Medicine & Biology
Kwok Fai Tam, Tun Hing Lui
Achilles tendon tear is common and increasingly frequent. Magnetic resonance imaging (MRI) is the modality of choice for radiological evaluation. It is accurate to assess the status and integrity of the tendon with well documented features. In this article, the MR findings of a normal Achilles tendon as well as common diseases like insertional and noninsertional tendinosis, chronic tendinosis with marked lengthening, tendon rupture are illustrated. After a torn Achilles tendon receives surgical repair, it undergoes different stages of healing process including inflammatory, reparative and remodeling phases...
2017: Open Orthopaedics Journal
Bong Young Kong, Minjoon Cho, Hwa Ryeong Lee, Young Eun Choi, Sae Hoon Kim
BACKGROUND: High-grade partial-thickness rotator cuff tears (hPTRCTs) are frequently encountered in the shoulder. However, little information is available on the prevalence or timing of tear progression. Purpose/Hypothesis: The purpose was to prospectively evaluate the structural progression of hPTRCTs with a minimum follow-up of 1 year using magnetic resonance imaging (MRI). The hypothesis was that a substantial portion of hPTRCT patients would experience tear progression or evolution to a full-thickness rotator cuff tear...
January 2018: American Journal of Sports Medicine
David F Dow, Kaushal Mehta, Yuanfang Xu, Eric England
OBJECTIVE: Fatty infiltration in the rotator cuff muscles has been well studied in the setting of rotator cuff tendon tears to help predict outcomes of surgical repair. Fatty infiltration in the rotator cuff has also been independently correlated to the variables of age and sex. The purpose of our study was to determine if there is a relationship between body mass index and fatty infiltration in patients with no imaging evidence of rotator cuff tendinosis or tear. METHODS: Radiology reports of all magnetic resonance imaging examinations of the shoulder were searched over a 2-year period...
September 20, 2017: Journal of Computer Assisted Tomography
James F Stenson, Christopher W Reb, Joseph N Daniel, Sundeep S Saini, Mohammed F Albana
Nonoperative treatment for midportion Achilles tendinosis is well defined by the literature. Multiple modalities are described for the management of insertional Achilles pathology, but no consensus exists regarding efficacy. Surgical intervention for insertional Achilles tendinosis (IAT) is successful greater than 80% of the time. Our objective was to risk stratify patients who would fail nonsurgical management of IAT and thus benefit progressing to surgery. We reviewed the records of 664 patients with IAT...
September 1, 2017: Foot & Ankle Specialist
Leanne Dupley, Charalambos P Charalambous
Purpose: Patellar tendinosis (PT) is a common condition amongst athletes. In this study, we perform a meta-analysis on randomised controlled trials (RCTs) to evaluate the use of platelet-rich plasma (PRP) for refractory PT. Methods: A literature search was undertaken in various databases from their year of inception to October 2015. The primary outcome measure was the Victorian Institute of Sports Assessment-Patella (VISA-P) score. Results: We identified 2 RCTs comparing PRP injections to alternative treatment options (extracorporeal shockwave therapy [ESWT] and dry needling of the tendon)...
September 1, 2017: Knee Surgery & related Research
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