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Achilles tendon repair

Alison N Agres, Tobias J Gehlen, Adamantios Arampatzis, William R Taylor, Georg N Duda, Sebastian Manegold
BACKGROUND: Although early functional rehabilitation (EFR) has been suggested to yield rapid functional recovery after Achilles tendon rupture (ATR) compared to conventional rehabilitation (CR), most quantitative assessments occur long after rehabilitation has been completed. Few data exist regarding the short-term functional gains during the healing period post-ATR. It remains unclear if EFR allows for an objectively faster return to function. The aim of this study was to examine EFR's effect on gait, plantarflexor strength, and tendon properties in early post-operative follow-ups...
March 5, 2018: Gait & Posture
Daniel J Liechti, Gilbert Moatshe, Jonathon D Backus, Daniel Cole Marchetti, Thomas O Clanton
Achilles tendon ruptures are a common tendon injury, usually occurring in middle-aged men during recreational sporting activities. Both nonoperative and operative management are employed to treat these injuries. Several operative treatments are described in the literature, including percutaneous Achilles repair, mini-open repair, and open repair. Open Achilles repair is associated with higher rates of impaired wound healing and infection, whereas minimally invasive techniques have been reported to have an increased risk of iatrogenic sural nerve injury...
February 2018: Arthroscopy Techniques
Meletis Rozis, Ioannis Benetos, Panagiotis Karampinas, Vasilios Polyzois, John Vlamis, Spyros Pneumaticos
BACKGROUND: Conservative treatment of an acute Achilles rupture remains a viable and acceptable option as does surgical fixation, with open and percutaneous repair consisting the main operative techniques. The purpose of this study was to compare the outcomes and complication rates of open versus percutaneous surgical procedures. METHODS: From 2009 to 2016, 131 patients were admitted to our department with clinically and radiologically confirmed acute Achilles tendon ruptures...
March 1, 2018: Foot & Ankle International
Alper Çıraklı, Pınar Naile Gürgör, Erdal Uzun, Havva Erdem, Soner Çankaya, Orhan Baş
OBJECTIVES: This study aims to evaluate the potential adverse effects of tranexamic acid (TA) on tendon healing. MATERIALS AND METHODS: Twelve male Wistar-Albino rats (weighing 300 g to 350 g) were used in the study. Rats were divided into two groups. Right legs of the rats were determined as the TA group and left legs as the serum physiologic (SP) group. Bilateral Achilles tenotomy was performed and surgically repaired. For the right side, 1 mL of TA and for the left side, 1 mL of SP were applied...
April 2018: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Yılmaz Eren, Oktay Adanır, Yaşar Mahsut Dinçel, Erdinç Genç, Yunus Ziya Arslan, Aysel Çağlar
OBJECTIVES: This study aims to compare the histopathological and biomechanical effects of low molecular weight heparin (LMWH) and rivaroxaban, which are frequently used in orthopedic surgery for thromboembolic prophylaxis, on rat Achilles tendon healing. MATERIALS AND METHODS: In the study, 36 adult, male Sprague Dawley rats weighing between 300 g and 400 g were used. Three groups were formed including 12 rats in each. Achilles tendons of all rats were cut and repaired...
April 2018: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Tomoya Sakabe, Keiko Sakai, Toru Maeda, Ataru Sunaga, Nao Furuta, Ronen Schweitzer, Takako Sasaki, Takao Sakai
Tendon is a dense connective tissue that transmits high mechanical forces from skeletal muscle to bone. The transcription factor scleraxis (Scx) is a highly specific marker of both precursor and mature tendon cells (tenocytes). Mice lacking scx exhibit a specific and virtually complete loss of tendons during development. However, the functional contribution of Scx to wound healing in adult tendon has not yet been fully characterized. Here, using ScxGFP-tracking and loss-of-function systems, we show in an adult mouse model of Achilles tendon injury that paratenon cells, representing a stem cell antigen-1 (Sca-1)-positive and Scx-negative progenitor subpopulation, display Scx induction, migrate to the wound site, and produce extracellular matrix (ECM) to bridge the defect, whereas resident tenocytes exhibit a delayed response...
March 5, 2018: Journal of Biological Chemistry
Sebastian A Müller, Christopher H Evans, Patricia E Heisterbach, Martin Majewski
BACKGROUND: The role of the paratenon in tendon healing is unknown. The present study compares healing in the presence or absence of the paratenon in an Achilles tendon defect model in rats. HYPOTHESIS: Resection of the paratenon impairs tendon healing. STUDY DESIGN: Controlled laboratory study. METHODS: Sixty skeletally mature Sprague Dawley rats were randomly assigned to either a resected paratenon (RP) group or an intact paratenon (IP) group...
March 1, 2018: American Journal of Sports Medicine
Yavuz Selim Karatekin, Bedri Karaismailoglu, Gokhan Kaynak, Tahir Ogut, Atilla Suleyman Dikici, Emel Ure Esmerer, Onder Aydingoz, Huseyin Botanlioglu
BACKGROUND: Achilles tendon injuries are one of the most common tendon injuries. Surgical treatment is preferred in young and active patients. Although there are studies which evaluate the repair area with magnetic resonance imaging and ultrasonography after surgical treatment, there are very few studies which analyzes the elasticity of the tendon by quantitative methods. ARFI (acoustic radiation force impulse) elastography is a simple and non-invasive method that can quantitatively measure the elasticity of the soft tissues...
March 2, 2018: Journal of Orthopaedic Surgery and Research
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
Geir Aasmund Hjorthaug, Endre Søreide, Lars Nordsletten, Jan Erik Madsen, Finn P Reinholt, Sanyalak Niratisairak, Sigbjørn Dimmen
Background and purpose - Outcome after ligament reconstruction or tendon repair depends on secure tendon-to-bone healing. Increased osteoclastic activity resulting in local bone loss may contribute to delayed healing of the tendon-bone interface. The objective of this study was to evaluate the effect of the bisphosphonate zoledronic acid (ZA) on tendon-to-bone healing. Methods - Wistar rats (n = 92) had their right Achilles tendon cut proximally, pulled through a bone tunnel in the distal tibia and sutured anteriorly...
March 1, 2018: Acta Orthopaedica
Bobby G Yow, David J Tennent, Thomas C Dowd, Jeremy P Loenneke, Johnny G Owens
Blood flow restriction (BFR) training is a technique shown to be safe and effective at increasing muscular strength and endurance in healthy fitness populations and is under study for its use in postinjury rehabilitation. BFR stimulates muscular strength and hypertrophy gains at much lower loads than traditional methods, allowing patients to begin the rehabilitation process much sooner. We report on 2 patients who incorporated BFR training into their traditional rehabilitation program after Achilles tendon ruptures...
February 21, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Erdinç Genç, Ozan Beytemur, Serdar Yuksel, Yılmaz Eren, Aysel Çağlar, Bedri Onur Küçükyıldırım, Mehmet Akif Güleç
OBJECTIVE: The aim of this study to evaluate the effects of autologous conditioned serum (ACS) on the healing of transected rat Achilles tendons via the assessment of biomechanical and histological parameters. METHODS: The study was conducted on 45 male Sprague-Dawley rats. Five rats were used as donors for ACS preparation. Animals were randomly assigned to the experimental or control group. In both groups, the Achilles tendon was cut transversally and then sutured...
February 14, 2018: Acta Orthopaedica et Traumatologica Turcica
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
John J Marcel, Katherine Sage, Gregory P Guyton
BACKGROUND: Open Achilles tendon surgery with the patient in the supine position potentially avoids the complications of the prone position, but the safety and viability of the supine position for this procedure are not known. The aim of this study was to test the hypothesis that supine positioning for open repair of acute Achilles tendon ruptures would be safe, with low wound and neurologic complication rates. METHODS: Supine position safety in acute Achilles tendon repair was investigated...
February 1, 2018: Foot & Ankle International
Kengo Harato, Shu Kobayashi, Kazuhiko Udagawa, Yu Iwama, Ko Masumoto, Hiroyuki Enomoto, Yasuo Niki
Although surgical treatment is the gold standard for chronic patellar tendon rupture, the technique of patellar tendon reconstruction is still difficult. Basically, good clinical results of surgical repair for acute patellar tendon rupture have been reported. However, the results of reconstructive surgery for chronic patellar tendon rupture are still inconsistent. Some surgical options have been previously reported. For example, surgeons need to choose between 1- and 2-stage reconstruction. Furthermore, contralateral bone-tendon-bone graft, ipsilateral semitendinosus tendon graft, Achilles tendon allograft, and an artificial ligament have been used to reconstruct the patellar tendon...
October 2017: Arthroscopy Techniques
M Yasser Anathallee, Ben Liu, Adam Budgen, James Stanley
BACKGROUND: To assess the outcome of delayed repair of ruptured Achilles tendon using the Achillon mini-open technique. METHODS: A review of all patients who underwent delayed repair (>10 days post injury) of ruptured Achilles tendon with mini invasive technique was compared to acute repairs carried out at the same unit. Leppilahti Score and Achilles Tendon Total Rupture Score (ATRS) were utilised. Complication rates including re-rupture were also reviewed. RESULTS: 14 patients were identified as having delayed repair (11-31 days)...
March 23, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Marcello Zappia, Daniela Berritto, Francesco Oliva, Nicola Maffulli
BACKGROUND: Percutaneous Achilles tendon repair has been developed to minimise soft tissue complications following treatment of tendon ruptures. However, there are concerns because of the risk of sural nerve injury. Few studies have investigated the relationship between the Achilles tendon, the sural nerve and its several anatomical course variants. METHODS: We studied 7 cadaveric limbs (7 Achilles tendons) in which a percutaneous repair of the Achilles tendon was performed...
March 30, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Ilhan Alcelik, Zubair M Saeed, Ben A Haughton, Rizwan Shahid, John C Alcelik, Craig Brogden, Adam Budgen
BACKGROUND: Open Achilles tendon repairs (OATR) are associated with high complication rates. Minimally invasive surgery (MIS) techniques like the Achillon Achilles tendon repair (AATR) were developed to reduce this. We performed a systematic review and meta-analysis to compare OATR with AATR. METHODS: We performed an extensive literature search including all studies that compared the two techniques. Outcomes assessed included overall complication rate, re-rupture rate, sural nerve injury, wound length, The American Orthopaedic Foot and Ankle Scores (AOFAS) scores and return to sports...
May 4, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Don Koh, Jeremy Lim, Jerry Y Chen, Inderjeet R Singh, Kevin Koo
BACKGROUND: Repairs of chronic Achilles tendon ruptures are technically challenging due to large defects after scar excision. Multiple techniques for repair have been proposed but little consensus on best practice established. This study aims to compare flexor hallucis longus (FHL) transfers versus turndown flaps augmented by FHL transfers. METHODS: Between 2005 and 2015, 49 unilateral repairs of chronic Achilles tendon ruptures were performed. We retrospectively compared the outcomes of 20 patients who underwent FHL transfer with 19 patients who underwent turndown flaps augmented with FHL transfer before surgery and at three time points after surgery (three, six and twelve months)...
November 10, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Daniele Munegato, Giulia Gridavilla, Stefano Guerrasio, Marco Turati, Carlo Cazzaniga, Nicolò Zanchi, Giovanni Zatti, Marco Bigoni
Background: The aim of the study was to compare the mini-open to the classic open repair techniques for Achilles tendon ruptures. Methods: We retrospectively evaluated at a minimum of 2 years follow-up 32 subcutaneous Achilles tendon ruptures; 17 underwent mini-open surgery (Group A) and 15 the open technique (Group B). Results: No difference in Achilles Tendon Total Rupture Score and in modified Leppillahti score was observed. With respect to the contralateral side the width of the operated Achilles tendon was 4...
July 2017: Muscles, Ligaments and Tendons Journal
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