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Achilles tendon repair

C-F Hsieh, P Alberton, E Loffredo-Verde, E Volkmer, M Pietschmann, P E Müller, M Schieker, D Docheva
Tendon's natural healing potential is extremely low and inefficient, with significant dysfunction and disability due to hypocellularity and hypovascularity of tendon tissues. The application of stem cells can aid in significantly enhanced repair of tendon rupture; therefore, the main aim of this study is to assess the potential of using periodontal ligament cells (PDL), usually obtained from patients undergoing orthodontic treatment, as a novel cell source for cell-based therapy for tendon injuries in a clinically relevant rat full-size Achilles tendon defect...
October 20, 2016: European Cells & Materials
Xudong Miao, Yongping Wu, Huimin Tao, Disheng Yang, Lu Huang
BACKGROUND: Transfer of a flexor hallucis longus (FHL) tendon can not only reconstruct the Achilles tendon but also provide ischemic tendinous tissues with a rich blood supply to enhance wound healing. This retrospective study aims to investigate clinical outcomes in patients who underwent repair of Kuwada grade IV chronic Achilles tendon rupture with long hallucis longus tendons harvested using a minimally invasive technique. MATERIALS AND METHODS: 35 patients who were treated for Kuwada grade IV Achilles tendon injuries from July 2006 to June 2011 were included in this retrospective study...
September 2016: Indian Journal of Orthopaedics
Salvatore Gitto, Anna Guja Draghi, Chandra Bortolotto, Ferdinando Draghi
This review aims to provide the radiologist with simple and systematic guidelines for evaluation of the Achilles tendon after complete rupture repair. Currently, there is a plethora of nonsurgical and surgical treatments, but sonographic examination has shown no significant differences between them. A systematic analysis of several parameters (morphologic characteristics, structure, color Doppler vascularization, and mobility) should be undertaken. Morphologically, the repaired tendon is larger, wider, or both...
October 13, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Gary M LiMarzi, Kurt F Scherer, Michael L Richardson, David R Warden, Christopher W Wasyliw, Jack A Porrino, Christopher R Pettis, Gideon Lewis, Christopher C Mason, Laura W Bancroft
A variety of surgical procedures exist for repair of both traumatic and degenerative osseous and soft-tissue pathologic conditions involving the foot and ankle. It is necessary for the radiologist to be familiar with these surgical procedures, so as to assess structural integrity, evaluate for complicating features, and avoid diagnostic pitfalls. Adequate interpretation of postoperative changes often requires access to surgical documentation to evaluate not only the surgery itself but the expected timeline for resolution of normal postoperative changes versus progressive disease...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Masaaki Katayama
OBJECTIVE: To report appositional augmentation of Achilles tendon rupture in a toy breed dog with an intact flexor digitorum lateralis (FDL) muscle tendon. STUDY DESIGN: Clinical case report. ANIMALS: Two-year-old spayed female Toy Poodle with Achilles tendon rupture. METHODS: The Achilles tendon was accidentally ruptured by hair clippers during grooming. The dog demonstrated a plantigrade stance without digital flexion of the right hind limb...
October 6, 2016: Veterinary Surgery: VS
Hiroyuki Oda, Kanae Sano, Yoko Kunimasa, Paavo V Komi, Masaki Ishikawa
BACKGROUND: Patients who have had an Achilles tendon (AT) rupture repaired are potentially at higher risk for re-rupture than those without previous rupture. Little attention has been given to the neuromechanical modulation of muscle-tendon interaction and muscle activation profiles during human dynamic movements after AT rupture repair. OBJECTIVE: The purpose of this study was to examine muscle-tendon behavior and muscle activation during bilateral hopping. METHODS: We enrolled nine subjects who had undergone surgical repair of unilateral AT rupture within the past 1-2 years...
October 3, 2016: Sports Medicine
Stuart R Young, Bruce Gardiner, Arash Mehdizadeh, Jonas Rubenson, Brian Umberger, David W Smith
While it is known that musculotendon units adapt to their load environments, there is only a limited understanding of tendon adaptation in vivo. Here we develop a computational model of tendon remodeling based on the premise that mechanical damage and tenocyte-mediated tendon damage and repair processes modify the distribution of its collagen fiber lengths. We explain how these processes enable the tendon to geometrically adapt to its load conditions. Based on known biological processes, mechanical and strain-dependent proteolytic fiber damage are incorporated into our tendon model...
September 2016: PLoS Computational Biology
H Ozkan, T Ege, K Koca, N Can, Y Yurttas, S Tunay
The aim of the current study was to assess the changes of plantar foot pressures with pedobarography in -patients with Achilles tendon repair by minimally -invasive surgical technique. This retrospective study consisted of 15 consecutive patients who were treated for acute Achilles' tendon repair with minimally invasive technique in our clinic in a two year period between 2010 and 2012. All patients were male. The mean age was 28.7 years (24-42) and the mean follow-up time was 2.3 years (1.5- 3). All patients had sports related Achilles' tendon rupture and all had undergone surgery in 24-48 hours...
August 2016: Acta Orthopaedica Belgica
B Hajipour, A M Navali, S Ali Mohammad, G Mousavi, M Gahvechi Akbari, T Maleki Miyandoab, L Roshangar, B Mohammadi Saleh, T Asvadi Kermani, F Moutab Laleh, M Ghabili
INTRODUCTION: Tendons are vulnerable to various types of acute or chronic injures. Different methods have been investigated to achieve better healing. Phenytoin is a drug which could stimulate fibroblasts to produce collagen. This experimental study was performed to assess the effect of phenytoin on tendon healing in a rat model of tendon rupture. METHODS: Thirty healthy rats were divided into 3 groups, 1) Sham group; 2) Tendon rupture; 3) Tendon rupture+phenytoin (100 mg/kg intraperitoneally) for 21 days...
2016: Bratislavské Lekárske Listy
Travis J Dekker, Yash Avashia, Suhail K Mithani, Andrew P Matson, Alexander J Lampley, Samuel B Adams
: Introduction Achilles tendon and posterior heel wound complications are difficult to treat. These typically require soft tissue coverage via microvascular free tissue transfer at a tertiary referral center. Here, we describe coverage of a series of posterior heel and Achilles wounds via simple, local tissue transfer, called a bipedicle fasciocutaneous flap. This flap can be performed by an orthopaedic foot and ankle surgeon, without resources of tertiary/specialized care or microvascular support...
September 23, 2016: Foot & Ankle Specialist
Shirley Chen, Adam Fleischer, Craig Wirt, Richmond Robinson, Carolina Barbosa, Arezou Amidi, Robert Joseph
INTRODUCTION AND OBJECTIVES: The purpose of this study was to determine whether some foot/ankle surgeries would benefit from routine use of low molecular weight heparin (LMWH) as postoperative DVT prophylaxis. METHODS: We conducted a formal cost-effectiveness analysis using a decision analytic tree to represent the risk of complications under a scenario of no prophylaxis and a scenario of routine LMWH prophylaxis for 4 weeks. The two scenarios were compared for five procedures: 1) Achilles tendon repair (ATR), 2) total ankle replacement (TAR), 3) hallux valgus surgery (HVS), 4) hindfoot arthrodesis (HA), and 5) ankle fracture surgery (AFS)...
September 2016: Journal of the American Podiatric Medical Association
Gabriella Meier Bürgisser, Maurizio Calcagni, Elias Bachmann, Gion Fessel, Jess G Snedeker, Pietro Giovanoli, Johanna Buschmann
After tendon rupture repair, two main problems may occur: re-rupture and adhesion formation. Suitable non-murine animal models are needed to study the healing tendon in terms of biomechanical properties and extent of adhesion formation. In this study 24 New Zealand White rabbits received a full transection of the Achilles tendon 2 cm above the calcaneus, sutured with a 4-strand Becker suture. Post-surgical analysis was performed at 3, 6 and 12 weeks. In the 6-week group, animals received a cast either in a 180 deg stretched position during 6 weeks (adhesion provoking immobilization), or were re-casted with a 150 deg position after 3 weeks (adhesion inhibiting immobilization), while in the other groups (3 and 12 weeks) a 180 deg position cast was applied for 3 weeks...
September 15, 2016: Biology Open
Heidi Krueger, Shannon David
Clinical Scenario: There are two approaches available for surgical repair of the Achilles tendon: open repair, or percutaneous repair. However, there is controversy whether or not an open repair or percutaneous repair is superior. Focused Clinical Question: Which type of surgery is better in providing the best overall patient outcome, open or percutaneous repair, in physically active males and females with acute Achilles tendon ruptures? Summary of Search, "Best Evidence" Appraised and Key Findings: The literature was searched for studies of level 3 evidence or higher that investigated the effectiveness of open repair versus percutaneous repair on acute Achilles tendon ruptures in physically active males and females...
August 24, 2016: Journal of Sport Rehabilitation
Hamza Ozer, Hakan Y Selek, Gulcan Harput, Ali Oznur, Gul Baltaci
The aim of the present study was to investigate the outcomes after open repair of Achilles tendon rupture augmented with a distal turndown gastrocnemius flap and deep posterior crural fasciotomy based on the modified Lindholm technique. Twenty-three patients with acute Achilles tendon injury underwent open end-to-end tendon repair augmented with a distal turndown gastrocnemius flap and deep posterior compartment fasciotomy. The concentric and eccentric muscle strength was measured using a functional squat system, and dynamic balance was assessed using the Y-balance test with anterior, posteromedial, and posterolateral reach distances...
August 23, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Paul A Byrne, Graeme P Hopper, William T Wilson, Gordon M Mackay
Rupture of the Achilles tendon is an increasingly common injury, particularly in physically active males, and current evidence favors minimally invasive surgical repair. We describe the case of a 36-year-old male elite bobsled athlete with complete rupture of the Achilles tendon. He was treated with surgical repair of the ruptured tendon using an innovative, minimally invasive procedure based on an internal bracing concept and was able to undergo early mobilization and aggressive physiotherapy rehabilitation...
August 20, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Kars P Valkering, Susanna Aufwerber, Francesco Ranuccio, Enricomaria Lunini, Gunnar Edman, Paul W Ackermann
PURPOSE: Functional weight-bearing mobilization may improve repair of Achilles tendon rupture (ATR), but the underlying mechanisms and outcome were unknown. We hypothesized that functional weight-bearing mobilization by means of increased metabolism could improve both early and long-term healing. METHODS: In this prospective randomized controlled trial, patients with acute ATR were randomized to either direct post-operative functional weight-bearing mobilization (n = 27) in an orthosis or to non-weight-bearing (n = 29) plaster cast immobilization...
August 18, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Erica Domeij-Arverud, Paul W Ackermann
Tendon metabolism after acute Achilles tendon rupture (ATR) is associated with major complications related to immobilization, which results in reduced circulation, high risk of deep venous thrombosis (DVT), impaired healing and functional deficits.DVT has been demonstrated to occur in up to 50 % of the patients with ATR. Suffering from a DVT during tendon healing has been demonstrated as an independent predictive factor for impaired patient outcome at 1 year after ATR, suggesting that specific interventions are warranted to prevent DVT...
2016: Advances in Experimental Medicine and Biology
Patrick S Buckley, David I Pedowitz
Chronic Achilles tendon ruptures occur after an unrecognized, untreated, or misdiagnosed acute Achilles tendon rupture and present a potentially debilitating injury for the patient. Various techniques have been described to reconstruct the Achilles tendon after chronic ruptures. The technique chosen depends on the length of tendon defect that is present after debridement. If the tendon gap is greater than 3 cm, additional techniques are generally used, as direct repair is often not possible. The authors present a novel intraoperative technique using pointed reduction clamps to gain and maintain length of the Achilles tendon to decrease the gap between ends of the Achilles tendon and allow for end-to-end repair when it may have otherwise not been possible...
August 9, 2016: Orthopedics
Gi Won Choi, Hak Jun Kim, Tae Hoon Lee, Se Hyun Park, Hee Seop Lee
PURPOSE: Several different Krackow stitch configurations have been used for acute Achilles tendon rupture repair. Although several biomechanical studies compared different Krackow stitch configurations, to our knowledge, no previous studies compared the clinical outcome of these different suture methods. Therefore, in this study, we aimed to compare the clinical outcomes and complications of the two-stranded single and four-stranded double Krackow techniques. METHODS: Sixty-eight consecutive patients who underwent open repair by using the four-stranded double Krackow (33 patients, group A) or the two-stranded single Krackow (35 patients, group B) techniques between September 2011 and August 2014 were reviewed retrospectively...
August 9, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
A Marchesi, Pc Parodi, M Brioschi, M Riccio, Re Perrotta, M Colombo, Gm Calori, L Vaienti
INTRODUCTION: Defects of the Achilles tendon region represent a challenge for reconstructive surgeons. Several options are available but there is still no reconstructive ladder for this specific and tricky area. An up-to-date reconstructive ladder according to local and general conditions is proposed based on our multicentre experience and an extensive review of the English literature on PubMed. MATERIALS AND METHODS: An extensive review of the English literature was performed on PubMed using the following key-words: "Achilles region", "heel", "soft-tissue reconstruction", "flaps", "grafts" and "dermal substitutes"...
August 1, 2016: Injury
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