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Hakan Alfredson

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https://www.readbyqxmd.com/read/27789336/differential-plantaris-achilles-tendon-motion-a-sonographic-and-cadaveric-investigation
#1
Jay Smith, Håkan Alfredson, Lorenzo Masci, Jacob L Sellon, Charonn D Woods
OBJECTIVE: To determine whether differential, multidirectional motion exists between the plantaris tendon (PT) and Achilles tendon (AT) as documented by dynamic ultrasound (US) and post-dissection examination in an unembalmed cadaveric model. DESIGN: Prospective, cadaveric laboratory investigation. SETTING: Procedural skills laboratory in a tertiary medical center. SUBJECTS: 20 unembalmed knee-ankle-foot specimens (9 right, 11 left) obtained from 6 male and 10 female donors ages 55-96 years (mean 80 years) with BMI's of 14...
October 24, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27320798/nerve-distributions-in-insertional-achilles-tendinopathy-a-comparison-of-bone-bursae-and-tendon
#2
Gustav Andersson, Ludvig J Backman, Jens Christensen, Håkan Alfredson
BACKGROUND/AIM: In a condition of pain in the Achilles tendon insertion there are multiple structures involved, such as the Achilles tendon itself, the retrocalcaneal bursa and a bony protrusion at the calcaneal tuberosity called Haglund's deformity. The innervation patterns of these structures are scarcely described, and the subcutaneous calcaneal bursa is traditionally not considered to be involved in the pathology. This study aimed at describing the innervation patterns of the four structures described above to provide a better understanding of possible origins of pain at the Achilles tendon insertion...
June 20, 2016: Histology and Histopathology
https://www.readbyqxmd.com/read/27274323/low-recurrence-rate-after-mini-surgery-outside-the-tendon-combined-with-short-rehabilitation-in-patients-with-midportion-achilles-tendinopathy
#3
Håkan Alfredson
BACKGROUND: There is a general opinion that a structured and specific rehabilitation is needed after treatment of midportion Achilles tendinopathy to minimize recurrence of the condition. There is sparse knowledge about the recurrence rates in large patient materials after specific treatments for midportion Achilles tendinopathy. AIM: This study aimed to investigate the recurrence rates in a large number of patients with chronic painful midportion Achilles tendinopathy that had been surgically treated with the ultrasound (US) and Doppler (DP)-guided mini-surgical scraping technique...
2016: Open Access Journal of Sports Medicine
https://www.readbyqxmd.com/read/26925234/a-pilot-study-on-biomarkers-for-tendinopathy-lower-levels-of-serum-tnf-%C3%AE-and-other-cytokines-in-females-but-not-males-with-achilles-tendinopathy
#4
James E Gaida, Håkan Alfredson, Sture Forsgren, Jill L Cook
BACKGROUND: Achilles tendinopathy is a painful musculoskeletal condition that is common among athletes, and which limits training capacity and competitive performance. The lack of biomarkers for tendinopathy limits research into risk factors and also the evaluation of new treatments. Cytokines and growth factors involved in regulating the response of tendon cells to mechanical load have potential as biomarkers for tendinopathy. METHODS: This case-control study compared serum concentration of cytokines and growth factors (TNF-α, IL-1β, bFGF, PDFG-BB, IFN-γ, VEGF) between individuals with chronic Achilles tendinopathy and controls...
2016: BMC Sports Science, Medicine and Rehabilitation
https://www.readbyqxmd.com/read/26912241/how-to-diagnose-plantaris-tendon-involvement-in-midportion-achilles-tendinopathy-clinical-and-imaging-findings
#5
Lorenzo Masci, Christoph Spang, Hans T M van Schie, Håkan Alfredson
BACKGROUND: The purpose of this investigation was to evaluate if clinical assessment, Ultrasound + Colour Doppler (US + CD) and Ultrasound Tissue Characterisation (UTC) can be useful in detecting plantaris tendon involvement in patients with midportion Achilles tendinopathy. METHODS: Twenty-three tendons in 18 patients (14 men, mean age: 37 years and 4 women: 44 years) (5 patients with bilateral tendons) with midportion Achilles tendinopathy were surgically treated with a scraping procedure and plantaris tendon removal...
February 24, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/26537813/clinical-commentary-of-the-evolution-of-the-treatment-for-chronic-painful-mid-portion-achilles-tendinopathy
#6
Håkan Alfredson
The chronic painful Achilles tendon mid-portion was for many years, and still is in many countries, treated with intratendinous revision surgery. However, by coincidence, painful eccentric calf muscle training was tried, and it showed very good clinical results. This finding was unexpected and led to research into the pain mechanisms involved in this condition. Today we know that there are very few nerves inside, but multiple nerves outside, the ventral side of the chronic painful Achilles tendon mid-portion...
September 2015: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/26445419/clinical-commentary-of-the-evolution-of-the-treatment-for-chronic-painful-mid-portion-achilles-tendinopathy
#7
Håkan Alfredson
The chronic painful Achilles tendon mid-portion was for many years, and still is in many countries, treated with intratendinous revision surgery. However, by coincidence, painful eccentric calf muscle training was tried, and it showed very good clinical results. This finding was unexpected and led to research into the pain mechanisms involved in this condition. Today we know that there are very few nerves inside, but multiple nerves outside, the ventral side of the chronic painful Achilles tendon mid-portion...
October 6, 2015: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/25880199/protease-activated-receptors-in-the-achilles-tendon-a-potential-explanation-for-the-excessive-pain-signalling-in-tendinopathy
#8
Jens Christensen, Håkan Alfredson, Gustav Andersson
BACKGROUND/AIM: Tendinopathies are pathological conditions of tissue remodelling occurring in the major tendons of the body, accompanied by excessive nociceptive signalling. Tendinopathies have been shown to exhibit an increase in the number of mast cells, which are capable of releasing histamine, tryptase and other substances upon activation, which may play a role in the development of tendinopathies. This study set out to describe the distribution patterns of a family of receptors called protease-activated receptors (PARs) within the Achilles tendon...
2015: Molecular Pain
https://www.readbyqxmd.com/read/25875933/serum-levels-of-oxylipins-in-achilles-tendinopathy-an-exploratory-study
#9
Sandra Gouveia-Figueira, Malin L Nording, Jamie E Gaida, Sture Forsgren, Håkan Alfredson, Christopher J Fowler
BACKGROUND: Linoleic acid-derived oxidation products are found in experimental pain models. However, little is known about the levels of such oxylipins in human pain. In consequence, in the present study, we have undertaken a lipidomic profiling of oxylipins in blood serum from patients with Achilles tendinopathy and controls. METHODOLOGY/PRINCIPAL FINDINGS: A total of 34 oxylipins were analysed in the serum samples. At a significance level of P<0.00147 (<0...
2015: PloS One
https://www.readbyqxmd.com/read/24797812/sclerosing-injections-and-ultrasound-guided-arthroscopic-shaving-for-patellar-tendinopathy-good-clinical-results-and-decreased-tendon-thickness-after-surgery-a-medium-term-follow-up-study
#10
Kerstin Sunding, Lotta Willberg, Suzanne Werner, Håkan Alfredson, Magnus Forssblad, Martin Fahlström
PURPOSE: Treatment of patellar tendinopathy/jumper's knee with ultrasound-guided sclerosing injections or ultrasound-guided arthroscopic shaving has shown good clinical short-term results. Former studies indicate that the tendon thickness and structure stays unaffected after successful treatment. The aim of this study was to evaluate the sonographic findings and clinical outcome 3-5 years after treatment of patellar tendinopathy with ultrasound-guided sclerosing injections or arthroscopic shaving...
August 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/23584762/sports-and-exercise-related-tendinopathies-a-review-of-selected-topical-issues-by-participants-of-the-second-international-scientific-tendinopathy-symposium-ists-vancouver-2012
#11
Alex Scott, Sean Docking, Bill Vicenzino, Håkan Alfredson, Richard J Murphy, Andrew J Carr, Johannes Zwerver, Kirsten Lundgreen, Oliver Finlay, Noel Pollock, Jill L Cook, Angela Fearon, Craig R Purdam, Alison Hoens, Jonathan D Rees, Thomas J Goetz, Patrik Danielson
In September 2010, the first International Scientific Tendinopathy Symposium (ISTS) was held in Umeå, Sweden, to establish a forum for original scientific and clinical insights in this growing field of clinical research and practice. The second ISTS was organised by the same group and held in Vancouver, Canada, in September 2012. This symposium was preceded by a round-table meeting in which the participants engaged in focused discussions, resulting in the following overview of tendinopathy clinical and research issues...
June 2013: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/23378267/the-plantaris-tendon-in-association-with-mid-portion-achilles-tendinosis-tendinosis-like-morphological-features-and-presence-of-a-non-neuronal-cholinergic-system
#12
Christoph Spang, Håkan Alfredson, Mark Ferguson, Beverley Roos, Johan Bagge, Sture Forsgren
The plantaris tendon is often neglected in morphological/clinical studies on the lower extremity. There is, however, clinical evidence that the plantaris tendon is involved in cases with Achilles midportion tendinopathy/tendinosis. It is nevertheless unclear if the plantaris tendon exhibits tendinosis-like features in this situation. We therefore investigated the plantaris tendon of patients with midportion Achilles tendinosis when the plantaris tendon was found to be located very close to or invaginated into the Achilles tendon, a situation which very often has been found to be the case...
May 2013: Histology and Histopathology
https://www.readbyqxmd.com/read/23193327/unilateral-surgical-treatment-for-patients-with-midportion-achilles-tendinopathy-may-result-in-bilateral-recovery
#13
Håkan Alfredson, Christoph Spang, Sture Forsgren
BACKGROUND: Bilateral midportion Achilles tendinopathy/tendinosis is not unusual, and treatment of both sides is often carried out. Experiments in animals suggest of the potential involvement of central neuronal mechanisms in Achilles tendinosis. OBJECTIVES: To evaluate the outcome of surgery for Achilles tendinopathy. METHODS: This observational study included 13 patients (7 men and 6 women, mean age 53 years) with a long duration (6-120 months) of chronic painful bilateral midportion Achilles tendinopathy...
October 2014: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/22676721/high-impact-loading-on-the-skeleton-is-associated-with-a-decrease-in-glucose-levels-in-young-men
#14
Peder Wiklund, Anna Nordström, Magnus Högström, Håkan Alfredson, Patrik Engström, Thomas Gustafsson, Paul W Franks, Peter Nordström
OBJECTIVE: The skeleton has been suggested to be involved in energy metabolism through osteocalcin (OC), an osteoblast-specific molecule. The objective of this study was to investigate whether high-impact (HI) exercise stimulating bone formation would lead to changes in glucose and lipid metabolism independent of cardiorespiratory effects and whether OC mediates this association. DESIGN: Prospective intervention study. METHODS: Fifty men aged 20-32 years were allocated to an intervention group or a control group...
December 2012: Clinical Endocrinology
https://www.readbyqxmd.com/read/22572155/evidence-of-the-tnf-%C3%AE-system-in-the-human-achilles-tendon-expression-of-tnf-%C3%AE-and-tnf-receptor-at-both-protein-and-mrna-levels-in-the-tenocytes
#15
James Edmund Gaida, Johan Bagge, Craig Purdam, Jill Cook, Håkan Alfredson, Sture Forsgren
UNLABELLED: Understanding adaption to load is essential for prevention and treatment of tendinopathy/tendinosis. Cytokine release in response to load is one mechanism involved in mechanotransduction. The cytokine tumor necrosis factor alpha (TNF-α) is implicated in tendinosis and can induce apoptotic effects via tumor necrosis factor receptor 1 (TNFR1). The complete absence of information concerning the TNF-α system in Achilles tendon is a limitation as mid-portion Achilles tendinosis is very frequent...
2012: Cells, Tissues, Organs
https://www.readbyqxmd.com/read/21931835/increased-expression-of-cannabinoid-cb%C3%A2-receptors-in-achilles-tendinosis
#16
Emmelie Björklund, Sture Forsgren, Håkan Alfredson, Christopher J Fowler
BACKGROUND: The endogenous cannabinoid system is involved in the control of pain. However, little is known as to the integrity of the cannabinoid system in human pain syndromes. Here we investigate the expression of the cannabinoid receptor 1 (CB₁) in human Achilles tendons from healthy volunteers and from patients with Achilles tendinosis. METHODOLOGY: Cannabinoid CB₁ receptor immunoreactivity (CB₁IR) was evaluated in formalin-fixed biopsies from individuals suffering from painful Achilles tendinosis in comparison with healthy human Achilles tendons...
2011: PloS One
https://www.readbyqxmd.com/read/21808665/novel-information-on-the-non-neuronal-cholinergic-system-in-orthopedics-provides-new-possible-treatment-strategies-for-inflammatory-and-degenerative-diseases
#17
Sture Forsgren, Håkan Alfredson, Dennis Bjur, Solbritt Rantapää-Dahlqvist, Orjan Norrgård, Tore Dalén, Patrik Danielson
Anti-cholinergic agents are used in the treatment of several pathological conditions. Therapy regimens aimed at up-regulating cholinergic functions, such as treatment with acetylcholinesterase inhibitors, are also currently prescribed. It is now known that not only is there a neuronal cholinergic system but also a non-neuronal cholinergic system in various parts of the body. Therefore, interference with the effects of acetylcholine (ACh) brought about by the local production and release of ACh should also be considered...
June 30, 2009: Orthopedic Reviews
https://www.readbyqxmd.com/read/21628352/midportion-achilles-tendinosis-and-the-plantaris-tendon
#18
Håkan Alfredson
OBJECTIVES: When re-operating patients with midportion Achilles tendinosis, having had a poor effect of ultrasound (US) and Doppler-guided scraping, the author found the involvement of the plantaris tendon to be a likely reason for the poor result. The aim of this study was to investigate the occurrence of a plantaris tendon in close relation to the Achilles tendon in consecutive patients with midportion Achilles tendinosis undergoing treatment with US and Doppler-guided scraping. MATERIAL AND METHODS: This study includes 73 consecutive tendons with chronic painful midportion Achilles tendinosis, where US+Doppler examination showed thickening, irregular tendon structure, hypo-echoic regions, and localised high blood flow outside and inside the ventral Achilles midportion...
October 2011: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/21393261/sclerosing-polidocanol-injections-or-arthroscopic-shaving-to-treat-patellar-tendinopathy-jumper-s-knee-a-randomised-controlled-study
#19
RANDOMIZED CONTROLLED TRIAL
Lotta Willberg, Kerstin Sunding, Magnus Forssblad, Martin Fahlström, Håkan Alfredson
BACKGROUND: Proximal patellar tendinopathy/jumper's knee (PT/JK) is well known to be difficult to treat. Recent studies using an ultrasound and colour Doppler-based treatment approach on the dorsal side of the tendon, sclerosing polidocanol injections and ultrasound-guided arthroscopic shaving, have shown promising clinical results. OBJECTIVES: To compare the clinical effects after treatment with sclerosing polidocanol injections and arthroscopic shaving. MATERIAL AND METHODS: 52 patellar tendons (43 men and two women) with ultrasound and colour Doppler-verified diagnosis of PT/JK were randomly assigned to treatment with ultrasound and colour Doppler-guided sclerosing polidocanol injections (group A) or ultrasound and colour Doppler-guided arthroscopic shaving (group B)...
April 2011: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/21367809/where-to-now-with-achilles-tendon-treatment
#20
EDITORIAL
Håkan Alfredson
No abstract text is available yet for this article.
April 2011: British Journal of Sports Medicine
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