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1.
Ahmet Dogan Onat Uzumcugil Bartu Sarisozen Bulent Ozdemir Y. Emre Akman Ergun Bozdag Emin Sunbuloglu Erol Bozkurt 《Journal of children's orthopaedics》2009,3(6):485-491
Purpose
To investigate the effect of Achilles tenotomy performed percutaneously and by mini-open methods on tendon healing and final strength. 相似文献2.
Francesco Franceschi Umile Giuseppe Longo Laura Ruzzini Giacomo Rizzello Nicola Maffulli Vincenzo Denaro 《BMC musculoskeletal disorders》2007,8(1):123
Background
With advances in arthroscopic surgery, many techniques have been developed to increase the tendon-bone contact area, reconstituting a more anatomic configuration of the rotator cuff footprint and providing a better environment for tendon healing. 相似文献3.
Yunus Dogramaci Vedat Uruc Raif Ozden İbrahim Gökhan Duman Aydiner Kalaci Muhammed Enes Altuğ Cafer Tayar İşler Esin Atik 《Archives of orthopaedic and trauma surgery》2014,134(7):1031-1035
Introduction
The side-to-side (SS) tenorrhaphy technique has been used in tendon transfer surgery. The mechanical properties of SS tendon suture have been studied previously. However, the histo-pathological healing of the SS tenorrhaphy of the tendons is unknown. The aim of this study was to assess the gross and histological effects of SS tenorrhaphy in a rabbit model.Materials and methods
Twenty New Zealand rabbits were used. The extensor hallucis longus and tibialis anterior tendon were sewed SS at the level distal to the ankle joint. The patellar tendon (PT) at the same side was used as control group. A unilateral midline incision was made and repaired with a single suture. The animals were killed at the 12th week postoperatively. The histological sections were obtained from the side of surgery from each group. Each sample was stained with hematoxylene and eosin (H&E). Gross and microscopic healing was compared between the two groups.Results
Gross examination of the control group showed complete healing with a thin peri-tendinous sheath formation around the suture site, whereas in the study group, a thick peri-tendinous sheath was formed around the area of the tendon–tendon anastomosis. In the control group, at the 12th week after surgery, the healing was almost completed in all samples. In the study group, a thick fibro vascular sheath has formed around the side of anastomosis. In all specimens few inter-digitations were observed between the tendons;however, the trough was still present.Conclusion
The result of the current study showed that histological healing and union of SS tenorrhaphy differ from that in primary tendon injury and healing. Further studies are required to clarify the healing stages at the tenorrhaphy site. 相似文献4.
Background
About 10% of patients not responding to 3–6 months of conservative management for insertional Achilles tendinopathy undergo surgery. Traditionally, surgery of the Achilles tendon is performed through longitudinal extensile incisions. Such surgery is prone to the complications of wound healing, wound breakdown and iatrogenic nerve injury. 相似文献5.
De Wilde LF De Coninck T De Neve F Berghs BM 《Clinical orthopaedics and related research》2012,470(8):2193-2201
Background
Osteotomy of the lesser tuberosity in shoulder arthroplasty allows bony healing of the subscapularis tendon but does not prevent fatty degeneration in its muscle. Occurrence or increase in fatty degeneration may depend on the surgical technique. 相似文献6.
Buchmann S Walz L Sandmann GH Hoppe H Beitzel K Wexel G Battmann A Vogt S Hinterwimmer S Imhoff AB 《Archives of orthopaedic and trauma surgery》2011,131(3):429-435
Background
The aim of the study was to develop a standardized rat model for chronic rotator cuff tears. Therefore, a time point of degenerative changes that shows comparable histological changes to the chronic tendon tears in humans had to be determined. The rat shoulder has already been described as a standardized model for investigation of the healing behavior in acute supraspinatus lesions. Little data exist about the possibility of generating a chronic rotator cuff lesion. 相似文献7.
Atilla Polat Mehmet Kerem Canbora Dilek Akakin Faruk Aykanat 《Indian Journal of Orthopaedics》2013,47(5):500-504
Introduction:
Montelukast sodium (MS) a selective leukotriene antagonist of the cysteinyl leukotriene receptor, has been used in the treatment of asthma and allergic rhinitis. In this study, we evaluated the effect of MS on the early inflammatory phase (histological) of nonsynovial tendon healing.Materials and Methods:
Rats were divided randomly into two groups (n = 6 each). MS (Singulair) was administered to one group at 10 mg/kg/day [250 g/day intraperitoneally (i.p.)]. The control group was administered 250 g/day of 0.9% saline i.p. This nonsynovial tendon was longitudinally divided at the midportion, cut transversely and then sutured. In both groups, the rats were sacrificed by decapitation 10 days later.Results:
Decreased inflammatory cell infiltration and more properly oriented collagen fibres were observed in the MS group''s histopathological specimens as compared to the control group''s (P < 0.05). Additionally, vascularity was decreased in the MS group.Conclusion:
MS decreased tendon healing, apparently by inhibiting the early inflammatory phase of nonsynovial tendon healing. 相似文献8.
James E Gaida Håkan Alfredson Zoltan S Kiss Shona L Bass Jill L Cook 《BMC musculoskeletal disorders》2010,11(1):41
Background
Adiposity is a modifiable factor that has been implicated in tendinopathy. As tendon pain reduces physical activity levels and can lead to weight gain, associations between tendon pathology and adiposity must be studied in individuals without tendon pain. Therefore, the purpose of this study was to determine whether fat distribution was associated with asymptomatic Achilles tendon pathology. 相似文献9.
Thorsten Schepull Joanna Kvist Christer Andersson Per Aspenberg 《BMC musculoskeletal disorders》2007,8(1):116
Background
There are presently few methods described for in vivo monitoring of the mechanics of healing human tendon ruptures, and no methods for prediction of clinical outcome. We tested if Roentgen stereophotogrammetric analysis (RSA) can be used to follow the restoration of mechanical properties during healing of ruptured Achilles tendons, and if early measurements can predict clinical results. 相似文献10.
John B. Turner Rubina L. Corazzini Timothy J. Butler David S. Garlick Brian D. Rinker 《Hand (New York, N.Y.)》2015,10(3):482-488
Background
Reduction of peritendinous adhesions after injury and repair has been the subject of extensive prior investigation. The application of a circumferential barrier at the repair site may limit the quantity of peritendinous adhesions while preserving the tendon’s innate ability to heal. The authors compare the effectiveness of a type I/III collagen membrane and a collagen-glycosaminoglycan (GAG) resorbable matrix in reducing tendon adhesions in an experimental chicken model of a “zone II” tendon laceration and repair.Methods
In Leghorn chickens, flexor tendons were sharply divided using a scalpel and underwent repair in a standard fashion (54 total repairs). The sites were treated with a type I/III collagen membrane, collagen-GAG resorbable matrix, or saline in a randomized fashion. After 3 weeks, qualitative and semiquantitative histological analysis was performed to evaluate the “extent of peritendinous adhesions” and “nature of tendon healing.” The data was evaluated with chi-square analysis and unpaired Student’s t test.Results
For both collagen materials, there was a statistically significant improvement in the degree of both extent of peritendinous adhesions and nature of tendon healing relative to the control group. There was no significant difference seen between the two materials. There was one tendon rupture observed in each treatment group. Surgical handling characteristics were subjectively favored for type I/III collagen membrane over the collagen-GAG resorbable matrix.Conclusion
The ideal method of reducing clinically significant tendon adhesions after injury remains elusive. Both materials in this study demonstrate promise in reducing tendon adhesions after flexor tendon repair without impeding tendon healing in this model. 相似文献11.
Ji JH Shafi M Jeong JJ Lee YS McFarland EG Kim TK Chung JY 《Archives of orthopaedic and trauma surgery》2012,132(3):335-342
Introduction
Partial articular surface of the rotator cuff tendon tears has been recognized as a source of treatable shoulder pain and a precursory pathology for full-thickness tendon tears. Arthroscopic rotator cuff repair is a possible surgical method of treatment. Recent data have shown that the treating partial-thickness rotator cuff repairs with transtendon technique shows good clinical outcome. The use of this technique enables the reconstitution of the tendon with complete reconstruction of its footprint without damaging its intact bursal part. In cases of high grade partial articular-sided degenerative rotator cuff tears (involving >50% of the tendon) in older patients, there is a possibility of poor healing or re-tear of the rotator cuff repair, which may be associated with poor tendon quality and substantial thinning of the rotator cuff, subsequently revision surgery in these patients will be demanding. 相似文献12.
13.
Brianne K. Connizzo BS Sarah M. Yannascoli MD Jennica J. Tucker BS Adam C. Caro DVM Corinne N. Riggin BS Robert L. Mauck PhD Louis J. Soslowsky PhD David R. Steinberg MD Joseph Bernstein MD 《Clinical orthopaedics and related research》2014,472(8):2433-2439
Background
Current clinical treatment after tendon repairs often includes prescribing NSAIDs to limit pain and inflammation. The negative influence of NSAIDs on bone repair is well documented, but their effects on tendon healing are less clear. While NSAIDs may be detrimental to early tendon healing, some evidence suggests that they may improve healing if administered later in the repair process.Questions/purposes
We asked whether the biomechanical and histologic effects of systemic ibuprofen administration on tendon healing are influenced by either immediate or delayed drug administration.Methods
After bilateral supraspinatus detachment and repair surgeries, rats were divided into groups and given ibuprofen orally for either Days 0 to 7 (early) or Days 8 to 14 (delayed) after surgery; a control group did not receive ibuprofen. Healing was evaluated at 1, 2, and 4 weeks postsurgery through biomechanical testing and histologic assessment.Results
Biomechanical evaluation resulted in decreased stiffness and modulus at 4 weeks postsurgery for early ibuprofen delivery (mean ± SD [95% CI]: 10.8 ± 6.4 N/mm [6.7–14.8] and 8.9 ± 5.9 MPa [5.4–12.3]) when compared to control repair (20.4 ± 8.6 N/mm [16.3–24.5] and 15.7 ± 7.5 MPa [12.3–19.2]) (p = 0.003 and 0.013); however, there were no differences between the delayed ibuprofen group (18.1 ± 7.4 N/mm [14.2–22.1] and 11.5 ± 5.6 MPa [8.2–14.9]) and the control group. Histology confirmed mechanical results with reduced fiber reorganization over time in the early ibuprofen group.Conclusions
Early administration of ibuprofen in the postoperative period was detrimental to tendon healing, while delayed administration did not affect tendon healing.Clinical Relevance
Historically, clinicians have often prescribed ibuprofen after tendon repair, but this study suggests that the timing of ibuprofen administration is critical to adequate tendon healing. This research necessitates future clinical studies investigating the use of ibuprofen for pain control after rotator cuff repair and other tendon injuries. 相似文献14.
Chunfeng Zhao MD Yasuhiro Ozasa MD PhD Ramona L. Reisdorf BS Andrew R. Thoreson MS Gregory D. Jay MD PhD Kai-Nan An PhD Peter C. Amadio MD 《Clinical orthopaedics and related research》2014,472(9):2569-2578
Background
Adhesions and poor healing are complications of flexor tendon repair.Questions/purposes
The purpose of this study was to investigate a tissue engineering approach to improve functional outcomes after flexor tendon repair in a canine model.Methods
Flexor digitorum profundus tendons were lacerated and repaired in 60 dogs that were followed for 10, 21, or 42 days. One randomly selected repair from either the second or fifth digit in one paw in each dog was treated with carbodiimide-derivatized hyaluronic acid, gelatin, and lubricin plus autologous bone marrow stromal cells stimulated with growth and differentiation factor 5; control repair tendons were not treated. Digits were analyzed by adhesion score, work of flexion, tendon-pulley friction, failure force, and histology.Results
In the control group, 35 of 52 control tendons had adhesions, whereas 19 of 49 treated tendons had adhesions. The number of repaired tendons with adhesions in the control group was greater than the number in the treated group at all three times (p = 0.005). The normalized work of flexion in treated tendons was 0.28 (± 0.08), 0.29 (± 0.19), and 0.32 (± 0.22) N/mm/° at Day 10, Day 21, and Day 42 respectively, compared with the untreated tendons of 0.46 (± 0.19) at Day 10 (effect size, 1.5; p = 0.01), 0.77 (± 0.49) at Day 21 (effect size, 1.4; p < 0.001), and 1.17 (± 0.82) N/mm/° at Day 42 (effect size, 1.6; p < 0.001). The friction data were comparable to the work of flexion data at all times. The repaired tendon failure force in the untreated group at 42 days was 70.2 N (± 8.77), which was greater than the treated tendons 44.7 N (± 8.53) (effect size, 1.9; p < 0.001). Histologically, treated repairs had a smooth surface with intrinsic healing, whereas control repairs had surface adhesions and extrinsic healing.Conclusions
Our study provides evidence that tissue engineering coupled with restoration of tendon gliding can improve the quality of tendon healing in a large animal in vivo model.Clinical Relevance
Tissue engineering may enhance intrinsic tendon healing and thus improve the functional outcomes of flexor tendon repair. 相似文献15.
Background and purpose
Several studies have shown that nicotine has a detrimental effect on the development of rotator cuff tear. However, little is known about its mechanism. We evaluated the effect of nicotine on the maximum tensile load, the maximum tensile stress, and the elastic modulus of the supraspinatus tendon in a rat model.Methods
27 rats were randomly assigned to 3 groups. Subcutaneously implanted osmotic pumps delivered two different concentrations of nicotine solution (high dose: 45 ng/mL; low dose: 22.5 ng/mL) or saline solution (controls) over a 12-week period. The level of serum cotinine, a breakdown product of nicotine, was evaluated. We performed tensile testing using the left supraspinatus tendon in each rat. The maximum load of the supraspinatus tendon was measured, and the maximum tensile stress and elastic modulus were calculated.Results
Serum cotinine levels showed controlled systemic release of nicotine. The maximum tensile load and stress were similar in the three groups. The elastic modulus was, however, higher in the nicotine groups than in the control group.Interpretation
In a rat model, ncotine caused a change in the material properties of the supraspinatus tendon. This change may predispose to a tear in the supraspinatus tendon.Cigarette smoke is composed of a large variety of substances including nitrogen, oxygen, and carbon dioxide. Among these substances, nicotine is a highly toxic alkaloid that constitutes one of the addictive components of tobacco (Syversen et al. 1999).The relationship between smoking and rotator cuff tear has been reported by several authors. Itoi et al. (1996) reported that smoking was a risk factor for rotator cuff tear. They clearly showed that the more the individual smoked, the greater was the tear size. More recently, Baumgarten et al. (2009) also confirmed that there was a dose-dependent and time-dependent relationship between smoking and rotator cuff tears. Kane et al. (2006) reported that macroscopic rotator cuff tears and microscopic rotator cuff degeneration were seen more frequently in cadavers of patients with a history of smoking than in those without such histories. Mallon et al. (2004) reported that smokers showed less improvement after rotator cuff repair surgery than non-smokers.The effects of nicotine on the mechanical properties of tendon tissue are unclear. Duygulu et al. (2006) reported that nicotine impaired the Achilles tendon healing after surgical repair in a rabbit model. Galatz et al. (2006) reported that the systemic administration of nicotine delayed the tendon-to-bone healing in a rat shoulder model. In their study, the mechanical properties of the repaired tendon in the nicotine group lagged behind those in a group treated with saline. Both studies focused on the effects of nicotine on the healing process of repaired tendons. To date, no studies have been published on the effects of nicotine on the mechanical properties of normal tendon tissue.We determined the effect of nicotine on the maximum tensile load, the maximum tensile stress, and the elastic modulus of the normal supraspinatus tendon. 相似文献16.
Background
We have recently reported that interpositional synovium grafts from tendon sheath have a potential to accelerate tendon healing when implanted at the repair site. The purpose of this study was to investigate the effect of orientation of the synovium after synovium graft transplantation, by comparing the ability of cells from the visceral and parietal surfaces to migrate into the tendon in a canine tissue culture model.Methods
The synovium graft was placed within a complete tendon laceration, with either the visceral or parietal surface facing the proximal end of the lacerated tendon. The number of migrating cells was quantified by a cell migration assay. Qualitative immunohistochemistry and confocal laser microscopy were also used at day 10.Results
Many labeled synovial cells were observed within the tendon to which the visceral surface of the synovium graft was facing. Migrated cells were also observed on the parietal side, but there were fewer cells compared to visceral surface cells. Migrating cells all expressed α-smooth muscle actin.Conclusion
We found that graft orientation affected cell migration. Whether this finding has clinical significance awaits in vivo study. 相似文献17.
George Mihai Avram MD Diana Cosmina Neculau MD Bogdan Obada MD Maria Victoria Pomenta Bastidas MD Dragos Popescu MD Markas Fiodorovas MD Ion-Andrei Popescu MD MHBA 《Orthopaedic Surgery》2023,15(8):2174-2180
Background
There is no clear consensus on the treatment of partial articular-sided supraspinatus tendon avulsions. Debridement alone might not be sufficient to prevent further tendon degradation or alleviate patient complaints. Direct repair using a suture anchor without treating the concomitant conditions of the long head of the biceps tendon might come with residual anterior shoulder pain or even further loss of function in cases of failed repair. The purpose of the present study is to describe an arthroscopic technique by which the long head of the biceps tendon can be included in the partial articular-sided supraspinatus tendon avulsion repair.Technique Presentation with video
In this technical note we describe the arthroscopic repair and augmentation with tenotomized biceps of partial supraspinatus tendon tears to address three main concepts for successful rotator cuff repairs, namely rotator cuff biologic augmentation, tendon to bone healing and postoperative pain prevention.Conclusion
The biceps tendon is a mechanically robust, locally available autograft that can be used in borderline partial articular-sided supraspinatus tendon avulsions in order to biologically augment healing at the tendon-bone interface without any immunogenic reactions or morbidity following harvesting. 相似文献18.
Nakamae A Deie M Adachi N Nakasa T Nishimori M Ochi M 《Journal of orthopaedic science》2012,17(1):39-45
Background
It is desirable to maintain the morphology of the semitendinosus muscle–tendon complex after tendon harvesting for anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to evaluate the effect of knee immobilization on morphological changes in the semitendinosus muscle–tendon complex. 相似文献19.
Chong Shen Zhi-Hong Tang Jun-Zu Hu Guo-Yao Zou Rong-Chi Xiao Dong-Xue Yan 《Archives of orthopaedic and trauma surgery》2014,134(9):1279-1285
Introduction
To determine whether immobilization after arthroscopic rotator cuff repair improved tendon healing compared with early passive motion.Materials and methods
A systematic electronic literature search was conducted to identify randomized controlled trials (RCTs) comparing early passive motion with immobilization after arthroscopic rotator cuff repair. The primary outcome assessed was tendon healing in the repaired cuff. Secondary outcome measures were range of motion (ROM) and American Shoulder and Elbow Surgeons (ASES) shoulder scale, Simple Shoulder Test (SST), Constant, and visual analog scale (VAS) for pain scores. Pooled analyses were performed using a random effects model to obtain summary estimates of treatment effect with 95 % confidence intervals. Heterogeneity among included studies was quantified.Results
Three RCTs examining 265 patients were included. Meta-analysis revealed no significant difference in tendon healing in the repaired cuff between the early-motion and immobilization groups. A significant difference in external rotation at 6 months postoperatively favored early motion over immobilization, but no significant difference was observed at 1 year postoperatively. In one study, Constant scores were slightly higher in the early-motion group than in the immobilization group. Two studies found no significant difference in ASES, SST, or VAS score between groups.Conclusion
We found no evidence that immobilization after arthroscopic rotator cuff repair was superior to early-motion rehabilitation in terms of tendon healing or clinical outcome. Patients in the early-motion group may recover ROM more rapidly.Level of evidence
Level II; systematic review of levels I and II studies. 相似文献20.
Hisateru Niki Hiroshi Nakajima Takaaki Hirano Hirokazu Okada Moroe Beppu 《Journal of orthopaedic science》2013,18(1):70-75