Less invasive Achilles tendon reconstruction

Background  

The optimal management of chronic ruptures of the Achilles tendon is surgical reconstruction. Reconstruction of the Achilles tendon using peroneus brevis has been widely reported. Classically, these procedures involve relatively long surgical wounds in a relatively hypovascular area which is susceptible to wound breakdown.     

Patella tendon length after patella arthroplasty

Aim  

The study aimed to assess tendon length change following patello-femoral replacement (PFR) surgery and total knee replacement (TKR).     

Effect of training and sudden detraining on the patellar tendon and its enthesis in rats

Background  

Different conditions may alter tendon characteristics. Clinical evidence suggests that tendon injuries are more frequent in athletes that change type, intensity and duration of training. Aim of the study was the assessment of training and especially detraining on the patellar tendon (PT) and its enthesis.     

Operative treatment of achilles tendon rupture: a minimally invasive technique allowing functional after-treatment

Objectives  

Surgical repair of ruptured Achilles tendon with minimal additional tissue damage. Functional after-treatment.     

Characterization of differential properties of rabbit tendon stem cells and tenocytes

Background  

Tendons are traditionally thought to consist of tenocytes only, the resident cells of tendons; however, a recent study has demonstrated that human and mouse tendons also contain stem cells, referred to as tendon stem/progenitor cells (TSCs). However, the differential properties of TSCs and tenocytes remain largely undefined. This study aims to characterize the properties of these tendon cells derived from rabbits.     

Subcutaneous rupture of the Achilles tendon and ipsilateral fracture of the medial malleolus

Background  

Although ankle fractures and an Achilles tendon rupture are relatively frequent in isolation, their association in the same injury is uncommon.     

The effect of ethanol intake on tendon healing: a histological and biomechanical study in a rat model

Introduction  

Ethanol has a suppressive effect on inflammation and the immune system, but the effect of ethanol on tendon healing in vivo has not been studied. The purpose of this study was to investigate the histological and biomechanical effects of ethanol intake on tendon healing in a rat tendon injury model.     

Primary ACL reconstruction: comparison of Achilles tendon allograft with tibial anatomical fixation and patellar tendon allograft with external aperture fixation

Purpose  

The purpose of this study was to compare the outcome of primary anterior cruciate ligament (ACL) reconstruction between Achilles tendon allograft with tibial anatomical bifixation and bone-patellar tendon-bone (BPTB) allograft with tibial external aperture fixation.     

Treatment of flexor tendon reconstruction failures: multicentric experience with Brunelli active tendon implant

Introduction

Secondary repair of flexor tendon injuries remain a challenging procedure for hand surgeons. Usually, secondary reconstruction should be performed by staged approach. When the tendon and pulley integrity are intact, tenolysis may be the first surgical option. One-/two-stage tendon grafts are suggested when the integrity of flexor tendon is compromised. Active tendon implants (Brunelli prostheses) may represent an efficient option in patients with a poor prognosis, as well as whenever classical techniques fail. Due to lack of literature about this second-line treatment, the authors present the experience of two different orthopedic departments with the permanent active tendon implant.

Materials and method

Nineteen consecutive patients with failed previous flexor tendons repairs were treated with active tendon implants between 2000 and 2011. The functional outcome of the patients was examined with a mean follow-up of 5.6 years, using Strickland assessment and QuickDASH.

Results

In 16 cases, the tendon implants were well tolerated and patients resulted satisfied with a QuickDASH score less than 33. Strickland score was fair to excellent in 10 patients. We registered adhesion complications in 3 cases.

Conclusion

We can conclude that these prostheses represent an alternative to biological reconstructions and a potentially permanent procedure in complicated flexor tendon injuries.

Level of evidence

Multicentric case series, Level IV.

     

Gene expression markers of tendon fibroblasts in normal and diseased tissue compared to monolayer and three dimensional culture systems

Background  

There is a paucity of data regarding molecular markers that identify the phenotype of the tendon cell. This study aims to quantify gene expression markers that distinguish between tendon fibroblasts and other mesenchymal cells which may be used to investigate tenogenesis.     

Transfer of either index finger extensor tendon to the extensor pollicis longus tendon

BACKGROUND:

Extensor pollicis longus (EPL) tendon ruptures have been treated succesfully with the transfer of the extensor indicis proprius (EIP) tendon. Situations exist in which, due to intraoperative observations, another tendon transfer may be considered preferable to the standard EIP transfer method.

OBJECTIVES:

To determine whether transfer of the extensor digitorum communis II (EDC II) tendon from the index finger to the EPL tendon, leaving the EIP tendon to the index finger intact, would serve as an equally efficient transfer and not adversely affect the function of the hand.

METHODS:

Two patients who had the EDC II tendon transferred to the ruptured EPL tendon, and two patients who had the EIP tendon transferred, were retrospectively reviewed. In each transfer type, one patient had suffered an EPL tendon rupture after a Colles’ fracture, and the other had rheumatoid arthritis. The rupture occurred on the non-dominant side in one patient in each transfer type. Each patient was examined and subjected to range of motion and power testing at least one year following surgery.

RESULTS:

All four patients showed a minimal extension lag with the lift off test, but there was no noticeable difference in range of motion, pinch grip and hand grip strength between the transfer types. Both EDC II transfer patients demonstrated an 8° to 15° loss of thumb interphalangeal joint flexion compared with the unoperated side; EIP transfer patients demonstrated less than a 5° loss. Three patients demonstrated a minor extension lag in the index finger and middle finger. Extension power of the thumb and index finger in all patients varied with wrist flexion and extension and ranged from 50% to 150% of the unoperated side.

CONCLUSIONS:

These case reports suggest that either index finger tendon may be successfully transferred in EPL tendon ruptures.     

New modified Achilles tendon allograft for treatment of chronic patellar tendon ruptures following total knee arthroplasty

Introduction

Patellar tendon rupture is an infrequent but debilitating lesion. Several surgical repairs have been suggested for patellar tendon rupture. Our aim is to propose a modified technique from the classic Achilles allograft procedure.

Materials and methods

Five consecutive patients diagnosed with chronic patellar tendon rupture following total knee arthroplasty (TKA) were included in the presented study. All patients were operated with a modified Achilles allograft technique, dividing the Achilles tendon into two bundles and overcrossing these through the distal part of the quadricipital tendon.

Results

All patients regained their extension mechanism and have discontinued using crutches. No complications were observed.

Conclusions

The modified Achilles allograft has shown to be a safe, time-reducing repair for chronic patellar tendon ruptures following TKA, and should be considered as an alternative surgical repair.     

Cellular response and extracellular matrix breakdown in rotator cuff tendon rupture

Purpose  

The aim of this study was to investigate the relationship between the disruption of ECM and cellular events including autophagic cell death, apoptosis and cell differentiation into myofibroblasts in the degenerative rotator cuff tendon.     

Giant cell tumour of tendon sheath of the digits. A systematic review

Background  

We reviewed the literature to evaluate the demographic, clinical and histological profile of giant cell tumour of tendon sheath of the digits (GCTTSD). The overall recurrence rate and the factors affecting tumour recurrence were also assessed.     

Transfer of extensor hallucis longus tendon (modified robert jones procedure)

Objectives  

Transfer of the extensor hallucis longus tendon to the neck of the first metatarsal to correct a claw toe deformity of the great toe. This transfer counteracts the pathologic action of the extrinsic toe muscles and produces an active elevation of the first metatarsal.     

The effect of platelet-rich plasma gel in the early phase of patellar tendon healing

Introduction  

The aim of this study is to assess if an application of platelet-rich plasma (PRP) gel would improve the mechanical properties of rabbit’s patellar tendon after resecting its central portion.     

Flexor tendon repair using a new suture technique: a comparative in vitro biomechanical study

Introduction  

The purpose of this experimental study was to evaluate the biomechanical characteristics of two new four-strand core suture techniques for flexor tendon repair.     

Surface treatment of flexor tendon autograft and allograft decreases adhesion without an effect of graft cellularity: a pilot study

Background  

Flexor tendon grafting is often required to reconstruct a failed tendon repair. Previous reports have demonstrated flexor grafts coated with lubricants such as carbodiimide derivatized hyaluronic acid (cd-HA) decrease adhesion formation and improve digit function. However, whether this surface modification would affect graft adhesion and cellularity is unknown.     

Asymptomatic Achilles tendon pathology is associated with a central fat distribution in men and a peripheral fat distribution in women: a cross sectional study of 298 individuals

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.     

Acute Achilles tendon rupture: minimally invasive surgery versus non operative treatment,with immediate full weight bearing. Design of a randomized controlled trial

Background  

We present the design of an open randomized multi-centre study on surgical versus conservative treatment of acute Achilles tendon ruptures. The study is designed to evaluate the effectiveness of conservative treatment in reducing complications when treating acute Achilles tendon rupture.