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Achilles Tendonitis

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3. Side-to-side differences in Achilles tendon geometry and mechanical properties following achilles tendon rupture (PubMed)

Side-to-side differences in Achilles tendon geometry and mechanical properties following achilles tendon rupture Recovery of tendon structure has been suggested to play a role in clinical success following Achilles tendon rupture. The purpose of this study was to identify side-to-side differences in tendon geometry and mechanical properties following Achilles tendon rupture and investigate the relationship of tendon structure with clinical outcomes.Participants within 1 year post complete (...) rupture were included. Tendon geometry and mechanical properties were quantified using B-mode ultrasound imaging and continuous shear wave elastography (cSWE). Clinical outcomes included the heel-rise test. Participant self-reported function was measured using the Achilles tendon Total Rupture Score, Foot and Ankle Outcome Score - quality of life subscale, and the Physical Activity Scale.Twenty participants [mean (SD) age: 42.7(13.6) years, 13 managed surgically] were included. Tendon thickness

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2018 Muscles, ligaments and tendons journal

4. Soft tissue microcirculation around the healthy Achilles tendon: a cross-sectional study focusing on the Achilles tendon and dorsal surgical approaches to the hindfoot (PubMed)

Soft tissue microcirculation around the healthy Achilles tendon: a cross-sectional study focusing on the Achilles tendon and dorsal surgical approaches to the hindfoot Dorsal approaches to the hindfoot are frequently used. Furthermore, the vascular supply is discussed as a possible cause for ruptures and degeneration of the Achilles tendon. The aim of this study was to evaluate the microperfusion of three possible posterior approaches to the hindfoot and different areas of the Achilles (...) tendon.In 111 subjects, a laser Doppler/white light spectroscopy was used to measure microperfusion in terms of blood flow (Flow) and capillary venous oxygen saturation (SO2) in the hindfoot and Achilles tendon. Measurements were performed at two measurement points (MP, proximal and distal) of three dorsal approaches (medial, lateral and central) and inside the Achilles tendon.Microperfusion differed partially between the surgical approaches. The medial and the lateral approaches were significantly

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2018 Journal of orthopaedic surgery and research

5. Tendon end separation with loading in an Achilles tendon repair model: comparison of non-absorbable vs. absorbable sutures (PubMed)

Tendon end separation with loading in an Achilles tendon repair model: comparison of non-absorbable vs. absorbable sutures Rupture of the Achilles tendon often leads to long-term morbidity, particularly calf weakness associated with tendon elongation. Operative repair of Achilles tendon ruptures leads to reduced tendon elongation. Tendon lengthening is a key problem in the restoration of function following Achilles tendon rupture. A study was performed to determine differences in initial (...) separation, strength and failure characteristics of differing sutures and numbers of core strands in a percutaneous Achilles tendon repair model in response to initial loading.Nineteen bovine Achilles tendons were repaired using a percutaneous/minimally invasive technique with a combination of a modified Bunnell suture proximally and a Kessler suture distally, using non-absorbable 4-strand 6-strand repairs and absorbable 8-strand sutures. Specimens were then cyclically loaded using phases of 10 cycles

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2017 Journal of experimental orthopaedics

6. Book-shaped decellularized tendon matrix scaffold combined with bone marrow mesenchymal stem cells-sheets for repair of Achilles tendon defect in Rabbit. (PubMed)

Book-shaped decellularized tendon matrix scaffold combined with bone marrow mesenchymal stem cells-sheets for repair of Achilles tendon defect in Rabbit. Tissue-engineering approaches have great potential to improve the treatment of tendon injuries which are major musculoskeletal disorders. The purpose of this study was to assess the tissue engineering potential of a novel multilayered decellularized tendon "book" scaffold with bone marrow mesenchymal stem cells (BMSCs) sheets for repair (...) of an Achilles tendon defect in a rabbit model. In this study, we developed a novel book-shaped decellularized scaffold derived from the extracellular matrix of tendon tissues from New Zealand white rabbits. Hematoxylin and eosin (H&E) staining, 4', 6-diamidino-2-phenylindole (DAPI) staining, DNA quantitation, and scanning electron microscopy (SEM) confirmed the efficiency of decellularization. After culturing BMSCs on decellularized scaffolds, 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide

2019 Journal of Orthopaedic Research

7. Age is a risk factor for contralateral tendon rupture in patients with acute Achilles tendon rupture. (PubMed)

Age is a risk factor for contralateral tendon rupture in patients with acute Achilles tendon rupture. Rupture of the contralateral Achilles tendon following Achilles tendon rupture can lead to devastating outcomes. However, despite the clinical importance, the risk factors and incidence of contralateral Achilles tendon rupture have not been well studied. This study aimed to determine the incidence of contralateral tendon rupture after Achilles tendon rupture and to identify associated patient (...) characteristics.Medical records for 226 consecutive patients with Achilles tendon rupture were retrospectively reviewed. The occurrence of contralateral Achilles tendon rupture and patient characteristics were determined through review of medical records and telephone surveys.The cumulative incidences of contralateral Achilles tendon rupture at 1, 3, 5, and 7 years after Achilles tendon rupture were 0.4%, 1.8%, 3.4%, and 5.1%, respectively. The only statistically significant risk factor was age between 30 and 39

2019 Knee Surgery, Sports Traumatology, Arthroscopy

8. It is possible to release the plantaris tendon under ultrasound guidance: a technical description of ultrasound guided plantaris tendon release (UPTR) in the treatment of non-insertional Achilles tendinopathy. (PubMed)

It is possible to release the plantaris tendon under ultrasound guidance: a technical description of ultrasound guided plantaris tendon release (UPTR) in the treatment of non-insertional Achilles tendinopathy. Open plantaris tendon excision and ventral paratendinous stripping is a recognised treatment option in selected patients with non-insertional Achilles tendinopathy. The aim of this study was to develop a minimally invasive outpatient technique of ultrasound guided plantaris tendon release (...) , USA) were all able to cut the plantaris tendon. However, on dissection the hook knife (Smith and Nephew, Boston MA) caused less damage to surrounding structures. Subsequently, the plantaris tendon was successfully divided in three patients using UPTR technique without complication.UPTR is a viable technique for treating plantaris related non-insertional Achilles tendinopathy.

2019 Knee Surgery, Sports Traumatology, Arthroscopy

9. MRI Assessment of Degeneration of the Tendon in Achilles Tendon Ruptures. (PubMed)

MRI Assessment of Degeneration of the Tendon in Achilles Tendon Ruptures. The extent of tendinosis along the entire tendon in Achilles tendon ruptures (ATRs) has not previously been assessed. MR images of acute ATRs were evaluated to assess this extent, even in areas distant from the rupture.Patients who had MR images for an ATR were reviewed. Each tendon was divided into a proximal, middle, and distal segment with the full tendon length defined as the length measured from the myotendinous (...) junction to the insertion. The site of tendon rupture, presence of tendinosis and/or additional tearing, and largest anteroposterior (AP) diameter in the remaining segments were noted. In total, 45 MR iamges were included in our study.The mean total tendon length was 9.93 cm, while the length from the insertion to the tear was 5.86 cm. Of the 45 ruptures, 20 (44.4%) were in the proximal third, 19 (42.2%) in the middle third, and 6 (13.3%) in the distal third. In all remaining segments where no ruptured

2019 Foot & Ankle International

10. Minimally Invasive Versus Open Repair for Acute Achilles Tendon Rupture: Meta-Analysis Showing Reduced Complications, with Similar Outcomes, After Minimally Invasive Surgery

Minimally Invasive Versus Open Repair for Acute Achilles Tendon Rupture: Meta-Analysis Showing Reduced Complications, with Similar Outcomes, After Minimally Invasive Surgery There is no consensus on the optimal technique for repairing an acute Achilles tendon rupture. The purpose of this meta-analysis was to compare the complications, subjective outcomes, and functional results between minimally invasive surgery and open repair of an Achilles tendon rupture.A systematic literature search (...) of MEDLINE/PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EBSCOhost, and ClinicalTrials.gov was performed. Eligible studies were randomized controlled trials (RCTs) comparing minimally invasive surgery and open repair of acute Achilles tendon ruptures. A meta-analysis was performed, while bias and the quality of the evidence were rated according to the Cochrane Database questionnaire and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. The meta

2019 EvidenceUpdates

11. Operative treatment versus nonoperative treatment of Achilles tendon ruptures: systematic review and meta-analysis. (PubMed)

Operative treatment versus nonoperative treatment of Achilles tendon ruptures: systematic review and meta-analysis. To compare re-rupture rate, complication rate, and functional outcome after operative versus nonoperative treatment of Achilles tendon ruptures; to compare re-rupture rate after early and late full weight bearing; to evaluate re-rupture rate after functional rehabilitation with early range of motion; and to compare effect estimates from randomised controlled trials (...) and observational studies.Systematic review and meta-analysis.PubMed/Medline, Embase, CENTRAL, and CINAHL databases were last searched on 25 April 2018 for studies comparing operative versus nonoperative treatment of Achilles tendon ruptures.Randomised controlled trials and observational studies reporting on comparison of operative versus nonoperative treatment of acute Achilles tendon ruptures.Data extraction was performed independently in pairs, by four reviewers, with the use of a predefined data extraction

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2019 BMJ

12. Transverse tendon stiffness is reduced in people with Achilles tendinopathy: A cross-sectional study. (PubMed)

Transverse tendon stiffness is reduced in people with Achilles tendinopathy: A cross-sectional study. The objective of the current cross-sectional study was to examine Achilles tendon transverse stiffness in a group of recreational runners with Achilles tendinopathy, in comparison to an asymptomatic group of runners with similar training history. We also aimed to determine the between-week intra-individual reliability of this measurement technique.Cross-sectional cohort study.A hand-held (...) dynamometer was used to assess the transverse stiffness of the Achilles tendon (AT) in twenty-five recreational runners. In ten people with midportion Achilles tendinopathy (5 men, 5 women), measurements were taken directly over the most symptomatic location. In 15 people who were free of AT symptoms (7 men, 8 women), measurements were taken at an equivalent location on the tendon. Participants returned after one week to determine measurement reliability (intra-class correlation coefficient/ICC

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2019 PLoS ONE

13. Achilles tendinosis does not always precede Achilles tendon rupture. (PubMed)

Achilles tendinosis does not always precede Achilles tendon rupture. Degenerative change is a typical histologic finding of Achilles tendinosis and is thought to be a factor associated with Achilles tendon rupture; however, this relationship remains controversial. Therefore, the aim of this study was to review the histological findings of ruptured Achilles tendons and analyze demographics and injury patterns.Retrospective analysis was performed for all patients who underwent Achilles tendon (...) repair for acute Achilles tendon rupture at our institution between 2008 and 2015. The presence of Achilles tendinosis was determined by light microscopic histology of ruptured Achilles tendons. Patients were grouped according to the presence of Achilles tendinosis and patient demographics, sports activities, and clinical outcomes were compared. Ankle activity score was used to evaluate the level of sports activity and Achilles tendon total rupture score (ATRS) was used to evaluate clinical

2018 Knee Surgery, Sports Traumatology, Arthroscopy

14. The Ruptured Achilles Tendon Elongates for 6 Months After Surgical Repair Regardless of Early or Late Weightbearing in Combination With Ankle Mobilization: A Randomized Clinical Trial

The Ruptured Achilles Tendon Elongates for 6 Months After Surgical Repair Regardless of Early or Late Weightbearing in Combination With Ankle Mobilization: A Randomized Clinical Trial Treatment strategies for Achilles tendon rupture vary considerably, and clinical outcome may depend on the magnitude of tendon elongation after surgical repair. The aim of this project was to examine whether tendon elongation, mechanical properties, and functional outcomes during rehabilitation of surgically (...) repaired acute Achilles tendon ruptures were influenced by different rehabilitation regimens during the early postsurgical period.Restricted early weightbearing that permits only limited motion about the ankle in the early phase of tendon healing limits tendon elongation and improves functional outcome.Randomized controlled trial; Level of evidence, 1.75 consecutive patients with an acute Achilles tendon rupture were included. They underwent surgical repair, and tantalum beads were placed in the distal

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2018 EvidenceUpdates

15. Achilles and tail tendons of perlecan exon 3 null heparan sulphate deficient mice display surprising improvement in tendon tensile properties and altered collagen fibril organisation compared to C57BL/6 wild type mice (PubMed)

Achilles and tail tendons of perlecan exon 3 null heparan sulphate deficient mice display surprising improvement in tendon tensile properties and altered collagen fibril organisation compared to C57BL/6 wild type mice The aim of this study was to determine the role of the perlecan (Hspg2) heparan sulphate (HS) side chains on cell and matrix homeostasis in tail and Achilles tendons in 3 and 12 week old Hspg2 exon 3 null HS deficient (Hspg2Δ3 - ∕Δ3 -) and C57 BL/6 Wild Type (WT) mice. Perlecan (...) in normal tendon function and in tendon repair processes. Tail and Achilles tendons from each genotype were biomechanically tested (ultimate tensile stress (UTS), tensile modulus (TM)) and glycosaminoglycan (GAG) and collagen (hydroxyproline) compositional analyses were undertaken. Tenocytes were isolated from tail tendons from each mouse genotype and grown in monolayer culture. These cultures were undertaken in the presence of FGF-2 to assess the cell signaling properties of each genotype. Total RNA

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2018 PeerJ

16. Effect of Training-Induced Changes in Achilles Tendon Stiffness on Muscle–Tendon Behavior During Landing (PubMed)

Effect of Training-Induced Changes in Achilles Tendon Stiffness on Muscle–Tendon Behavior During Landing During rapid deceleration of the body, tendons buffer part of the elongation of the muscle-tendon unit (MTU), enabling safe energy dissipation via eccentric muscle contraction. Yet, the influence of changes in tendon stiffness within the physiological range upon these lengthening contractions is unknown. This study aimed to examine the effect of training-induced stiffening of the Achilles (...) tendon on triceps surae muscle-tendon behavior during a landing task. Twenty-one male subjects were assigned to either a 10-week resistance-training program consisting of single-leg isometric plantarflexion (n = 11) or to a non-training control group (n = 10). Before and after the training period, plantarflexion force, peak Achilles tendon strain and stiffness were measured during isometric contractions, using a combination of dynamometry, ultrasound and kinematics data. Additionally, testing

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2018 Frontiers in physiology

17. Measurement properties of the Victorian Institute of Sport Assessment: greater trochanteric pain syndrome (VISA-G), proximal hamstring tendons (VISA-H), patellar tendinopathy (VISA-P), and Achilles tendinopathy (VISA-A) questionnaires. A systematic review

Measurement properties of the Victorian Institute of Sport Assessment: greater trochanteric pain syndrome (VISA-G), proximal hamstring tendons (VISA-H), patellar tendinopathy (VISA-P), and Achilles tendinopathy (VISA-A) questionnaires. A systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied

2019 PROSPERO

18. MRI Evaluation of Achilles Tendon Rotation and Sural Nerve Anatomy: Implications for Percutaneous and Limited-Open Achilles Tendon Repair. (PubMed)

MRI Evaluation of Achilles Tendon Rotation and Sural Nerve Anatomy: Implications for Percutaneous and Limited-Open Achilles Tendon Repair. Limited-open and percutaneous Achilles tendon (AT) repair techniques have limited visibility, which may result in sural nerve violation and poor tendon targeting. The goal of this study was to assess the in vivo rotation of the AT and its distance to the sural nerve in ruptured and nonruptured ATs to develop guidelines to aid in limited-open and percutaneous (...) 5.9 ± 9.0 degrees, P = .008) but not at 10 cm proximal to the tendon's insertion (10.9 ± 10.9 degrees vs 6.1 ± 8.4 degrees, P = .139). Proximal AT rotation was negatively correlated with rupture height (r = -0.477, P = .029). At 4 cm proximal to the AT insertion, the sural nerve was closer anteriorly to and farther laterally from the AT in ruptures than in nonruptures (P < .001). At 10 cm proximal to the AT insertion, the sural nerve was farther posteriorly and laterally from the AT in ruptures

2016 Foot & Ankle International

19. Cast versus functional brace in the rehabilitation of patients treated non-operatively for a rupture of the Achilles tendon: protocol for the UK study of tendo achilles rehabilitation (UK STAR) multi-centre randomised trial. (PubMed)

Cast versus functional brace in the rehabilitation of patients treated non-operatively for a rupture of the Achilles tendon: protocol for the UK study of tendo achilles rehabilitation (UK STAR) multi-centre randomised trial. Achilles tendon rupture affects over 11 000 people yearly in the UK, and the incidence is increasing. Controversy remains with regard to the best rehabilitation strategy for these patients. In operatively treated patients, functional bracing provides better outcomes (...) compared with plaster casts. However, the role of functional bracing in non-operatively managed patients is unclear. This is the protocol for a multicentre randomised trial of plaster cast immobilisation versus functional bracing for patients with a non-operatively managed Achilles tendon rupture.All adults presenting with a primary rupture of the Achilles tendon will be screened. Non-operatively treated patients will be eligible to take part in the trial. Broad eligibility criteria will ensure

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2017 BMJ open

20. Platelet rich Plasma in Achilles Tendon Healing 2 (PATH-2) trial: protocol for a multicentre, participant and assessor-blinded, parallel-group randomised clinical trial comparing platelet-rich plasma (PRP) injection versus placebo injection for Achilles t (PubMed)

Platelet rich Plasma in Achilles Tendon Healing 2 (PATH-2) trial: protocol for a multicentre, participant and assessor-blinded, parallel-group randomised clinical trial comparing platelet-rich plasma (PRP) injection versus placebo injection for Achilles t Achilles tendon injuries give rise to substantial long-lasting morbidity and pose considerable challenges for clinicians and patients during the lengthy healing period. Current treatment strategies struggle to curb the burden of this injury (...) on health systems and society due to lengthy rehabilitation, work absence and reinjury risk. Platelet-rich plasma (PRP) is an autologous preparation that has been shown to improve the mechanobiological properties of tendons in laboratory and animal studies. The use of PRP in musculoskeletal injuries is on the increase despite the lack of adequately powered clinical studies.This is a multicentre randomised controlled trial to evaluate the efficacy and mechanism of PRP in patients with acute Achilles

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2017 BMJ open

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