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At least 307 records · Page 17Linked to original sources
PubMed2003

Comparison between the cross-sectional area of bone-patellar tendon-bone grafts and multistranded hamstring tendon grafts obtained from the same patients.

This study intraoperatively compared the cross-sectional area (CSA) and graft-tunnel fit of bone-patellar tendon-bone (BTB) and multistranded hamstring tendon (STG) grafts harvested from the same patient. Twenty-two patients with a mean age of 26 years were the subjects of the study. Each BTB graft was harvested from the central third of the patellar tendon. Tripled or quadrupled semitendinosus tendon with or without gracilis tendon was used as a STG graft. CSAs of both grafts in the same patients were intraoperatively measured using a custom-made area micrometer during primary ACL reconstruction and revision surgery or during combined ACL and PCL reconstruction. Graft-tunnel fit was calculated by dividing the CSA of the graft by that of the tibial bone tunnel. The average CSA of STG grafts was significantly greater than that of BTB grafts. The average value of graft-tunnel fit for the STG grafts% was also greater than that of the BTB grafts%. Thus STG grafts have a larger CSA and closer graft-tunnel fit than BTB grafts in a clinical setting.

Adolescent↗
PubMed2006

Reconstruction of quadriceps tendon with Achilles tendon allograft in older children with congenital dislocation of the knee.

This is a case report of two children with congenital dislocation of the knee. They have been treated surgically with Z-lengthening of the quadriceps tendon and additional reconstruction of the quadriceps tendon with Achilles tendon allograft to fill in the remaining average 6 cm gap of the tendon. The patients were two girls, 6 and 9 years old. One of them had an operative treatment previously with a tendon lengthening procedure and it was failed and the other patient was untreated before. Preoperatively, untreated case was unable to walk. The other patient was limping. None of them was able to flex their knees beyond the neutral extension position. Postoperatively, both patients were able to walk and the knees were reduced to a range of motion of 0 degrees -95 degrees of flexion. The mean follow-up time was 20 months.

Achilles Tendon↗
PubMed1996

Atraumatic tendon handling during tendon repair.

Two techniques are presented for atraumatic handling of tendon ends during repair of flexor and extensor tendons. If the tendon is cleanly transected, the suture is carried out by holding the tendon in nerve holding forceps. If debridement is needed, a slice is partly cut and used to handle the tendon; the slice is then cut off and discarded.

Humans↗
PubMed2005

The innervation pattern of the human Achilles tendon: studies of the normal and tendinosis tendon with markers for general and sensory innervation.

Pain-free normal Achilles tendons and chronic painful Achilles tendons were examined by the use of antibodies against a general nerve marker (protein gene-product 9.5, PGP9.5), sensory markers (substance P, SP; calcitonin gene-related peptide, CGRP), and immunohistochemistry. In the normal tendons, immunoreactions against PGP9.5 and against SP/CGRP were encountered in the paratendinous loose connective tissue, being confined to nerve fascicles and to nerve fibers located in the vicinity of blood vessels. To some extent, these immunoreactions also occurred in the tendon tissue proper. Immunoreaction against PGP9.5 and against SP/CGRP was also observed in the tendinosis samples and included immunoreactive nerve fibers that were intimately associated with small blood vessels. In conclusion, Mechanoreceptors (sensory corpuscles) were occasionally observed, nerve-related components are present in association with blood vessels in both the normal and the tendinosis tendon.

Achilles Tendon↗
PubMed2006

Persistent popliteal pain derived from cavernous hemangioma involving gracilis tendon and tendon sheath.

Hemangiomas arising from tendon and tendon sheath are rarely reported, and may be confused with other lesions of tendons. In this case report, a 19-year-old woman was diagnosed with a cavernous hemangioma originating in the left gracilis tendon and tendon sheath. When her symptoms initially developed, MRI did not delineate the lesion due to the relatively small size of the tumor. Nine years after the onset of the patient's complaints of knee pain and swelling, the tumor was adequately diagnosed on physical examination and MRI, and was resected with complete relief of symptoms.

Adult↗
PubMed1995

Flexor tendon-pulley interaction after tendon repair. A biomechanical study.

Ten normal ring fingers from ten donors were used to determine the effect of flexor tendon repair on the gliding resistance between the tendon and the A2 pulley. Gliding resistance was measured for the intact FDP tendon and for the same tendon after it was cut transversely and repaired with a 4/0 Ticron core suture and a 6/0 running epitendinous nylon suture. After repair, the gliding pattern of the tendon through the A2 pulley changed significantly. The resistance and the friction coefficient were approximately doubled (P < 0.005).

Biomechanical Phenomena↗
PubMedDate not supplied

Mechanical comparison of two extensor tendon repairs of ankle tendons.

Complete disruption of the extensor tendons is commonly encountered with lacerations to the dorsal aspect of the ankle. The purpose of this study was to compare two tendon repairs (modified Krackow and Kessler-Tajima) to determine which repair was stronger in an anatomical cadaver model. Twenty tendons (10 extensor hallucis longus and 10 tibialis anterior tendons) from 10 fresh-frozen cadaver legs were lacerated and then repaired with either a modified Krackow or Kessler-Tajima repair. Each tendon repair was tested for gap formation and maximum load failure. Results showed that the mean force to produce gap formation in the modified Krackow repair was 64.7 N in the extensor hallucis longus and 82.3 N with the tibialis anterior. Mean gap formation for the Kessler-Tajima in the extensor group was 26.0 N and the tibialis anterior was 41.8 N. This represented a 40% and 50% greater resistance to gap formation for the modified Krackow in these groups. With maximum load failure, the mean for the modified Krackow was 99.5 N for the extensor hallucis longus and 126.8 N for the tibialis anterior, while the Kessler-Tajima was 45.6 N and 72.1 N for these groups. This represented a 45% and 58% greater difference in the maximum load failure for the modified Krackow. Statistical analysis using a Student's t-test (p < .05) showed that there was a significant statistical difference between the two repairs for gap formation and maximum load failure. The authors conclude that the modified Krackow is stronger than the Kessler-Tajima repair.

Ankle Joint↗
PubMed2002

The skeletal attachment of tendons--tendon "entheses".

Tendon entheses can be classed as fibrous or fibrocartilaginous according to the tissue present at the skeletal attachment site. The former can be "bony" or "periosteal", depending on whether the tendon is directly attached to bone or indirectly to it via the periosteum. At fibrocartilaginous entheses, the uncalcified fibrocartilage dissipates collagen fibre bending and tendon narrowing away from the tidemark; calcified fibrocartilage anchors the tendon to the bone and creates a diffusion barrier between the two. Where there are additional fibrocartilaginous specialisations in the tendon and/or bone next to the enthesis, an "enthesis organ" is created that reduces wear and tear. Little attention has been paid to bone at entheses, despite the obvious bearing this has on the mechanical properties of the interface and the clinical importance of avulsion fractures. Disorders at entheses (enthesopathies) are common and occur in conditions such as diffuse idiopathic skeletal hyperostosis and the seronegative spondyloarthropathies. They are also commonly seen as sporting injuries such as tennis elbow and jumper's knee.

Bone and Bones↗
PubMed2000

Flexor tendon grafting to the hand: an assessment of the intrasynovial donor tendon-A preliminary single-cohort study.

We report the results of a pilot study using intrasynovial donor tendons for flexor tendon reconstruction in 8 patients (10 digits) at a mean follow-up time of 3.8 years for neglected or failed primary repair of zone 2 lacerations and for neglected flexor digitorum profundus avulsions. The flexor digitorum longus to the second toe was used as the donor tendon graft. Four patients (4 digits) underwent single-stage reconstruction and 4 patients (6 digits) had multistage reconstruction. The overall patient satisfaction using a standardized visual analog reporting scale was excellent. There was 1 excellent, 1 good, 1 fair, and 1 poor result in the single-stage reconstruction group, including 1 repair site rupture and 1 digit requiring tenolysis. In the multistage reconstruction group there was 1 excellent, 3 good, 1 fair, and no poor results, including 1 digit requiring tenolysis. One patient was lost to follow-up. There was no donor site morbidity. The average active motion recovery was 64% and 56% for single-stage and multistage reconstructions, respectively, and was 73% overall for single digit reconstructions. The results of this pilot study suggest that intrasynovial tendon grafting may offer an improved alternative for tendon grafting to the synovial spaces of the digit.

Adolescent↗
PubMed1980

The absent lateral canthal tendon: reconstruction using a Y graft of palmaris longus tendon.

Absence of the lateral canthal tendon, whether congenital or acquired, imposes cosmetic and functional deformities that are surgically correctable. We propose a means of reconstructing the lateral canthal tendon using a Y graft of palmaris longus tendon. The benefits of this method are discussed. We believe it offers an alternative approach for supporting the lateral canthus and lower eyelid, and is especially useful when reestablishment of the lateral canthal tendon is necessary because of local tissue destruction or congenital absence. Three patients with congenital absence of the lateral canthal tendon are presented.

Abnormalities, Multiple↗
PubMed1997

Reconstruction of a sagittal band and extensor tendon centralization using a palmaris longus tendon graft.

A technique of delayed extensor tendon reconstruction and centralization using a palmaris longus tendon graft is presented. The tendon graft is woven through the base of the proximal phalanx and up and over the reconstructed extensor tendon to simulate the natural sagittal bands. As described, the technique allows gliding of the extensor tendon while maintaining its vitally important central location.

Accidents, Traffic↗
PubMed1995

Tendonitis of the deep digital flexor tendon in the distal metacarpal/metatarsal region associated with tenosynovitis of the digital sheath in the horse.

Twenty-four horses with ultrasonographic evidence of tendonitis of the deep digital flexor tendon in the metacarpal/metatarsal region were seen over a 7 year period. Most horses had mild to moderate lameness and distension of the digital flexor tendon sheath in the affected limb. Intrasynovial analgesia of the digital flexor tendon sheath consistently improved the degree of lameness. Ultrasonography most commonly revealed small, distinct, often circular, focal hypoechoic areas within the deep digital flexor tendon which usually extended less than 1 cm proximodistally. The degree of lameness and swelling generally improved with box rest and controlled exercise, however, exacerbation of the clinical signs and ultrasonographic lesions was common when affected horses were returned to work or allowed free exercise at pasture. Of 24 cases, only 7 horses made a full recovery and returned to their intended athletic activity.

Animals↗
PubMed2005

Clinical comparison of the Tutoplast allograft and autologous patellar tendon (bone-patellar tendon-bone) for the reconstruction of the anterior cruciate ligament: 2- and 6-year results.

BACKGROUND: The use of an allograft as a suitable transplant is still open to debate, in terms of donor morbidity, implantation reaction, and long-term results, as well as the risk of disease transmission. HYPOTHESIS: The clinical results 2 and 6 years after implantation of a bone-patellar tendon-bone allograft (Tutoplast) and bone-patellar tendon-bone autograft show no significant difference in relation to stability, function, and rate of rupture. STUDY DESIGN: Cohort study; Level of evidence, 2. METHOD: Between 1995 and 1998, 268 patients with anterior cruciate ligament ruptures were surgically treated: 132 patients received a bone-patellar tendon-bone allograft implantation and 136 patients a bone-patellar tendon-bone autograft. The results were evaluated using the International Knee Documentation Committee, Noyes, and Lysholm scores. RESULTS: There were 201 patients assessable after 2 years and 186 patients after 6 years. Ruptures of the implants in the allograft group occurred in 20 patients (20.6%) within 2 years and in 38 patients (44.7%) after 6 years. In the autograft group, transplants ruptured in 5 patients (4.8%) after 2 years and in 6 patients (5.9%) after 6 years. CONCLUSION: Based on the data, it would appear that the regular use of bone-patellar tendon-bone allografts, particularly for physically active patients, is unsuitable.

Adult↗
PubMedDate not supplied

Prospective evaluation of arthroscopically assisted anterior cruciate ligament reconstruction. Patellar tendon versus semitendinosus and gracilis tendons.

Eighty consecutive patients with chronic laxity due to a torn ACL underwent arthroscopically assisted reconstruction with either autogenous patellar tendon or doubled semitendinosus and gracilis tendons. Reconstructions were performed on a one-to-one alternating basis. Preoperatively, no significant differences between the two groups were noted with respect to age, sex, level of activity, and degree of laxity (chi square analysis). A standard rehabilitation regimen was used for all patients after surgery including immediate passive knee extension, early stationary cycling, protected weightbearing for 6 weeks, avoidance of resisted terminal knee extension until 6 months, and return to activity at 10 to 12 months postoperatively. Seventy-two patients were evaluated at a minimum of 24 months postoperatively (range, 24 to 40 months). No significant differences were noted between groups with respect to subjective complaints, functional level, or objective laxity evaluation, including KT-1000 measurements. Seventeen of 72 patients (24%) experienced anterior knee pain after ACL reconstruction. Overall, 46 of 72 patients (64%) returned to their preinjury level of activity. Mean KT-1000 scores were 1.6 +/- 1.4 mm for the patellar tendon group and 1.9 +/- 1.3 mm for the semitendinosus and gracilis tendons group. This study did find a statistically significant weakness in peak hamstrings torque at 60 deg/sec when reconstruction was performed with double-looped semitendinosus and gracilis tendons.

Adolescent↗
PubMed2006

The long-term outcome of tendon lengthening for chronic Achilles tendon pain.

BACKGROUND: The purpose of this study was to assess the long-term results of tendon lengthening surgery for the treatment of chronic Achilles tendon pain. METHODS: The results of 21 procedures in 18 patients were assessed. Each patient had an open Z-plasty to lengthen the Achilles tendon by 1 cm. RESULTS: Results showed a long-term (7.5 years) reduction in visual analogue pain scores for sporting activity in 20 of 21 procedures (median 50 point reduction, p < 0.0005). The tendon lengthening was apparent in a mean increase in dorsiflexion of 5 degrees. Two patients had minor gait abnormalities postoperatively. One patient had a reduction in plantarflexion power on the operated side, but five patients had improved power compared to the nonoperated limb. One major and five minor surgical complications were noted. CONCLUSIONS: The retrospective nature of this study must be noted in drawing conclusions. However, the results suggest excellent long-term reduction of Achilles pain after tendon lengthening. This must be weighed against a relatively high complication rate for any procedure in this region. This treatment does not appear to cause long-term deficits in plantarflexion power or gait.

Achilles Tendon↗
PubMed1995

The strength of Achilles tendon repair: an in vitro study of the biomechanical behavior in human cadaver tendons.

Eighteen fresh frozen human Achilles tendons were used to test the ultimate strength of repaired tendon "ruptures." Three methods, the Kessler, the Bunnell, and the locking loop, were used to test the initial strength of Achilles tendon repair. The Kessler and Bunnell methods are current standard clinical configurations described for Achilles tendon repair. Under uniform and standardized laboratory conditions, the specimens were loaded to failure. The locking loop suture method was substantially stronger than either of the other two standard configurations. The latter two did not differ significantly from each other. The results of this study may be clinically relevant in terms of the choice of the repair method for surgically treated Achilles tendon ruptures.

Achilles Tendon↗
PubMed2003

Tenosynovitis of the digital flexor tendon sheath and annular ligament constriction syndrome caused by longitudinal tears in the deep digital flexor tendon: a clinical and surgical report of 17 cases in warmblood horses.

REASONS FOR PERFORMING STUDY: Inflammation of the digital flexor tendon sheaths is a chronic and nebulous condition often unresponsive to medical and surgical treatment. OBJECTIVES: To evaluate the incidence of longitudinal tears (LT) as the underlying cause of chronic tenosynovitis and annular ligament constriction syndrome (ALCS) in warmblood horses. METHODS: The records of 25 horses with chronic tenosynovitis and ALCS in which tenoscopical inspection of the digital flexor tendon sheath (DFTS) was performed between 1999-2000 were reviewed. Of 25 horses, 17 were diagnosed with an LT in the deep digital flexor tendon (DDFT). All horses had a history of distension of the DFTS and/or signs of an ALCS. All cases presented typical signs of a chronic inflamed DFTS on ultrasonography and 11 horses showed ultrasonographic changes (echogenic material or an irregular outlining) at the lateral or medial border of the DDFT. The diagnosis of LTs of the DDFT was established in all cases by tenoscopy. Surgical treatment consisted of removal of the torn collagen fibrils using a mechanical resector and decompressing the fetlock canal by a transection of the palmar annular ligament (PAL) using a hook knife under tenoscopic control. RESULTS: Ten horses became sound and resumed their previous level of work, 3 horses remained lame, 4 horses returned to previous level of work but needed intrasynovial treatment of the DFTS and reduced competition frequency to remain sound. CONCLUSIONS: Horses presented with chronic inflamed DFTS and/or ALCS might suffer from LTs in the DDFT; however, the diagnosis cannot be established with absolute certainty using only ultrasonography. Longitudinal tears should be suspected if ultrasonographic changes are present lateral or medial to the border of the DDFT but tenoscopical examination of the tendon sheath is essential to establish an accurate diagnosis and an effective treatment. POTENTIAL RELEVANCE: The presence of these LTs might explain why some cases of chronic tenosynovitis of the digital flexor tendon sheath and/or ALCS do not respond on surgical transection of the PAL alone without tenoscopy.

Animals↗
PubMed1991

Hyaluronic acid in flexor tendon sheath fluid after sheath reconstructions in rabbits. A comparison between tendon sheath transplantation and conventional two stage procedures.

Because the synovial environment has been suggested to be important in limiting the number of postoperative adhesions after flexor tendon surgery, and a high concentration of hyaluronic acid is a characteristic feature of synovial fluid, we have examined the hyaluronic acid concentrations in fluid collected from different kinds of reconstructed flexor tendon sheaths in rabbits. The hyaluronic acid concentration in normal rabbit flexor tendon sheaths was similar to that in normal human sheath and joint fluid. Rabbit tendon sheaths restored by autologous sheath grafts and partial pseudosheaths contained similar or somewhat lower hyaluronic acid concentrations, whereas in complete pseudosheaths the concentrations were considerably lower. The data suggest that tendon sheath reconstructions should consist at least partly of synovial membrane so that they are as similar as possible to normal synovial membrane.

Animals↗