Tenotomy of the ligamentum patellae in spina bifida: management of limited flexion range at the knee.
Explore the source record for details and available documents.
Adolescent↗
SEARCH · Search PubMed
Results for “Tenotomy”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[Posterior tenotomy of the superior oblique muscle in A-pattern squint].
Explore the source record for details and available documents.
Humans↗
Prolongation of ambulation through early percutaneous tenotomy and bracing with plastic orthoses.
Explore the source record for details and available documents.
Braces↗
Tenotomy for infraspinatus muscle contracture.
Explore the source record for details and available documents.
Animals↗
Techniques of psoas tenotomy and rectus femoris transfer: "new" operations for cerebral palsy diplegia--a description.
Two novel operations for cerebral palsy are described. Both procedures, originally proposed and performed by Gage, have been advocated as biomechanically more effective than previous procedures in achieving the objectives of eliminating hip and knee contractures in cerebral palsy. Description of the operative technique and the rationale of use are stated to assist the operator.
Cerebral Palsy↗
[Expression of myosin heavy chain IIx mRNA as a molecular marker of disuse of soleus muscle in rats].
Objective. To make an Achilles tenotomy rat model to observe the change in soleus weight and expression of myosin heavy chain (MHC) isoform mRNA, and to find some clues for elucidating the mechanisms of soleus disuse. Method. Thirty male Sprague-Dawley [correction of Sprangue] rats were divided into 6 groups. On the lst, 3rd, 7th, 14th, 21st and 28th days after Achilles tenotomy, wet weight of soleus (SOL), plantaris (PL), gastrocnemius mediales (MG), and gastrocnemius lateral (LG) muscles were measured. Expression of MHC IIx mRNA was observed by means of reverse transcriptase-polymerase chain reaction (RT-PCR). Result. Wet weight of SOL, MG, LG, and PL decreased significantly on the 3rd day after the tenotomy. The wet weight of these muscles reduced to the minimum on the 7th or 14th days after the tenotomy, and then recovered slightly on the 21st day after the tenotomy. There was only the expression of MHC I and MHC IIa mRNA in normal soleus muscle, but no MHC IIx or MHC IIb mRNA. The expression of MHC IIx mRNA occurred in SOL on the 3rd day after tenotomy and still expressed on the 28th day after tenotomy. There was no expression of MHC IIb mRNA in SOL after Achilles tenotomy. Conclusion. The appearance of atrophy of rat soleus induced by Achilles tenotomy is similar in time and extent with that induced by tail-suspension. The expression of MHC IIx mRNA is shown in rat soleus muscles in Achilles tenotomy and tail-suspension models. The study suggests that expression of MHC IIx mRNA may be used as a molecular marker of soleus muscle disuse in rats.
Achilles Tendon↗
A comparison of two surgical approaches to the scapulohumeral joint in dogs.
Two scapulohumeral arthrotomy techniques were evaluated and compared in 10 normal, young adult greyhounds. A caudolateral approach with craniodorsal retraction of the teres minor muscle (no-tenotomy) and a craniolateral approach with tenotomy of the infraspinatus tendon were each performed unilaterally in 5 dogs. The dogs were evaluated using force plate gait analysis, lameness evaluation, radiography, and goniometry for 5 weeks and then euthanatized. Tenotomy sites and sections of the humeral articular cartilage were collected from shoulder joints that had been operated on and examined microscopically. The same surgical approach has then performed on the contralateral shoulder in the cadavers and exposure of the humeral articular cartilage was measured using planimetry. Peak vertical force applied to the operated limbs in the tenotomy group was significantly less than preoperative leads on day 3 and significantly less than the no-tenotomy group on days 21 and 28. The peak vertical force applied to the operated limbs in the no-tenotomy group was not significantly different from preoperative levels during the study. Scapulohumeral arthrotomy by tenotomy of the infraspinatus resulted in decreased range-of-motion and joint extension compared with joints operated on without tenotomies, but provided significantly greater exposure to the articular surface. Scapulohumeral arthrotomy with craniodorsal retraction of the teres minor muscle did not significantly alter goniometric measurements compared with unoperated joints. Both techniques resulted in similar subjective lameness scores and caused no gross microscopic or radiographic evidence of articular cartilage damage.
Animals↗
[Prevention of development of hip joint instability in patients with the spastic form of juvenile cerebral palsy].
PURPOSE OF THE STUDY: How effective are the hip adductors and flexors tenotomies for the correction of unstable hip joint in cerebral palsy? MATERIAL: The study included 45 children with contractures of the hip adductors and flexors and hip subluxations due to spastic cerebral palsy. Thirty three of them were boys and 12 were girls. Their ages ranged from 2 to 13 years. Preoperative and postoperative roentgenograms of 82 hip joints were investigated. METHODS: Open tenotomies of m. adductor longus and brevis, m. gracilis, m. rectus femoris and m. psoas major. The immobilisation by POP casts lasted for 6 weeks. Abduction and extension bracing followed the plaster removal in all children. The hip joints were radiographed in neutral rotation both before and at least 6 months after the operation. Reimers migration percentage (MP) and Wiberg angle (CE angle) known as the parameters of hip instability were assessed. The obtained data were statistically analysed. RESULTS: The preoperative MP was below 25% in 25 hips, between 25 and 39% in 33 hips, between 40 and 59% in 14, and over 59% in 10 hips. The analysis of postoperative roentgenograms showed the following MP distribution: 56 less than 25%, 23 between 25 and 39%, and 3 greater than 40%. No postoperative MP was higher than 49%. 54% formerly subluxated hips achieved normal MP. The difference between preoperative and postoperative MP was statistically significant (P < 0.001). Before the tenotomies 24 hips were normal with CE angle over 20 degrees. It was between 20 degrees and 11 degrees in 28 cases and between 10 degrees and 1 degree in 17 cases. The preoperative CE angle was negative in 13 cases. Postoperatively CE angle was higher than 20 degrees in 53 hips. It was between 20 degrees and 11 degrees in 22 cases and between 10 degrees and 1 degree in 7 cases. The minimum CE angle after soft-tissue release was 4 degrees. The difference between preoperative and postoperative CE angles was statistically significant (P < 0.001). MP improved in 93% and CE angles in 96% of cases. DISCUSSION: Classical tenotomies of the spastic hip adductors used to be recommended in prevention of the hip subluxation in cerebral palsy patients. MP improved in 70% of cases in the Reimers' study (1980) based on selective adductors tenotomies. If the soft tissue release was unsuccessful bony operation was indicated. Kalen and Black claimed in 1985 that if psoas tenotomy was performed in addition to adductors tenotomies MP improvement was attained in 80-100% of cases. CONCLUSION: Adductors and flexors tenotomies can correct the spastic hip joint instability fully and permanently if the operation is performed prior to bony changes of the hip. The operation being followed by appropriate immobilisation and physiotherapy increases the percentage of good results.
Adolescent↗
Blood flow to the metatarsal head after chevron bunionectomy.
BACKGROUND: Avascular necrosis (AVN) of the metatarsal head is a known, but infrequent, complication of a chevron bunionectomy. An increased incidence of AVN has been reported with the addition of an adductor tenotomy and lateral release. The purpose of this study was to document the vascular insult to the metatarsal head during a chevron bunionectomy with adductor tenotomy and lateral release through direct blood flow measurements during the procedure. METHODS: A prospective study of 20 patients was performed. A chevron bunionectomy was performed under regional anesthesia without tourniquet control by two surgeons. Blood flow recordings were documented during key portions of the procedure: baseline, medial capsulotomy, adductor tenotomy and lateral release, and chevron osteotomy. The Periflux PF3 laser Doppler probe (Perimed, Inc., North Royalton, OH) was used to record blood flow. Mauchly's test of Sphericity and a pairwise comparison were performed with significance defined as p < 0.05. All patients had radiographs 3 months postoperatively to assess AVN. RESULTS: There was a statistically significant decrease in blood flow to the metatarsal head at each portion of the procedure. The greatest insult occurred with the medial capsulotomy (45% decrease). The lateral release and adductor tenotomy caused a 13% decrease and the chevron osteotomy caused a 13% decrease, totaling 71% decrease from the baseline. There was no evidence of AVN at 3 months, and all patients had radiographic evidence of union without recurrence or over-correction. CONCLUSION: The addition of the adductor tenotomy with lateral release often is crucial to obtain the desired correction and avoid the complication of recurrence. The disruption of microvascular blood flow to the metatarsal head after a chevron bunionectomy with adductor tenotomy and lateral release was not complete, totaling 71% in the study population. The greatest insult occurred with the medial capsulotomy. There were no occurrences of AVN. Despite the fear of AVN, this study demonstrated that an adductor tenotomy and lateral release could be done safely completed with a chevron bunionectomy.
Adult↗
The role of neural and mechanical influences in maintaining normal fast and slow muscle properties.
The relative importance of neural and mechanical influences in maintaining normal slow and fast muscle properties remains unclear. To address this issue, we studied the effects of 10 days of hindlimb unloading (HU) with or without tenotomy and/or denervation on the cross-sectional area (CSA), myosin heavy chain (MHC) expression (immunohistochemistry) and composition (gel electrophoresis), and myonuclear number in soleus and plantaris fibers in adult male Wistar rats. In general, the adaptations in fiber type and size were similar using either single fiber gel or immunohistochemical analyses. HU resulted in atrophy of type I and I+IIa/x MHC fibers in the soleus and in type I, I+IIa/x, IIa/x, IIa/x+IIb, and IIb MHC fibers in the plantaris. Addition of tenotomy and/or denervation in HU rats had minimal effects on fiber CSA in the soleus, but fiber CSA in the plantaris further decreased, particularly in fibers expressing only fast MHCs. HU resulted in a de novo appearance of type I+IIa/x+IIb and IIa/x+IIb MHC fibers in the soleus and of type I+IIa/x+IIb MHC fibers in the plantaris. Tenotomy and/or denervation in HU rats had no further effect on the fiber type composition of either muscle. Mean myonuclear number/mm of type I fibers was decreased in the soleus of HU rats, and increased in type I and I+IIa/x fibers in HU plus tenotomy (HU+Ten) rats. In the plantaris, mean myonuclear number/mm of type IIa/x, IIa/x+IIb, and IIb fibers was lower after HU with or without tenotomy and/or denervation. Mean cytoplasmic volume/myonucleus ratio of type I and I+IIa/x fibers in the soleus of the HU group tended to be smaller than in controls. The largest decrease was noted in the HU+Ten group. In the plantaris, this ratio was unaffected by HU alone, but was decreased by addition of tenotomy and/or denervation when all fiber types were combined. These data indicate that the major cause of fiber atrophy and adaptations in myonuclear domain size in the slow soleus of HU rats is the chronic reduction in force generation, whereas the elimination of neuromuscular contact via denervation results in additional fiber atrophy and adaptations in myonuclear domain size in the fast plantaris.
Animals↗
Fluorescein iris angiography. II. Disturbances in iris circulation following strabismus operation on the various recti.
Iris circulation was investigated by fluorescein iris angiography in 33 human eyes before and after tenotomy of one or more recti for correction of strabismus. Tenotomy of one or both horizontal recti produced no appreciable circulatory disturbance in the iris, but tenotomy of superior or inferior rectus produced circulatory delay in superior temporal or inferior temporal sectors, respectively, of the iris. When tenotomies of a horizontal and one or two vertical recti were combined, the defect occurred in the region of the vertical rectus only. Blood supply of the nasal half of the iris was usually not disturbed by tenotomy of the vertical and/or medial rectus. The findings indicate that the blood supply of the iris is segmental and suggest that, in strabismus surgery, cutting the two vertical recti along with the lateral rectus may subject the eye to the risk of anterior segment ischemia. In the light of the present findings, physiological anatomy of the blood supply of the iris and role of the major arterial circle of the iris are discussed.
Adolescent↗
Modifications in the histochemical and biochemical changes in tenotomized rat soleus by denervation.
Response of tenotomized rat soleus muscle to denervation performed at different time intervals, has been investigated. Tenotomized muscles showed typical central core lesions seven days post-operatively. These were not observed in m-ATPase stained sections of simultaneously denervated and tenotomized muscles, and muscles denervated 24 h after tenotomy. Central core lesions were not prevented in muscles denervated 28 h after tenotomy, indicating that tenotomy effects responsible for central lesions are completed by this time. Myosin light chain pattern of muscles denervated 28 h after tenotomy, and tenotomized only were similar showing increased LC3/LC1 ratio. Simultaneously denervated and tenotomized muscle however showed all the three light chains relatively equal in quantity. The results suggest that elimination of neural activation within 28 h prevents myofibrillar loss and minimized other changes which occur due to tenotomy.
Animals↗
To detach the long head of the biceps tendon after tenodesis or not: outcome analysis at the 4-year follow-up of two different techniques.
The aim of this study was to determine whether or not detaching the biceps tendon from the glenoid after tenodesis performed with the inclusion of the biceps in the rotator cuff suture results in an improved outcome. From 1999 to 2001, 22 patients had an arthroscopic rotator cuff repair and associated biceps tendon lesions that were repaired with two new arthroscopic techniques of tenodesis incorporating the biceps tendon in the rotator cuff suture. Patients were randomised into one of two groups: tenodesis without tenotomy (group 1) and tenodesis with tenotomy (group 2). Preoperative and postoperative functions were assessed by means of a modified UCLA rating scale and shoulder ROM. The mean follow-up period was 47.2 months (range 36- 59). In group 1 (tenodesis without tenotomy), eight patients had an excellent postoperative score and three a good postoperative score. The UCLA rating system used for evaluation showed a statistically significant improvement from the preoperative average rating of 10.5 (5-15) to the postoperative average score of 33 (29-35) (P<0.05). In group 2 (tenodesis with tenotomy), the UCLA rating system used for evaluation showed a statistically significant improvement from the preoperative rating of 11.1 to the postoperative score of 32.9 (P<0.05). No statistically significant difference in the total UCLA scores was found when comparing the repairs performed with or without tenotomy. Follow-up results with regard to ROM were not different between the two groups, and the range of motion was improved in all measured directions. In this series, every patient qualified as having good to excellent results according to the UCLA score. This study suggests that there is no difference between detaching and not detaching the biceps after including it in the repair.
Adult↗
Mechanical properties of tenotomized and denervated-tenotomized muscles.
Mechanical properties of rat soleus and plantaris muscles were studied in vitro following tenotomy, denervation, or tenotomy plus denervation, all of 3 wk duration. Controls included muscles from sham-operated animals and from animals with muscle tendons severed but immediately resutured. Results of twitch times, times to peak tension, and times to half-relaxation for 145 muscles clearly showed that the slight increase in muscle speed that occurs in the soleus muscles only is due to severance of the muscle tendon per se and not related to muscle shortening and possible related alterations in muscle spindle activity that occurs in simple tenotomy. Furthermore, any demonstrable mechanical changes that occur with tenotomy or with section and resuturing of the tendon requires the presence of intact innervation. We conclude that, contrary to published opinion, tenotomy does not transform slow contracting muscles into fast contracting muscles and that comments concerning the role of stretch receptors in this postulated transformation are pure conjecture, unsupported by experimental data.
Animals↗
[Responses of ankle plantar-flexors to various inhibitions of muscular activities in rats].
Effects of hindlimb suspension, tenotomy, denervation, and/or the combination of these models on plantar-flexors were studied in adult rats. Suspension-induced atrophy was not promoted by addition of tenotomy. But the magnitude of the atrophy was advanced if denervation or both denervation and tenotomy were combined with 5-day hindlimb suspension. Similar effects were noted in the cross-sectional area of single muscle fibers, especially of slow-twitch fibers. A shift of muscle fiber type from slow- to fast-twitch type was also induced mainly in soleus. The atrophy and fiber transformation were closely associated with a passive shortening of muscle due to the plantar-flexion of ankle and/or tenotomy and a disappeared electrical activity caused by denervation. The fiber atrophy, but not the shift of fiber type, was further advanced by the combination of tenotomy and denervation. It is suggested that muscle atrophy is caused by the decreased fiber size and protein content. The water content was also reduced proportionally.
Animals↗
Some hormonal factors (hypophysectomy, castration and testosterone administration) modifying the course of "compensatory" muscle hypertrophy in the rat.
1. Maximum compensatory hypertrophy of the soleus and plantaris muscle in male rats is attained seven days after tenotomy of the gastrocnemius muscle (39% and 9% respectively). When tenotomy of the gastrocnemius was performed seven days ater hypophysectomy, hypertrophy in these two muscles was aproximately half that found in control animals. 2. After 81-day castration of young male rats the weight of the saleus and plantaris was reduced and hypertrophy following tenotomy of the gastrocneumius muscle did not develop. 3. Chronically castrated rats received testosterone two weeks prior to tenotomy of the gastrocnemius and a week during the muscle hypertrophy phase. Hypertrophy of the soleus in castrated rats which had received testosterone seven days after tenotomy of the gastrocnemius was 25% as compared with muscles of castrated animals. The corresponding value in the plantaris muscle was 10%. 4. These results indicate that even calf muscles of the rat, namely the soleus and plantaris muscles, are significantly affected by testosterone under these conditions, although it is not, as yet, clear whether its action is direct or indirect.
Animals↗
Application of the potassium-titanyl-phosphate laser during extraocular muscle surgery: technique and histopathology.
We determined laser parameters and delivery system requirements for successful use of the potassium-titanyl-phosphate (KTP) laser for strabismus surgery and its histopathologic effect on extraocular muscle, tendon, sclera, and cornea of human and rabbit eyes. Enucleated cadaver eyes and exenterated rabbit orbital contents were used. Using a 200-microns fiberoptic tip delivery system, varying laser energies were used to perform muscle insertion site and corneal damage, tenotomies, and myotomies. Pulse durations of 0.5 second and energies above 0.8 watt were needed for tenotomy or myotomy. No damage to the surrounding tissues or sclera was observed with laser tenotomy or myotomy performed 0.5 mm from the insertion site. Energy above 0.8 watt applied directly caused full thickness disruption. In comparison to scissor myotomy, the laser provided charring of the superficial tissues. This study shows that the KTP laser can be safely and accurately used for extraocular muscle tenotomy or myotomy.
Animals↗
Calcium-activated protease activity in tenotomized muscle.
The purpose of this study was to investigate the possible role of calcium-activated neutral protease in the disorganization and dissolution of the myofibrils of the rat soleus that occurs following tenotomy. Rats were killed 3, 5, 7, 14, 21, and 42 days after tenotomy of the soleus, and the muscles were removed and assayed for calcium-activated protease activity. Maximal protease activity occurred 1 week after tenotomy, at the time when myofibril organization is completely disrupted. Activity was still high 2 and 3 weeks after the operation, but returned to normal levels by 6 weeks, when muscle histology had returned to normal. The time course of the calcium-activated protease activity corresponded closely to the time course of the morphological changes. Thus, calcium-activated neutral protease may play a major role in myofibrillar proteolysis following tenotomy and in making the myofibril susceptible to proteolytic attack by other, less specific proteases.
Animals↗