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At least 433 records · Page 24Linked to original sources
PubMed2001

There are differences in early morbidity after ACL reconstruction when comparing patellar tendon and semitendinosus tendon graft. A prospective randomized study of 107 patients.

The main objective of this study was to study solely early postoperative morbidity following anterior cruciate ligament (ACL) reconstruction by comparing the gold standard procedure, the bone-patellar tendon-bone graft (BTB), and one of the most common alternatives, the semitendinosus tendon graft (ST). The prospective study included 107 randomized patients (50 BTB and 57 ST). The follow-up period was set to 20-35 weeks postoperatively (mean 26.8 +/- 3.5 weeks). One patient suffered early graft rupture and 89 (84%) of the remaining 106 patients were able to attend the follow-up within the given time limit. There were no differences in sick leave between the groups. The Lysholm score, Tegner activity level score and Visual Analog Scales (VAS) with the questions "How does your knee function?" and "How does your knee affect your activity level?" revealed no differences between the groups. Subjective patellofemoral pain, patellofemoral compartment findings and donor site morbidity were more common in the BTB group, P < 0.05. Lachman test grade 1+ was more common in the ST group, P < 0.05, but there was no significant difference in instrumented Lachman side-to-side comparison. The ST group scored better in the one-leg hop test than the BTB group, P < 0.05. No correlations between these clinical and functional findings and subjective knee function scores were found. In conclusion, ACL reconstruction with ST tendon graft presented fewer short-term postoperative problems as compared to reconstruction with BTB.

Adolescent↗
PubMed1977

[Results of animal experiments on alloplastic tendon replacements using the Bader tendon prosthesis].

Based on our experimental results with the Bader tendon prosthesis, encouraging results for alloplastic tendon replacement were obtained. However a general recommendation for its clinical use cannot be given. Over a period of 4-6 weeks of immobilization healing of the artificial tendon with inflammation could be observed. In the biopsies we found the equivalent of connective tissue attachment between vital tissue and the alloplastic material. We could not clarify whether this connection would endure strain. The pronounced adhesions between the anstomosis and surrounding tissue make later function questionable.

Animals↗
PubMed1977

[Structure and configuration of human tendons. II. Development of tendon structure during ontogenesis].

In infants born in the 24th--30th weeks of the gravidity the praenatal development and the process of the organization of the tendinous structure have been examined by the authors. By means of photo- and polarization microscopic examinations it was found that the tendon of the flexor hand muscles (M. flexor carpi radialis, M. flexor digitorum comm.) shows mature tendinous structure earlier, than the tendons of the flexor muscles of the lower extremity (M. semitendinosus femoris, M. triceps surae). The tendons of the extensor muscles of the lower extremity (M. quadriceps femoris, M. tibialis ant.) are underdeveloped and inordinate in the foetal life--their structure develops only during the postnatal life.

Hand↗
PubMed1991

Combined split anterior tibial-tendon transfer and intramuscular lengthening of the posterior tibial tendon. Results in patients who have a varus deformity of the foot due to spastic cerebral palsy.

Twenty patients who had a varus deformity of the foot secondary to spastic cerebral palsy had twenty-two operations involving combined split anterior tibial-tendon transfer and intramuscular lengthening of the posterior tibial tendon, with and without concomitant lengthening of the Achilles tendon. Preoperatively, all patients had had a dynamic varus deformity of the hindfoot and adduction of the forefoot in both the stance phase and the swing phase of gait. At an average follow-up of 6.2 years (range, 2.3 to 8.8 years), there were fourteen excellent, four good, and four poor clinical results. Two patients who had a fixed varus deformity of the hindfoot and one patient who had a very weak anterior tibial muscle had a poor result. We concluded that the combined procedure is effective for correction of a flexible varus deformity of the foot in patients who have spastic cerebral palsy.

Adolescent↗
PubMed1986

Flexor tendon injuries. Part 1. Anatomy, physiology, biomechanics, healing, and adhesion formation around a repaired tendon.

A review of the advances that have been made in recent years toward a better understanding of flexor tendon anatomy, physiology, biomechanics, healing and the development of adhesions around a repaired tendon. Despite the advances that have been made, results of flexor tendon repairs, particularly in the area of Zone 2, have been less than satisfactory. Adhesions also seem to be a biologic inevitability. A need for continued investigation.

Finger Joint↗
PubMed1979

[Quantitative measurement of the tendon reflexes. A study on Achilles tendon reflex (author's transl)].

Quantitative analyses of tendon reflexes were performed for the purpose of clinical application. Tendon tap was marked with a WNS-5D semiconductor load cell inserted in the hammer to measure tapping force. Achilles tendon reflex (ATR) was measured with a LAS-0.1 displacement transducer in kneeling position on the chair. In ATR, six factors, i.e. duration of reaction time, the height of the wave, the time from the hammer tap to the top of the wave, the maximum speed of contraction, the time from the hammer tap to the maximum speed and half relaxation time, were analyzed. Correlation between these six factors were discussed. From the analyses of these factors, half relaxation time may serve as the best indicator of clinical status among the factors obtained by analysis of ATR.

Achilles Tendon↗
PubMed1996

Single tendon--two insertion versus two tendon transfers for reablement of ulnar-median palsied thumb in leprosy.

Twenty-three opponensplasties for ulnar median paralysis in 20 leprosy patients were performed by two different procedures i.e. extensor indicis proprius and flexor digitorum superficialis transfers using standard techniques. The results were evaluated using various objective and subjective, anatomical and functional parameters. Two tendon transfers appeared to be superior to single tendon two insertion transfers. It was concluded that if situation permits, two tendon transfers should be performed for combined ulnar median paralysis.

Adolescent↗
PubMed1997

[Isolated lesions of the subscapularis tendon and internal malpositions of the biceps tendon. Apropos of 45 cases].

Our series consists of 45 lesions of the subscapularis tendon investigated by arthrography and CT arthrography. Arthrography demonstrated opacification of the subacromial bursa in 24% of cases, internal malposition of the long head of biceps in 46% of cases and direct signs of a lesion of the subscapularis tendon in 91% of cases. CT arthrography showed incomplete transverse avulsion in 18% of cases and complete transverse avulsion in 82% of cases. The biceps was dislocated in 35% of cases, and subluxed in 11% of cases. The subscapularis muscle was infiltrated by fat in 46% of cases. Isolated lesions of the subscapularis can be difficult to diagnose clinically and are more frequent than generally thought. CT arthrography must therefore be requested at the slightest doubt, as the intraoperative search for a lesion of the subscapularis tendon is sometimes difficult.

Adult↗
PubMedDate not supplied

Repair of neglected Achilles tendon ruptures with a triceps surae muscle tendon advancement.

Neglected Achilles tendon ruptures, although rare, can be a surgical challenge for the lower extremity specialist. These injuries often present with large defects which require special reconstructive techniques and principles. This paper presents an overview of this problem, various treatment strategies, and two case reports utilizing a triceps surae muscle tendon flap advancement.

Achilles Tendon↗
PubMed1993

Repair of chronic Achilles tendon rupture with flexor hallucis longus tendon transfer.

A new technique is described for reconstruction of chronic Achilles tendon rupture using the flexor hallucis longus tendon. Follow-up on seven patients (mean age 52 years) is provided (average follow-up 17 months, range 3-30 months). All patients were re-examined to assess postoperative range of motion, scar healing, and sensation. Motor strength was assessed by Cybex testing. Subjective satisfaction was examined by completion of a questionnaire. There were no postoperative infections, skin losses, or re-ruptures. Each patient developed a small but functionally insignificant loss in range of motion in the involved ankle and great toe. All patients had a satisfactory return of function. One patient required a molded foot-ankle orthosis for extended ambulation but was able to play golf.

Achilles Tendon↗
PubMed1989

[Problems of the two-stage restoration of flexor tendon injuries. II. Light- and scanning electron microscopy studies of flexor tendon sheaths from hens and from humans].

Authors examined the normal flexor tendon/tendon sheat unit of the toes of the hen and in the zone Verdan 2 of the human hand with light and scanning electron microscope. The fine structure of the synovial membrane was studied with special care. It was found, in accordance with some previous literary data, that the morphology of the hen's and human tenosynovium resemble to each other. The structures of the parietal visceral synovial membranes are described and compared, and the mechanism of the secretion of the synovial fluid is discussed. The results of the present investigations may serve, over the description of the normal anatomical relations, as a comparison to other experiments of two-phase tendon transplantations with the formation of pseudo tendon sheats and also for clinical practice.

Animals↗
PubMedDate not supplied

Supraspinatus tendon composition remains altered long after tendon detachment.

Most rotator cuff surgery is performed on chronic tears, but changes in the composition of chronically torn tendons remain poorly understood. In this study we surgically created supraspinatus tears in the rat and analyzed the composition of the tendon over time using immunohistochemistry. We found that collagen types I and XII were greatly increased initially after injury and then decreased with time. Collagen type III was detected and persisted in the scar for months. Decorin and biglycan were increased initially and then decreased, although decorin remained elevated from normal for months after injury. Aggrecan and collagen type II were detected in small amounts after detachment, which was associated with the expression of sulfated glycosaminoglycans. These alterations were similar to those seen in human studies. As the quality of the tendon is an important factor in repair, these findings may partially explain why chronic tears heal differently than acute tears.

Animals↗
PubMed2002

Flexor tendon healing in vitro: effects of TGF-beta on tendon cell collagen production.

Flexor tendon healing is complicated by adhesions to the surrounding sheath. Transforming growth factor beta (TGF-beta) is a cytokine with numerous activities related to wound healing. We examined the effects of TGF-beta-1, -2 and -3 on tendon cell proliferation and collagen production. Three separate cell lines--sheath fibroblasts, epitenon and endotenon tenocytes--were isolated from rabbit flexor tendons and cultured separately. Cell culture media was supplemented with 1 or 5 ng/mL of TGF-beta-1, -2, or -3. Cell number and collagen I and III production were measured and compared with unsupplemented control cultures. The addition of TGF-beta to cell culture media resulted in a decrease in cell number in all 3 lines that did not reach statistical significance. There was a significant increase (p <.05) in collagen I and III production with the addition of all 3 TGF-beta isoforms. Modulation of TGF-beta production may provide a mechanism to modulate adhesion formation clinically.

Animals↗
PubMed2003

Duplicate extensor tendons of the thumb mimicking rupture of the extensor pollicis longus tendon.

We report a patient with duplicate extensor pollicis longus tendons, who complained of inability to extend the thumb fully because of impingement of the musculotendinous junction of the duplicate tendons. Extension of the thumb recovered completely after Lister's tubercle was excised and the extensor retinaculum was released. Selective windowing with highlighting of the soft tissue in the axial T1-weighted magnetic resonance image at the level of the distal radioulnar joint showed two tendons in the third extensor compartment.

Diagnosis, Differential↗
PubMed2006

Post-operative use of knee brace in bone-tendon-bone patellar tendon anterior cruciate ligament reconstruction: 5-year follow-up results of a randomized prospective study.

Sixty patients were prospectively randomized to brace and no-brace groups after bone-tendon-bone patellar tendon anterior cruciate ligament (ACL) reconstruction. The brace group wore a rehabilitation knee brace for 12 weeks post-operatively, while the no-brace group was mobilized immediately, and crutches were discarded 2 weeks post-operatively. The groups were comparable with respect to age, gender, time from injury to surgery and concomitant injuries. There were no differences either pre-operatively or 5 years post-operatively (80% of patients reviewed) between the groups in terms of the knee score (Lysholm), activity level (Tegner), degree of laxity or isokinetic peak muscle torque. Thus it appears that knee braces are not needed in the post-operative rehabilitation after ACL reconstruction with the patellar tendon graft.

Adolescent↗
PubMed1987

Use of a previously repaired tendon for tendon transfer.

A patient in whom a previously repaired flexor digitorum superficialis tendon was used for transfer to correct a claw deformity is described. I have found this to be possible under optimal conditions of tendon repair, thus providing the hand surgeon with another choice of donor material.

Child↗
PubMed1993

Tendon excursions after flexor tendon repair in zone. II: Results with a new controlled-motion program.

Metal markers were used to study flexor digitorum profundus tendon excursions during early controlled motion with a new program combining dynamic traction and passive flexion to all four digits. The mean excursion was 2.3 mm along the middle phalanx and 11.7 mm along the proximal phalanx. This was more than twice the mean size of excursions previously achieved with a modified traditional Kleinert traction program. The mean excursion per 10 degrees of combined distal and proximal interphalangeal controlled joint motion amounted to 73% of the corresponding excursion recorded during active motion. Taken together with the findings of our previous study on tendon excursions, the results also indicate that the magnitude of excursions induced by both the distal and the proximal interphalangeal joints during controlled motion has a significant effect on adhesion formation and clinical results. However, in the region of 6 to 9 mm there appears to be a threshold beyond which the effect of a further increase in excursions becomes insignificant.

Adolescent↗
PubMed1998

Freehand resection of the patella in total knee arthroplasty referencing the attachments of the quadriceps tendon and patellar tendon.

A freehand technique of patellar resurfacing using anatomic references was prospectively evaluated. This technique utilizes an osteotomy beginning at the inferior pole of the patella just posterior to the insertion of the patellar tendon and is carried proximally posterior to the insertion of the quadriceps tendon. Evaluation of 55 total knee arthroplasties in 41 patients showed an average restored patellar thickness within 0.1 mm. The overall patellar thickness was restored to within 1 mm of its preoperative thickness in 50 (91%) of 55 knees. Patellar tilt was equal to or less than 4 degrees in 42 (89%) of 47 arthroplasties evaluated radiographically. The patellar thickness averaged 17.9 mm, well above the critical value of 15 mm reported in the literature.

Adult↗