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At least 487 records · Page 27Linked to original sources
PubMed1981

Achilles tendon injury. 4. Structure of rabbit calf muscles after tendon repair with removable traction suture.

Immobilization after surgical treatment of Achilles tendon rupture with calf-muscles in a slackened position induces extensive degeneration of the tonic muscle fibres. The optimal treatment in view of maintained muscle structure should be immobilization with kept tone in the muscles. This may be possible to achieve by using a traction suture. In this investigation such a method has been applied on rabbits. It was found that in spite of the occurrence of degenerative morphologic changes the total relative fibre area was numerically larger and separation of tendon ends was significantly smaller than when the routine method had been performed. It was concluded that the investigated technique offers some advantages with regard to the muscle fibre structure.

Achilles Tendon↗
PubMed1994

Characterization of type I procollagen N-proteinase from fetal bovine tendon and skin. Purification of the 500-kilodalton form of the enzyme from bovine tendon.

Procollagen N-proteinase (EC 3.4.24.14) is the enzyme that specifically cleaves the NH2-terminal propeptides from type I procollagen. Two forms of N-proteinase with apparent molecular sizes of 300 and 500 kDa were found in partially purified preparations from fetal bovine tendon extracts. The 500-kDa form of enzyme was purified 16,000-fold with a recovery of 8% from the extracts of the tendons by six purification steps. The purified enzyme was a neutral, Ca(2+)-dependent proteinase (5-10 mM) that was inhibited by metal chelators. The 500-kDa enzyme contained unreduced polypeptides of 58, 125, 170, and 190 kDa which were separated by polyacrylamide gel electrophoresis in sodium dodecyl sulfate. Electron microscopic study indicated that the enzyme molecules were generally globular and had diameters of 33 +/- 4 nm. Other properties of the 500-kDa enzyme were: 1) the Km for type I procollagen is 35 nM at pH 7.5 and 35 degrees C, and the kcat is 290 h-1; 2) the activation energy for reaction with type I procollagen is 10,050 cal mol-1; 3) the isoelectric point is 3.8; 4) the enzyme cleaves the NH2-terminal propeptides of type II procollagen as well as type I procollagen but not of type III procollagen; and 5) the enzyme specifically cleaves a -Pro-Gln- bond in the pro-alpha 1(I) chain and an -Ala-Gln- bond in the pro-alpha 2(I) chain. The bovine N-proteinase with a mass of 300 kDa was found to be similar to the 500-kDa enzyme and appeared to be a degraded form of the 500-kDa enzyme generated during purification. The N-proteinase from fetal bovine skin extracts also contained 300-kDa and 500-kDa enzyme forms.

Amino Acid Sequence↗
PubMed1994

Reconstruction of anterior cruciate ligaments with bone-patellar tendon-bone and achilles tendon allografts.

Two hundred fourteen patients had anterior cruciate ligament (ACL) reconstructions performed with banked freeze-dried or frozen allografts using an arthroscopic-assisted technique. Of these, 181 patients were available for follow-up testing and examination. Minimum follow-up time was four years (average, 57 months). All patients were evaluated by using KT-1000 arthrometer and Biodex testing as well as by physical examination. Final results were rated as satisfactory or unsatisfactory by using a modified Feagin knee scoring scale. Patients who were classified as good or excellent were considered to have satisfactory results. Those who were classified as fair or poor were considered to have unsatisfactory results. During the course of the study, 79% of the patients had satisfactory results. The percentage of patients with satisfactory results increased as the study progressed. The surgical technique was modified as new biomechanical principles were applied to ACL reconstruction. Rehabilitation of the patients was also progressively changed from conservative to aggressive. The authors attribute the improvement from 67% of patients with satisfactory results in 1984 to 85% in 1988 at least partially to these modifications. It was concluded that either frozen or freeze-dried aseptically excised and processed bone-patellar tendon-bone and Achilles tendon allografts can serve adequately for the reconstruction of ACLs. Complications may be reduced and clinical end results improved by adherence to an exact, reproducible surgical technique and an aggressive rehabilitation regimen.

Achilles Tendon↗
PubMedDate not supplied

[Extracorporeal shock-wave lithotripsy for the treatment of calcific tendonitis of the glutaeus maximus tendon].

Calcific tendinitis at the femoral insertion of the glutaeus maximus tendon is an unusual but well-described location for an ossifying enthesopathy. Extracorporeal shock-wave lithotripsy has become a standard therapy for various pathologies in orthopaedics. We report a case of a 50-year-old man with painful calcific tendinitis at the femoral insertion of the glutaeus maximus tendon who successfully underwent extracorporeal shock-wave treatment.

Adult↗
PubMed2006

Anterior cruciate ligament reconstruction in females: a comparison of hamstring tendon and patellar tendon autografts.

This study compared hamstring (HS) and patellar tendon (PT) anterior cruciate ligament (ACL) reconstruction in females. Sixty-five patients (43 HS, 22 PT) were evaluated at a mean 3.8-year postoperatively. Evaluation included IKDC 2000, SF-36, Cincinnati sports activity scores, anterior knee pain (AKP), kneeling pain, range of motion and anterior knee laxity. One PT patient sustained a traumatic graft rupture. There were no differences between the two grafts in terms of anterior knee laxity or IKDC scores. The HS group had higher sports activity scores and higher scores on the Physical Functioning and General Health subscales of the SF-36. Despite no difference in AKP, there was greater kneeling pain in the PT patients, who also had greater extension deficits. Both HS and PT are satisfactory ACL grafts in females, but HS grafts were associated with less morbidity, greater return to preinjury level of activity and higher quality of life scores.

Adolescent↗
PubMed2001

Patellar tendon vs. doubled semitendinosus and gracilis tendon for anterior cruciate ligament reconstruction.

In a prospective study on ACL reconstruction we treated 17 patients with a "central third-bone-patellar tendon-bone" autograft (PT group) and 32 patients with a doubled semitendinosus/doubled gracilis autograft (HS group). Patients were reviewed at 6 weeks, and at 3, 6, and 12 months postoperatively and the groups compared. Up till 6 months, the KT-1000 side-to-side difference was significantly greater in the HS group (P<0.05) and at 6 and 12 months isokinetic hamstrings strength was lower (P<0.05). No significant differences were noted at any stage with respect to quadriceps strength, functional scores, range of motion, or swelling.

Adolescent↗
PubMed2006

Monopolar radiofrequency energy application to the dorsal extensor tendon apparatus in a canine model of tendon injury.

PURPOSE: To evaluate the use of monopolar radiofrequency energy (MRFE) to shorten stretched dorsal extensor tendon apparatus (DETA) tissues in a canine model. METHODS: Eleven adult canine forelimbs were used in this in vitro investigation. The DETA tissue was isolated between the metacarpophalangeal and proximal interphalangeal joints in the third and fourth digits of each limb. Isolated tissue was stretched in all but 2 of the digits (control group). After tissue stretching, monopular radiofrequency energy (MRFE) was applied to 18 of the digits at 1 of 3 temperatures: 50 degrees C, 60 degrees C, or 70 degrees C (stretch-treatment group). Two digits were treated identically, but MRFE was not applied (stretch-only group). Tissue length was measured before and after stretching and after treatment. Percent stretch, percent shortening, and percent original length were compared among the 3 stretch-treatment groups. All DETA specimens were examined with light microscopy. RESULTS: Histologic changes were apparent in the stretch-treatment and stretch-only specimens compared with controls. Percent stretch was not significantly different between groups. Percent shortening and percent original length were significantly lower and higher, respectively, in the 50 degrees C group than in the 60 degrees C and 70 degrees C stretch-treatment groups, which were not significantly different from each other. There was a significant linear correspondence between percent shortening and treatment temperature. CONCLUSIONS: The application of MRFE at a temperature of 60 degrees C and a power of 10 W appears to shorten stretched DETA tissue to approximately the prestretched length in an in vitro canine model. Further investigation is necessary to determine the effect of treatment on the tissue's mechanical properties.

Animals↗
PubMed1977

Repair of flexor tendons by intratendinous tendon suture.

In a three year period, severed flexor tendons in the fingers and palm of 50 patients were repaired using an intratendinous suture method. The majority were secondary repairs, and 21 of 50 were in children less than 15 years of age. Results were satisfactory, with 79% being rated as good or excellent. The technique apparently causes little disturbance in the circulation, and if adhesions develop, they are limited and good results can be expected from tenolysis.

Adolescent↗
PubMed1979

Determination of muscle-tendon unit properties during tendon transfer.

Data on passive lengthening and active shortening from electrical stimulation to give a total functional excursion are presented. Length-tension characteristics of certain muscles used for transfer are given. Electrical stimulation of the newly transferred tendon gives useful information that is reproducible. This new knowledge obtained at operation is an important adjunct to the traditional techniques and provides helpful information in performing better procedures.

Adult↗
PubMedDate not supplied

Reconstruction of neglected Achilles' tendon defect with peroneus brevis tendon allograft: a case report.

This case report describes the use of a peroneus brevis allograft to reconstruct a neglected Achilles' tendon injury in a 75-year-old woman. She had difficulty walking, had stiffness, and was unable to perform a heel raise from a single-leg standing position. Magnetic resonance imaging confirmed a 6.8-cm wide defect 13 months after the initial injury. Surgical repair of the neglected rupture was performed using 4 strands of peroneus brevis allograft to bridge the defect. Early weight bearing and rehabilitation was allowed. At follow-up clinical examination 14 months postoperation, the patient could perform 15 full-range standing heel raises on the involved side versus 22 on the noninvolved side. Maximum calf circumference was 30.7 cm in the operated leg versus 33 cm at the noninvolved side. At 24 months postoperation the patient could perform 16 full-range standing heel raises on the injured leg versus 24 on the normal leg (33% deficit). The maximum calf circumference improved to 31 cm on the injured side compared with 34 cm on the noninvolved side (9% deficit). The AOFAS Ankle-Hindfoot Clinical Rating System score improved from 55 just before operation to 96 at 14 months postoperatively. The score further improved to 100 at the 2-year follow-up examination. The patient was playing recreational doubles tennis 1 to 2 times per week without symptoms.

Achilles Tendon↗
PubMed2001

Limitation of flexor tendon excursion by heterotopic ossification after isolated flexor tendon laceration.

A patient, one year after flexor digitorum superficialis/profundus repair in the left index finger, was diagnosed with heterotopic ossification involving the palmar surface of the proximal phalanx creating a secondary proximal interphalangeal joint contracture. A Compass PIP Hinge facilitated the treatment. Flexor tendon excursion improved, and active range of motion increased from 60 to 90 degrees before surgery to 30 to 105 degrees 20 months after surgery. Ectopic bone involvement of the hand is rare. This article reports a successful treatment for a unique complication of flexor injury and repair.

Accidents, Occupational↗
PubMed1989

[Suture of the Achilles tendon with a reinforcing-plasty--experiences with 30 primary sutures of Achilles tendon ruptures].

We analysed 32 patients with fresh Achilles tendon rupture. 30 operations with a special primary suture and plasty of the fascia triceps muscle. Most of the patients were content with the operative treatment and the functional result. We saw one wound infection and one wound rand necrosis. The objective controls of OSG foot function and the muscle activity is good.

Achilles Tendon↗
PubMed2002

[Clinico-histologic comparison of allogenic and autologous bone-tendon-bone using one-third of the patellar tendon in reconstruction of the anterior cruciate ligament].

Reconstruction of the ruptured anterior cruciate ligament (ACL) using modern techniques achieves successful long-term results in up to 90% of all cases. Yet the discussion continues as to the suitable implant to replace the ACL in terms of donor morbidity, implant reaction, long-term results, and potenzial risk of carrier concerning the allograft. The clinical and histological results from 2 years experience with the BPTB allograft (Tutoplast) and the BPTB autograft for ACL reconstruction are compared with reference to stability, functionality, rerupture rate, and histological reaction of the remodelling process. A BTB patella tendon allograft was implanted into 132 patients and a BPTB autograft into 136 patients. The patients were randomly allocated to the two groups. The results were recorded by an independent researcher and assessed according to the IKDC and Lysholm score. In the allograft group, a total of 20 patients (2.6%) reruptured within an average period of 11.75 months. In the autograft group, the transplant reruptured in five patients (4.8%) after an average of 17 months. Histological reappraisal indicated delayed incorporation and extended reconstruction in the BPTB allograft. There were clearer and more protracted indications of hypercellularity and hypervascularity, and the collagen matrix had not regularly aligned longitudinally even 1 year later. A detailed analysis of the BPTB allograft group indicated that especially in young and very sporty patients there is increased elongation of the implant and a clearly higher rerupture rate. Hence, according to the data we have collected, it would seem that the use of the BPTB allograft (Tutoplast) is not suitable especially in young patients who frequently practice high-level sports involving high knee stress.

Adult↗
PubMed2006

A prospective comparison of bone-patellar tendon-bone and hamstring tendon grafts for anterior cruciate ligament reconstruction in male patients.

The aim of the study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using central-third, bone-patellar tendon-bone (BPTB Group) (n = 45) and four-strand semitendinosus/gracilis (ST/G Group) (n = 78) autografts in male patients. The type of study is non-randomised, prospective consecutive series. A consecutive series of 126 male patients, all with unilateral ACL ruptures, was included in the study. In both groups, interference screw fixation of the graft was used at both ends and 123/126 (97%) of the patients returned for the follow-up examination after a period of 25 (23-33) months. The pre-operative assessments in both groups were similar in terms of the Tegner activity level, the Lysholm knee scoring scale, KT-1000 measurements, one-leg-hop test and knee-walking test. A significant reduction in knee laxity as measured with the KT-1000 arthrometer, compared with the pre-operative assessments, was found in both groups (P < 0.001). No significant differences in the post-operative knee-laxity measurements were found between the groups. Both groups had a significantly improved functional outcome at follow-up in terms of the Lysholm knee scoring scale, Tegner activity level and one-leg-hop test. The BPTB Group had a significantly higher Tegner activity level at follow-up, compared with the ST/G Group (P = 0.02). Moreover, the patients in the BPTB Group were significantly more likely to have a Tegner activity level of 6 or above (P = 0.03). Otherwise, no significant differences were found between the two study groups at the 2-year follow-up. Two years after an ACL reconstruction, the two groups displayed no significant differences in terms of functional outcome and knee laxity. However, more patients in the BPTB Group returned to a higher Tegner activity level than that in the ST/G Group.

Adolescent↗
PubMed1989

The independent long extensor tendon of the fifth toe as a source of tendon grafts for the hand.

The anatomical relationships of the extensor of the fifth toe to the long extensor of the other toes have been studied in 78 cadaver specimens. 50% of the specimens had an independent extensor to the fifth toe without interconnections to the other long toe extensors or the peroneus tertius. The independent fifth toe extensor was consistently of good quality and adequate length for use as a tendon graft, for which purpose it has been successfully used in five patients, with transfer of the adjacent long extensor from the fourth toe to maintain extension of the fifth metatarso-phalangeal joint.

Hand↗
PubMed2004

Biceps tendon and triceps tendon injuries.

Injuries to the biceps and triceps tendons about the elbow are relatively infrequent. Typically, they are traumatic events that occur as a result of a forceful eccentric contraction. Early recognition of these injuries and prompt intervention are the cornerstones to a successful outcome. Acute anatomic repair of complete injuries offers predictably good results. Conservative management, on the other hand, is typically reserved for partial injuries with little functional compromise, and for patients unfit for surgery. The challenges posed by chronic injuries can be addressed with a variety of surgical options. This article focuses on the timely identification and diagnosis of these injuries and specific indications and guidelines for their treatment.

Adult↗
PubMed2003

The assessment of flexor tendon function after primary tendon repair.

Because the actual methods of assessment and the grading of these methods in favor at any one time have changed so much over the last 50 years, the usefulness of the considerable experience in this field for practitioners today is much reduced. Agreement on the systems of assessment to be used for the different parts of the flexor system would allow a better exchange of knowledge worldwide at this time and a more useful cumulative experience for the next 50 years. If an acceptable method of assessment of any particular injury and its treatment can be agreed on by all, two stages remain for us to audit our work. The first is identifying how much we must downgrade the expectations of the assessment to accommodate the imperfections of our treatments. Most patients would consider an "excellent" result to be a return to normal. Currently, using, for example, the first Strickland system of assessment, we are happy to call any result of primary repair of a zone 2 flexor tendon division greater than 85% of normal, "excellent." How much we should reasonably downgrade our assessments is a variable that one hopes would reduce with accumulated experience, but one that makes repeated adjustment of our methods of assessment essential. Having set the level of the "excellent," "good," "fair," and "poor" qualifying bands relative to normal digital function, it only remains to take our measuring instruments out of their boxes and measure!

Finger Injuries↗