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At least 631 records · Page 35Linked to original sources
PubMed1990

Dystrophin-deficient mdx muscle fibers are preferentially vulnerable to necrosis induced by experimental lengthening contractions.

Lengthening contractions were induced in the right anterior tibialis muscles (ATM) of anaesthetized normal and mdx (dystrophic) mice by supramaximal, nonfatiguing stimulation of the sciatic nerve for 180 min. In the left ATM of the same animals identical stimulation caused shortening contractions because of a prestimulation Achilles tenotomy. The prevalence of recently necrotic fibers was determined in all stimulated ATM by demonstrating the presence of IgG in the necrotic fibers using immunoperoxidase staining of cryostat sections. The results were compared to unstimulated normal and mdx ATM. A significantly higher rate of necrosis was demonstrated after lengthening contractions in the mdx ATM than normal ATM. Unstimulated normal and mdx ATM have either no or extremely infrequent necrotic fibers. We suggest that the enhanced vulnerability of mdx muscle fibers to lengthening contractions is related to the deficiency of dystrophin, which renders the sarcolemma more susceptible to suffer focal breaks. A similar situation may occur in Duchenne muscular dystrophy.

Animals↗
PubMed1975

The effects of zinc on ectopic bone formation.

The effect of dietary zinc deficiency was studies in ectopic bone formation subsequent to Achilles tenotomy and also following the implantation of demineralized bone matrix in the muscle of rats. Three experiments were performed. The first was designed to investigate the relationship between zinc and calcium concentration during the formation of ectopic bone in rats fed a commercial laboratory ration, the second concerned the effects of dietary zinc deficiency on ectopic bone formation, and the third studies the subsequent effects of dietary zinc repletion on ectopic bone formation. The results indicated that, with the commercial ration, zinc increased concomitantly with calcium during ectopic bone formation in rats. Dietary zinc deficiency caused a retardation of ectopic bone formation and a significant reduction of in situ zinc and calcium concentration. Dietary zinc repletion to zinc-deficient animals restored the zinc concentration in ectopic bone to a level comparable to that of zinc-sufficient animals. Thus, these experiments present strong evidence that zinc plays an active role in bone metabolism.

Abdomen↗
PubMedDate not supplied

Anterior segment ischemia after strabismus surgery.

Surgery on the extraocular muscles of the eye is generally consisted a safe procedure which is associated with low morbidity and mortality. While infrequent, intra-operative complications occasionally occur. Tenotomy of multiple rectus muscles can result in interruption of the vascular supply to the anterior segment of the eye. Anterior segment ischemia (ASI) may result. This article reviews the complication of anterior segment ischemia as a result of strabismus surgery and its potential for producing permanent visual loss.

Anterior Eye Segment↗
PubMed1992

Ultrastructural morphometry of membrane-bound intracytoplasmic collagen fibrils in tendon fibroblasts exposed to He:Ne laser beam.

Collagen fibrils are not found in fibroblast cytoplasm except in certain pathological conditions or in the presence of drugs and other agents that accelerate collagen turnover. Because low energy laser photostimulation is both a non-pathogenic and non-chemical accelerator of collagen synthesis, its effects were studied on four groups of calcaneal tendons from 18 rabbits (1) to test the hypothesis that vacuolar fibrils are not produced exclusively by diseases and chemical agents, and (2) to compare the morphometry of matrical and vacuolar fibrils. The right calcaneal tendons of nine rabbits were surgically tenotomized and repaired; six of these were transcutaneously irradiated with He:Ne laser everyday. The right calcaneal tendon of six of the remaining nine rabbits were similarly irradiated with laser, but without prior tenotomy and repair. 21 days later, all tendons were fixed in situ and processed for electron microscopy. Fibril-bearing vacuoles were found only in fibroblasts of tenotomized laser-irradiated tendons. Similar vacuoles were not seen in non-tenotomized laser-irradiated tendons nor in non-irradiated tendons whether tenotomized or not. Mann-Whitney U tests revealed no statistically significant differences in the cross-sectional areas or diameters of matrical and vacuolar fibrils. These findings suggest (a) that matrical and vacuolar fibrils have a common origin, and (b) that vacuolar fibrils can be induced by a non-pathologic, non-chemical accelerator of collagen synthesis.

Animals↗
PubMed1986

Increase of neurite-promoting activity for spinal neurons in muscles of 'paralysé' mice and tenotomised rats.

Various lines of evidence from in vivo and in vitro experiments suggest that muscle-derived factors may enhance the survival and axonal outgrowth of spinal neurons. Our previous results using cultures of embryonic spinal neurons showed that denervation of skeletal muscle increased levels of a neurite-promoting activity in soluble muscle extracts. Here, two other experimental models in which muscle activity was also lowered were investigated. The mutant mouse 'paralysé' exhibits a spontaneous regression of motor nerve endings, with concomitant paralysis. In 'paralysé' mutant muscle extracts, specific neurite-promoting activity was up to 10-fold higher than in extracts prepared from control littermates. Tenotomy is known to retard the regression of polyneuronal motor innervation in skeletal muscle from neonatal rats. Three days after operation, levels of neurite-promoting activity were increased 2-fold with respect to total protein. These results suggest that skeletal muscle activity might regulate the synthesis of molecules affecting nerve growth.

Age Factors↗
PubMed1983

Rapid adjustment of sarcomere length in tenotomized muscles depends on an intact innervation.

Mean sarcomere length has been determined by laser diffraction in fibres of mouse soleus muscle at various times after division of the proximal tendon. Sarcomere length was initially reduced by 27% but was normal from 7 days after tenotomy. Initial shortening was less but recovery slower if the muscle was also denervated. Sarcomere length did not recover by 14 days if the tendon was cut soon after the muscle fibres became reinnervated after nerve section. It is suggested that afferent nervous pathways are involved in the short-term adjustment of sarcomere length to fibre length.

Afferent Pathways↗
PubMed1984

Purification, molecular properties and biosynthesis of a specific protein component induced under compensatory hypertrophy in the rat skeletal muscle.

The compensatory hypertrophy in the rat skeletal muscle was induced by the method employing tenotomy and the protein components of the hypertrophied muscle were compared with those of the control muscle by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. A protein component, referred to as 64-kDa protein, increased in quantity in the hypertrophied muscle. 64-kDa protein was purified to homogeneity from the extract of the rat skeletal muscle and its molecular properties were studied. Based on criteria which include molecular weight, amino acid composition and immunochemical reactivity, 64-kDa protein was indistinguishable from rat serum albumin. In vitro culture of muscle cells provided evidence showing that 64-kDa protein is synthesized in the muscle cells and rate of its synthesis is significantly greater in the hypertrophied muscle.

Amino Acids↗
PubMed1989

Difference in thiamine metabolism between extensor digitorum longus and soleus muscles.

1. Thiamine diphosphate level was higher in soleus muscle than in extensor digitorum longus muscle in various animals, whereas thiamine triphosphate level was less in the former muscle than in the latter except for mouse. 2. 2-Oxoglutarate dehydrogenase, transketolase and thiamine pyrophosphokinase activities were higher in soleus muscle than in extensor digitorum longus in rat and guinea pig. 3. The differences between rat two muscle phenotypes in thiamine diphosphate, but not thiamine triphosphate, level and the thiamine-related enzyme activities disappeared after denervation. 4. Tenotomy had little effect on thiamine phosphate levels and the thiamine-related enzyme activities in rat skeletal muscles.

Animals↗
PubMed1996

Early postnatal muscle contractile activity regulates the carbonic anhydrase phenotype of proprioceptive neurons in young and mature mice: evidence for a critical period in development.

Carbonic anhydrase activity, a marker of mouse proprioceptive neurons in adult dorsal root ganglia, is first detectable in the perinatal period, increases until postnatal day 60 and remains stable in adulthood. The onset of carbonic anhydrase staining begins after the neurons have made connections with their targets suggesting that neuron-target interactions regulate carbonic anhydrase phenotype development. To examine this possibility, we first analysed carbonic anhydrase expression in mdx mice which are characterized by a massive but reversible degeneration of skeletal muscle concomitant with the carbonic anhydrase ontogenesis. Neuronal carbonic anhydrase expression in mdx mice stopped developing when the period of muscular degeneration-regeneration began. Furthermore this alteration persisted during adulthood. We then analysed carbonic anhydrase expression in fifth lumbar dorsal root ganglion of developing control mice before and after surgical procedures that might interfere with central and peripheral target influences on dorsal root ganglion neurons. Central disconnection (dorsal rhizotomy) did not affect the development of carbonic anhydrase activity. Disrupting neuron-peripheral target interactions by sciatic nerve transection or blocking muscle contraction by tenotomy stopped the development of neuronal carbonic anhydrase content. Finally, recovery was monitored following sciatic nerve crush. In adults, recovery of carbonic anhydrase activity was obtained after functional recuperation; similar manipulations during the first month of life induced irreversible alteration of the carbonic anhydrase phenotype. These results show that the development of carbonic anhydrase activity in proprioceptive neurons is regulated by neuron-muscle interactions (i.e. muscle contraction). They also provide evidence for a critical period in the development of the carbonic anhydrase phenotype. We suggest that these two mechanisms are responsible for the altered carbonic anhydrase phenotype of the dorsal root ganglion neurons in mdx mice, a model of human muscular dystrophy.

Age Factors↗
PubMed1995

Arthrogryposis multiplex congenita due to congenital myasthenic syndrome.

Two children, now 5 1/2 and 6 years of age, presented as neonates with hypotonia, multiple joint contractures, ptosis, extraocular weakness, bulbar symptoms, and respiratory distress. Fluctuations and episodic exacerbations of weakness necessitated respiratory support. Both children are developmentally delayed and cannot walk independently, although one child underwent bilateral tenotomies. Biochemical investigations and electromyography, including slow-rate, repetitive nerve stimulation, were normal. Acetylcholine receptor antibodies in serum were absent. Single-fiber electromyography with axonal stimulation revealed prolonged mean jitter in the tibialis anterior and extensor digitorum muscles, with more than 2 abnormal individual jitter values in each muscle. Muscle biopsy demonstrated normal pattern and morphology of muscle fibers; immunohistochemical staining for cholinesterase was positive. Electron microscopy revealed abnormalities in motor endplates: atrophy, flattening of primary synaptic clefts, and paucity of side branches. These findings represent one of the postsynaptic abnormalities (i.e., acetylcholine receptor deficiency or paucity of synaptic folds). Both children improved clinically on pyridostigmine therapy. Arthrogryposis congenital multiplex due to congenital myasthenic syndrome, as diagnosed in our patients, has been reported once before. The diagnosis can be established by clinical history, neurologic examination, and electrophysiologic and pathologic findings. Clinical improvement can be achieved with high-dose anticholinesterase therapy.

Arthrogryposis↗
PubMed2004

Arthroscopic biceps tenodesis.

Arthroscopic biceps tenodesis is indicated for the treatment of severe biceps tendonopathy, partial- or full-thickness tendon tears, or biceps instability typically associated with rotator cuff tear, although there has been considerable debate on tenotomy versus tenodesis. We advocate tenodesis, for the following reasons: to re-establish the resting muscle length so as to avoid scaring and spasm, to allow biceps use for complex elbow motion, and to avoid cosmetic defects in cases in which deformity can sometimes equal disability. This technical note provides illustrations and detailed descriptions of our arthroscopic tenodesis technique using a Arthrex (Naples, FL) biotenodesis system.

Absorbable Implants↗
PubMed2004

Arthroscopic bicipital sheath repair: two-year follow-up with pulley lesions.

PURPOSE: The purpose of this study was to evaluate arthroscopic repair in patients who had lesions of both the subscapularis insertion/medial head of the coracohumeral ligament and the lateral head of the coracohumeral ligament and supraspinatus tendon (a type 5 biceps subluxation/instability classification), and to determine if primary repair of the torn structures used to reconstruct the bicipital sheath was associated with a high biceps rupture rate. The null hypothesis, that there is no difference between preoperative and postoperative outcomes, was tested. TYPE OF STUDY: Prospective cohort. METHODS: Since 1995, the author has had 18 patients who had lesions that affected both the medial and lateral wall of the bicipital sheath. An adjunct was added if tendonitis was present with fraying, and the biceps tendon was debrided if the fraying consisted of 50% or less the width of the tendon. This was chosen arbitrarily. Greater than 50% fraying of the biceps tendon was treated with repair of the supraspinatus and subscapularis. The biceps tendon was treated with tenotomy or tenodesis in these cases and these patients were not included in this study. This article reports on the repair technique and results having a minimum of 2-year follow-up. RESULTS: There were 12 male patients (age range, 45 to 80 years; average, 62 years) and 6 female patients (age range, 50 to 85 years; average, 66 years). The dominant extremity was involved in 12 of the 16 extremities. Preoperative, ASES Index, Total Constant scores, Subjective Constant scores, Objective Constant scores, visual analog pain scales, and percent function were 31 +/- 19, 53 +/- 13, 12 +/- 8, 41 +/- 8, 7 +/- 3, and 42 +/- 17, respectively. Postoperative scores were 80 +/- 14, 77 +/- 10, 30 +/- 4, 47 +/- 7, 2 +/- 2, and 84 +/- 14, respectively. The null hypothesis was rejected at a level of P = .001, .001, .001, .05, .001, and .001, respectively. CONCLUSIONS: There was 1 biceps disruption in this cohort following repair, for an incidence rate of 6%. There were 2 patients, active tennis players, who had recurrence of biceps inflammation in the follow-up period with no evidence of biceps subluxation. The arthroscopic technique reported is a primary repair used to reconstruct the normal structures of the groove. This may explain why previous recommendations not to reconstruct the groove because of the high biceps disruption rate have been noted previously. This study did not deepen the groove, tubulize the biceps tendon, or close the rotator interval in nonanatomic fashion. This arthroscopic technique is technically feasible and can alleviate the symptoms of biceps tendon inflammation and/or subluxation in the majority of cases in this cohort. LEVEL OF EVIDENCE: Level IV, Case Series.

Aged↗
PubMed2005

Arthroscopic-assisted surgical treatment for developmental dislocation of the hip.

PURPOSE: Treatment of developmental dislocation of the hip (DDH) includes surgical management in older children or in those who cannot be treated conservatively. However, complication rates of surgical treatment are quite high. The purpose of this report is to introduce our new surgical technique that can eliminate existing pathologic changes in DDH. TYPE OF STUDY: A small case series. METHODS: We performed arthroscopic-assisted surgical treatment in 4 hips of 4 female children who had DDH and no previous treatment. Their ages ranged from 11 to 14 months. Closed reduction under general anesthesia was tried just before the surgical intervention, but it failed in all of them. Tightness of the iliopsoas tendon was released followed by dissection of capsular adhesions using an anterolateral mini-incision. Excision of the hypertrophic ligamentum teres, transverse acetabular ligament, and pulvinar tissue was carried out using a double-portal arthroscopic procedure. We performed percutaneus adductor tenotomies in 2 cases. A spica cast and abduction splint were used for 12 to 17 weeks postoperatively. The follow-up of the patients was a minimum of 1 year. Although a 1-year follow-up period is adequate to evaluate the short-term results, it has been considered that there is a need for further studies that include long-term follow-up. We used the acetabular index and Shenton's line for preoperative and postoperative radiologic evaluation. Also, the cases were evaluated postoperatively in respect to range of motion restriction and the leg length discrepancy. RESULTS: The mean follow-up was 13.7 months (range, 12 to 16 months). Acetabular index measurements of the cases in the preoperative/postoperative periods were as follows: in the first case, 34 degrees/27 degrees; in the second case, 35 degrees/22 degrees; in the third case, 52 degrees/39 degrees; and in the fourth case, 40 degrees/28 degrees. Hip joint restriction and leg length discrepancy were not observed postoperatively. CONCLUSIONS: All the intra-articular structures (hypertrophic ligamentum teres, transverse acetabular ligament, and pulvinar tissue) in the acetabulum that impede the reduction of the femoral head have been eliminated by using the arthroscopic technique. The arthroscopic-assisted surgical treatment of DDH is successful in the short-term follow-up period. LEVEL OF EVIDENCE: Level IV, Case Series.

Acetabulum↗
PubMed2005

Arthroscopic biceps tenodesis using interference screw: end-tunnel technique.

The conflict between tenotomy versus tenodesis for biceps lesions of the shoulder has not been resolved. We, however, believe that tenodesis is the treatment of choice until proven otherwise. Hence our department has been performing arthroscopic tenodesis for biceps subluxation or partial tears that involved over 50% of its diameters. We introduce our technique of arthroscopic biceps tenodesis in which the biceps tendon is fixed in the sequentially enlarged bony end-tunnel using bioabsorbable interference screws without transosseous drilling.

Absorbable Implants↗
PubMed2005

Posterior heel pain (retrocalcaneal bursitis, insertional and noninsertional Achilles tendinopathy).

The majority of patients with Achilles tendinopathy respond to nonoperative treatment. In patients with refractory symptoms, surgery can be considered. If paratenonitis is present, the paratenon is partially excised, and adhesions are released. Areas of symptomatic tendinosis are excised with repair of the residual defect in the Achilles tendon. An alternative for patients with tendinosis who are at increased risk for wound problems or who do not want a large open incision is percutaneous or endoscopic tenotomy. A symptomatic Haglund's deformity or inflamed retrocalcaneal bursa is excised. Augmentation of the Achilles tendon may be considered if debridement threatens the structural integrity of the tendon, in older patients, and in revision surgery.

Achilles Tendon↗
PubMed2006

The Ponseti technique for treatment of talipes equinovarus.

Traditional treatment for clubfoot usually includes initial casting and an extensive posterior medial soft tissue release with biplanar pinning, followed by more casting. This treatment has significant risks, complications, and the potential for a poorer prognosis as the patients age, usually with stiff and scarred feet. In contradistinction, Ignacio Ponseti has been using his unique technique of clubfoot manipulation, casting, and Achilles tenotomy for more than 50 years with a high degree of success. Currently, there are many peer-reviewed and independently verified studies that replicate his success in treating clubfoot. This technique is easy to learn and is becoming the accepted treatment of idiopathic clubfoot all over the world.

Achilles Tendon↗
PubMed2006

Reconstruction of the foot after leg or foot compartment syndrome.

Compartment syndrome should be treated early and aggressively to prevent late complications. Patients may have late deformity because of a failure of diagnosis, inadequate decompression, or a delay in fasciotomies. Late reconstruction will allow a plantigrade and relatively functional foot. Complete excision of scarred muscle will prevent recurrence in established deformities. Early treatment may prevent significant functional impairment by well-placed tenotomies. In patients with severe long-term deformities with extensive soft tissue contraction, incremental correction may be an appropriate intermediate intervention.

Compartment Syndromes↗