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PubMed2000

Morphological changes of capillaries in the rat soleus muscle following experimental tenotomy.

We examined the structural changes of capillaries in the rat soleus muscle 4, 7, 14, and 35 days after experimental limb tenotomy. In the soleus muscles after tenotomy, muscle fibres degenerated and some of them were destroyed; the muscle did not seem to recover until the 35th day. On the 14th day, some small muscle fibres, probably regenerating muscle fibres, started forming within the basal-lamina tube and remained after necrosis of a pre-existing muscle fibre. Most capillaries at each stage were of the continuous type. However, about 10% of the capillaries around degenerated muscle fibres at days 4, 7 and 14 consisted of endothelial cells with a small number of fenestrae bridged by a single-layered diaphragm. On the 14th day, capillaries around small regenerating muscle fibres also often had a small number of fenestrations. Even on the 35th day, capillaries occasionally had fenestrations. Additionally, some of the fenestrated capillaries formed small pores at the fenestrated portion of the endothelial cells. The untreated muscles contained only continuous capillaries. These findings suggest that fenestrations in the endothelial cells may occur in intramuscular capillaries not only around degenerated muscle fibres but also around regenerating muscle fibres after tenotomy.

Achilles Tendon↗

PubMedDate not supplied

Prolongation of ambulation in children with Duchenne muscular dystrophy by subcutaneous lower limb tenotomy.

To assess the effect of subcutaneous (s.c.) lower limb tenotomies on the ambulatory ability of patients with Duchenne muscular dystrophy (DMD), 54 patients were followed. Twenty-nine patients underwent hip, knee, and ankle tenotomies at a mean age of 10 2/12 years and were followed postoperatively for an average of 3 9/12 years. These children continued ambulation in long-leg braces to a mean age of 12 8/12 years and stood to an average of 13 5/12 years. Contracture correction was 49% at the hip, 58% at the knee, and 100% at the ankle. A separate group of 25 children to whom operation was offered but declined, was followed: these children ceased ambulating at a mean age of 10 years and ceased standing at a mean age of 10 2/12 years. Thus, we propose that s.c. tenotomy is effective in allowing braced ambulation well beyond what the natural history would allow.

Achilles Tendon↗

PubMed1986

The effects of tenotomy and compensatory hypertrophy on the postnatal development of soleus motor units in the cat.

Kittens, 5-7 days old, were subjected to tenotomy of either the soleus muscle or all its Achilles tendon synergists. When the cats had reached the adult stage, the physiological properties of the soleus motor units were investigated in both the atrophic and hypertrophic situations. Tenotomy resulted in a marked muscle weight loss and overload due to tenotomy of synergists in a marked gain in muscle weight compared to the contralateral side. The motor units of the tenotomized soleus muscles exhibited a moderate shortening of the twitch contraction time, and also a change in twitch shape, related to the degree of atrophy. In the motor units of the hypertrophic soleus muscles, an increased fatiguability could be demonstrated. Further, in this group, there was a tendency towards differentiation of the normally uniform motor units into two groups with different features. The functional implications of this process are discussed. The development of motor units in both the tenotomized and the hypertrophic muscles were only marginally influenced by the operations, and it is concluded that the basic features of their development are largely unaffected by the functional manipulations imposed in the present study.

Animals↗

PubMed1969

Functional consequences of tenotomy in hind limb muscles of the cat.

1. The chronic EMG activity and the contractile properties of normal, denervated or tenotomized cat triceps surae muscles were measured.2. Following Achilles tenotomy no measurable change in EMG activity occurred in either the soleus or medial gastrocnemius muscles.3. No change in the twitch time or tetanus-twitch ratio was seen following tenotomy in these muscles despite marked atrophy of the muscle. Measurements were made 3-10 weeks following the tenotomy procedures.4. Denervation results in some prolongation of the gastrocnemius twitch.5. The relationship between the contractile properties of a given muscle and the aggregate amount of activity imposed on that muscle by its innervation is discussed.

Achilles Tendon↗

PubMed2000

Tenotomy decreases reporter protein synthesis via the 3'-untranslated region of the beta-myosin heavy chain mRNA.

We tested the hypothesis that the beta-myosin heavy chain (beta-MHC) 3'-untranslated region (UTR) mediates decreased protein expression after tenotomy of the rat soleus. We also tested the hypothesis that decreased protein expression is the result of RNA-protein interactions within the 3'-UTR. beta-MHC was chosen for study because of its critical role in the function of postural muscles such as soleus. Adult rat soleus muscles were directly injected with luciferase (LUC) reporter constructs containing either the beta-MHC or SV40 3'-UTR. After 48 h of tenotomy, there was no significant effect on LUC expression in the SV40 3'-UTR group. In the beta-MHC 3'-UTR group, LUC expression was 37.3 +/- 4% (n = 5, P = 0.03) of that in sham controls. Gel mobility shift assays showed that a protein factor specifically interacts with the beta-MHC 3'-UTR and that tenotomy significantly increases the level of this interaction (25 +/- 7%, n = 5, P = 0.02). Thus the beta-MHC 3'-UTR is directly involved in decreased protein expression that is probably due to increased RNA-protein binding within the UTR.

3' Untranslated Regions↗

PubMed1983

Primate ocular blood flow following contiguous recti tenotomy.

Tenotomy of the medial and superior recti resulted in decreased blood flow to only the superior quadrant of the unit iris, ciliary body with processes (ICBCP). Blood flow to the medial, lateral, and inferior quadrants of the ICBCP was maintained. These data support the contention that tenotomy initiates a compensatory increase in medial quadrant blood flow, probably via the medial long posterior ciliary artery. The superior quadrant appears to be the least protected from ischemia immediately following recti tenotomy.

Animals↗

PubMed1990

The effect of tenotomy and immobilisation on intramuscular connective tissue. A morphometric and microscopic study in rat calf muscles.

The effect of tenotomy and of immobilisation in lengthened and shortened positions on the intramuscular connective tissue of the calf muscles of the rat was studied morphometrically and with a scanning electron microscope. Both tenotomy and immobilisation produced a marked increase in both the endomysial and the perimysial collagen networks, with a simultaneous decrease in intramuscular capillary density. The increase in connective tissue volume was more pronounced and occurred more rapidly in the soleus, which consists mainly of type I, slow-twitch fibres than in the gastrocnemius, which is mainly of type II, fast-twitch fibres. The relative volume of connective tissue increased in parallel with the duration of immobilisation or after tenotomy. There was slightly more increase after immobilisation in a shortened rather than in a lengthened position.

Animals↗

PubMed2006

Correlation of clinical and ultrasonographic findings after Achilles tenotomy in idiopathic club foot.

Achilles tenotomy is a recognised step in the Ponseti technique for the correction of idiopathic congenital talipes equinovarus in most percutaneous cases. Its use has been limited in part by concern that the subsequent natural history of the tendon is unknown. In a study of 11 tendons in eight infants, eight tendons were shown to be clinically intact and ten had ultrasonographic evidence of continuity three weeks after tenotomy. At six weeks after tenotomy all tendons had both clinical and ultrasonographic evidence of continuity.

Achilles Tendon↗

PubMed2006

Sonographically guided percutaneous needle tenotomy for treatment of common extensor tendinosis in the elbow.

OBJECTIVE: Chronic tendinosis of the common extensor tendon of the lateral elbow can be a difficult problem to treat. We report our experience with sonographically guided percutaneous needle tenotomy to relieve pain and improve function in patients with this condition. METHODS: We performed sonographically guided percutaneous needle tenotomy on 58 consecutive patients who had persistent pain and disability resulting from common extensor tendinosis. Under a local anesthetic and sonographic guidance, a needle was advanced into the common extensor tendon, and the tip of the needle was used to repeatedly fenestrate the tendinotic tissue. Calcifications, if present, were mechanically fragmented, and the adjacent bony surface of the apex and face of the epicondyle were abraded. Finally, the fenestrated tendon was infiltrated with a solution containing corticosteroid mixed with bupivacaine. After the procedure, patients were instructed to perform passive stretches and to undergo physical therapy. During a subsequent telephone interview, patients answered questions about their experience, their functioning level, and their perceptions of procedure outcome. RESULTS: Fifty-five (95%) of 58 patients were contacted by telephone and agreed to participate in the study. Thirty-five (63.6%) of 55 respondents reported excellent outcomes, 16.4% good, 7.3% fair, and 12.7% poor. The average follow-up time from the date of the procedure to the date of the interview was 28 months (range, 17-44 months). No adverse events were reported; 85.5% stated that they would refer a friend or close relative for the procedure. CONCLUSIONS: Sonographically guided percutaneous needle tenotomy for lateral elbow tendinosis is a safe, effective, and viable alternative for patients in whom all other nonsurgical treatments failed.

Activities of Daily Living↗

PubMed1990

Tenotomy and postoperative brace treatment for muscular torticollis.

A postoperative corrective brace for congenital muscular torticollis is introduced and the results and indications for its use are presented. Thirty-three of 55 patients who underwent open tenotomy of the sternocleidomastoid muscle with application of the brace following surgery were evaluated in follow-up. Tenotomy was performed at the sternoclavicular origin of the muscle. The mean age at operation was six years; the mean follow-up period was seven years. The results were good in 21 patients (64%), fair in seven (21%), and poor in five (15%). Facial asymmetry remained in all patients over the age of ten who underwent operation. Alopecia, one of the complications of the brace, was found only in patients under age five. This combined treatment with tenotomy and postoperative brace is considered best indicated for patients between six and ten years of age.

Adolescent↗

PubMedDate not supplied

Adductor tenotomies in children with quadriplegic cerebral palsy: longer term follow-up.

Adductor tenotomy procedures for prophylaxis against severe hip subluxation in children with quadriplegic cerebral palsy have reported good to excellent success rates; however, the overall follow-up has been short. In a retrospective review designed to obtain longer term follow-up of adductor tenotomies in these children, we found that 58% of our patients had continued subluxation or dislocation with the eventual need for further surgery. These results differ significantly from those of previous studies. There was a trend among the patients who did well to have less preoperative subluxation than those who needed further intervention, but we did not find a statistically significant cut-off value that was predictive of success or failure. Age at the time of surgery also did not influence the outcome in our patient population. An 8-year average follow-up of adductor tenotomies showed a higher loss of hip stability than previous mid range follow-up studies.

Cerebral Palsy↗

PubMedDate not supplied

Influence of rectus eye muscles tenotomy on the aqueous humor composition in rabbits.

INTRODUCTION: Anterior segment ischaemia manifesting in aqueous malformation may follow tenotomy of the extraocular muscles. MATERIAL AND METHODS: Tenotomy of 2 or 4 rectus eye muscles was performed on the right eyes of 23 adult rabbits. The aqueous humor was withdrawn from the anterior chamber of both eyes in 7 rabbits on the 11th, on the 22nd in 8 and on the 32nd postoperative day in 8 rabbits. Aqueous natrium, potassium and glucose concentrations and protein electrophoresis were examined. RESULTS: The only significant change was lower mean aqueous potassium concentration in the operated eyes as compared to controls on the 11th postoperative day. CONCLUSION: Tenotomy of rectus eye muscles in healthy rabbits evoked a discrete blood-aqueous barrier break-down.

Albumins↗

PubMed1998

[The degeneration and regeneration of skeletal muscle after tenotomy].

In order to investigate the degeneration and regeneration of skeletal muscle fiber after tenotomy, the tenotomy were carried out on gastrocnemius muscles in 15 adult BALB/C mice. The tenotomized muscles were removed on 1, 2 and 4 weeks postoperatively. Specimens were processed for histological study with light microscope and TEM, and skeletal muscle specific protein expression analysis with myoactin (MA) and myoglobin (MG) immunohistochemical staining. The results showed that the regenerating muscle cells and the degenerating muscle fibre coexisted in tenotomized muscle. The internal structure and histochemical pattern of muscle fiber changed after tenotomy. The regenerating muscle cells fused with degenerating fibres.

Actins↗

PubMed2004

Graded partial tenotomy of vertical rectus muscles for treatment of hypertropia.

PURPOSE: To evaluate the effectiveness of graded (adjustable intraoperatively) partial vertical rectus muscle tenotomy at the insertion in correcting small degrees of hypertropia. METHODS: All patients with best-corrected visual acuity of better than 6/30 in both eyes who over a 30-month period underwent partial tenotomy of vertical rectus muscle(s) only (no concurrent oblique muscles) were included. Improvement was evaluated 6 weeks postoperatively as change in alignment in prism diopters (PD) in primary gaze and in the field of action of the affected rectus muscle(s). Binocular function was evaluated by Titmus stereoacuity and the Worth 4-light tests. RESULTS: All 24 patients who met criteria for inclusion had diplopia preoperatively versus seven patients (29%) postoperatively (P < .005, Student's paired t test). Prisms were used by six preoperatively versus two postoperatively (P < .05, Student's paired t test). The average vertical deviation in primary gaze decreased from 8 PD to 2 PD (P < .005, Student's paired t test). In the field of action of the treated rectus muscle, hypertropia decreased from an average of 8 PD to 3 PD (P < .005, Student's paired t test). For the preoperative and the postoperative assessments available, stereoacuity improved after 10 (56%) of the 18 procedures and Worth 4-light testing showed improvement or maintenance of fusion after 15 (79%) of 19 procedures. CONCLUSIONS: Graded vertical rectus partial tenotomy can effectively reduce small degrees of hypertropia and associated diplopia, improve binocular function, and reduce or eliminate the need for prism correction.

Depth Perception↗

PubMed1991

Changes in muscle structure following tenotomy. A scanning electron microscopical study in the rat.

The alterations caused by Achilles tenotomy in the calf muscles of the rat were studied one, two and three weeks postoperatively by scanning electron microscopy (SEM). One week after tenotomy connective tissue had accumulated in endomyseal and perimyseal structures, which continued to increase even more after two and three weeks. The normal muscle architecture was markedly disturbed and in individual muscle cells hypercontracted segments, longitudinal splitting as well as destruction of myofilaments were found. Apparently due to the loss of muscle tension some muscle cells were reversed on their long axis and fixed with the adjacent collagen fibres. Some muscle cells were spiral in shape or crossing over each other. Formation of myotubes indicated onset of regenerative processes. According to the SEM-analyses tenotomy has many severe deleterious effects on muscle structure. In clinical practice tendon ruptures should therefore be repaired as soon as possible to avoid degenerative--potentially irreversible--changes in the muscular tissue.

Animals↗

PubMed1986

Effects of tenotomy of the tensor tympani muscle on the acoustic reflex in dogs.

The acoustic reflex (AR) was recorded from 12 healthy mixed-breed dogs. Latency and amplitude were measured from ipsilateral and contralateral AR at stimulus frequencies of 1 and 2 kHz and intensities of 70 to 110 dB sound pressure level for ipsilateral AR and 70 to 120 dB hearing level for contralateral AR. Mean latencies for ipsilateral and contralateral AR were between 33.46 and 206.10 ms and between 45.26 and 180.89 ms, respectively, and amplitudes were between 0.14 and 1.79 cm3 and between 0.31 and 1.86 cm3 of air, respectively. Stimulus frequencies and intensities had significant effects (P less than 0.05) on ipsilateral and contralateral AR latencies and amplitudes. Ipsilateral and contralateral AR decays were determined by measuring compliance change during a 10-s pure-tone stimulation at frequencies of 1 and 2 kHz at an intensity of 10 dB above AR threshold. Reflex decays for 1 kHz and 2 kHz frequencies averaged 5.74% and 9.71%, respectively, for ipsilateral AR and 5.08% and 5.40%, respectively, for contralateral AR. Bilateral tympanograms and brain stem auditory-evoked responses were performed on each dog. Mean normal static compliance of the middle ear, as determined by tympanometry, was 0.15 cm3. Unilateral tenotomy of the tensor tympani muscle was done on 6 of the 12 dogs, and each of the preceding procedures were repeated within 1 week after surgical operation. Transection of the tensor tympani tendon did not alter (P greater than 0.05) the latencies or amplitudes of 1 kHz- or 2 kHz-evoked contralateral AR, the latency or amplitude of 1 kHz-evoked ipsilateral AR, or the amplitude of 2 kHz-evoked ipsilateral AR. However, the latency of 2 kHz-evoked ipsilateral AR was significantly (P less than 0.05) increased. Reflex decay increased significantly (P less than or equal to 0.001) for the contralateral reflex elicited by the 2 kHz stimulus. Neither compliance of the middle ear system nor amplitude and latency of the brain stem auditory-evoked response were affected (P greater than 0.05) by tenotomy. Since tenotomy eliminates participation of the tensor tympani in the AR, these data indicate that contraction of this muscle is not primarily responsible for the compliance changes recorded during an acoustic reflex in dogs.

Animals↗

PubMed1979

[Indications and results of the tenotomy of the superior oblique (author's transl)].

The tenotomy or tenectomy of an overactive superior oblique produces a similar effect as an elongation of the tendon. Its efficiency cannot be compared with the tenotomy or myotomy of an overactive inferior oblique or rectus muscle. No discernible underaction or complete paralysis of the superior oblique are to be feared, if the surgical indication and technique are correct. We prefer the tenotomizing of the overactive superior oblique to the recession of its insertion. Commonly, but still not always, the overaction of the superior obliques is associated with an A syndrome. Besides, the tenotomy and tenectomy of the superior oblique may be useful in true Brown's syndrome and as an additional procedure in cases of paralysis of the two elevators of one eye, During the past four years this operation was done 32 times on 24 patients. In none of these cases an insufficiency of the superior oblique was produced.

Adolescent↗

PubMed1979

Muscle atrophy in rats following denervation, casting, inflammation, and tenotomy.

One week after unilateral denervation, tenotomy, casting, or joint inflammation, skeletal muscles of adult female Wistar rats were studied to determine the effect of these processes on muscle weights and fiber diameters of the soleus, the red and white regions of the plantaris, plus muscle weights and protein content of the gastrocnemius. All atrophic processes caused greater weight loss of the soleus than of the plantaris or gastrocnemiums. Within the soleus and plantaris muscles, the type-I fiber atrophy was equal to the type-II fiber atrophy except for the white region of the plantaris following tenotomy, where the wasting of the type-I fiber was greater than that of type II. This study also demonstrated that denervation, tenotomy, casting, and inflammation resulted in a greater loss of myofibrillar proteins (content and absolute amounts) than of sarcoplasmic and stromal proteins. Denervation generally was found to have the greatest effect on the parameters evaluated. The findings are consistent with the hypothesis that slow muscle is more dependent than fast muscle on neuronal control, and that nerve controls muscle through the dual role of impulse activity and axoplasmic flow.

Animals↗