Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “TENDONS”

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.

At least 1,099 records · Page 61Linked to original sources
PubMed1993

Rheumatoid arthritis: evaluation of wrist extensor tendons with clinical examination versus MR imaging--a preliminary report.

To determine whether magnetic resonance (MR) imaging can improve assessment of the extensor tendons of the wrist and their propensity to rupture, the dorsal tendons in 23 wrists in 20 patients with rheumatoid arthritis were clinically assessed and then examined with MR imaging. Clinical and MR imaging evaluations were performed blindly and independently. The six extensor tendon compartments were assessed with MR imaging for presence of pannus, synovial effusion, and tendon involvement or rupture. Clinical scores of systemic disease, dorsal tendon sheath swelling, and risk of tendon rupture ranged from 0 to 3 in each category; the overall score was not associated with any MR imaging category. Clinical assessment of enlargement of the dorsal tendon sheath and clinical risk of rupture correlated poorly with findings on MR images. All eight wrists with clinically minimal risk of rupture had pannus, effusions, and tendon involvement on MR images; the findings were similar in the wrists with moderate (grade 2) risk of rupture. MR imaging depicts involvement of the dorsal tendon sheath and dorsal tendons that cannot be assessed with other radiologic or clinical means.

Adult↗
PubMed2004

Insulin-dependent diabetes impairs the inflammatory response and delays angiogenesis following Achilles tendon injury.

Although impaired wound healing associated with type 1 diabetes mellitus has been well studied in skin tissue, the influence of this metabolic disorder on tendon healing and recovery has not been extensively investigated. Because tendons are known to have limited repair potential, we studied the tendon-healing process by using a diabetic rat tendonitis model. We tested the hypothesis that diabetes influences the inflammatory response, cell proliferation, and angiogenesis in injured Achilles tendons. Diabetes was induced by injecting streptozotocin at 45 mg/kg body wt. Non-diabetic rats as well as diabetic and insulin-treated diabetic animals were then injected with collagenase. The accumulation of inflammatory cells was quantified in transversal sections of Achilles tendon by using immunohistochemical staining at days 0, 1, 3, 7, 14, and 28 posttrauma. The number of proliferative cells and the extent of neovascularization was also quantified in the paratenon and the core of the tendon at days 0, 3, 7, 14, and 28 posttrauma. Relative to nondiabetic and insulin-treated diabetic animals, the numbers of accumulated neutrophils and ED1(+) and ED2(+) macrophages in diabetic rats decreased by 46, 43, and 52%, respectively, in the first 3 days after injury compared with levels in nondiabetic and insulin-treated diabetic animals. The density of newly formed blood vessels decreased by 35 and 29% in the paratenon and the core of tendon, respectively, at days 3 and 7 after injury. Lastly, the concentration of proliferative cells decreased by 34% in the paratenon at day 7 posttrauma in injured tendons from diabetic rats relative to nondiabetic rats. These results indicate that alterations in inflammatory, angiogenic, and proliferative processes occurred in the diabetic state that might eventually perturb tendon healing and remodeling.

Achilles Tendon↗
PubMed2001

Effects of long-term exercise on the biomechanical properties of the Achilles tendon of guinea fowl.

The purpose of this study was to determine the effect of long-term exercise on tendon compliance and to ascertain whether tendons adapt differently to downhill running vs. running on a level surface. We carried out this investigation on the gastrocnemius tendon of helmeted guinea fowl (Numida meleagris) that were trained for 8-12 wk before commencing experimental procedures. We used an in situ technique to measure tendon stiffness. The animals were deeply anesthetized with isofluorane during all in situ procedures. Our results indicate that long-term exercise increased tendon stiffness. This finding held true after normalization for the cross-sectional area of the free tendon, likely reflecting a change in the material properties of the exercised tendons. Whether training consisted of level or downhill running did not appear to influence response of the tendon to exercise. We hypothesize that the increased stiffness observed in tendons after a long-term running program may be a response to repeated stress and may function as a mechanism to resist tendon damage due to mechanical fatigue.

Achilles Tendon↗
PubMed2006

Low-intensity tensile loading increases intratendinous glucose uptake in the Achilles tendon.

The metabolic activity of tendinous tissues has traditionally been considered to be of limited magnitude. However, recent studies have suggested that glucose uptake increases in the force-transmitting tissues as a response to contractile loading, which in turn indicates an elevated tissue metabolism. The purpose of the present study was to investigate whether such a mechanism could be observed for the human Achilles tendon following tensile loading. Six subjects participated in the study. Unilateral Achilles tendon loading was applied by 25-min intermittent voluntary plantar flexor contractions. A radioactive tracer ([18F]-2-fluoro-2-deoxy-D-glucose) was administered during muscle action, and glucose uptake was measured by use of PET. Regions of interest were defined on the PET images corresponding to the cross section of Achilles tendon at two longitudinally separated sites (insertion and free tendon). Glucose uptake index was determined within respective regions of interest for the active and resting leg. Tendon force during voluntary contractions was approximately 13% of maximal voluntary contraction force. Tendon loading induced an elevated glucose uptake index compared with that of the contralateral resting tendon in the region of tendon insertion (0.13 +/- 0.05 vs. 0.09 +/- 0.02; P < 0.05) and at the free tendon (0.12 +/- 0.01 vs. 0.08 +/- 0.02; P < 0.05). The present data suggest that tissue metabolism is elevated in the human Achilles tendon in response to low-intensity loading.

Achilles Tendon↗
PubMed2003

Effect of habitual running on human Achilles tendon load-deformation properties and cross-sectional area.

Whether the cross-sectional area (CSA) and mechanical properties of the human Achilles tendon change in response to habitual exercise remains largely unexplored. The present study evaluated the CSA and contraction-induced displacement of the aponeurosis-tendon complex of the triceps surae in 11 untrained subjects before (tests 1 and 2) and after (test 3) approximately 9 mo of regular running ( approximately 78 training sessions). Displacement of the tendon-aponeurosis complex obtained by ultrasonography; electromyography of the gastrocnemius, soleus, and dorsiflexor muscles; and joint angular rotation were recorded during graded isometric plantarflexion ramps. Tendon CSA and moment arm were measured by using MRI, and tendon force was calculated from joint moments and tendon moment arm. A treadmill test was used to determine submaximal oxygen consumption (Vo2) at a given speed and maximal Vo2. The total running duration was approximately 43 h, distributed over 34 wk. Maximal Vo2 increased 8.6% (P < 0.01), and submaximal Vo2 decreased 6.2% (P < 0.05). Tendon-aponeurosis displacement during maximal voluntary contraction was unchanged (tests 1-3, 5.2 +/- 0.6, 5.2 +/- 0.5, and 5.3 +/- 0.4 mm, respectively) and yielded a structural stiffness of 365 +/- 50, 358 +/- 40, and 384 +/- 52 N/mm for tests 1-3, respectively (P > 0.05). Tendon CSA also remained unchanged (tests 1-3, 34.2 +/- 2.2, 33.9 +/- 2.2, and 33.8 +/- 2.1 mm2, respectively). In conclusion, a total training stimulus of approximately 9 mo of running in previously untrained subjects was adequate to induce significant cardiovascular improvements, although it did not result in any changes in the mechanical properties of the triceps surea tendon-aponeurosis complex or in the dimensions of Achilles tendon.

Achilles Tendon↗
PubMed1996

Supernumerary tendons of the abductor pollicis.

During a study of variants of the tendon of the abductor pollicis longus (APL) muscle, in 1 of 110 upper extremities prepared, we recorded the rare finding of a division of the APL muscle tendon into 7 sections in the first tunnel. Whereas the actual main tendon inserted at the base of the first metacarpal bone, as depicted in the textbooks, the supernumerary tendons attached to the fascia of the opponens pollicis muscle to the radial edge of the abductor pollicis brevis muscle and to the dorsoradial third of the base of the first metacarpal bone. All accessory tendons were arranged in a radial formation around the main tendon within the same synovial sheath, but the main tendon occupied a separate compartment. In 80% of the upper extremities prepared for this study, the classical description of the abductor tendon did not apply. The classical representation of a single abductor tendon applied to only 20% of the upper extremities examined. In about one third of the wrists prepared, the first tunnel was clearly divided by a septum, so that 2 or more osteofibrous tunnels were present within the main tunnel. The number, thickness and length of such accessory tendons have a functional significance in the development of de Quervain's stenosing tendovaginitis and possibly also have a practical significance, as they may be regarded as a source of transplant material for plastic reconstructions.

Aged↗
PubMed2005

The "ligamentization" process in human anterior cruciate ligament reconstruction with autogenous patellar and hamstring tendons: a biochemical study.

BACKGROUND: There is little information documenting whether the phenomenon of "ligamentization," as proposed by Amiel, occurs in the human anterior cruciate ligament after clinically effective reconstruction. To clarify this point, we analyzed biochemical differences between the native anterior cruciate ligament; the patellar, semitendinosus, and gracilis tendons; and anterior cruciate ligaments reconstructed with autografts. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Fifty patients who underwent arthroscopically assisted anterior cruciate ligament reconstruction using either semitendinosus and gracilis tendon or bone-patellar tendon-bone autografts were selected for the study. Samples of grafted tissue were collected during arthroscopy and quantitatively analyzed for collagen content and the amount of reducible and nonreducible crosslinks at 4 to 6 postoperative months in patients with semitendinosus and gracilis tendon grafts and at 11 to 13 months in all patients with semitendinosus and gracilis tendon or bone-patellar tendon-bone grafts. RESULTS: The total collagen content and nonreducible/reducible crosslink ratios increased significantly during the postoperative period (P < .05). The dihydroxylysinonorleucine/hydroxylysinonorleucine ratio was 3.11 +/- 0.56 in the native anterior cruciate ligament, 1.21 +/- 0.47 in the patellar tendon, and 3.59 +/- 1.58 in the anterior cruciate ligaments reconstructed with bone-patellar tendon-bone autografts 1 year after surgery. The dihydroxylysinonorleucine/hydroxylysinonorleucine ratio in both semitendinosus and gracilis tendons was less than 1.0. However, in anterior cruciate ligaments reconstructed with semitendinosus and gracilis tendon autografts, it was 2.34 +/- 0.98 at 4 to 6 months and 3.43 +/- 1.61 at 11 to 13 months after the operation. CONCLUSIONS: After anterior cruciate ligament reconstruction with autografts, biochemical characteristics of the graft resembled those of the native anterior cruciate ligament. These findings suggest that, regarding the amount of collagen crosslinks and their architecture, the phenomenon of ligamentization occurs in the successfully reconstructed human anterior cruciate ligament within 1 year after operation.

Adolescent↗
PubMedDate not supplied

Biomechanical assessment of the healing response of the rabbit patellar tendon after removal of its central third.

The objective of this study was to determine the biomechanical properties of the healing patellar tendon after removal of its central third. This was accomplished by removing the central third of the patellar tendon from the right limb of 30 mature New Zealand White rabbits. The tendon of the contralateral normal limb served as the unoperated control. The rabbits were separated into five test groups according to healing time: time of surgery and 1, 2, 3, and 6 months after surgery. The ultimate failure strength of the patellar tendons with the central third removed was significantly less than the failure strength of the contralateral normal patellar tendons at all time intervals after surgery. At the time of surgery, the ultimate failure strength values of the operated patellar tendons were on average 53% of the normal patellar tendons, increasing to 72% of normal at 6 months. There was a significant correlation between the ultimate failure strength of the operated tendons and healing time. The positive slope for this regression indicated that the ultimate failure strength of the operated tendons converged toward normal as healing progressed. Failure mode of the operated tendon did not depend on healing time.

Animals↗
PubMedDate not supplied

The reharvested central third of the patellar tendon. A histologic and biomechanical analysis.

We assessed the histologic, mechanical, and structural properties of the reharvested central-third patellar tendon in greyhounds. Twelve dogs had the central third of the patellar tendon (5 mm) removed with corresponding bone blocks from the patella and tibia; the remaining tendon defect was loosely closed. Six dogs were sacrificed at 6 months and six at 12 months, and the central third of the patellar tendon was harvested from both the operative and the contralateral control knees. Analysis of the structural changes in the tendons revealed a significant increase in thickness for reharvested tendons at both 6 and 12 months when compared with controls. The entire residual tendons were narrower at 6 months and were shorter at 12 months compared with controls. Mechanical testing showed that the average failure load, ultimate tensile strength, strain at failure, and average modulus for the reharvested central third of the patellar tendon were significantly less than that of controls at both 6 and 12 months. Analysis of collagen fiber size by electron microscopy revealed a significant increase in collagen fiber diameter at 6 months (135 +/- 41 nm versus 49 +/- 4 nm) but no difference between the operative limbs and controls at 12 months. The reharvested bone-patellar tendon-bone complex does not have the same properties as the primary patellar tendon graft up to 1 year after harvest in a canine model, and its use for revision cruciate ligament reconstruction must be carefully reexamined.

Animals↗
PubMed2003

Effects of medializing calcaneal osteotomy on Achilles tendon lengthening and plantar foot pressures.

Posterior tibial tendon insufficiency, or adult acquired flatfoot deformity, involves collapse of the longitudinal arch of the foot with ensuing changes in the bony architecture of the foot as well. While it is generally accepted that a medializing calcaneal osteotomy (MCO) is a very useful treatment for restoring the fallen arch, questions regarding the effects of this procedure upon plantar foot pressures and Achilles tendon length changes need to be answered. This study focuses on changes in plantar foot pressures and Achilles tendon length as the result of performing a MCO. Fourteen fresh-frozen cadaver legs were used to test the effects of MCO on Achilles tendon length changes 2 cm proximal to the Achilles tendon insertion on the calcaneus. Differential variable reluctance transducers were anchored in ventromedial, dorsomedial, dorsolateral, and ventrolateral positions of the Achilles tendon at the aforementioned level. The effects of the MCO on plantar foot pressures were assessed simultaneously using the Tekscan HR Mat. Axial loading (100 lbs) of each specimen was performed in neutral and dorsiflexion (15 degrees). Data were gathered for Achilles tendon length changes and plantar foot pressures for three trials in both the neutral and dorsiflexed positions. A medializing calcaneal osteotomy (1 cm medial translation) was then performed and testing was repeated in the fashion outlined heretofore. Analysis of the data revealed that there was no significant increase in Achilles tendon length as a result of the MCO. The data also showed that average pressure over the first and second metatarsal regions of the forefoot decreased significantly after MCO. At the same time there was a significant increase in average pressure over the medial and lateral aspect of the heel. These findings suggest that the Achilles tendon aids in inversion of the forefoot without undergoing a significant increase in length change of Achilles tendon fibers in any of the regions tested.

Achilles Tendon↗
PubMed2006

Distal anatomical relationship of the flexor hallucis longus and flexor digitorum longus tendons.

BACKGROUND: The distal attachment of the flexor hallucis longus (FHL) tendon with the flexor digitorum longus (FDL) tendon varies antomically. The presence of a strong link between the two tendons can preserve distal function if one of the tendons is used for transfer. METHODS: Twenty-four cadaver legs were dissected, and the distal relationship of the FHL tendon with the FDL tendon was analyzed. The width of the tendons and their attachments were measured to the closest 0.5 mm. RESULTS: Three different configurations were found. In type 1, a tendinous slip branched from the FHL to the FDL (10 of 24 feet). In type 2, a slip branched from the FHL to the FDL and another from the FDL to FHL (10 of 24). In type 3, no attachment was present (four of 24). In four cadavers the attachment was different in the right and left feet. CONCLUSION AND CLINICAL RELEVANCE: The absence of a cross connection between the two tendons in the foot may be more frequent than previously reported. Three configurations of the anatomical relationship of the distal FDL to FHL tendons were found in this study with a small sample size. Based on these findings, to preserve the distal function of the FDL after transfer of the proximal FDL tendon, routine tenodesis should be done or a wider exposure and tenodesis in type 3 variations.

Aged↗
PubMed2006

Achilles tendon torsion has no effect on percutaneous triple-cut tenotomy results.

BACKGROUND: Achilles tendon lengthening is an important part of the operative management of numerous foot and ankle disorders. The most commonly used percutaneous technique involves three hemitenotomies: medial, lateral, and medial. The discovery that Achilles tendon fibers may undergo external torsion created concern that improper consideration of this feature could result in fiber division insufficient to allow adequate percutaneous lengthening. Varying degrees of torsion have been reported since it was originally described. We hypothesized that torsion of the Achilles tendon does not decrease the effectiveness of a percutaneous lengthening procedure. This hypothesis was tested by comparing the medial-lateral-medial tenotomy pattern to a lateral-medial-lateral pattern. If tendon torsion affects fiber division, then asymmetrical tenotomy patterns should yield different results. METHODS: Mechanical testing was performed using 22 human fresh tissue lower extremities. Specimens were divided into two groups (11 in each group): "MLM" which underwent testing using a medial-lateral-medial pattern and "LML" which underwent a lateral-medial-lateral pattern. Dorsiflexion load was applied evenly across the forefoot and measured with a force transducer. Dorsiflexion measurements were made from reproducible reference marks. After testing, specimens were dissected to examine tenotomy gap widths and other tissue effects. RESULTS: All specimens lengthened successfully. None of the following parameters were statistically different: pre-tenotomy or post-tenotomy dorsiflexion, force to lengthen, total tissue lengthening, and individual gap widths. In no specimen was there complete disruption of the Achilles tendon, and in 18 of 22 specimens (81.8%) the paratenon sleeve was intact except for the tenotomy puncture. In one LML specimen, the sural nerve was partially cut at the distal tenotomy site. CONCLUSIONS: Regardless of pattern, percutaneous triple-cut Achilles tendon lengthening was effective in achieving additional dorsiflexion at roughly one-third degree per millimeter of tissue lengthening. The pattern of the Achilles tendon lengthening used and, by inference, Achilles tendon torsion had no effect on achievable dorsiflexion. One explanation is that both patterns cut all tendon fibers at least once. We concluded that a properly designed triple-cut tenotomy would be successful regardless of Achilles torsion. Percutaneous Achilles tendon lengthening also appears to be a safe procedure if care is taken to avoid the sural nerve.

Achilles Tendon↗
PubMed1993

Achilles tendon injuries: a comparison of surgical repair versus no repair in a rat model.

Controversy exists regarding the treatment of Achilles tendon ruptures. The aim of this study was to determine whether surgical repair of the rat Achilles tendon offered any biomechanical, functional, or morphological advantage over no repair. Thirty-two male Sprague-Dawley rats were randomly allocated into four groups: (1) sham operated (skin incision only), (2) no repair (complete division of the Achilles tendon and plantaris tendon without repair), (3) internal splint (plantaris left intact), and (4) Achilles repair (with a modified Kessler-type suture). Functional performance was determined from the measurements of hindpaw prints utilizing the Achilles Functional Index. On day 15, the animals were killed, and biochemical and histological evaluations were performed on both the injured and uninjured Achilles tendon constructs. All groups subjected to Achilles tendon division had a significant initial functional impairment that gradually improved so that by day 15 there were no functional or failure load impairments in any group. The injured tendons in all three groups subjected to Achilles tendon division had a 13-fold increase in the cross-sectional area and were less stiff and more deformable than uninjured and sham-operated tendons on day 15 (P < .001). The magnitude of the biomechanical and morphological changes at postoperative day 15 and the initial impairment and rate of functional recovery were similar for no repair, internal splint, and Achilles repair groups. In summary, this study demonstrates that surgical repair of the Achilles tendon in the rat does not offer any advantage over nonoperative management.

Achilles Tendon↗
PubMed2004

Coordinated development of muscles and tendons of the Drosophila leg.

Since Miller's morphological description, the Drosophila leg musculature and its formation has not been revisited. Here, using a set of GFP markers and confocal microscopy, we analyse Drosophila leg muscle development, and describe all the muscles and tendons present in the adult leg. Importantly, we provide for the first time evidence for tendons located internally within leg segments. By visualising muscle and tendon precursors, we demonstrate that leg muscle development is closely associated with the formation of internal tendons. In the third instars discs, in the vicinity of tendon progenitors, some Twist-positive myoblasts start to express the muscle founder cell marker dumbfounded (duf). Slightly later, in the early pupa, epithelial tendon precursors invaginate inside the developing leg segments, giving rise to the internal string-like tendons. The tendon-associated duf-lacZ-expressing muscle founders are distributed along the invaginating tendon precursors and then fuse with surrounding myoblasts to form syncytial myotubes. At mid-pupation, these myotubes grow towards their epithelial insertion sites, apodemes, and form links between internally located tendons and the leg epithelium. This leads to a stereotyped pattern of multifibre muscles that ensures movement of the adult leg.

Animals↗
PubMed1998

Tendon transfer with a microvascular free flap for injured feet in children.

We reviewed 11 patients who had been treated between January 1986 and June 1994 for severe foot injuries by tendon transfer with microvascular free flaps. Their mean age was 5.6 years (3 to 8). Five had simultaneous tendon transfer and a microvascular free flap and six had separate operations. The mean interval between the tendon transfer and the microvascular free flap was 5.8 months (2 to 15) and the mean time between the initial injury and the tendon transfer was 9.6 months (2 to 21). The anterior tibial tendon was split in five of six cases. The posterior tibial tendon was used three times and the extensor digitorum longus tendon twice. The mean follow-up was 39.7 months (24 to 126). There were nine excellent and two good results. Postoperative complications included loosening of the transferred tendon (2), plantar flexion contracture (1) mild flat foot deformity (1) and hypertrophic scars (2). We recommend tendon transfer with a microvascular free flap in children with foot injuries combined with nerve injury and extensive loss of skin, soft tissue and tendon.

Ankle Joint↗
PubMed2004

Effect of hyaluronic acid on the excursion resistance of tendon grafts. A biomechanical study in a canine model in vitro.

The excursion resistance between the tendon and pulley is an important factor contributing to the limitation of function after surgery to the hand. The administration of hyaluronic acid (HA) in the early rehabilitation after tendon grafting may help to prevent adhesions. We evaluated changes in the excursion resistance between potential sources of flexor tendon grafts and the annular pulley in a canine model after administration of HA. The intrasynovial and extrasynovial tendons were soaked in 10 mg/ml of HA for five minutes. The excursion resistance between these tendons and the annular pulley of an intact proximal phalanx and that of the same tendons of the opposite foot without administration of HA were evaluated. The tendon of flexor digitorum profundus of the second toe without administration of HA was used as a control. The gliding resistance of canine tendons was significantly decreased after the administration of HA especially in the extrasynovial tendons. Our findings suggest that the administration of HA may improve the gliding function of a flexor tendon graft.

Adjuvants, Immunologic↗
PubMed1993

Tendon-healing in a bone tunnel. A biomechanical and histological study in the dog.

Our study evaluated tendon-to-bone healing in a dog model. Twenty adult mongrel dogs had a transplantation of the long digital extensor tendon into a 4.8-millimeter drill-hole in the proximal tibial metaphysis. Four dogs were killed at each of five time-periods (two, four, eight, twelve, and twenty-six weeks after the transplantation), and the histological and biomechanical characteristics of the tendon-bone interface were evaluated. Serial histological analysis revealed progressive reestablishment of collagen-fiber continuity between the bone and the tendon. A layer of cellular, fibrous tissue was noted between the tendon and the bone, along the length of the bone tunnel; this layer progressively matured and reorganized during the healing process. The collagen fibers that attached the tendon to the bone resembled Sharpey fibers. High-resolution radiographs showed remodeling of the trabecular bone that surrounded the tendon. At the two, four, and eight-week time-periods, all specimens had failed by pull-out of the tendon from the bone tunnel. The strength of the interface was noted to have significantly and progressively increased between the second and the twelfth week after the transplantation. At the twelve and twenty-six-week time-periods, all specimens had failed by pull-out of the tendon from the clamp or by mid-substance rupture of the tendon. The progressive increase in strength was correlated with the degree of bone ingrowth, mineralization, and maturation of the healing tissue, noted histologically.

Animals↗
PubMed1995

Tendon-healing to cortical bone compared with healing to a cancellous trough. A biomechanical and histological evaluation in goats.

This study was performed to test the hypothesis that attaching a tendon to a trough in cancellous bone results in tendon-healing that is biomechanically superior to that after direct fixation of a tendon to cortical bone. Twenty adult female goats were treated with a bilateral tenotomy of the infraspinatus tendon with subsequent reattachment of the tendon. In shoulders randomized to the cancellous-fixation group, a cancellous bed was prepared with a motorized burr and a template measuring twenty by five by five millimeters. The repair in the shoulders randomized to the cortical-fixation group was performed in the same manner, except that the tendon was attached to cortical bone. Three outcome measures were assessed, six and twelve weeks after the repair, with the Student paired t test and analysis of variance: load to failure, energy to failure, and stiffness. The types of repair were not significantly different with regard to any of the three outcomes. When the six and twelve-week data were combined, an average difference in load to failure of 3.9 per cent in favor of cancellous repair was observed but it was not significant (p = 0.78). The associated 95 per cent confidence interval for the difference ranged from 10.5 per cent in favor of cortical repair to 18.3 per cent in favor of cancellous repair. Histological analysis at six and twelve weeks revealed progressive maturation and reorganization of the bone-tendon interface with re-establishment of collagen-fiber continuity between the tendon and bone. This process was indistinguishable between the cortical and cancellous specimens. This study demonstrated no significant benefit from the creation of a trough to expose the tendon to cancellous bone. In this model, at both six and twelve weeks, the tendon-to-bone healing process of the two groups appeared similar and the biomechanical properties were approximately equal.

Analysis of Variance↗