Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “TENDONITIS”

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 19 recordsLinked to original sources
PubMedDate not supplied

Soft tissue and tendon reconstruction after achilles tendon rupture: adipofascial sural turnover flap associated with cryopreserved gracilis tendon allograft for complicated soft tissue and achilles tendon losses. A case report and literature review.

Soft tissue and tendon reconstruction after Achilles tendon rupture:Adipofascial sural turnover flap associated with cryopreserved gracilis tendon allograft for complicated soft-tissue tendon losses.A case report and literature review Achilles tendon rupture is often complicated by skin substance loss around the tendon, which is a poorly-vascularized site. Treatment may be conservative or surgical, but the former is not generally accepted by the orthopedic community and is reserved for selected cases, while surgery remains the most widely-used approach. Soft tissue repair at this site is a crucial reconstruction problem, and becomes very complex if skin reconstruction has to be associated with a complex tendon repair. The Authors describe a new approach to the repair of Achilles tendon substance loss compounded by a soft tissue defect, using a cryopreserved gracilis tendon allograft in combination with a distally-based adipofascial sural flap.

Achilles Tendon↗
PubMed1976

[Experimental single-stage reconstruction of the tendon sheath and flexor tendon (free tendon graft, using a vein for sheath on the flexor tendon in dogs)].

In dog experiments the flexor tendons of the 2nd toe together with their tendon sheaths have been extirpated by the authors. Then on the place of the tendon sheath complex-resembling the human hand's "no man's land" -for the substitution of the tendon sheath-free inautotransplants with long vein-segments have been grafted in one sitting. Resuming the results of the macroscopic and light microscopic examinations carried out in definite times it has been found by the authors that while the vein segment was revascularized in the course of one or two weeks, the regeneration of the tendon transplant was slightly retarded. Between the vein and the tendon but adhesion of medium degree were found. The possibilities of the clinical use of the method are discussed.

Animals↗
PubMed2006

Patterns of mRNA expression for matrix molecules and growth factors in flexor tendon injury: differences in the regulation between tendon and tendon sheath.

PURPOSE: Injuries to tendons, particularly flexor tendons, can lead to loss of function after healing due to adhesion formation and other complications. The aim of this study was to increase our understanding of the healing process in tendons and tendon sheaths to develop methods to affect the healing process and improve the outcome of tendon repair in the future. METHODS: In a rabbit model of flexor tendon injury, tissues were harvested 3, 6, 12, and 24 days after surgery (n = 6 for each group). After RNA extraction, messenger RNA (mRNA) levels for relevant genes in tendon and tendon sheaths were measured using the reverse transcription polymerase chain reaction. Messenger RNA levels for a subset of relevant molecules at different time points after injury were compared with those of uninjured controls for tendons and tendon sheaths. RESULTS: Initially after injury, there was a shift in collagen expression with a marked increase in type III mRNA levels in both the tendon and tendon sheath, whereas those for collagen I increased only in the sheath at later time points. Aggrecan and versican mRNA levels were increased in both tissues, but temporal aspects of the changes were different. The mRNA levels for biglycan and lumican were all upregulated throughout the healing interval examined, whereas those for decorin were significantly decreased throughout in the tendon more so than the sheath. The mRNA levels for basic fibroblastic growth factor and transforming growth factor beta were elevated after injury in the tendon but not in the sheath. In contrast, mRNA levels for connective tissue growth factor were unaltered or decreased in both tissues throughout the interval assessed. CONCLUSIONS: Healing after injury to the rabbit flexor tendon and tendon sheath follow a reproducible pattern of gene expression; however, the pattern in the tendon is very different from that in the sheath. These findings indicate that interventions developed to improve healing of these tissues will have to address these differences, because they will likely affect the outcomes.

Animals↗
PubMed1985

[Experimental reconstruction of flexor tendon injuries with a free transplant tendon-tendon sheath unit].

The authors, in their experiments on chickens, imitate human "no man's land" flexor tendon injuries of bad prognosis. For reconstruction of gliding surfaces they transplanted composite flexor tendon grafts containing flexor tendons with their sheath, pulleys, and vincula. Autologous grafts were compared with homologous composite tendon grafts preserved in beta-propiolacton. Summarizing the results of macroscopic and light microscopic examinations they state that the tendon sheath of the autologous composite tendon grafts revitalize in two weeks, and their tissue structure remains practically intact. The composite tendon allografts conserved in beta-propiolacton on the contrary rebuild much more slowly, on the average over three months. Regeneration is accompanied by round-cell infiltration. In the case of the autogenous graft generally smaller, and in the case of homologous composite flexor tendon graft more multitudinous adhesions occurred between flexor tendon and tendon sheath. The authors conclude from the literature and their own results that the reconstruction of flexor tendons with autologous composite flexor tendon grafts is a proper method for the restoration of severe flexor tendon injuries. Before clinical use, homologous composite flexor tendon grafts require more experimental investigation.

Animals↗
PubMed2006

Ex vivo infiltration of fibroblasts into the tendon deteriorates the mechanical properties of tendon fascicles but not those of tendon bundles.

BACKGROUND: After ligament reconstruction, mechanical deterioration of the grafted tendon is observed with revascularization and cellular infiltration. However, the effect of cellular infiltration on the mechanical properties of the tendon matrix has not been fully understood. METHODS: Cultured fibroblasts derived from the rabbit patellar tendon were seeded around an acellular rabbit patellar tendon that had undergone freeze-thaw treatment. At time-0, 3, and 6 weeks after seeding the cells, we evaluated cellular distribution in the tendon using a confocal laser microscope and the mechanical evaluations of the tendon fascicles and the tendon bundles. FINDINGS: The confocal laser microscopic analysis showed fibroblast infiltration ex vivo into the acellular tendon matrix. We could not find significant effects of the cellular infiltration on the tangent modulus of the tendon bundle, although the ex vivo cellular infiltration significantly reduced the modulus of the tendon fascicle. In addition, the tangent modulus of the incubated tendon without fibroblasts significantly decreased with time, particularly in the tendon bundle levels. INTERPRETATION: The findings of this study suggested that the effects of ex vivo cellular infiltration on the mechanical properties of the tendon bundles are relatively small, compared with its striking effect on the tendon fascicles.

Animals↗
PubMed1999

Flexor tendon-tendon sheath interaction after tendon grafting: a biomechanical study in a human model in vitro.

A human cadaver tendon sheath model was used to study the differences in excursion resistance of tendons that might be considered as sources of clinical tendon grafts. The flexor digitorum profundus and superficialis tendons, the extensor indicis proprius tendon used in its normal proximal-distal orientation, the extensor indicis proprius tendon used in a reversed distal-proximal orientation, and the palmaris longus tendon were studied in 7 fingers. The intrasynovial tendons (the flexor digitorum profundus and superficialis tendons and the reversed extensor indicis proprius tendon) produced less excursion resistance (p < .05) than the extrasynovial tendons (the normally oriented extensor indicis proprius tendon and the palmaris longus tendon). In contrast to studies measuring resistance against a single pulley, resistance within a complete tendon sheath may be affected by contact with other structures, particularly in joint extension.

Aged↗
PubMed1998

Patellar tendon ultrasonography in asymptomatic active athletes reveals hypoechoic regions: a study of 320 tendons. Victorian Institute of Sport Tendon Study Group.

OBJECTIVE: To compare patellar tendon sonographic findings in active, currently asymptomatic, elite athletes with those in nonathletic controls. DESIGN: Cross-sectional cohort study with convenience control sample. SETTING: The Victorian Institute of Sport Tendon Study Group, an institutional elite athlete study group in Australia. PATIENTS AND PARTICIPANTS: Two hundred elite male and female athletes from the sports of basketball, cricket, netball, and Australian rules football. Forty athletes who had current symptoms of jumper's knee were excluded from analysis, leaving 320 subject tendons in athletes who were currently asymptomatic. Twenty-seven nonathletic individuals served as controls. MAIN OUTCOME MEASURE: Sonographic patellar tendon appearance. We measured the dimensions of subject tendons and noted the presence or absence of hypoechoic regions and tendon calcification. Dimensions of hypoechoic regions were measured, and approximate cross-sectional areas were calculated. Chi-squared analysis was used to test the prevalence of hypoechoic regions in subjects and controls and men and women. RESULTS: In currently asymptomatic subjects, hypoechoic regions were more prevalent in athlete tendons (22%) than in controls (4%), in male subject tendons (30%) than in female subjects (14%), and in basketball players (32%) than in other athletes (9%) (all p < 0.01). Bilateral tendon abnormalities were equally prevalent in men and women but more prevalent in basketball players (15%) than in other athletes (3%) (p < 0.05). Sonographic hypoechoic regions were present in 35 of 250 (14%) patellar tendons in athletes who had never had anterior knee pain. CONCLUSIONS: Patellar tendon sonographic hypoechoic areas were present in asymptomatic patellar tendons of a proportion of elite athletes but rarely present in controls. This has implications for clinicians managing athletes with anterior knee pain.

Adult↗
PubMed2005

[Reconstruction of the anterior cruciate ligament: comparison of patellar bone-tendon-bone and hamstring tendon graft methods. Part 2. Short-term evaluation of the hamstring tendon graft technique with use of the Rigidfix system].

PURPOSE OF THE STUDY: The high number of patients with femoropatellar complaints following ACL reconstruction with bone-tendon-bone (B-T-B) autograft led us to use and subsequently evaluate hamstring tendon grafts fixed with the Rigidfix system. In this study we present the evaluation of short-term results. MATERIAL: We evaluated 85 patients (51 male and 34 female) at an average follow-up of 14 months. The average age of the group was 29.7 years (range, 16 to 59 years). In 46 patients we treated the right knee and in 39 patients the left knee. Fifty-five patients in this group also had an associated injury to the soft knee tissues. For reconstruction, a semitendinosus tendon graft was used in 56 knees and a semitendinosus-gracilis tendon graft in 29 patients. METHODS: The operation was carried out with tourniquet application to the extremity in a flexed position. The tendon of the semitendinosus muscle was harvested through an oblique incision and, in some cases, when its width and length was not sufficient for graft construction, the gracilis muscle tendon was harvested too. The graft, at least 75 mm by 8 mm in size, was prepared on a graft board. After having drilled the both tunnels, the femoral Rigidfix reamer was inserted in a routine manner and protective sleeves for Rigidfix cross pins were introduced. With the extremity in semiflexion, the inserted graft was fixed to the cortical bone by absorbable cross pins on the femur and absorbable interference screws on the tibia. The postoperative treatment involved procedures as in the B-T-B technique. RESULTS: The group was evaluated by the Lysholm score system, with an average of 84.3 scores achieved. The men showed better outcomes than women, i. e., 85.7 and 81.4, respectively. The scores in the patients with a single tendon did not differ significantly from the patients with a combined tendon (semitendinosus, 83.2 vs. semitendinosus-gracilis, 84.2), nor did they greatly differ between the patients with injury to ACL alone and those with ACL and associated soft tissue injuries (ACL, 83.9 vs. ACL+ associated injury, 85.5). Most of the patients (94 %) were satisfied with the outcome of treatment. The complications involved thrombosis of the operated lower extremity in three patients and repeat surgery for hematoma in two patients. Knee instability was found in five patients. One graft failed to restructure and incorporate, in two knee tunnels were incorrectly centered and two grafts ruptured due to trauma. Three of these patients underwent repeat surgery. DISCUSSION: Our results, as evaluated by the Lysholm score system, were in agreement with those of other authors. We did not find any difference in knee stability between the patients treated by the hamstring tendon technique and those undergoing reconstruction with a patellar B-T-B autograft. However, the patients with hamstring tendon reconstruction reported a considerably lower number of femoropatellar problems. CONCLUSIONS: ACL reconstruction with a hamstring tendon autograft fixed with the Rigidfix system is a suitable alternative technique to ACL reconstruction carried out with a patellar B-T-B graft. It provides equal knee stability but has significantly lower donor site morbidity. It is suitable for patients who have contraindications for the B-T-B technique and in persons practicing little or no sports.

Adolescent↗
PubMed2003

Tendon transfer fixation: comparing a tendon to tendon technique vs. bioabsorbable interference-fit screw fixation.

Tendon transfer techniques in the foot and ankle are used for tendon ruptures, deformities, and instabilities. This fresh cadaver study compares the tendon fixation strength in 10 paired specimens by performing a tendon to tendon fixation technique or using 7 x 20-25 mm bioabsorbable interference-fit screw tendon fixation technique. Load at failure of the tendon to tendon fixation method averaged 279N (Standard Deviation 81N) and the bioabsorbable screw 148N (Standard Deviation 72N) [p = 0.0008]. Bioabsorbable interference-fit screws in these specimens show decreased fixation strength relative to the traditional fixation technique. However, the mean bioabsorbable screw fixation strength of 148N provides physiologic strength at the tendon-bone interface.

Absorbable Implants↗
PubMedDate not supplied

Recent progress in flexor tendon healing. The modulation of tendon healing with rehabilitation variables.

Until recently, attempts to optimize the postoperative regimen following intrasynovial flexor tendon repair had been essentially empirical, in that both the time and graduation of the exercise regimen have lacked clear conceptual guidelines. The magnitude of load applied in previous studies had not been clearly controlled, and similarly, the effects of increased repair site excursion and gap formation had not been evaluated in clinically relevant models. Recent experimental in vivo data on the application of force and excursion as independent variables by the authors and other investigators have helped to clarify the respective roles of these two variables. The goal of surgical treatment of intrasynovial flexor tendon lacerations is the achievement of a primary tendon repair of tensile strength sufficient to allow early controlled motion after surgery. The implementation of an appropriate postoperative rehabilitation protocol will, based on the experimental data discussed in this article, decrease the formation of intrasynovial adhesions, facilitate the restoration of the gliding surface, and stimulate the accrual of strength at the repair site.

Hand Injuries↗
PubMed1989

[Scanning electron microscopy studies following two-stage tendon and tendon sheath reconstruction in experimental flexor tendon injuries].

This study involves the initial injury of a flexor tendon in chickens toes, followed by a two-step reconstruction of the tendon and its sheath. At first the damaged scarred tendon sheath region was replaced by a transplanted vein or fascia. Tendon restoration was done in the second step with a free tendon transplantation. The restored tendon sheath was then studied in sections under EM. It was observed that the surface of the reconstructed sheath was very similar to that of an intact sheath; the inner surface of the fascia being smoother than the vein. Likewise, the surface and inner structure of the transplanted tendon was proved to resemble an intact tendon. On the basis of the results of this investigation, it is believed that this procedure may be successfully applied to the reconstruction of human flexor tendon injuries in the future.

Animals↗
PubMed1989

Comparative study of the use of prefabricated bone tendon grafts and conventional tendon grafts in flexor tendon reconstruction.

In tendon grafting the weakest area is the junction between the grafted tendon and bone. In dogs a strong union between tendon and bone can be produced by threading the flexor carpi radialis tendon through a hole drilled in the radius. In experimental repair of canine flexor tendons, 3 weeks after operation the strength of the union between a composite bone-tendon graft prepared in this way is double that of the bone-tendon junction of a conventional graft. Use of prefabricated bone-tendon grafts should permit earlier postoperative movement and limit formation of adhesions between a tendon graft and its bed.

Animals↗
PubMed1986

[A new method for the reconstruction of injured flexor tendons of the hand: tendons and tendon sheath reconstruction in 2 stages].

The authors have developed a new two-stage method of flexor tendon reconstruction for injuries in the critical zone of the hand. In the first phase of the secondary operation, they preserve the intact portions of tendon sheath. They replace the scarred tendon sheath: small retinacular defects with autologous vein grafts, larger pulley defects with fascial grafts. A silicon rubber rod is placed in the reconstructed tendon sheath. In the second stage of the operation, after six weeks generally, an autologous tendon is placed in the reconstructed tendon sheath. The authors present their material and results: In 12 of 18 flexor tendon reconstructions they achieved excellent or good results. Therefore, they propose their method for reconstructing injured flexor tendons with an unfavourable prognosis.

Adult↗
PubMedDate not supplied

Tenocytes from ruptured and tendinopathic achilles tendons produce greater quantities of type III collagen than tenocytes from normal achilles tendons. An in vitro model of human tendon healing.

Type I collagen is the main collagen in tendons; type III collagen is present in small amounts. Ruptured Achilles tendons contain a significantly greater proportion of type Ill collagen, which predisposes them to rupture. We used an in vitro model to determine whether tenocytes from Achilles tendons that were ruptured (N = 22), nonruptured (N = 7), tendinopathic (N = 12), and fetal (N = 8) show different behavior. Samples of Achilles tendon were digested with collagenase and the released tenocytes were collected. Primary tenocyte cultures were established and subsequently cultured onto glass coverslips. Once a confluent monolayer was obtained, the cell populations were "wounded" by scraping a pipette tip along the surface. The cultures were further incubated for either 1, 4, 8, 12, 16, or 24 hours, and production of types I and II collagen was assessed by immunostaining. In cultures from ruptured and tendinopathic tendons, there was increased production of type Ill collagen. Athletic participation places excess stress on the Achilles tendon, which could potentially lead to areas of microtrauma within the tendon. These areas may heal by the production of type III collagen, which is an abnormal healing response. Accumulation of such episodes of microtrauma could resuit in a critical point where the resistance of the tissue to tensile forces is compromised and tendon rupture occurs.

Achilles Tendon↗
PubMed1987

[Experimental 2-stage tendon and tendon sheath reconstruction in tendon sheath injuries].

The whole tendon sheath of hens were cannulated by a silicone rubber stick in a first stage and only the injured part of the tendon sheath was substituted by a autologous venous or fascial transplant. The tendon was reconstructed by a free tendon transplant in a second stage. The venous respectively the fascial patches revitalize within 2 weeks. Smooth slide faces originated on their inner surface. The adhesions between the reconstructed tendon sheath and the tendon were small in general. The healing of the tendon ran down without any disturbance.

Animals↗
PubMed1999

Calf muscle atrophy and Achilles tendon healing following experimental tendon division and surgery in rats. Comparison of postoperative immobilization of the muscle-tendon complex in relaxed and tensioned positions.

We used a rat model to study the effects of immobilization of the calf muscle-tendon complex after an experimental Achilles tendon repair. Immobilizations of the complex in either a relaxed or tensioned position were compared by histochemical and morphometric analyses at the site of the tendon injury as well as in the gastrocnemius and soleus muscle bellies. The type of immobilization did not affect the healing of the tendon injury because no reruptures occurred in either of the treatment groups and the average tendon end-to-end distance did not differ between the groups. However, immobilization in a relaxed position led to a significantly more extensive fiber atrophy in the calf muscles. In clinical practice, these results suggest that rehabilitation after Achilles tendon surgery can be early and gradually tension- and load-increasing without a significant increase in the risk of rerupture of the tendon.

Achilles Tendon↗