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Tendon Rupture (tendon + rupture)
Selected AbstractsUltrasonographic detection of spontaneous rupture in the Biceps tendon of a patient with rheumatoid arthritisINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 4 2007Hyun-Sook KIM Abstract Ultrasonography is a useful imaging modality for the diagnosis of pathologic conditions in the biceps tendon. We describe a 64-year old man with rheumatoid arthritis (RA) who suddenly developed a painless lump in the antecubital region of the right arm. The bulging was prominent when he flexed his forearm. Proximal loss of the long head in biceps tendon could be demonstrated by ultrasonography. The ultrasonographic features of spontaneous isolated biceps tendon rupture occurring in a patient with RA are described. [source] Compression therapy promotes proliferative repair during rat Achilles tendon immobilizationJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 7 2010Nikos Schizas Abstract Achilles tendon ruptures are treated with an initial period of immobilization, which obstructs the healing process partly by a reduction of blood circulation. Intermittent pneumatic compression (IPC) has been proposed to enhance tendon repair by stimulation of blood flow. We hypothesized that daily IPC treatment can counteract the deficits caused by 2 weeks of immobilization post tendon rupture. Forty-eight Sprague-Dawley SD) rats, all subjected to blunt Achilles tendon transection, were divided in three equal groups. Group A was allowed free cage activity, whereas groups B,C were immobilized at the operated hindleg. Group C received daily IPC treatment. Two weeks postrupture the rats were euthanatized and the tendons analyzed with tensile testing and histological assessments of collagen organization and collagen III-LI occurrence. Immobilization significantly reduced maximum force, energy uptake, stiffness, tendon length, transverse area, stress, organized collagen diameter and collagen III-LI occurrence by respectively 80, 75, 77, 22, 47, 65, 49, and 83% compared to free mobilization. IPC treatment improved maximum force 65%, energy 168%, organized collagen diameter 50%, tendon length 25%, and collagen III-LI occurrence 150% compared to immobilization only. The results confirm that immobilization impairs healing after tendon rupture and furthermore demonstrate that IPC-treatment can enhance proliferative tendon repair by counteracting biomechanical and morphological deficits caused by immobilization. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:852,858, 2010 [source] Changes in gene expression of individual matrix metalloproteinases differ in response to mechanical unloading of tendon fascicles in explant cultureJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 10 2008Diane R. Leigh Abstract Immobilization of the tendon and ligament has been shown to result in a rapid and significant decrease in material properties. It has been proposed that tissue degradation leading to tendon rupture or pain in humans may also be linked to mechanical unloading following focal tendon injury. Hence, understanding the remodeling mechanism associated with mechanical unloading has relevance for the human conditions of immobilization (e.g., casting), delayed repair of tendon ruptures, and potentially overuse injuries as well. This is the first study to investigate the time course of gene expression changes associated with tissue harvest and mechanical unloading culture in an explant model. Rat tail tendon fascicles were harvested and placed in culture unloaded for up to 48 h and then evaluated using qRT-PCR for changes in two anabolic and four catabolic genes at 12 time points. Our data demonstrates that Type I Collagen, Decorin, Cathepsin K, and MMP2 gene expression are relatively insensitive to unloaded culture conditions. However, changes in both MMP3 and MMP13 gene expression are rapid, dramatic, sustained, and changing during at least the first 48 h of unloaded culture. This data will help to further elucidate the mechanism for the loss of mechanical properties associated with mechanical unloading in tendon. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:1306,1312, 2008 [source] Physical activity modulates nerve plasticity and stimulates repair after achilles tendon ruptureJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 2 2007Daniel K-I. Abstract In a rat model of tendon rupture using semiquantitative methodology, healing was assessed according to the diameter of newly organized collagen and the occurrence of the sensory neuropeptides (SP, CGRP) in relation to different levels of physical activity. Normally, innervation of the Achilles tendon is confined to the paratenon. After rupture new nerve fibers grow into the tendon proper, but disappear after healing. In a first experiment to establish peak tissue and nerve regeneration after rupture, tendon tissues from freely moving rats were collected consecutively over 16 weeks. A peak increase in organized collagen and nerve ingrowth was observed between week 2 to 4 post rupture. Therefore, in a second experiment week 4 was chosen to assess the effect of physical activity on tendon healing in three groups of rats, that is, wheel running, plaster treated, and freely moving (controls). In the wheel-running group, the diameter of newly organized collagen was 94% (,p,=,0.001) greater than that in the plaster-treated group and 48% (,p,=,0.02) greater than that in the controls. Inversely, the neuronal occurrence of CGRP in the tendon proper was 57% (,p,=,0.02) lower in the wheel-running group than that in the plaster-treated group and 53% (,p,=,0.02) lower than that in the controls, suggesting an earlier neuronal in-growth and disappearance in the more active group. Physical activity speeds up tendon healing, which may prove to be linked to accelerated neuronal plasticity. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:164,172, 2007 [source] Achilles tendon rupture and its association with fluoroquinolone antibiotics and other potential risk factors in a managed care populationPHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 11 2006DrPH, John D. Seeger Pharm D Abstract Background Case reports and observational studies have implicated fluoroquinolone antibiotic exposure as a risk factor for Achilles tendon rupture (ATR), an uncommon condition for which there are few formal studies. We sought to quantify the strength of association between exposure to fluoroquinolone antibiotics and the occurrence of ATR, accounting for other risk factors. Methods This was a case-control study nested within a health insurer cohort. Cases of ATR were identified and confirmed using patterns of health insurance claims that were validated through sampled medical record review. Information on risk factors, including fluoroquinolone exposure, came from health insurance claims. Results There were 947 cases of ATR and 18,940 controls. A dispensing of a fluoroquinolone antibiotic in the past 6 months was more common among ATR cases than controls, although not significantly so (odds ratio (OR),=,1.2; 95% confidence interval (CI),=,0.9,1.7), and exposure to a higher cumulative fluoroquinolone dose was more strongly associated (OR,=,1.5, 95%CI,=,1.0,2.3). Other risk factors for ATR were trauma (OR,=,17.2, 95%CI,=,14.0,20.2), male sex (OR,=,3.0, 95%CI,=,2.6,3.5), injected corticosteroid administration (OR,=,2.2, 95%CI,=,1.6,2.9), obesity (OR,=,2.0, 95%CI,=,1.2,3.1), rheumatoid arthritis (OR,=,1.9, 95%CI,=,1.0,3.7), skin or soft tissue infections (OR,=,1.5, 95%CI,=,0.9,2.3), oral corticosteroids (OR,=,1.4, 95%CI,=,1.0,1.8), and non-fluoroquinolone antibiotics (OR,=,1.2, 95%CI,=,1.1,1.5). Conclusions The elevation in ATR risk associated with fluoroquinolones was similar in magnitude to that associated with oral corticosteroids or non-fluoroquinolone antibiotics. Trauma and male sex were more strongly associated with ATR, as were obesity and injected corticosteroids. Copyright © 2006 John Wiley & Sons, Ltd. [source] The arterial anatomy of the Achilles tendon: Anatomical study and clinical implicationsCLINICAL ANATOMY, Issue 3 2009Tony M. Chen Abstract The Achilles tendon is the most frequently ruptured tendon in the lower limb and accounts for almost 20% of all large tendon injuries. Despite numerous published studies describing its blood supply, there has been no uniformity in describing its topography. The current study comprises a detailed anatomical study of both the intrinsic and extrinsic arterial supply of the Achilles tendon, providing the detail sought from studies calling for improved planning of surgical procedures where damage to the vascularity of the Achilles tendon is likely. A dissection, microdissection, histological, and angiographic study was undertaken on 20 cadaveric lower limbs from 16 fresh and four embalmed cadavers. The Achilles tendon is supplied by two arteries, the posterior tibial and peroneal arteries. Three vascular territories were identified, with the midsection supplied by the peroneal artery, and the proximal and distal sections supplied by the posterior tibial artery. The midsection of the Achilles tendon was markedly more hypovascular that the rest of the tendon. The Achilles tendon is at highest risk of rupture and surgical complications at its midsection. Individuals with particularly poor supply of the midsection may be at increased risk of tendon rupture, and approaches to the tendon operatively should consider the route of supply by the peroneal artery to this susceptible part of the tendon. Clin. Anat. 22:377,385, 2009. © 2009 Wiley-Liss, Inc. [source] Compression therapy promotes proliferative repair during rat Achilles tendon immobilizationJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 7 2010Nikos Schizas Abstract Achilles tendon ruptures are treated with an initial period of immobilization, which obstructs the healing process partly by a reduction of blood circulation. Intermittent pneumatic compression (IPC) has been proposed to enhance tendon repair by stimulation of blood flow. We hypothesized that daily IPC treatment can counteract the deficits caused by 2 weeks of immobilization post tendon rupture. Forty-eight Sprague-Dawley SD) rats, all subjected to blunt Achilles tendon transection, were divided in three equal groups. Group A was allowed free cage activity, whereas groups B,C were immobilized at the operated hindleg. Group C received daily IPC treatment. Two weeks postrupture the rats were euthanatized and the tendons analyzed with tensile testing and histological assessments of collagen organization and collagen III-LI occurrence. Immobilization significantly reduced maximum force, energy uptake, stiffness, tendon length, transverse area, stress, organized collagen diameter and collagen III-LI occurrence by respectively 80, 75, 77, 22, 47, 65, 49, and 83% compared to free mobilization. IPC treatment improved maximum force 65%, energy 168%, organized collagen diameter 50%, tendon length 25%, and collagen III-LI occurrence 150% compared to immobilization only. The results confirm that immobilization impairs healing after tendon rupture and furthermore demonstrate that IPC-treatment can enhance proliferative tendon repair by counteracting biomechanical and morphological deficits caused by immobilization. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:852,858, 2010 [source] Changes in gene expression of individual matrix metalloproteinases differ in response to mechanical unloading of tendon fascicles in explant cultureJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 10 2008Diane R. Leigh Abstract Immobilization of the tendon and ligament has been shown to result in a rapid and significant decrease in material properties. It has been proposed that tissue degradation leading to tendon rupture or pain in humans may also be linked to mechanical unloading following focal tendon injury. Hence, understanding the remodeling mechanism associated with mechanical unloading has relevance for the human conditions of immobilization (e.g., casting), delayed repair of tendon ruptures, and potentially overuse injuries as well. This is the first study to investigate the time course of gene expression changes associated with tissue harvest and mechanical unloading culture in an explant model. Rat tail tendon fascicles were harvested and placed in culture unloaded for up to 48 h and then evaluated using qRT-PCR for changes in two anabolic and four catabolic genes at 12 time points. Our data demonstrates that Type I Collagen, Decorin, Cathepsin K, and MMP2 gene expression are relatively insensitive to unloaded culture conditions. However, changes in both MMP3 and MMP13 gene expression are rapid, dramatic, sustained, and changing during at least the first 48 h of unloaded culture. This data will help to further elucidate the mechanism for the loss of mechanical properties associated with mechanical unloading in tendon. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:1306,1312, 2008 [source] |