scholarly journals Reconstruction of Chronic Foveal TFCC Tears with an Autologous Tendon Graft

2015 ◽  
Vol 04 (01) ◽  
pp. 009-014 ◽  
Author(s):  
Kevin Eng ◽  
Yu Lee ◽  
Duncan Mcguire ◽  
Matthias Zumstein ◽  
Gregory Bain
Keyword(s):  
Tendon Graft ◽  
Autologous Tendon Graft

Evaluation of an Autologous Tendon Graft Repair Method for Gap Healing of the Deep Digital Flexor Tendon in Horses

1996 ◽  
Vol 25 (4) ◽  
pp. 342-350 ◽  
Author(s):  
MIGUEL A. VALDÉS-VÁZQUEZ ◽  
J. RAYMOND McCLURE ◽  
JULIAN L. OLIVER III ◽  
SANTOS RAMIREZ ◽  
THOMAS L. SEAHORN ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Graft ◽  
Repair Method ◽  
Autologous Tendon Graft

The Fate of Host and Graft Cells in Early Healing of Bone Tunnel after Tendon Graft

2005 ◽  
Vol 33 (12) ◽  
pp. 1892-1897 ◽  
Author(s):  
Masashi Kobayashi ◽  
Nobuyoshi Watanabe ◽  
Yasushi Oshima ◽  
Yoshiteru Kajikawa ◽  
Mitsuhiro Kawata ◽  
...  
Keyword(s):  
Green Fluorescent Protein ◽  
Fluorescent Protein ◽  
Tendon Graft ◽  
Bone Tunnel ◽  
Host Cells ◽  
Wild Type ◽  
Group A ◽  
Group B ◽  
Green Fluorescent ◽  
Autologous Tendon Graft

Background The behavior of host and graft cells during the healing process after autologous tendon graft has not been elucidated. Hypothesis Host cells will integrate into the bone-tendon interface and contribute to cellular repopulation of the graft. Study Design Controlled laboratory study. Methods Twelve-week-old, genetically identical, female green fluorescent protein transgenic rats (n = 20) and wild-type rats (n = 20) were used. The rats were divided into 2 experimental groups. In group A, the Achilles tendons of wild-type rats were harvested and transplanted into the transcondylar femoral bone tunnels of green fluorescent protein rats. In group B, the Achilles tendons of green fluorescent protein rats were transplanted into a transcondylar femoral bone tunnel of wild-type rats. Immediately after transplantation (time zero) and at 1, 2, and 4 weeks after the transplantation, distal femoral epiphyses were harvested and cut into 14-μm serial sagittal frozen sections. The sections were examined with a confocal laser-scanning microscope to quantify green fluorescent protein-positive cell survival. Results At time zero, only host cells in group A and only graft cells in group B demonstrated green fluorescent protein signals. At 1 week in group A, many green fluorescent protein-positive cells were found in the graft. In group B, a few green fluorescent protein-positive cells were found in the graft. At 2 and 4 weeks in group A, many green fluorescent protein-positive cells were detected in the graft, but green fluorescent protein-positive cells had disappeared completely in group B. Conclusion Host cells, rather than graft cells, contribute to repair of the bone-tendon interface and the remodeling of grafts after simulated autologous tendon graft.

A Novel Approach for Meniscal Regeneration Using Kartogenin-Treated Autologous Tendon Graft

2017 ◽  
Vol 45 (14) ◽  
pp. 3289-3297 ◽  
Author(s):  
He Huang ◽  
Hongyao Xu ◽  
Jianning Zhao
Keyword(s):  
Chondrogenic Differentiation ◽  
Collagen Type ◽  
Tendon Graft ◽  
Histochemical Staining ◽  
Type I ◽  
Type Ii ◽  
Qrt Pcr ◽  
Autologous Tendon Graft

Background: The meniscus is one of the most commonly injured parts of the body, and meniscal healing is difficult. Hypothesis: Kartogenin (KGN) induces tendon stem cells (TSCs) to differentiate into cartilage cells in vitro and form meniscus-like tissue in vivo. A damaged meniscus can be replaced with a KGN-treated autologous tendon graft. Study Design: Controlled laboratory study. Methods: In the in vitro experiments, TSCs were isolated from rabbit patellar tendons and cultured with various concentrations of KGN, from 0 to 1000 µM. The effect of KGN on the chondrogenesis of TSCs in vitro was investigated by histochemical staining and quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). The in vivo experiments were carried out on 6 New Zealand White rabbits by removing a meniscus from the rabbit knee and implanting an autologous tendon graft treated with KGN or saline. The meniscus formation in vivo was examined by histological analysis and immune staining. Results: The proliferation of TSCs was promoted by KGN in a concentration-dependent manner. Both histochemical staining and qRT-PCR showed that the chondrogenic differentiation of TSCs was increased with KGN concentration. After 3 months of implantation, the tendon graft treated with KGN formed a meniscus-like tissue with a white and glistening appearance, while the saline-treated tendon graft retained tendon-like tissue and appeared yellowish and unhealthy. Histochemical staining showed that after 3 months of implantation, the KGN-treated tendon graft had a structure similar to that of normal meniscus. Many cartilage-like cells and fibrocartilage-like tissues were found in the KGN-treated tendon graft. However, no cartilage-like cells were found in the saline-treated tendon graft after 3 months of implantation. Furthermore, the KGN-treated tendon graft was positively stained by both anti–collagen type I and type II antibodies, but the saline-treated tendon graft was not stained by collagen type II. Conclusion: The findings indicated that KGN can induce the differentiation of TSCs into cartilage-like cells in vitro and in vivo. The results suggest that KGN-treated tendon graft may be a good substitute for meniscal repair and regeneration. Clinical Relevance: This study revealed the direct effects of KGN on the chondrogenic differentiation of TSCs in vitro and in vivo. A KGN-treated autologous tendon graft induced formation of a meniscus-like tissue in vivo. This study provides a new cartilage regenerating technology for the treatment of damaged meniscus.

scholarly journals The Prevalence and Patterns of Palmaris Longus Muscle Absence in an Iranian Population

2019 ◽  
Vol 9 (4) ◽  
pp. 279-282
Author(s):  
Mehdi Forouzesh ◽  
Abdolrazagh Barzegar ◽  
Fardin Fallah
Keyword(s):  
Gender Difference ◽  
Clinical Importance ◽  
Tendon Graft ◽  
Iranian Population ◽  
Geographical Variability ◽  
Palmaris Longus ◽  
Longus Muscle ◽  
Palmaris Longus Muscle ◽  
And Gender ◽  
Gender Specific

Palmaris Longus (PL) is a muscle of the forearm, i.e., not functionally necessary and does not exist in all people. It is a choice for tendon graft and investigating its prevalence is of clinical importance. During April-October 2009, 102 cadavers (78 males, 24 females) were bilaterally necropsied for PL exploration in Zanjan City, Iran. PL Absence (PLA) was observed in 37 (36.3%) cases (28 males, 9 females). PLA prevalence was similar in men (36%) and women (37.5%). Of PLA cases, 19 (51%) were unilateral (14 males, 5 females), and 18 (49%) were bilateral (14 males, 4 females). In conclusion, PLA prevalence of 36.3% in our population was similar to other studies conducted in Iran. We found no gender difference in PLA prevalence and its patterns. Due to geographical variability in PLA rate, future regional and national studies with more magnificent sample sizes are recommended to determine the prevalence and gender-specific patterns of PLA.

scholarly journals Distal radioulnar joint stabilization with open foveal reinsertion versus tendon graft reconstruction: an experimental study using radiostereometry

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Janni Kjærgaard Thillemann ◽  
Sepp De Raedt ◽  
Torben Bæk Hansen ◽  
Bo Munk ◽  
Maiken Stilling
Keyword(s):  
Experimental Study ◽  
Surgical Techniques ◽  
Distal Radioulnar Joint ◽  
Tendon Graft ◽  
Imaging Method ◽  
Radioulnar Joint ◽  
Clinical Recommendation ◽  
Surgical Methods ◽  
Custom Made ◽  
Stabilizing Effect

Abstract Purpose Symptomatic instability of the distal radioulnar joint (DRUJ) caused by lesion of the Triangular Fibrocartilage Complex (TFCC) can be treated with a number of surgical techniques. Clinical examination of DRUJ translation is subjective and limited by inter-observer variability. The aim of this study was to compare the stabilizing effect on DRUJ translation with two different surgical methods using the Piano-key test and a new precise low-dose, non-invasive radiostereometric imaging method (AutoRSA). Methods In a randomized experimental study we evaluated the DRUJ translation in ten human cadaver arms (8 males, mean age 78 years) after cutting the proximal and distal TFCC insertions, and after open surgical TFCC reinsertion (n = 5) or TFCC reconstruction using a palmaris longus tendon graft ad modum Adams (n = 5). The cadaver arms were mounted in a custom-made fixture for a standardized Piano-key test. Radiostereometric images were recorded and AutoRSA software was used for image analyses. Standardised anatomical axes and coordinate systems of the forearm computer tomography bone models were applied to estimate DRUJ translation after TFCC lesions and after surgical repair. Results The DRUJ translation after cutting the proximal and distal TFCC insertions was 2.48 mm (95% CI 1.61; 3.36). Foveal TFCC reinsertion reduced DRUJ translation by 1.78 mm (95% CI 0.82; 2.74, p = 0.007), while TFCC reconstruction reduced DRUJ translation by 1.01 mm (95% CI -1.58; 3.60, p = 0.17). Conclusion In conclusion, foveal TFCC reinsertion significantly decreased DRUJ translation while the stabilizing effect of Adams TFCC reconstruction was heterogeneous. This supports the clinical recommendation of TFCC reinsertion in patients suffering from symptomatic DRUJ instability due to acute fovea TFCC lesions.

scholarly journals Comparative Study of Flexor Hallicus Longus Tendon Length through Single Incision or Accessory Plantar Medial Incision: A Cadaver Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0018
Author(s):  
Caitlin Curtis Crocker ◽  
Eildar Abyar ◽  
Sean Young ◽  
Fatemah Razaghi ◽  
Gerald McGwin ◽  
...  
Keyword(s):  
Single Incision ◽  
Plantar Flexion ◽  
Cadaver Study ◽  
Tendon Graft ◽  
Interference Screw ◽  
Flexor Hallucis Longus ◽  
Tunnel Length ◽  
Exact Test ◽  
Fresh Frozen ◽  
The Mean

Category: Ankle; Hindfoot Introduction/Purpose: Flexor Hallucis Longus (FHL) tendon transfer to the calcaneus is a common adjuvant procedure in the treatment of Achilles pathology. The FHL tendon can be harvested using a posterior incision where the tendon is dissected along its course into the fibroosseous tunnel. Alternatively, the FHL may be harvested through a separate plantar medial incision as it crosses the flexor digitorium longus at the Knot of Henry. This study aims to quantify FHL tendon lengths achieved through the two common approaches utilizing pair matched cadavers. Methods: Seven pair matched fresh-frozen cadaver legs without signs of musculoskeletal abnormalities were used for this assessment. One leg in each pairing underwent a single incision harvest while the contralateral leg underwent an accessory medial plantar harvest. After dissecting the tendon, a calcaneus tunnel was prepared from dorsal to plantar in both calcanei in standard fashion. Two measurements were obtained. The first measurement was taken from the distal aspect of the muscle belly to the distal end of the tendon. The tendon was then pulled through the calcaneus, and the foot was held in tension at 20 degrees of plantar flexion. The second measurement was taken from site where tendon entered the calcaneous to the distal end of the tendon graft. The measurements were analyzed using Wilcoxon Signed Ranks Test and Fischer Exact Test. Results: Using a posterior incision, the mean tendon measurement from calcaneous tunnel to the distal end of the tendon was 4.0 cm. Using an accessory plantar medial incision, the mean tendon measurement from the calcaneous tunnel to the distal end of the tendon was 7.2 cm. The average tunnel length obtained using an accessory medial incision was significantly greater than the length obtained using the single incision approach (p= 0.0003, p=0.0022, and p=0.0016). The accessory plantar medial incision obtained an FHL tendon tunnel length that was an average of 2.9 cm greater than the posterior incision. Conclusion: The single incision approach provided sufficient length to safely anchor the FHL into the calcaneus which suggests that the accessory plantar medial approach is not necessary for routine FHL transfers to the calcaneus with interference screw fixation. However, if additional length is needed for other applications such as posterior tibialis tendon dysfunction or peritoneal tendon tears, the accessory incision does provide an average of 2.9 cm of additional length.

scholarly journals Anterior Knee Pain After Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712096108
Author(s):  
Fabiano da Silva Marques ◽  
Pedro Henrique Borges Barbosa ◽  
Pedro Rodrigues Alves ◽  
Sandro Zelada ◽  
Rodrigo Pereira da Silva Nunes ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Extension Deficit ◽  
Anterior Cruciate ◽  
Anterior Knee

Background: Anterior knee pain is a frequent condition after anterior cruciate ligament reconstruction (ACLR), but its origin remains uncertain. Studies have suggested that donor site morbidity in autologous bone–patellar tendon–bone reconstructions may contribute to patellofemoral pain, but this does not explain why hamstring tendon reconstructions may also present with anterior pain. Purpose: To evaluate the prevalence of anterior knee pain after ACLR and its predisposing factors. Study Design: Case-control study; Level of evidence, 3. Methods: We evaluated the records of all patients who underwent ACLR between 2000 and 2016 at a private facility. The prevalence of anterior knee pain after surgery was assessed, and possible risk factors (graft type, patient sex, surgical technique, range of motion) were evaluated. Results: The records of 438 patients (mean age, 30 years) who underwent ACLR were analyzed. Anterior knee pain was found in 6.2% of the patients. We found an increased prevalence of anterior knee pain with patellar tendon graft, with an odds ratio of 3.4 ( P = .011). Patients who experienced extension deficit in the postoperative period had an odds ratio of 5.3 of having anterior pain ( P < .001). Anterior knee pain was not correlated with patient sex or surgical technique. Conclusion: The chance of having anterior knee pain after ACLR was higher when patellar tendon autograft was used compared with hamstring tendon graft, as well as in patients who experienced extension deficit in the postoperative period.

scholarly journals MRI Evaluation of Patella Alignment Before and After Anatomical Reconstruction of ACL Undergoing Unified Rehabilitation Programme Introduced by CMC Physical Therapy Team

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0014
Author(s):  
Dariusz Straszewski ◽  
Marcin Plenzler ◽  
Joanna Szczepaniak ◽  
Robert Śmigielski ◽  
Beata Ciszkowska-Łysoń ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Muscle Activation ◽  
Weight Bearing ◽  
Tendon Graft ◽  
Rehabilitation Programme ◽  
Anatomical Reconstruction ◽  
Patella Baja ◽  
Functional Rehabilitation ◽  
Patellar Tendon Graft ◽  
The Impact

Objectives: The aim of the study was to asses the impact of the functional rehabilitation on patella alignment with MRI imaging in patients who underwent the ACL reconstruction. The surgical approach with the use of patellar tendon graft is known to carry the risk of lowering patella height (patella baja), which, in turn, may lead to accelerated cartilage wear in patellofemoral joint. Methods: 30 patients after the anatomical reconstruction of ACL took part in this study (23 male, and 7 female, mean age = 28 ± 10,6 years). During the procedure a patellar tendon graft was used. The Insali-Salvati ratio measured with MRI (images taken pre-procedural, and 9 months after the surgery) was used for the assessment of patellar alignment. The measurements were taken by one radiology specialist on MRI scans in sagittal view in PD sequence. During the examination, patellar joint was in flexion (approx.10 degrees). As the point of reference for patella’s position ISR ratio was in the range of 0.8 - 1.2. All patients were operated on by the same team of surgeons and underwent an unified rehabilitation programme led by a team of selected physiotherapists. The main features of the programme were: an early muscle activation (second day after the procedure); mobilisation of the patella and tissues of the anterior compartment of the knee; weight bearing co-contraction exercises, and the sensomotoric training of the entire kinetic chain of the lower limb. The data recorded was statistically analysed using the Wilcoxon signed-rank test in order to establish parameters’ changes within the study group.. Results: The mean ISR value before the procedure was 0.84 (± 0,1), whereas 9 months after the surgery it was 0.85 (± 0,1). The results’ analysis did not show any statistically significant changes between ISR values. Nine months after the procedure patella baja has not been observed in any of the evaluated patients. Conclusion: The functional rehabilitation programme designed by the CMC team had no negative impact on patella alignment, as no patella baja, which is a common complication after these kinds of surgeries, has been observed. The applied functional rehabilitation programme enabled patients to keep the proper patella alignment, similar to the alignment recorded before the surgery.

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