scholarly journals Calcaneoplasty coupled with an insertional Achilles tendon reattachment procedure for the prevention of secondary calcaneal impingement: a retrospective study

2020 ◽  
Vol 11 ◽  
pp. 204062232094479
Author(s):  
Yanbin Pi ◽  
Yuelin Hu ◽  
Qinwei Guo ◽  
Dong Jiang ◽  
Xin Xie ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Pain Scale ◽  
Mri Findings ◽  
Aofas Score ◽  
Foot Function ◽  
Magnetic Resonance Imaging Mri ◽  
Pain Symptoms ◽  
Tegner Score ◽  
Calcaneal Tuberosity

Background: Posterior heel pain may occur after an Achilles insertional rupture reattachment procedure and could be attributed to an impingement between the calcaneal tuberosity and Achilles tendon, which could be observed using postoperative magnetic resonance imaging (MRI). Moreover, such impingement, which may be associated with postoperative pain symptoms, could be relieved by calcaneoplasty. Methods: Postoperative Visual Analog Pain Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) score, Foot Function Index (FFI), Ankle Activity Score (AAS), and Tegner score were obtained and compared between 10 patients who underwent calcaneoplasty (calcaneoplasty group) and 11 patients who did not receive calcaneoplasty (non-calcaneoplasty group). Several signs of calcaneal tuberosity impingement identified in MRI were also compared between the two groups, which included retrocalcaneal bursitis, postoperative tendinopathy, tendon calcification, bone marrow edema, increased Achilles tendon diameter, and bony spurs. Results: The VAS score was 2.00 ± 1.41 and 2.18 ± 1.83 ( p = 0.803), the AOFAS score was 90.60 ± 4.22 and 81.82 ± 7.77 ( p = 0.005), the FFI was 5.00 ± 2.86 and 17.18 ± 15.92 ( p = 0.028), the AAS was 5.50 ± 2.55 and 5.82 ± 2.04 ( p = 0.750), and the Tegner score was 4.30 ± 1.49 and 4.45 ± 1.21 ( p = 0.797) in the calcaneoplasty and non-calcaneoplasty groups, respectively. The AOFAS score and FFI were significantly different between the groups. MRI findings revealed that the non-calcaneoplasty group had significant signs of calcaneal impingement compared with the calcaneoplasty group. Conclusions: Secondary calcaneal impingement due to insertional tendon enlargement may occur, and prophylactic calcaneoplasty coupled with an insertional reattachment procedure could achieve promising postoperative outcomes for patients with insertional Achilles tendon rupture.

Partial achilles tendon rupture presenting with giant hematoma; MRI findings of 4 year follow up

The Foot ◽  
2011 ◽  
Vol 21 (4) ◽  
pp. 204-206
Author(s):  
Aysegul Sarsilmaz ◽  
Makbule Varer ◽  
Gulten Coskun ◽  
Melda Apaydın ◽  
Orhan Oyar
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Mri Findings

scholarly journals Achilles tendon repair by a minimally invasive technique using Tenolig®

2020 ◽  
Vol 14 (3) ◽  
pp. 269-273
Author(s):  
Vinicius Oliveira ◽  
Sérgio Prata
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Postoperative Infection ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Case Series ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Aofas Score ◽  
Functional Scores

Objective: To assess the degree of postoperative satisfaction of patients with acute Achilles tendon rupture who underwent surgical reconstruction by a minimally invasive technique using Tenolig®. Methods: A retrospective observational study was conducted with 18 patients with acute Achilles tendon rupture diagnosed by a positive Thompson test who underwent surgery. Outcomes were assessed using the American  arthopaedic Foot and Ankle Society (AOFAS) score and the Foot Function Index (FFI). Furthermore, quantitative variables were descriptively treated, and patients’ age was correlated with FII and AOFAS score using Spearman’s correlation coefficient at a significance level of 5%. Results: Patients underwent surgery from one to six days after injury and were discharged one day later. Only one patient had a superficial postoperative infection. Patients’ AOFAS scores ranged from 75 to 100 points, and FFI ranged from 0 to 20%. The patient withsuperficial postoperative infection had an AOFAS score and a FFI of 75 points and 20%, respectively. Conclusion: Percutaneous repair of complete Achilles tendon rupture with Tenolig® resulted in high functional scores and a low rate of complications. Level of Evidence IV; Therapeutic Studies; Case Series.

Acute Achilles Tendon Rupture Treated by Double Side-Locking Loop Suture Technique With Early Rehabilitation

2016 ◽  
Vol 38 (2) ◽  
pp. 167-173 ◽  
Author(s):  
Wataru Miyamoto ◽  
Shinji Imade ◽  
Ken Innami ◽  
Hirotaka Kawano ◽  
Masato Takao
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Plantar Flexion ◽  
Weight Bearing ◽  
Achilles Tendon Rupture ◽  
Case Series ◽  
Full Weight Bearing ◽  
Aofas Score ◽  
Accelerated Rehabilitation ◽  
Athletic Activities

Background: Although early accelerated rehabilitation is recommended for the treatment of acute Achilles tendon rupture, most traditional rehabilitation techniques require some type of brace. Methods: We retrospectively analyzed 44 feet of 44 patients (25 male and 19 female) with a mean age of 31.8 years who had an acute Achilles tendon rupture related to athletic activity. Patients had been treated by a double side-locking loop suture (SLLS) technique using double antislip knots between stumps and had undergone early accelerated rehabilitation, including active and passive range of motion exercises on the day following the operation and full weight-bearing at 4 weeks. No brace was applied postoperatively. The evaluation criteria included the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Scale (AOFAS) score; active plantar flexion and dorsiflexion angles; and the intervals between surgery and the time when patients could walk normally without any support, perform double-leg heel raises, and perform 20 continuous single-leg heel raises of the operated foot. Results: Despite postoperative early accelerated rehabilitation, the AOFAS score and active dorsiflexion angles improved over time (6, 12, and 24 weeks and 2 years). A mean of 4.3 ± 0.6 weeks was required for patients to be able to walk normally without any support. The mean period to perform double-leg heel raises and 20 continuous single-leg heel raises of the injured foot was 8.0 ± 1.3 weeks and 10.9 ± 2.1 weeks, respectively. All patients, except one who was engaged in classical ballet, could return to their preinjury level of athletic activities, and the interval between operation and return to athletic activities was 17.1 ± 3.7 weeks. Conclusion: The double SLLS technique with double antislip knots between stumps adjusted the tension of the sutured Achilles tendon at the ideal ankle position and provided good clinical outcomes following accelerated rehabilitation after surgery without the use of a brace. Level of Evidence: Level IV, retrospective case series.

scholarly journals Achilles tendon rupture in camel (Camelus dromedarius): Radiographic and Ultrasonographic findings

2019 ◽  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Soft Tissues ◽  
Weight Bearing ◽  
Achilles Tendon Rupture ◽  
Clinical Decision ◽  
Heterogeneous Structure ◽  
Dromedary Camels ◽  
Fracture Of The Calcaneus ◽  
Calcaneal Tuberosity

This study describes the clinical presentation of Achilles tendon rupture and evaluates the utility of radiography and ultrasonography in the diagnosis of such disorder in dromedary camels. Seventeen camels were included in this study based on the clinical, radiographic and ultrasonographic evidence of Achilles tendon rupture. The clinical, radiographic and sonographic findings of studied camels differ according to the type, duration, and location of the tendon rupture. Complete and incomplete rupture of the Achilles tendon was precisely diagnosed in five (29.4%) and twelve (70.6%) camels respectively; ruptured deep and superficial parts of the Achilles tendon were recorded in 10 (58.8%) and 2 (11.8%) camels respectively. Clinically, the camels exhibited an acute non-weight-bearing lameness (second to fourth-grade lameness), with swelling in the tendon near the calcaneus. Radiographs revealed swelling of the soft tissues surrounding the Achilles tendon just proximal to the calcaneal tuberosity in most of the camels with the presence of avulsion fracture of the calcaneus in few cases (n=2). Ultrasonographically, the ruptured part was precisely diagnosed as swollen, oedematous, heterogeneous structure with the presence of anechoic or hypoechoic areas (core lesion). In conclusion, lateromedial radiographs and ultrasonography were helpful in diagnosis and differential diagnosis of different types of Achilles tendon rupture and subsequent clinical decision and surgical interference in dromedary camels.

scholarly journals Achilles tendon rupture in camel (Camelus dromedarius): Radiographic and Ultrasonographic findings

2019 ◽  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Soft Tissues ◽  
Weight Bearing ◽  
Achilles Tendon Rupture ◽  
Clinical Decision ◽  
Heterogeneous Structure ◽  
Dromedary Camels ◽  
Fracture Of The Calcaneus ◽  
Calcaneal Tuberosity

This study describes the clinical presentation of Achilles tendon rupture and evaluates the utility of radiography and ultrasonography in the diagnosis of such disorder in dromedary camels. Seventeen camels were included in this study based on the clinical, radiographic and ultrasonographic evidence of Achilles tendon rupture. The clinical, radiographic and sonographic findings of studied camels differ according to the type, duration, and location of the tendon rupture. Complete and incomplete rupture of the Achilles tendon was precisely diagnosed in five (29.4%) and twelve (70.6%) camels respectively; ruptured deep and superficial parts of the Achilles tendon were recorded in 10 (58.8%) and 2 (11.8%) camels respectively. Clinically, the camels exhibited an acute non-weight-bearing lameness (second to fourth-grade lameness), with swelling in the tendon near the calcaneus. Radiographs revealed swelling of the soft tissues surrounding the Achilles tendon just proximal to the calcaneal tuberosity in most of the camels with the presence of avulsion fracture of the calcaneus in few cases (n=2). Ultrasonographically, the ruptured part was precisely diagnosed as swollen, oedematous, heterogeneous structure with the presence of anechoic or hypoechoic areas (core lesion). In conclusion, lateromedial radiographs and ultrasonography were helpful in diagnosis and differential diagnosis of different types of Achilles tendon rupture and subsequent clinical decision and surgical interference in dromedary camels.

scholarly journals Achilles Tendon Enthesitis Evaluated by MRI Assessments in Patients with Axial Spondyloarthritis and Psoriatic Arthritis: A Report of the Methodology of the ACHILLES Trial

2020 ◽  
Author(s):  
Xenofon Baraliakos ◽  
Philipp Sewerin ◽  
Eugenio de Miguel ◽  
Effie Pournara ◽  
Christine Kleinmond ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Achilles Tendon ◽  
Scoring System ◽  
Bone Erosion ◽  
Mri Findings ◽  
Clinical Trial Registry ◽  
Magnetic Resonance Imaging Mri ◽  
The Individual ◽  
Clinical Measures ◽  
Quantitative Scoring

Abstract Background: The currently available scoring methods for enthesitis are often measures of pain but not of inflammation at entheseal sites. The Outcome Measures in Rheumatology Clinical Trials (OMERACT) psoriatic arthritis (PsA) magnetic resonance imaging (MRI) scoring system (PsAMRIS) assesses inflammation and damage in PsA and was particularly developed for the hands. The ACHILLES trial used clinical measures for heel enthesitis in combination with MRI scoring based on PsAMRIS.Methods: Patients (age ≥ 18 years) with spondyloarthritis (SpA) and PsA were included in the trial if they presented with clinical and MRI-positive heel enthesitis. MRI of the affected heel was performed at three time points: screening, Week 24 and Week 52. Inflammatory MRI findings (tendinitis, bursitis and bone marrow oedema [BME]) in the area of the Achilles tendon and/or plantar aponeurosis, periarticular inflammation of the ankle joint and heel erosion were assessed qualitatively (absent/present). In addition, BME and bone erosion were quantitatively assessed based on PsAMRIS, where their proportion was compared to the volume of the affected bone. Mean scores of BME and bone erosion quantification were calculated, and the mean composite score (based on PsAMRIS) was calculated based on the individual score of each subject for periarticular inflammation, BME and bone erosion and further extended for bursitis and tendinitis. Modifications to PsAMRIS were introduced by categorising oedema length as ≤/> 0.5 cm and locating bone erosion.Conclusions: In ACHILLES, MRI was used to assess and evaluate heel enthesitis. Due to the lack of a validated scoring system for heel enthesitis at the time of ACHILLES initiation, this trial applied quantitative scoring based on PsAMRIS, with specific adaptations for the heel.Trial registration: National Clinical Trial Registry, NCT02771210. Registered 13 May 2016. https://clinicaltrials.gov/ct2/show/NCT02771210?term=NCT02771210&draw=2&rank=1

scholarly journals Achilles tendon rupture in camel (Camelus dromedarius): Radiographic and Ultrasonographic findings

2019 ◽  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Soft Tissues ◽  
Weight Bearing ◽  
Achilles Tendon Rupture ◽  
Clinical Decision ◽  
Heterogeneous Structure ◽  
Dromedary Camels ◽  
Fracture Of The Calcaneus ◽  
Calcaneal Tuberosity

This study describes the clinical presentation of Achilles tendon rupture and evaluates the utility of radiography and ultrasonography in the diagnosis of such disorder in dromedary camels. Seventeen camels were included in this study based on the clinical, radiographic and ultrasonographic evidence of Achilles tendon rupture. The clinical, radiographic and sonographic findings of studied camels differ according to the type, duration, and location of the tendon rupture. Complete and incomplete rupture of the Achilles tendon was precisely diagnosed in five (29.4%) and twelve (70.6%) camels respectively; ruptured deep and superficial parts of the Achilles tendon were recorded in 10 (58.8%) and 2 (11.8%) camels respectively. Clinically, the camels exhibited an acute non-weight-bearing lameness (second to fourth-grade lameness), with swelling in the tendon near the calcaneus. Radiographs revealed swelling of the soft tissues surrounding the Achilles tendon just proximal to the calcaneal tuberosity in most of the camels with the presence of avulsion fracture of the calcaneus in few cases (n=2). Ultrasonographically, the ruptured part was precisely diagnosed as swollen, oedematous, heterogeneous structure with the presence of anechoic or hypoechoic areas (core lesion). In conclusion, lateromedial radiographs and ultrasonography were helpful in diagnosis and differential diagnosis of different types of Achilles tendon rupture and subsequent clinical decision and surgical interference in dromedary camels.

scholarly journals Achilles tendon rupture in camel (Camelus dromedarius): Radiographic and Ultrasonographic findings

2019 ◽  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Soft Tissues ◽  
Weight Bearing ◽  
Achilles Tendon Rupture ◽  
Clinical Decision ◽  
Heterogeneous Structure ◽  
Dromedary Camels ◽  
Fracture Of The Calcaneus ◽  
Calcaneal Tuberosity

This study describes the clinical presentation of Achilles tendon rupture and evaluates the utility of radiography and ultrasonography in the diagnosis of such disorder in dromedary camels. Seventeen camels were included in this study based on the clinical, radiographic and ultrasonographic evidence of Achilles tendon rupture. The clinical, radiographic and sonographic findings of studied camels differ according to the type, duration, and location of the tendon rupture. Complete and incomplete rupture of the Achilles tendon was precisely diagnosed in five (29.4%) and twelve (70.6%) camels respectively; ruptured deep and superficial parts of the Achilles tendon were recorded in 10 (58.8%) and 2 (11.8%) camels respectively. Clinically, the camels exhibited an acute non-weight-bearing lameness (second to fourth-grade lameness), with swelling in the tendon near the calcaneus. Radiographs revealed swelling of the soft tissues surrounding the Achilles tendon just proximal to the calcaneal tuberosity in most of the camels with the presence of avulsion fracture of the calcaneus in few cases (n=2). Ultrasonographically, the ruptured part was precisely diagnosed as swollen, oedematous, heterogeneous structure with the presence of anechoic or hypoechoic areas (core lesion). In conclusion, lateromedial radiographs and ultrasonography were helpful in diagnosis and differential diagnosis of different types of Achilles tendon rupture and subsequent clinical decision and surgical interference in dromedary camels.

scholarly journals Age and Tightness of Repair Are Predictors of Heel-Rise Height After Achilles Tendon Rupture

2020 ◽  
Vol 8 (3) ◽  
pp. 232596712090955 ◽  
Author(s):  
Michael R. Carmont ◽  
Jennifer A. Zellers ◽  
Annelie Brorsson ◽  
Katarina Nilsson-Helander ◽  
Jón Karlsson ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Multiple Regression ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Stepwise Multiple Regression ◽  
Secondary Outcome ◽  
Outcome Variable ◽  
Operative Repair ◽  
Rise Height ◽  
Tegner Score

Background: Achilles tendon rupture leads to weakness of ankle plantarflexion. Treatment of Achilles tendon rupture should aim to restore function while minimizing weakness and complications of management. Purpose: To determine the influence of factors (age, sex, body mass index [BMI], weight, time from injury to operative repair, and tightness of repair) in the initial surgical management of patients after an acute Achilles tendon rupture on 12-month functional outcome assessment after percutaneous and minimally invasive repair. Study Design: Cohort study; Level of evidence, 3. Methods: From May 2012 to January 2018, patients sustaining an Achilles tendon rupture receiving operative repair were prospectively evaluated. Tightness of repair was quantified using the intraoperative Achilles tendon resting angle (ATRA). Heel-rise height index (HRHI) was used as the primary 12-month outcome variable. Secondary outcome measures included Achilles tendon total rupture score (ATRS) and Tegner score. Stepwise multiple regression was used to create a model to predict 12-month HRHI. Results: A total of 122 patients met the inclusion criteria for data analysis (mean ± SD age, 44.1 ± 10.8 years; 78% male; mean ± SD BMI, 28.1 ± 4.3 kg/m2). The elapsed time to surgery was 6.5 ± 4.0 days. At 12-month follow-up, patients had an HRHI of 82% ± 16% and performed 82% ± 17% of repetitions compared with the noninjured side. Participants had a mean ATRS of 87 ± 15 and a median Tegner score of 5 (range, 1-9), with a reduction in Tegner score of 2 from preinjury levels. The relative ATRA at 12 months was –4.8° ± 3.9°. Multiple regression identified younger age (B = ±0.006; P < .001) and greater intraoperative ATRA (B = 0.005; P = .053) as predictors of more symmetrical 12-month HRHI ( R 2 = 0.19; P < .001; n = 120). Conclusion: Age was found to be the strongest predictor of outcome after Achilles tendon rupture. The most important modifiable risk factor was the tightness of repair. It is recommended that repair be performed as tight as possible to optimize heel-rise height 1 year after Achilles tendon rupture and possibly to reduce tendon elongation.

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