Fibrin biopolymer sealant and aquatic exercise association for calcaneal tendon repair

Este estudo objetivou comparar o efeito da reparação tendínea por Abelmoschus esculentus Linn (AEL) e ultrassom terapêutico (US) em modelo experimental de tenotomia. Foram selecionados 40 ratos machos Wistar que passaram por uma tenotomia na pata direita sendo tratados durante 7 e 14 dias consecutivos, os animais foram divididos em grupos com tratamento de AEL por via tópica, US, conjunto das duas terapias, além do grupo controle. Após o tratamento os tendões foram removidos para análise histológica, sendo realizado a contagem de células inflamatórias e fibroblásticas. A análise estatística foi feita através da variação do número de células no respectivo grupo, utilizando a análise de One Way ANOVA seguido pelo teste de Newman-keuls com nível de significância de 5% (p0,05). Nos resultados foi visto a redução significativa (p0,05) de células polimorfonucleadas do grupo tratado com US + AEL em relação ao grupo controle no tempo de 14 dias. Em relação ao número de células fibroblásticas houve aumento significativo nos grupos tratados com sonoforese em relação ao grupo controle em 7 e 14 dias. Nos outros grupos não houve diferenças significativas. A terapia com US e AEL mostrou efeito adjuvante no processo de reparo do tendão, demostrando eficácia da sonoforese com AEL.Palavras-chave: Ratos Wistar. Tendinite. Quiabo. Terapia por Ultrassom. Fonoforese. REPAIR OF THE CALCANEAL TENDON IN RATS AFTER TENOTOMY AND TREATMENT BY ABELMOSCHUS ESCULENTUS LINN AND THERAPEUTIC ULTRASOUNDABSTRACT: This study aimed to compare the effect of tendon repair by Abelmoschus esculentus Linn (AEL) and therapeutic ultrasound (US) in an experimental model of tenotomy. A total of 40 male Wistar rats were submitted to a tenotomy in the right paw and were treated for 7 and 14 consecutive days. The animals were divided into groups with AEL treatment topical, US, all of the therapies, as well as the control group. After the treatment, the tendons were removed for histological analysis, counting inflammatory and fibroblast cells. Statistical analysis was done by varying the number of cells in the respective group, using One Way ANOVA followed by Newman-keuls test with significance level of 5% (p0.05). The results showed a significant reduction (p 0.05) in polymorphonucleated cells from the US + AEL treated group compared to the 14-day control group. In relation to the number of fibroblastic cells there was a significant increase in the groups treated with phonophoresis in relation to the control group in 7 and 14 days. There were no significant differences in the other groups. US and AEL therapy showed an adjuvant effect on the tendon repair process, demonstrating the efficacy of phonophoresis with AEL.Keywords: RatsWistar. Tendinopathy. Abelmoschus. Ultrasonic Therapy. Phonophoresis.

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Tenorrhaphy of the Common Calcaneal Tendon in Dogs and Cats

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.84404 ◽

2016 ◽

Vol 44 (1) ◽

pp. 7

Author(s):

ísis Dos Santos Dal-Bó ◽

Cássio Ricardo Auada Ferrigno ◽

Aline Schafrum Macedo ◽

Fernanda Paes ◽

Jaqueline França Dos Santos ◽

...

Keyword(s):

Body Weight ◽

Hind Limb ◽

Weight Bearing ◽

Tendon Repair ◽

Distal Portion ◽

Bovine Pericardium ◽

Calcaneal Tendon ◽

The Common ◽

The Right ◽

Locking Screw

Background: Common calcaneal tendon (CCT) is usually affected by injuries in dogs and less frequently in cats. The Achilles mechanism consists of the convergence of three distinct structures: the tendons of the gastrocnemius muscle, superficial digital flexor muscle and the common tendons of the biceps femoris, gracilis, and semitendinosus muscles. Classification of lesions is based upon their location, severity and chronicity. Clinical signs include lameness, plantigrade stance and various degrees of tarsal hyperflexion according to the injury’s severity. The purpose of this study is to report four cases of reconstruction of the common calcaneus in three dogs and a cat.Cases: Case 1. A 10-year-old male canine, Brazilian Terrier, 7.7 kg of body weight, with a 6-month history of nonweightbearing lameness of the right hind limb attended consultation. Orthopedic examination showed plantigrade stance, hyperflexion of the right tibial-tarsal joint (TTJ) and swelling with fibrous thickening of the distal portion of the CCT. Surgical tendon repair was achieved through insertion of a locking screw on the calcaneo-tibial, tenorrhaphy and suture of a titanium plate on the caudal aspect of the CCT. Case 2. A 2-year-old female mongrel canine, with 13.3 kg of body weight was presented with the complaint of chronic left hind leg lameness. The owner described trauma at the area of the hock six months prior to consultation. On orthopedic exam, severe lameness was noted, swelling with fibrous thickening of the distal portion of the common calcaneal tendon and hyperflexion of the left TTJ (plantigrade position) were visible. Tendon repair was performed in the same manner as in case 1, except that in this case a bovine pericardium graft preserved in glycerin 98% was sutured over the tendon/plate conjunction. Case 3. A 6-year-old female mongrel canine, with 18.6 kg of body weight was attended with a 22-day history of right hind limb lameness. On physical exam intermittent lameness during gait performance and non-weight-bearing position in stance were noted. The distal portion of the limb was internally rotated with plantigrade stance and discontinuity of the CCT was palpable. Tenorrhaphy was performed similarly to case 2. Case 4. A 6 kg, 3-year-old, mixed breed male feline was admitted with a wound on the CCT region for 7 days. The wound was originated after animal interaction with a stray feline. On clinical examination the animal was non-weight bearing on the right hind limb, with plantigrade posture and with a 1 cm wound on the caudal portion of the CCT with tendon exposure. Surgical repair was performed by tenorrhaphy with placement of a surgical steel plate on the caudal aspect of the CCT. A bovine pericardium graft preserved in glycerin 98% was sutured on top of the plate. The TTJ was immobilized with a type II transarticular external fixator.Discussion: Ultrasonography is the test of choice to monitor tendon healing after tenorrhaphy. At this report, this exam was crucial to determine when the calcaneal-tibial screw could be removed. Two dogs and the cat from this report received an association of plate and bovine pericardium preserved in glycerin 98%. The purpose of this association was to increase the strength of the tenorrhaphy, and the pericardium graft had also the function of reducing the formation of peritendinous adhesions. Immobilization of the TTJ has the purpose of opposing muscle forces to avoid stress at tenorrhaphy suture increasing the strength of the healed tendon allowing early weight bear while minimizing the recurrence risk and avoiding limb contracture. We chose to perform the procedure with hyperextension of the TTJ in order to promote greater relaxation of the tendon since there was need to remove large portions of calcaneal fibrous tissues of the dogs and devitalized tissue in the cat from this report. Surgical treatment of injuries of the Achilles mechanism has good prognosis in complete closed lesions treated by tenorrhaphy associated with suture of a plate, suture of bovine pericardial graft preserved in 98% glycerin, calcaneal-tibial locking screw and splint for six weeks.Keywords: Achilles tendon, rupture, calcaneo-tibial screw, locking-loop suture pattern.

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Common calcaneal tendon repair with glycerin-preserved carotid artery xenografts and autologous bone marrow mononuclear cells in rabbits

Brazilian Journal of Veterinary Research and Animal Science ◽

10.11606/issn.1678-4456.bjvras.2016.100404 ◽

2017 ◽

Vol 53 (4) ◽

pp. 1

Author(s):

Robson José Gomes de Melo ◽

Gentil Ferreira Gonçalves ◽

Duvaldo Eurides ◽

Patricia Romagnolli ◽

Marshal Costa Leme ◽

...

Keyword(s):

Bone Marrow ◽

Carotid Artery ◽

Mononuclear Cells ◽

Tendon Repair ◽

Autologous Bone Marrow ◽

Bone Marrow Mononuclear Cells ◽

Calcaneal Tendon ◽

Autologous Bone

Utilizou-se 15 coelhos adultos para avaliar o reparo de lesão do tendão calcanear comum com implante de artéria carótida de cães, preservada em glicerina, associado ou não a células mononucleares autólogas da medula óssea (CMAs). Os animais foram observados diariamente por meio de avaliações clínicas e o local do implante foi analisado sob microscopia de luz decorridos 15, 30 e 60 dias de pós-operatório. Notou-se em todos os períodos de observação, com o implante associado às CMAs, melhor desempenho físico dos membros pélvico e maior intensidade de fibras colágenas, fibroblastos e linfócitos e neovascularização. A utilização de xenoimplante de artéria carótida de cães preservada em glicerina associado à administração de células mononucleares da medula óssea foi eficiente no reparo do tendão calcanear comum de coelhos.

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Os efeitos do ultrassom na cicatrização de tendões flexores de coelhos após reparo

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v9i6.5279 ◽

2020 ◽

Vol 9 (6) ◽

pp. 651-654

Author(s):

Edson Alves de Barros Junior ◽

Marisa de Cassia Registro Fonseca ◽

Salomão Chade Assan Zatiti ◽

Abimael Caetano do Nascimento ◽

Luis Guilherme Rosifini Alves Rezende ◽

...

Keyword(s):

Flexor Tendon ◽

Controlled Trial ◽

Tendon Repair ◽

Therapeutic Ultrasound ◽

Tendon Healing ◽

Calcaneal Tendon ◽

Therapeutic Modalities ◽

Nonsurgical Management ◽

Cross Linkage ◽

Ultrasound Intensity

Introdução: O efeito terapêutico do ultrassom no processo cicatricial dos tendões flexores permanece controverso na literatura. Objetivo: Avaliar morfologicamente os efeitos do ultrassom terapêutico na cicatrização de tendões flexores profundos de coelhos submetidos a tenotomia e posterior tenorrafia. Métodos: 30 coelhos foram divididos em dois grupos para tratamento com ultrassom e outro apenas para tenotomia. O ultrassom foi iniciado no 1º dia após tenorrafia e mantido até o 7º dia. Foram utilizadas frequência de 3MHz, intensidade de 0.4Wcm2 (SATA), ciclo de trabalho de 20% por 06 minutos. Cinco animais de cada grupo foram sacrificados no 8º, 15º e 30º dia de PO, tendo os tendões dissecados e analisados pela microscopia de luz quanto a reação inflamatória, grau de necrose, proliferação de fibroblastos, deposição de colágeno e formação de granuloma. Resultados: Não houve diferença estatisticamente significativa entre os grupos para nenhuma das variáveis analisadas (p = 0,0667 - 1.0000). Conclusão: O ultrassom não interferiu no reparo dos tendões flexores. Descritores: Ultrassom; Tendões; Suturas; Cicatrização. Referências Blume K, Matsuo E, Lopes MS, Lopes LG. Dosimetria proposta para o tratamento por ultrassom - uma revisão de literatura. Fisioter 2009;18(3):55-64. Acevedo B, Millis DL, Levine D, Guevara JL. Effect of therapeutic ultrasound on calcaneal tendon heating and extensibility in dogs. Front Vet Sci. 2019;6:185. Logan CA, Asnis PD, Provencher MT. The role of therapeutic modalities in surgical and nonsurgical management of orthopaedic injuries. J Am Acad Orthop Surg. 2017 Aug;25(8):556-68. Katzap Y, Haidukov M, Berland OM, Itzhak RB, Kalichman L. Additive effect of therapeutic ultrasound in the treatment of plantar fasciitis: a randomized controlled trial. J Orthop Sports Phys Ther. 2018;48(11):847-55. Ng GY, Fung DT. The effect of therapeutic ultrasound intensity on the ultrastructural morphology of tendon repair. Ultrasound Med Biol. 2007;33(11):1750-54. Olsson DC, Martins VMV, Pippi NL, Mazzanti A, Tognoli GK. Ultra-som terapêutico na cicatrização tecidual. Ciência Rural 2008; 38(4):1199-207. Romano CVG, Barbieri CH, Mazzer N, Volpon J, Shimano AC, Roncaglia FB. O ultrassom terapêutico não aumentou as propriedades mecânicas de tendões flexores após reparo. Acta Ortop Bras. 2010;18(1):10-4. Jackson BA, Schwane JA, Starcher BC. Effect of ultrasound therapy on the repair of Achilles tendon injuries in rats. Med Sci Sports Exerc. 1991;23(2):171-76. Gan BS, Huys S, Sherebrin MH, Scilley CG. The effects of ultrasound treatment on flexor tendon healing in the chicken limb. J Hand Surg Br. 1995;20(6):809-14. Ng GY, Ng CO, See EK. Comparison of therapeutic ultrasound and exercises for augmenting tendon healing in rats. Ultrasound Med Biol. 2004;30(11):1539-43. Matheus JPC, Oliveira FB, Gomide LB, Milani JGPO, Volpon JB, Shimano AC. Efeitos do ultrassom terapêutico nas propriedades mecânicas do músculo esquelético após contusão. Rev bras fisioter. 2008;12(3):241-47. Barros Júnior EA, Matias Júnior I, Capelosi GV, Vieira MCDV. Relação entre a técnica de sutura e a reabilitação no pós-operatório de tenorrafia dos flexores de dedos da mão: revisão da literatura. Saúde. 2015;4(1):55-72. Turner SM, Powell ES, Ng CS. The effect of ultrasound on the healing of repaired cockerel tendon: is collagen cross-linkage a factor? J Hand Surg Br. 1989;14(4):428-33. Venkatramani H, Varadharajan V, Bhardwaj P, Vallurupalli A, Sabapathy SR. Flexor tendon J Clin Orthop Trauma. 2019;10(5):853-61. Santos CA, Fialho HSA, Pinto JA, Alves MTS. Influência do ultrassom terapêutico na epífise de crescimento ósseo de coelhos. Fisioter Pesq. 2005;12(2):13-21. Fréz AR, Ariza D, Ferreira JRL, Alves EPB, Breda GR, Centenaro LA et al. Efeito do ultrassom terapêutico contínuo em placas epifisárias de coelhos. Rev Bras Med Esporte. 2006;12(3):150-52. Sardenberg T, Muller SS, Coelho KIR, Varanda D, Cortopassi AC, Pereira GJC. Lesão do tendão flexor: sutura na região avascular ou vascularizada? Estudo biomecânico e histopatológico em coelhos. Rev Bras Ortop. 2019;54(3):268-74. Enwemeka CS, Rodriguez O, Mendosa S. The biomechanical effects of low-intensity ultrasound on healing tendons. Ultrasound Med Biol. 1990;16(8):801-7. Tsai WC, Tang ST, Liang FC. Effect of therapeutic ultrasound on tendons. Am J Phys Med Rehabil. 2011;90(12):1068-73.

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Treatment of Common Calcaneal Tendon Rupture Using a Central Gastrocnemius Turnover Aponeurotic Flap Technique in a Dog

VCOT Open ◽

10.1055/s-0040-1715135 ◽

2020 ◽

Vol 03 (02) ◽

pp. e84-e89

Author(s):

Sergio Minei ◽

Filippo Cinti ◽

Brunella Pompei ◽

Paolo Abrescia

Keyword(s):

Tendon Rupture ◽

Weight Bearing ◽

Achilles Tendon Rupture ◽

Tendon Repair ◽

Tendon Healing ◽

Activity Level ◽

Free Form ◽

Intact Male ◽

Gradual Improvement ◽

Calcaneal Tendon

AbstractA 9-year-old, intact male, German wirehaired pointer was referred for suspected Achilles tendon rupture 3 weeks after an injury. A three-loop pulley suture pattern combined with a locking loop suture reduced the gap between the tendon ends to 7 mm and a central gastrocnemius turnover aponeurotic flap was used to cover the remaining gap. A type II free-form methyl methacrylate transarticular external skeletal fixator was used to keep the tarsocrural joint in extension until 45 days postoperatively. Short- and long-term clinical and ultrasonographic evaluations showed gradual improvement in weight-bearing and progressive tendon healing. At 6 months after surgery, the dog had normal limb function and had returned to the previous activity level. To the authors' knowledge, this tendon repair technique has been described in humans and in one cat but has not yet been reported in dogs.

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Anti-inflammatory action of pequi oil associated to ultrasound in tendinitis in rats: macroscopic and histological analysis

Manual Therapy Posturology & Rehabilitation Journal ◽

10.17784/mtprehabjournal.2016.14.347 ◽

2020 ◽

pp. 1-6

Author(s):

Luiz Fernando Batista Pereira da Silva ◽

Josefa Angélica Cerqueira Poty ◽

Marcelino Martins ◽

Nayana Pinheiro Machado de Freitas Coelho ◽

Antônio Luiz Martins Maia Filho ◽

...

Keyword(s):

Histological Analysis ◽

Statistical Significance ◽

Tendon Repair ◽

Inflammatory Cells ◽

Repair Process ◽

Male Rats ◽

Calcaneal Tendon ◽

Anti Inflammatory ◽

The Right ◽

Brazilian Northeast

Introduction: Repeated overloads of a tendon may give rise to an inflammatory response, called tendinitis, which usually begins suddenly. Researches report that the Brazilian Northeast is common to use the pequi oil (Caryocar Coriaceum wittm) in the treatment of inflammation and other diseases. Objective: To evaluate the anti-inflammatory effect of pequi oil in tendon repair process in rats after induced tendinitis. Methods: 36 male rats were divided into groups: control, ultrasound + oil pequi and pequi oil. To induce tendinitis, it was used a intratendineous injection of collagenase in the right calcaneal tendon. The treatment consisted of daily application of ultrasound + pequi oil or just pequi oil on the tendon. Macroscopic analysis was performed with the pachymeter on 1st, 7th and 14th days. Posteriorly, the rats were sacrificed with an overdose of intravenous barbiturate, then it was dissected and removed the tendon to enable the histological analysis with Hematoxylin & Eosin (HE). Results: There was a reduction in the number of inflammatory cells in the animals treated for 7 days in the groups UST + pequi oil and pequi oil compared to the control, with p <0,001. At 14 days, the group UST + pequi oil showed greater number of fibroblasts than the other groups, with p<0,01. Conclusion: The pequi oil accelerated the tendon repair in the animals and the treatment with US + pequi oil was the most effective because it reached good statistical significance in seven and 14 days.

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Use of a Transarticular Calcaneo-Tibial Locking Plate for Temporary Immobilization of the Tarsocrural Joint following Surgical Repair of Common Calcaneal Tendon Rupture in Eight Dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0041-1730356 ◽

2021 ◽

Author(s):

Alessandro Boero Baroncelli ◽

Francesca Chiara Ferrero ◽

Luca Omodeo ◽

Mattia Sarotti ◽

Bart Verdonck ◽

...

Keyword(s):

Tendon Rupture ◽

Locking Plate ◽

Surgical Repair ◽

Primary Repair ◽

Distal Tibia ◽

Tendon Repair ◽

Tendon Healing ◽

Clinical Communication ◽

Calcaneal Tendon ◽

Pull Out

Abstract Objective The purpose of this clinical communication is to report the management of common calcaneal tendon rupture in dogs using a transarticular calcaneo-tibial locking plate as a method of temporary immobilization of the tarsocrural joint to support primary repair of the common calcaneal tendon. Study Design Dogs presented with partial or complete common calcaneal tendon rupture treated with primary tendon repair supported by the transarticular calcaneo-tibial locking plate technique from July 2016 to December 2019 were included. The tarsus was placed at a standing angle of 150 degrees and the pre-contoured Fixin locking ‘L’ or ‘T’ plate was medially applied with two locking screws inserted in the calcaneus and two screws inserted in the distal tibia. Tendon healing judgement was mostly based on clinical palpation and ultrasound examination was not performed in all the cases. Plates were removed in all dogs 6 weeks postoperatively. Results All tendons healed and no complications at the level of the tenorrhaphy were noted in the postoperative period. All dogs returned to hunting activity with full function of the affected limb. No major complications requiring revision surgery were observed. Minor complications occurred in two cases; osteomyelitis and screw pull-out. Conclusion The use of a transarticular calcaneo-tibial locking plate for temporary immobilization of the tarsocrural joint after surgical repair of common calcaneal tendon rupture appears to be an effective technique with comparable results to other reported techniques.

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Flexor digitorum lateralis tendon transposition for the repair of bilateral calcaneal tendon rupture in a cat with severe thermal injury

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-15-01-0004 ◽

2016 ◽

Vol 29 (01) ◽

pp. 89-93

Author(s):

Hoong Wong ◽

Alexander Bush ◽

Daniel Hoffmann

Keyword(s):

Thermal Injury ◽

Tendon Rupture ◽

Tendon Repair ◽

Muscle Flap ◽

Clinical Report ◽

Semitendinosus Muscle ◽

Calcaneal Tendon ◽

Tendon Lengthening ◽

The Common ◽

Flexor Digitorum

SummaryObjective: To describe a novel technique utilizing the flexor digitorum lateralis tendon to repair rupture of the common calcaneal tendon with a gap defect.Clinical report: An eight-month-old male Domestic Shorthair cat with bilateral common calcaneal tendon rupture secondary to severe thermal injury underwent bilateral common calcaneal tendon repair performed in two stages. The first stage involved using the flexor digitorum lateralis tendon to reconstruct the common calcaneal tendon and a semitendinosus muscle flap for improved blood supply. A calcaneotibial screw was used for immobilization of the tarsocrural joint. The second surgery involved free skin grafting for complete wound closure. Twelve weeks after the calcaneotibial screws were placed, the calcaneotibial screws were removed and fibreglass splints were applied. The splints were removed after two weeks.Results: Full recovery took five months between the surgery and the final follow-up examination. The cat had a functional gait with no lameness and was able to jump to a height of approximately 75 cm.Clinical significance: Use of the flexor digitorum lateralis tendon may be considered for repair of a common calcaneal tendon rupture when a gap exists and traditional tendon lengthening techniques are not feasible.

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