Role of ultrasonography in the evaluation of Achilles tendon disorders

Background: The role of the paratenon in tendon healing is unknown. The present study compares healing in the presence or absence of the paratenon in an Achilles tendon defect model in rats. Hypothesis: Resection of the paratenon impairs tendon healing. Study Design: Controlled laboratory study. Methods: Sixty skeletally mature Sprague Dawley rats were randomly assigned to either a resected paratenon (RP) group or an intact paratenon (IP) group. In all animals, a 4-mm portion of the Achilles tendon was resected in the midsubstance. In the RP group, the paratenon was resected completely. In the IP group, the paratenon was opened longitudinally and closed again after the tendon defect had been created. One, 2, and 4 weeks after surgery, 7 animals per group were tested biomechanically and 3 animals per group examined histologically. Results: The recovery of mechanical strength was much more rapid in IP tendons. Tear resistance was significantly increased for IP tendons (41.3 ± 8.8 N and 47.3 ± 14.1 N, respectively) compared with RP tendons (19.3 ± 9.1 N and 33.2 ± 6.4 N, respectively) after 1 and 2 weeks. The cross-sectional area was larger in the IP group after 1 and 2 weeks (8.2 ± 2.3 mm2 and 11.3 ± 3.1 mm2 vs 5.0 ± 2.4 mm2 and 5.9 ± 2.0 mm2, respectively) compared with the RP group. Tendon stiffness was greater in the IP group after 1 week (10.4 ± 1.9 N/mm vs 4.5 ± 1.6 N/mm, respectively) compared with the RP group. In comparison, normal contralateral tendons had a maximal tear resistance of 56.6 ± 7.2 N, a cross-sectional area of 3.6 ± 0.7 mm2, and stiffness of 17.3 ± 3.8 N/mm. Hematoxylin and eosin staining revealed slightly delayed healing of RP tendons. Early collagen formation was seen in the IP group already after 1 week, whereas in the RP group, this only occurred after 2 weeks. After 4 weeks, the IP tendons showed more collagen crimp formation than the RP tendons. Conclusion: An intact paratenon promotes healing of the Achilles tendon. Clinical Relevance: Although incision or resection of the paratenon has been advocated when repairing injured or degenerative tendons, our data suggest that the integrity of the paratenon should be preserved.

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Role of the Skeletal Stem Cell in Achilles Tendon to Bone Interface Healing

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2019.08.502 ◽

2019 ◽

Vol 229 (4) ◽

pp. S228-S229

Author(s):

Ashley L. Titan ◽

Ruth Ellen Jones ◽

Ankit Salhotra ◽

Kiana S. Robertson ◽

Deshka Foster ◽

...

Keyword(s):

Stem Cell ◽

Achilles Tendon ◽

Bone Interface ◽

Skeletal Stem Cell

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Achilles tendon and plantar fascia in recently diagnosed type II diabetes: role of body mass index

Clinical Rheumatology ◽

10.1007/s10067-012-1955-y ◽

2012 ◽

Vol 31 (7) ◽

pp. 1109-1113 ◽

Cited By ~ 30

Author(s):

Michele Abate ◽

Cosima Schiavone ◽

Luigi Di Carlo ◽

Vincenzo Salini

Keyword(s):

Body Mass Index ◽

Achilles Tendon ◽

Body Mass ◽

Type Ii Diabetes ◽

Plantar Fascia ◽

Type Ii

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The Potential Role of Human Derived Amniotic Membrane Graft in The Repair of Induced Tendon Tear in Adult Male Albino Rat: Histological Study

QJM ◽

10.1093/qjmed/hcab099.002 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Dalia Ahmed Yousef Yehia ◽

Somaya Abd Al Aleem Mohammed ◽

Gehan Khalaf Megahed ◽

Nevine Bahaa El din Mohamed Soliman

Keyword(s):

Achilles Tendon ◽

Adult Male ◽

Amniotic Membrane ◽

Treated Group ◽

Human Amniotic Membrane ◽

Tendon Tear ◽

Group Iii ◽

Tendon Tears ◽

Group Ii

Abstract Introduction Achilles tendon tears cause severe impairment in patient mobility and productivity, causing significant reduction in the quality of life. Many complications are associated with the tendon healing process such as peritendinous adhesions and excessive fibrotic scars. Unsatisfactory results appeared with the existing medical and surgical treatments to regain full tendon structure and function. Amniotic membrane is avascular, and characterized by low immunogenicity, anti-inflammatory, antiscarring properties. These criteria render it as a natural biological substitute and a novel therapeutic alternative for tendon tears. Aim: The aim of the work was to study the effect of human amniotic membrane graft application on the repair of induced Achilles tendon tear. Material and methods Fresh human amniotic membrane (AM) grafts were prepared from harvested human full-term caesarian sections-delivered placentas. Thirty adult male albino rats were divided into 3 equal groups (n = 10); group I (control group), group II (tendon tear group) and group III (AM treated group). After anesthesia, a full thickness transverse incision was induced in the rat right Achilles tendons of group II and III. Human derived amniotic membrane graft measuring 1 cm2 was applied circumferentially on the tendon tear in group III. Rats were sacrificed after 28 days. Results After the tendon tear, the untreated group (II) showed gradual accumulation of fat cells replacing the collagen bundles in focal areas. Areas of mononuclear cellular infiltration were demonstrated. The AM-treated group showed many thick parallel regularly arranged collagen fibers with a significant increase in the collagen fibers area percentage. It also showed apparent increase in tenoblasts with regular organization and apparent decrease of mononuclear inflammatory cells. Conclusion This study demonstrated the potential therapeutic role of the application of human amniotic membrane grafts in the repair of Achilles tendon tears, suggesting a future alternative therapy for patients suffering from Achilles tendon tears.

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Poster 43: Free Mobilization Promotes Healing Faster than Immobilization of Partial Tear of Achilles Tendon in Mice and Its Correlation with the Role of LLLT: Histopathology Study

PM&R ◽

10.1016/j.pmrj.2017.07.016 ◽

2017 ◽

Vol 9 ◽

pp. S133-S134

Author(s):

Yose Waluyo

Keyword(s):

Achilles Tendon ◽

Partial Tear

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