scholarly journals Endoscopic Calcaneoplasty in an Elite Runner

2020 ◽  
pp. 1-3
Author(s):  
Sameh A Labib ◽  
Albert M. Pendelton ◽  
Jessica Y. Labib ◽  
Sameh A Labib
Keyword(s):  
Surgical Intervention ◽  
Weight Bearing ◽  
Achilles Tendinopathy ◽  
Hand Position ◽  
Prospective Analysis ◽  
Direct Visualization ◽  
Before And After ◽  
Haglund’S Deformity ◽  
Insertional Achilles Tendinopathy ◽  
Elite Runner

Haglund’s syndrome is a triad of postero-superior calcaneal prominence, retro-calcaneal bursitis and insertional Achilles tendinopathy. Endoscopic treatment of patients with this triad allows for earlier weight bearing, direct visualization of the Achilles insertion and less soft tissue disruption. In addition, it allows excellent visualization of the pathology. We report a case of an elite runner that underwent Endoscopic Calcaneoplasty done in the prone position. Prospective analysis of his performance before and after the surgical intervention as well as post-operative rehabilitation is detailed. Prone positioning allows for easier accessto the Haglund’s deformity, a more logical view on the monitor and a more ergonomic hand position.

scholarly journals Surgical treatment of insertional Achilles tendinopathy: results after removal of the subcutaneous bursa alone—a case series

2020 ◽  
Vol 6 (1) ◽  
pp. e000769
Author(s):  
Håkan Alfredson ◽  
Christoph Spang
Keyword(s):  
Achilles Tendon ◽  
Weight Bearing ◽  
Case Series ◽  
Achilles Tendinopathy ◽  
Full Weight Bearing ◽  
Bone Pathology ◽  
Level Of Evidence ◽  
Pain Mechanisms ◽  
Painful Condition ◽  
Insertional Achilles Tendinopathy

BackgroundInsertional Achilles tendinopathy is well known to be difficult to treat, especially when there is intra-tendinous bone pathology. This study is a case series on patients with chronic insertional Achilles tendon pain and major intra-tendinous bony pathology together with bursa and tendon pathology, treated with excision of the subcutaneous bursa alone.MethodsEleven patients (eight men and three women) with a mean age of 44 years (range 24–62) and a chronic (>6 months) painful condition from altogether 15 Achilles tendon insertions were included. In all patients, ultrasound examination showed intra-tendinous bone pathology together with pathology in the tendon and subcutaneous bursa, and all were surgically treated with an open excision of the whole subcutaneous bursa alone. This was followed by full weight-bearing walking in a shoe with open heel for 6 weeks.ResultsAt follow-up 21 (median, range 12–108) months after surgery, 9/11 patients (12/15 tendons) were satisfied with the result of the operation and 10/11 (13/15 tendons) were back in their previous sport and recreational activities. The median VISA-A score had improved from 41 (range 0–52) to 91 (range 33–100) (p<0.01).ConclusionIn patients with chronic painful insertional Achilles tendinopathy with intra-tendinous bone pathology, tendon and bursa pathology, open removal of the subcutaneous bursa alone can relieve the pain and allow for Achilles tendon loading activities. The results in this case series highlight the need for more studies on the pain mechanisms in insertional Achilles tendinopathy and the need for randomised studies to strengthen the conclusions.Level of evidenceIV Case series.

scholarly journals Outcome of Extracorporeal Shock Wave Therapy for Insertional Achilles Tendinopathy with and without Haglund’s Deformity

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ziying Wu ◽  
Wei Yao ◽  
Shiyi Chen ◽  
Yunxia Li
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Therapy ◽  
Likert Scale ◽  
Achilles Tendinopathy ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave ◽  
Haglund’S Deformity ◽  
Insertional Achilles Tendinopathy ◽  
Time Point

Purpose.To compare the results of extracorporeal shock wave therapy (ESWT) for insertional Achilles tendinopathy (IAT) with or without Haglund’s deformity.Methods.Between September 2014 and May 2015, all patients who underwent ESWT were retrospectively enrolled in this study. A total of 67 patients were available for follow-up and assigned into nondeformtiy group (n=37) and deformtiy group (n=30). Clinical outcomes were evaluated by VISA-A Score and 6-point Likert scale.Results.The VISA-A score increased in both groups, from49.57±9.98at baseline to83.86±8.59at14.5±7.2months after treatment in nondeformity group (P<0.001) and from48.70±9.38at baseline to67.78±11.35at15.3±6.7months after treatment in deformity group (P<0.001). However, there was a greater improvement in VISA-A Score for the nondeformity group compared with deformity group (P=0.005). For the 6-point Likert scale, there were decreases from3.92±0.80at baseline to1.57±0.73at the follow-up time point in nondeformity group (P<0.001) and from4.0±0.76at baseline to2.37±1.03at the follow-up time point in deformity group (P<0.001). There was no significant difference in improvement of the 6-point Likert scale between both groups (P=0.062).Conclusions.ESWT resulted in greater clinical outcomes in patients without Haglund’s deformity compared with patients with Haglund’s deformity.

DUAL-ENERGY CT WITH XENON IN PATIENTS WITH LUNG PATHOLOGY. FIRST DATA

2018 ◽  
pp. 47-51
Author(s):  
O. E. Karpov ◽  
O. Yu. Bronov ◽  
V. M. Kitaev ◽  
P. S. Vetshev ◽  
D. A. Pikhuta ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Lung Ventilation ◽  
Dual Energy ◽  
Diagnostic Methods ◽  
Dual Energy Ct ◽  
Lung Pathology ◽  
Preoperative Preparation ◽  
Before And After ◽  
Pulmonary Pathology ◽  
Postoperative Lung Function

Routine diagnostic methods have limitations in terms of predicting the ventilation function of the lungs before and after surgery. It was decided to investigate the possibilities of dual-energy CT (DECT) using xenon in assessment of lung ventilation function.Objective: to master the methods of examination of patients with pulmonary pathology, evaluate the possibility of justifying the volume of operative intervention and prediction of postoperative lung function based on the hybrid images.Materials and methods. For the study, 12 patients with different pulmonary pathologies were selected (COPD – 5, lung cancer – 4, bronchiectasis – 3). Results. It was found that the use of DECT with xenon reflects the functional state of lung tissue.Conclusions. DECT with xenon have potential for planning surgical intervention and introducing the method into modern protocols of preoperative preparation.

scholarly journals Ultrasound and surgical inspection of plantaris tendon involvement in chronic painful insertional Achilles tendinopathy: a case series

2021 ◽  
Vol 7 (1) ◽  
pp. e000979
Author(s):  
Håkan Alfredson ◽  
Lorenzo Masci ◽  
Christoph Spang
Keyword(s):  
Achilles Tendon ◽  
Clinical Symptoms ◽  
Fatty Infiltration ◽  
Case Series ◽  
Achilles Tendinopathy ◽  
Level Of Evidence ◽  
Plantaris Tendon ◽  
Medial Pain ◽  
Tendon Insertion ◽  
Insertional Achilles Tendinopathy

ObjectivesChronic painful insertional Achilles tendinopathy is known to be difficult to manage. The diagnosis is not always easy because multiple different tissues can be involved. The plantaris tendon has recently been described to frequently be involved in chronic painful mid-portion Achilles tendinopathy. This study aimed to evaluate possible plantaris tendon involvement in patients with chronic painful insertional Achilles tendinopathy.MethodsNinety-nine consecutive patients (74 males, 25 females) with a mean age of 40 years (range 24–64) who were surgically treated for insertional Achilles tendinopathy, were included. Clinical examination, ultrasound (US)+Doppler examination, and surgical findings were used to evaluate plantaris tendon involvement.ResultsIn 48/99 patients, there were clinical symptoms of plantaris tendon involvement with pain and tenderness located medially at the Achilles tendon insertion. In all these cases, surgical findings showed a thick and wide plantaris tendon together with a richly vascularised fatty infiltration between the plantaris and Achilles tendon. US examination suspected plantaris involvement in 32/48 patients.ConclusionPlantaris tendon involvement can potentially be part of the pathology in chronic painful insertional Achilles tendinopathy and should be considered for diagnosis and treatment when there is distinct and focal medial pain and tenderness.Level of evidenceIV case series.

scholarly journals Objective assessment of stiffness in Achilles tendinopathy: a novel approach using the MyotonPRO

2018 ◽  
Vol 4 (1) ◽  
pp. e000446 ◽  
Author(s):  
Gafin Ericson Morgan ◽  
Rhodri Martin ◽  
Lisa Williams ◽  
Owen Pearce ◽  
Keith Morris
Keyword(s):  
Dynamic Stiffness ◽  
Objective Assessment ◽  
Weight Bearing ◽  
Achilles Tendinopathy ◽  
Control Group ◽  
Asymptomatic Group ◽  
Musculotendinous Junction ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

ObjectivesThe aim of this study was to establish quantitative values for asymptomatic and symptomatic Achilles tendons.DesignCohort study with a single (cross-sectional) time point of patients diagnosed with unilateral Achilles tendinopathy and an asymptomatic group with comparative homogeneity.MethodsA sample of 50 participants: 25 diagnosed with symptomatic unilateral Achilles tendinopathy (AT group) and 25 with asymptomatic Achilles tendons (control group 2). The asymptomatic side of the AT group was used as a control (control group 1). Measurements at 2 cm intervals on the tendon from its insertion at the calcaneum up to the musculotendinous junction were taken non-weight bearing (NWB) and weight bearing (WB) using the MyotonPRO.ResultsThere was a significant (p<0.005) decrease in natural oscillation frequency (F) at points 2, 3 and 4 of the AT group (NWB condition) and points 2 and 3 for the WB condition. There was a significant (p<0.005) increase in logarithmic decrement (D) at points 2 and 3 signifying a decrease in elasticity. Dynamic stiffness (S) was significantly (p<0.005) reduced in the AT group at points 2 and 3 WB and point 3 WB. There was no significant difference in creep (C) observed between the symptomatic and asymptomatic tendons. There was a significant (p<0.005) increase in mechanical stress relaxation time (R) at point 2 NWB.There was a correlation between body weight and gender on tendon mechanics, with the symptomatic tendons. No significant differences were observed between the control group 1 and control group 2.ConclusionsThe MyotonPRO measured decreased stiffness over a section of the tendon corresponding clinically with Achilles tendinopathy. This may have potential in identifying risk of injury and informing rehabilitation, however further extensive research is required to generate baseline data for specific population groups monitoring variables over time. Age, gender and body mass index appear to have some bearing on the mechanical properties of the tendon but mainly in the tendinopathy group.

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