Fluoroquinolone Therapy and Achilles Tendon Rupture

2003 ◽  
Vol 93 (4) ◽  
pp. 333-335 ◽  
Author(s):  
Diane Vanek ◽  
Amol Saxena ◽  
John M. Boggs
Keyword(s):  
Achilles Tendon ◽  
Bacterial Infections ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Achilles Tendinopathy ◽  
The Relationship

Fluoroquinolones have been associated with tendinopathies. The authors present three cases of Achilles tendinopathy in which the patients’ symptoms were preceded by treatment for unrelated bacterial infections with ciprofloxacin. Although the exact mechanism of the relationship is not understood, those who engage in sports or exercise should be advised of the risk of quinolone-induced tendinopathy. (J Am Podiatr Med Assoc 93(4): 333-335, 2003)

scholarly journals The Risk of Achilles Tendon Rupture in the Patients with Achilles Tendinopathy: Healthcare Database Analysis in the United States

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Youichi Yasui ◽  
Ichiro Tonogai ◽  
Andrew J. Rosenbaum ◽  
Yoshiharu Shimozono ◽  
Hirotaka Kawano ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Older Patients ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
The United States ◽  
Achilles Tendinopathy ◽  
Healthcare Database ◽  
Number Of Patients ◽  
Acute Rupture ◽  
The Relationship

Introduction. Disorders of the Achilles tendon can be broadly classified into acute and chronic entities. Few studies have established chronic Achilles tendinopathy as a precursor to acute Achilles ruptures. In this study, we assessed the relationship between Achilles tendinopathy and rupture, clarifying the incidence of rupture in the setting of underlying tendinopathy.Methods. The United Healthcare Orthopedic Dataset from the PearlDiver Patient Record Database was used to identify patients with ICD-9 codes for Achilles rupture and/or Achilles tendinopathy. The number of patients with acute rupture, chronic tendinopathy, and rupture following a prior diagnosis of tendinopathy was assessed.Results.Four percent of patients with an underlying diagnosis of Achilles tendinopathy went on to sustain a rupture (7,232 patients). Older patients with tendinopathy were most vulnerable to subsequent rupture.Conclusions. The current study demonstrates that 4.0% of patients who were previously diagnosed with Achilles tendinopathy sustained an Achilles tendon rupture. Additionally, older patients with Achilles tendinopathy were most vulnerable. These findings are important as they can help clinicians more objectively council patients with Achilles tendinopathy.

scholarly journals Use of ankle resting angle as a surrogate for tendon elongation in individuals following Achilles tendon rupture

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Heather Gotha ◽  
Jennifer Zellers ◽  
Karin Silbernagel
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Plantar Flexors ◽  
Cross Sectional ◽  
Tendon Length ◽  
Tendon Elongation ◽  
The Relationship

Category: Ankle, Sports Introduction/Purpose: Tendon elongation is associated with poor functional outcome in individuals after Achilles tendon rupture. While imaging modalities are reliable to measure Achilles tendon length, alternative time- and cost-effective measures are of interest. The resting angle of the ankle in prone both with knee extended1 and knee flexed2 have been used in the literature as surrogates for measuring Achilles elongation, however, their relationship to tendon length is not well-established. The purpose of this study is to validate the ankle resting angle as a measure of tendon elongation and examine the relationship of ankle resting angle to tendon elongation and calf strength. Methods: Individuals following unilateral Achilles tendon rupture, treated surgically, were included in this cross-sectional study. Individuals were excluded if they had deep wound infection or lumbar radiculopathy affecting the ankle plantar flexors. Ankle resting angle with knee extended and knee flexed to 90 degrees was measured using a digital inclinometer positioned on the lateral, plantar surface of the foot. Relative resting angle was calculated by subtracting the uninjured from the injured side. Tendon length to gastrocnemius was measured using B mode, extended field of view ultrasound imaging3 (tendon elongation = ruptured- uninjured). Calf strength was measured using the heel-rise test4. Limb symmetry indexes (LSI) were calculated (ruptured/uninjured sidex100) for total work performed on the heel-rise test. Results: Twenty-five individuals, a mean(SD) age of 44.2(13.6) years and mean(SD) of 22.5(39.1) months post-rupture, were included in this study. Mean(SD) relative resting angle with knee flexed was -5.4(6.4)° and mean (SD) relative resting angle with knee extended was -6.7(8.8)°. Mean(SD) tendon elongation was 1.56(1.20)cm. Mean(SD) heel-rise test work LSI was 45.8(23.8)%. Ankle resting angle with knee flexed related to elongation (r = -0.452, p = 0.027) and heel-rise test work LSI (r = 0.591, p=0.006). Ankle resting angle with knee extended related to elongation (r=-0.528, p=0.008) (Figure 1) but not heel-rise test work LSI. Conclusion: The results of this study suggest that ankle resting angle with knee extended and flexed are related to tendon elongation, however, calf strength also has a relationship to resting angle with knee flexed. This suggests that the ability of the calf to put passive tension on the foot is also a component of resting angle. The relationship between tendon elongation and resting angle with knee flexed may have been limited by methodological concerns, as tendon length was measured with the participant positioned with knees extended.

scholarly journals The Achilles Tendon Rupture in Basketball: Systematic Review of the Present Literature

2021 ◽  
Vol 07 (03) ◽  
pp. e265-e270
Author(s):  
Berta Alegre ◽  
Roberto Seijas ◽  
Pedro Alvarez ◽  
Albert Pérez
Keyword(s):  
Systematic Review ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Injury Mechanism ◽  
Cochrane Library ◽  
Tendon Ruptures ◽  
Search And Selection ◽  
The Relationship ◽  
The U.S

Abstract Background The most common cause of the Achilles tendon ruptures in the U.S. population is sports, basketball is one among them. It is not one of the most frequent injuries of this sport, but it is one of the most serious and impactful in its practice. Purpose The objective of this work is to gather evidence and evaluate the relationship between Achilles' tendon ruptures and basketball. Study Design This study designed as a systematic review. Material and Methods A search of literature in the databases PubMed, Cochrane Library, and ClinicalTrials.gov was conducted during January and February 2020. Results After the search and selection, three relevant articles were obtained due to their epidemiological content, Raikin et al and Lemme et al. In 2013 and 2018, they, respectively, conducted studies in U.S. populations, establishing sport as the most frequent injury mechanism in Achilles' tendon ruptures. It was analyzed according to injury mechanism, gender, body mass index (BMI), and age. In both studies, the lesion resulted more frequently in men and the sport involved in most of the cases was basketball (32 and 42.6%, respectively). In 2019, Lemme et al published an epidemiological design analyzing the Achilles tendon ruptures in the National Basketball Association (NBA), identifying risk factors and results in professional players. After suffering the injury, 36.8% of the patients had to retire or were holders in less than 10 games to the rest of their sports career. Conclusions The relationship between basketball and Achilles' tendon rupture is clear in the general population. Despite this, new studies are required to complement the evidence obtained so far.

scholarly journals Risk factors for rerupture after conservative management of acute Achilles tendon rupture

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0030
Author(s):  
Kang Lee ◽  
Jong-Hwa Won
Keyword(s):  
Achilles Tendon ◽  
Conservative Management ◽  
Tendon Rupture ◽  
Cox Regression ◽  
Achilles Tendon Rupture ◽  
Achilles Tendinopathy ◽  
Complete Healing ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
History Of

Category: Sports Introduction/Purpose: Recently, results after conservative management for acute Achilles tendon rupture have been improving after the introduction of real time assessment of tendon healing using ultrasonography and introduction of early weight-bearing and functional brace. Yet, many surgeons prefer surgical management of all acute ruptures due to the risk of tendon rerupture. The purposes of this study are to evaluate incidence and pattern of rerupture of Achilles tendon after complete healing, and to investigate factors related to it. Methods: A total of 202 patients with acute Achilles tendon rupture, who underwent conservative management with cast(3 to 7 weeks) and functional brace, were the subjects of this study. In patients having both tendons injured, only one side was randomly selected for analysis. Hence, for 202 patients, migration free survivorship was analyzed using Kaplan-Meier method, and association with possible risk factors was analyzed by Cox regression analysis using proportional hazards model. Factors include age, sex, history of Achilles tendinopathy, cast duration, calf atrophy(mean calf circumference difference at least 2 cm), possibility of SHR(single heel raise), Achilles thickness after complete healing, and insufficient opposition of tendon ends(10mm>gap>5 mm) after cast, initial gap with ankle neutral. Results: Rerupture occurred in 7 of 202 patients. Factors significantly associated with rerupture in Kaplan-Meier survivorship analysis and univariate Cox regression analysis were sex, history of Achilles tendinopathy, calf atrophy, possibility of SHR. When these factors were analyzed by multivariate analysis, possibility of SHR was the only significant factor with a hazard ratio of 3.14. Conclusion: Our data suggest that possibility of SHR requires special attention during the follow-up. The risk of rerupture after conservative management of acute Achilles tendon rupture can be reduced by sufficient recovery of calf muscle strength with early weightbearing and accelerated rehabilitation with aid of ultrasonography.

scholarly journals Achilles Tendon Resting Angle Relates to Tendon Length and Function

2017 ◽  
Vol 39 (3) ◽  
pp. 343-348 ◽  
Author(s):  
Jennifer A. Zellers ◽  
Michael R. Carmont ◽  
Karin Grävare Silbernagel
Keyword(s):  
Mechanical Properties ◽  
Achilles Tendon ◽  
Test Performance ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Shear Wave Elastography ◽  
Level Of Evidence ◽  
Tendon Length ◽  
Tendon Elongation ◽  
The Relationship

Background: Following Achilles tendon rupture, tendon elongation leads to long term deficits in calf function. A surrogate measure of Achilles tendon length, Achilles tendon resting angle (ATRA), has been described but has not been validated against length measured using ultrasound. Therefore, the purpose of this study was to validate the ATRA against ultrasound. Secondarily, this study aimed to identify the relationship of other factors (tendon mechanical properties, heel-rise test performance) to the ATRA. Methods: Individuals following unilateral Achilles tendon rupture were included. ATRA was measured in knee flexed and extended positions. Tendon elongation was measured using extended field of view ultrasound imaging. Continuous shear wave elastography quantified tendon mechanical properties. The relationship between variables was tested using Spearman’s ρ. Subgroup analysis was used to compare subjects with less then or greater than 1 year following rupture. A total of 42 participants (with a mean of 18.2 months following rupture [SD = 35.9]) were included. Results: Tendon elongation related with relative ATRA with knee flexed (ρ = .491, P = .001) and knee extended (ρ = 0.501, P = .001) positions. In individuals greater than 1 year following rupture, relative ATRA with the knee flexed related to shear modulus (ρ = .800, P = .01) and total work on the heel-rise test (ρ = –.782, P = .008) relative to the uninjured side. Conclusion: Relative ATRA in both knee flexed and knee extended positions has a moderate relationship to tendon elongation within the first year following rupture. After 1 year, the relative ATRA with knee flexed may be a better indicator of tendon elongation and also related to tendon mechanical properties and heel-rise test performance. Level of Evidence: Level III, case-control study.

scholarly journals Comparative Gene Approach to the Investigation of SNPs within the Tenascin-C Gene in Achilles Tendon Injury in the Canine Patient

2016 ◽  
Vol 1 (3) ◽  
Author(s):  
Nina R Kieves ◽  
Alycen P Lundberg ◽  
Vicki L Wilke
Keyword(s):  
Achilles Tendon ◽  
Whole Blood ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Control Sample ◽  
Tendon Injury ◽  
Achilles Tendinopathy ◽  
Nucleotide Polymorphisms ◽  
Tenascin C ◽  
Starting Point

<p class="AbstractSummary"><strong>Objective: </strong>To evaluate for single nucleotide polymorphisms (SNPs) within the tenascin-C (TNC) gene in a population of dogs with atraumatic Achilles tendon rupture.</p><p class="AbstractSummary"><strong>Background:</strong> In humans, Achilles tendinopathy has been extensively studied for numerous polymorphisms within several genes and has been associated with polymorphisms in collagen (COL5A1) and the TNC genes.</p><p><strong>Evidentiary value:</strong> This study serves as a starting point for evaluating a genetic component of Achilles tendinopathy in the dog.</p><p><strong>Methods: </strong>Whole blood from twenty dogs with atraumatic Achilles tendon rupture and 14 matched control samples were used. DNA was extracted from whole blood run with primers designed around two SNPs previously identified to be related to Achilles tendinopathy in humans. One SNP was located in exon 29, and one exon 17 of the canine TNC gene. Polymerase chain reaction (PCR) was run on the samples and they were sequenced. Sequences of the affected canine population were compared to the control sample sequences.</p><p class="AbstractSummary"><strong>Results:</strong> There were no significant differences in genotype or allele frequency of the SNPs rs13321 and rs2104772 between any of the affected and control subjects with a <em>p</em>-value of 1.0.</p><p class="AbstractSummary"><strong>Conclusion: </strong>This study evaluated a population of canines with atraumatic Achilles tendon rupture for SNPs in the TNC gene. We found no difference in gene sequence for the study population compared to age, sex, and breed matched controls.</p><p><strong>Application:</strong> Though the data from this study did not show a correlation between the specific polymorphisms investigated, it is possible that other SNPs within the TNC gene or other genes involved in tendon composition and repair such as collagen may be associated with atraumatic Achilles tendon injury in the dog. </p><br /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" />

Sign in / Sign up

Export Citation Format

Share Document