Corticosteroid Injection Effects on the Biomechanical Properties of Rabbit Patellar Tendons

Phelps, Dennis B.; Sonstegard, David A.; Matthews, Larry S.

doi:10.1097/00003086-197405000-00049

Cited by 46 publications

(25 citation statements)

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“…However, the literature is largely made up of anecdotal clinical case reports and animal studies that have usually used Achilles tendon or patellar tendon models. Furthermore, numerous clinical and animal studies have also shown that peritendinous corticosteroid exposure causes no definitive adverse effects on tendon [15][16][17]36,37 . The absence of a clear consensus, as well as a lack of studies specifically on the effect on the rotator cuff tendon, underlies the current empiric nature of guidelines for subacromial corticosteroid use.…”

Section: Discussionmentioning

confidence: 99%

“…Animal studies performed primarily on the Achilles tendon, the patellar tendon, and the medial collateral ligament of the knee have found corticosteroid exposure to be associated with tendon and ligament atrophy, fragmentation of collagen bundles, decreased biomechanical properties, and delayed healing [10][11][12][13] . Other experimental studies, however, have yielded no clearly deleterious effect following local corticosteroid exposure [14][15][16][17] . The lack of consensus in the literature, combined with possible important sequelae, has led to a cautious use of subacromial corticosteroid injections in the clinical setting 3,5,18 .…”

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confidence: 99%

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The Effect of Corticosteroid on Collagen Expression in Injured Rotator Cuff Tendon

Wei

Callaci

Juknelis

et al. 2006

The Journal of Bone & Joint Surgery

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Background-Subacromial corticosteroid injections are commonly used in the nonoperative management of rotator cuff disease. The effects of corticosteroid injection on injured rotator cuff tendons have not been studied. Our aims were to characterize the acute response of rotator cuff tendons to injury through the analysis of the type-III to type-I collagen expression ratio, a tendon injury marker, and to examine the effects of corticosteroid on this response.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The Effect of Corticosteroid on Collagen Expression in Injured Rotator Cuff Tendon

Wei

Callaci

Juknelis

et al. 2006

The Journal of Bone & Joint Surgery

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“…Other investigators found no such negative effects. [35][36][37] Subacromial bursal injections were associated with rat rotator cuff tendon damage, 38 whereas local injections did not hinder the healing of recently sutured tendons. 39,40 Two animal studies examined the effects of corticosteroid injections on ligaments.…”

Section: Discussionmentioning

confidence: 99%

Complications Associated With the Use of Corticosteroids in the Treatment of Athletic Injuries

Nichols¹

2005

Clinical Journal of Sport Medicine

197

153

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This critical review reveals that the existing medical literature does not provide precise estimates for complication rates following the therapeutic use of injected or systemic corticosteroids in the treatment of athletic injuries. Tendon and fascial ruptures are often reported complications of injected corticosteroids, whereas tibial stress fractures and multifocal osteonecrosis were described with systemic corticosteroids.

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“…Intra-articular and intracollagenous injections of corticosteroid may reduce the stiffness, ultimate stress, and energy-to-failure of collagenous tissue, even after short-term administration [42][43][44]. These results indicate that steroids may predispose the user to tendon injuries.…”

Section: Steroidsmentioning

confidence: 99%

Mechanical Properties of Tendons

Maganaris¹,

Narici²

Tendon Injuries

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The primary role of tendons is to transmit contractile forces to the skeleton to generate joint movement. In doing so, however, tendons do not behave as rigid bodies. In this chapter, the mechanical behavior of tendons and its major determinants and implications are reviewed. In Vitro MeasurementsMost of our knowledge of the mechanical properties of tendons comes from isolated material testing. Two methods have traditionally been used in biomechanics investigations: 1) The free-vibration method, which is based on quantifying the decay in oscillation amplitude that takes place after a transient load is applied to a specimen [1-3]; and 2) tensile testing methodologies, in which the specimen is stretched by an external force while both the specimen deformation and the applied force are recorded [2,[4][5][6]. The latter methodology seems to be preferable, mostly because it is considered to mimic adequately the way that loading is imposed on tendons in real life [7][8][9][10][11][12][13][14].A tensile testing machine is composed of an oscillating actuator and a load cell (see Figure 2-1). The tendon specimen studied is gripped by two clamps, a static one mounted on the load cell and a moving one mounted on the actuator. The actuator is then set to motion while the load cell records the tension associated with the stretching applied. The tensile deformation of the specimen is taken from the displacement of the actuator, in which case the deformation of the whole specimen is quantified, or by means of an extensometer, in which case deformation measurements are taken over a restricted region of the whole specimen.A typical force-deformation plot of an isolated tendon is shown in Figure 2-2. Generally, in force-deformation curves, slopes relate to stiffness (N/mm), and areas to energy (J). In elongation-to-failure conditions, 4 different regions can be identified in the tendon force-deformation curve. Region I is the initial concave portion of the curve, in which stiffness gradually increases; it is referred to as the tendon "toe" region. Loads within the toe region elongate the tendon by reducing the crimp angle of the collagen fibers at rest, but they do not cause further fiber stretching. Hence, loading within the toe region does not exceed the tendon elastic limit, and subsequent unloading restores the tendon to its initial length. Further elongation brings the tendon into the "linear" Region II, in which stiffness remains constant as a function of elongation. In this region, elongation is the result of stretching imposed in the already aligned fibers by the load imposed in the preceding toe region. At the end point of this region, some fibers start to fail. Thus, A) the tendon stiffness begins to drop; and B) unloading from this point does not restore the tendon's initial length. Elongation beyond the linear region brings the tendon into Region III, where additional fiber failure occurs in an unpredictable fashion. Further elongation brings the tendon into Region IV, where complete failure occurs [4,5,[15][16][17][18...

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Corticosteroid Injection Effects on the Biomechanical Properties of Rabbit Patellar Tendons

Cited by 46 publications

References 0 publications

The Effect of Corticosteroid on Collagen Expression in Injured Rotator Cuff Tendon

The Effect of Corticosteroid on Collagen Expression in Injured Rotator Cuff Tendon

Complications Associated With the Use of Corticosteroids in the Treatment of Athletic Injuries

Mechanical Properties of Tendons

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