Management of acute Achilles tendon ruptures

Yang, Xuan; Meng, Hao; Qi, Qi; Jiang, Peng; Lu, Shibi; Wang, A.

doi:10.1302/2046-3758.710.bjr-2018-0004.r2

Cited by 77 publications

(67 citation statements)

References 113 publications

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“…28,29 This progress has been achieved following a transformation from recognized primary surgery to minimally invasive repairs and functional treatments that are in vogue. 11,30 In addition, current evidence indicates that adjunct biologics such as fibrin glues (adhering rupture ends), 31 platelet-rich fibrin matrix (releasing highly complex pools of signaling factors), 32 bone marrow aspirate concentrate (injecting mesenchymal stem cells) 33 and platelet-rich plasma (releasing more than 300 bioactive proteins), 34 have the potential to help accelerate tendon healing. There were several reasons for addressing the trend toward minimally invasive injection combined with bioactive agents.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10] Both limited open repair and conservative management are viable alternatives due to reported advantages such as similar rerupture rates, lower overall complication rates, satisfactory outcomes and a better cosmetic appearance when compared with traditional open repair. 11 However, these tendon repair methods result in healed tissue with poor mechanical and functional qualities.…”

Section: Introductionmentioning

confidence: 99%

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<p>Construction of Microunits by Adipose-Derived Mesenchymal Stem Cells Laden with Porous Microcryogels for Repairing an Acute Achilles Tendon Rupture in a Rat Model</p>

Yang

Meng

Peng

et al. 2020

IJN

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Objective: Tissue engineering approaches seem to be an attractive therapy for tendon rupture. Novel injectable porous gelatin microcryogels (GMs) can promote cell attachment and proliferation, thus facilitating the repair potential for target tissue regeneration. The research objectives of this study were to assess the efficacy of tissue-like microunits constructed by multiple GMs laden with adipose-derived mesenchymal stem cells (ASCs) in accelerated tendon regeneration in a rat model. Methods: Through a series of experiments, such as isolation and identification of ASCs, scanning electron microscopy, mercury intrusion porosimetry (MIP), laser scanning confocal microscopy and the CCK-8 test, the biocompatibility of GMs was evaluated. In an in vivo study, 64 rat right transected Achilles tendons were randomly divided into four groups: the ASCs+GMs group (microunits aggregated by multiple ASC-laden GMs injected into the gap), the ASCs group (ASCs injected into the gap), the GMs group (GMs injected into the gap) and the blank defect group (non-treated). At 2 and 4 weeks postoperatively, the healing tissue was harvested to evaluate the gross observation and scoring, biomechanical testing, histological staining and quantitative scoring. Gait analysis was performed over time. The 64 rats were randomly assigned into 4 groups: (1) micro-unit group (ASCs+GMs) containing ASC (10 5)-loaded 120 GMs in 60 μL DMEM; (2) cell control group (ASCs) containing 10 6 ASCs in 60 μL DMEM; (3) GM control group (GMs) containing 120 blank GMs in 60 μL DMEM; (4) blank defect group (Defect) containing 60 μL DMEM, which were injected into the defect sites. All animals were sacrificed at 2 and 4 weeks postsurgery (Table 1). Results: In an in vitro study, GMs (from 126 μm to 348 μm) showed good porosities and a three-dimensional void structure with a good interpore connectivity of the micropores and exhibited excellent biocompatibility with ASCs. As the culture time elapsed, the extracellular matrix (ECM) secreted by ASCs encased the GMs, bound multiple microspheres together, and then formed active tendon tissue-engineering microunits. In animal experiments, the ASCs+GMs group and the ASCs group showed stimulatory effects on Achilles tendon healing. Moreover, the ASCs+GMs group was the best at improving the macroscopic appearance, histological morphology, Achilles functional index (AFI), and biomechanical properties of repair tissue without causing adverse immune reactions. Conclusion: Porous GMs were conducive to promoting cell proliferation and facilitating ECM secretion. The ASCs-GMs matrices showed an obvious therapeutic efficiency for Achilles tendon rupture in rats.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

<p>Construction of Microunits by Adipose-Derived Mesenchymal Stem Cells Laden with Porous Microcryogels for Repairing an Acute Achilles Tendon Rupture in a Rat Model</p>

Yang

Meng

Peng

et al. 2020

IJN

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“…Aging changes not only the biochemical and biomechanical properties of the tissue but also its anatomy. Information regarding these changes could help to improve the treatment of diseases related to the AT (Kearney et al, ; González‐Quevedo et al, ; Yang et al, ).…”

Section: Discussionmentioning

confidence: 99%

The influence of aging on the insertion of the Achilles tendon: A magnetic resonance study

et al. 2019

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The aim of this study was to examine the variations of the Achilles tendon (AT) insertion point into the calcaneal bone (CB) in relation to age and sex using magnetic resonance imaging (MRI). A total of 202 foot and ankle MRIs were reviewed and patients were allocated into three age groups: (I) <18, (II) 18-65, and (III) >65 years. All measurements were obtained on a mid-sagittal scan. The mean measurement values were used to assess the relationships among the AT insertion point, sex, and age. Our main findings revealed that (1) the distance between the most inferior point of the CB and the most inferior part of the AT insertion into the CB increases with age, (2) the height of the AT insertion into the posterior aspect of the CB decreases with age, and (3) the length of the AT insertion into the posterior aspect of the CB decreases with age. The terminal insertion point of the ATon the CB in younger subjects was more distal, whereas in older individuals it was more proximal. These results could help in developing novel strategies for the treatment and prophylaxis of AT injuries in particular patient age groups. Anatomical data about the AT insertion are crucial for developing a computer model of the ATand for biomechanical considerations regarding this tendon. Clin. Anat. 33:545-551, 2020.

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“…Calcaneal tendon rupture is the most frequent tendon lesion in high physical activities of intensity sports such as running and jumping, affecting not only athletes, but also sedentary, and may limit the function and ability of patients to perform their activities of daily living, since it plays an important role in walking [1][2][3][4][5] . It affects young and middle-aged individuals more frequently, but recent studies have indicated its increasing incidence among active elderly 4,6 .…”

Section: ■ Introductionmentioning

confidence: 99%

Effect of low intensity photobiomodulation associated with norbixin-based poly (hydroxybutyrate) membrane on post-tenotomy tendon repair. In vivo study

et al. 2020

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Conception, design, intellectual and scientific content of the study; acquisition and interpretation of data; technical procedures; manuscript preparation and writing. II PhD, Collaborator, Postgraduate Program in Biomedical Engineering of the Research and Development Institute, UNIVAP, Sao Jose dos Campos-SP, Brazil. Conception, design, intellectual and scientific content of the study; interpretation of data; critical revision; final approval.

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Management of acute Achilles tendon ruptures

Cited by 77 publications

References 113 publications

<p>Construction of Microunits by Adipose-Derived Mesenchymal Stem Cells Laden with Porous Microcryogels for Repairing an Acute Achilles Tendon Rupture in a Rat Model</p>

<p>Construction of Microunits by Adipose-Derived Mesenchymal Stem Cells Laden with Porous Microcryogels for Repairing an Acute Achilles Tendon Rupture in a Rat Model</p>

The influence of aging on the insertion of the Achilles tendon: A magnetic resonance study

Effect of low intensity photobiomodulation associated with norbixin-based poly (hydroxybutyrate) membrane on post-tenotomy tendon repair. In vivo study

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