Medial Achilles tendon island flap—a novel technique to treat reruptures and neglected ruptures of the Achilles tendon

Lapidus, Lasse J; Ray, Bill Adams; Hamberg, Per

doi:10.1007/s00264-012-1521-x

Cited by 13 publications

(16 citation statements)

References 22 publications

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“…The ATRS score has high clinical utility, being both patient- and clinician-friendly, and it has been validated in many studies [15, 24–26]. Although it was originally developed for measuring outcome after the treatment of total Achilles tendon rupture, it is also extendable to the general evaluation of the Achilles tendon status.…”

Section: Discussionmentioning

confidence: 99%

Bi-exponential T2* analysis of healthy and diseased Achilles tendons: an in vivo preliminary magnetic resonance study and correlation with clinical score

et al. 2013

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ObjectiveTo compare mono- and bi-exponential T2* analysis in healthy and degenerated Achilles tendons using a recently introduced magnetic resonance variable-echo-time sequence (vTE) for T2* mapping.MethodsTen volunteers and ten patients were included in the study. A variable-echo-time sequence was used with 20 echo times. Images were post-processed with both techniques, mono- and bi-exponential [T2*m, short T2* component (T2*s) and long T2* component (T2*l)]. The number of mono- and bi-exponentially decaying pixels in each region of interest was expressed as a ratio (B/M). Patients were clinically assessed with the Achilles Tendon Rupture Score (ATRS), and these values were correlated with the T2* values.ResultsThe means for both T2*m and T2*s were statistically significantly different between patients and volunteers; however, for T2*s, the P value was lower. In patients, the Pearson correlation coefficient between ATRS and T2*s was −0.816 (P = 0.007).ConclusionThe proposed variable-echo-time sequence can be successfully used as an alternative method to UTE sequences with some added benefits, such as a short imaging time along with relatively high resolution and minimised blurring artefacts, and minimised susceptibility artefacts and chemical shift artefacts. Bi-exponential T2* calculation is superior to mono-exponential in terms of statistical significance for the diagnosis of Achilles tendinopathy.Key Points• Magnetic resonance imaging offers new insight into healthy and diseased Achilles tendons• Bi-exponential T2* calculation in Achilles tendons is more beneficial than mono-exponential• A short T2* component correlates strongly with clinical score• Variable echo time sequences successfully used instead of ultrashort echo time sequences

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Section: Discussionmentioning

confidence: 99%

Bi-exponential T2* analysis of healthy and diseased Achilles tendons: an in vivo preliminary magnetic resonance study and correlation with clinical score

et al. 2013

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“…Both AOFAS and ATRS scores are widely used in clinical practice and validated in many studies [20, 21]. They had general assessment of the AT situation.…”

Section: Discussionmentioning

confidence: 99%

UTE-T2⁎Analysis of Diseased and Healthy Achilles Tendons and Correlation with Clinical Score: An In Vivo Preliminary Study

Qiao

Tao

et al. 2017

BioMed Research International

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Objective. To compare T2⁎ value of healthy and diseased Achilles tendons (AT) with a recently introduced three-dimensional ultrashort echo time (3D-UTE) sequence and analyze the correlation between T2⁎ value and clinical scores. Methods. Ten patients with symptomatic Achilles tendon and ten healthy volunteers were investigated with 3D-UTE sequence on a 3T magnetic resonance (MR) scanner. T2⁎ values of four regions in Achilles tendons were calculated. The clinical outcomes of patients were evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS) score and Achilles Tendon Rupture Score (ATRS). An independent sample t-test was used to compare the differences of T2⁎ value and clinical scores between two groups. The Pearson correlation coefficient between clinical scores and T2⁎ values was assessed. Results. The T2⁎ values of Achilles tendon were statistically significantly different between patients and volunteers. The Pearson correlation coefficients between T2⁎ and AOFAS or ATRS scores of patients were r = −0.733 and r = −0.634, respectively. Conclusion. The variability of T2⁎ in healthy and pathologic AT can be quantified by UTE-T2⁎. T2⁎ may be a promising marker to detect and diagnose AT tendinopathy. UTE-T2⁎ could give a precise guidance to clinical outcome.

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“…These techniques have their own limitations [5]. Increasing the surgical time, injury to the normal tissues, pain, need for the extensive exposure, risk of reinjury and dehiscence are some examples for each of these techniques [51]. In addition, most of these methods are modified methods used by different surgeons based on the defect size, condition of the patient and experience of the surgeon [52].…”

Section: Discussionmentioning

confidence: 99%

Synthesis, development, characterization and effectiveness of bovine pure platelet gel‐collagen‐polydioxanone bioactive graft on tendon healing

Moshiri

Oryan

Meimandi-Parizi

2015

J Cellular Molecular Medi

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Bovine platelet gel (BPG) is an accessible and cost-effective source of growth factors which may have a value in tendon regenerative medicine. We produced a collagen implant (CI) as a tendon proper, covered it with polydioxanone (PDS) sheath to simulate paratenon and finally embedded the BPG as an active source of growth factor within the bioimplant to test whether BPG would be able to accelerate and enhance tendon regeneration and repair. After in vitro characterization of the bioactive grafts, the grafts were implanted in rabbit large tendon defect model. Untreated tendons and tendons treated with either CI or CI-PDS were served as controls for the CI-PDS-BPG. The animals were investigated clinically, ultrasonographically and haematologically for 120 days. After euthanasia, dry matter content, water uptake and delivery characteristics and also gross morphological, histopathological and scanning electron microscopic features of the healing tendons were assessed. In vitro, the activated platelets in the scaffold, released their growth factors significantly more than the controls. BPG also increased cell viability, and enhanced cellular differentiation, maturation and proliferation inside the CI-PDS compared with the controls. In vivo, the BPG modulated inflammation, increased quality and rate of fibroplasia and produced a remodelled tendon that had significantly higher collagen content and superior collagen fibril and fibre differentiation than controls. Treatment also significantly improved tendon water uptake and delivery characteristics, animals’ serum PDGF level, CI-PDS biocompatibility and biodegradability and reduced peritendinous adhesions, muscle fibrosis and atrophy. BPG was effective on tendon healing and CI-PDS-BPG may be a valuable bioscaffold in tendon reconstructive surgery.

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Medial Achilles tendon island flap—a novel technique to treat reruptures and neglected ruptures of the Achilles tendon

Abstract: Purpose There is a strong consensus for surgical treatment of reruptures and neglected ruptures of the Achilles tendon.

Cited by 13 publications

References 22 publications

Bi-exponential T2* analysis of healthy and diseased Achilles tendons: an in vivo preliminary magnetic resonance study and correlation with clinical score

Bi-exponential T2* analysis of healthy and diseased Achilles tendons: an in vivo preliminary magnetic resonance study and correlation with clinical score

UTE-T2⁎Analysis of Diseased and Healthy Achilles Tendons and Correlation with Clinical Score: An In Vivo Preliminary Study

Synthesis, development, characterization and effectiveness of bovine pure platelet gel‐collagen‐polydioxanone bioactive graft on tendon healing

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