Regenerative Rehabilitation in Injuries of Tendons

Highlights. A large number of studies are devoted to changes in connective tissues in persons with familial hypercholesterolemia. Studies that are focused on these changes in patients with dyslipidemia without family history of dyslipidemia are few, and most of them are based on ultrasound methods. The data presented in the article make it possible to timely assess the presence of minor changes in the Achilles tendons and thereby obtain additional information about the mechanism of lipid deposition in various tissues.Aim. To determine structural features of the Achilles tendon in men with dyslipidemia and atherosclerosis.Methods. The study included 138 men aged 45–65 years with or without atherosclerosis of the common carotid artery or the abdominal aorta and their aortic branches verified by multislice computed tomography.Results. In individuals with atherosclerosis, the frequency of calcification of the Achilles tendon was 2.5 times higher than in individuals without atherosclerosis. In individuals with carotid artery atherosclerosis, the cross-sectional area of the Achilles tendon was 1.2 times larger than in individuals with abdominal aortic atherosclerosis. In individuals with carotid artery atherosclerosis, the density of the Achilles tendon was 1.1 times higher than in individuals with abdominal aortic atherosclerosis. In individuals with carotid artery atherosclerosis, the frequency of calcification of the Achilles tendon was 2.0 times higher than in individuals with abdominal aortic atherosclerosis. An increase in the cross-sectional area of the tendon and its density, regardless of other factors, including the localization of the atherosclerosis, is directly associated with the total blood cholesterol. The presence of lipid and calcium deposition in the tendons, regardless of other factors, is directly associated with the total blood cholesterol and some of its fractions. The presence of lipid deposition in the tendons is inversely associated with the level of level of phosphate in the blood. The thickening of the tendon and the increase in its density is directly associated with the age of men.Conclusion. The study results revealed that persons with dyslipidemia and atherosclerosis present with changes in the connective tissues – in the structure of tendons, regardless of family history.

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Structural features of the Achilles tendon in men with dyslipidemia and atherosclerosis

Anikina

Щербакова

Nikitin

et al. 2023

Kompleks. probl. serdečno-sosud. zabol.

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Differential diagnosis and treatment of enthesopathies

Devald,

Khodus,

Belsner

et al. 2024

Medicinskij sovet

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The article provides a review of the literature on the pathology of the periarticular structure of the enthesis - the site of attachment of a tendon or ligament to the bone. The anatomical and functional features of the fibrocartilaginous enthesis are presented in detail from the position of the “enthesis organ”, which includes the enthesis and the adjacent synovial membrane, bursae and adipose tissue. The issues of the occurrence of degenerative changes against the background of mechanical stress and inflammatory rheumatic pathological processes in the above structural and functional anatomical unit are analyzed. The anatomical zones whose entheses are most often affected are given. The terminology of degenerative and inflammatory lesions of the enthesis is considered, including from the standpoint of ICD-10 codes. The advantages and disadvantages of modern terms are discussed, current concepts corresponding to the etiology of the pathological process are proposed: degenerative-dystrophic or traumatic enthesopathy and inflammatory enthesitis. This division of concepts is aimed at adopting the correct diagnostic and treatment tactics for a doctor of any specialization. The differential diagnosis of these nosologies and approaches to conservative treatment are considered. The possibilities of local injection therapy for enthesitis and enthesopathies, the use of anti-inflammatory and reparative techniques are discussed in detail. Based on our own clinical experience, the features of the treatment of various enthesopathies with glucocorticoids, autologous plasma, microinductive collagen, linear hyaluronates and polynucleotides are considered. Issues of priority methods in different clinical situations and the possibility of prolonging the therapeutic effect, as well as a combination of local and non-drug methods, were discussed. The tactics for ineffective local treatment, methods for correcting therapy and the choice of a leading specialist for various pathologies are discussed.

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Regenerative Rehabilitation in Injuries of Tendons

Cited by 2 publications

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Structural features of the Achilles tendon in men with dyslipidemia and atherosclerosis

Structural features of the Achilles tendon in men with dyslipidemia and atherosclerosis

Differential diagnosis and treatment of enthesopathies

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