Surgical Management of Insertional Calcific Achilles Tendinosis With a Central Tendon Splitting Approach

Johnson, Keith; Zalavras, Charalampos G.; Thordarson, David B.

doi:10.1177/107110070602700404

Cited by 124 publications

(94 citation statements)

References 16 publications

(37 reference statements)

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“…McGarvey et al used a central tendonsplitting approach that resulted in 20 of the 21 patients being able to resume routine activities by 3 months [14]. Similarly, Johnson et al used a central tendon-splitting approach on 22 patients and the patients' ability to work full-time increased from 45% preoperatively to 91% after surgery [8]. In our study, patients returned to normal function considerably earlier in the tendon-splitting group (4 months) when compared with the lateral approach group (6 months).…”

Section: Discussionmentioning

confidence: 94%

Surgery for Retrocalcaneal Bursitis: A Tendon-splitting versus a Lateral Approach

Anderson

Suero

O’Loughlin

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionmentioning

confidence: 94%

Surgery for Retrocalcaneal Bursitis: A Tendon-splitting versus a Lateral Approach

Anderson

Suero

O’Loughlin

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…Similar to Kawakami et al, 18 tendon stiffness was approximated using the coefficient of the linear portion of the curve. Because individuals with IAT often experience symptoms during activities that require dorsiflexion, 15 mechanical properties toward the end range of ankle motion, which coincides with the linear portion of the curve, were of particular interest in the current study. An abbreviated 2-point method (point 1, 10° of ankle plantar flexion; point 2, 10° of ankle dorsiflexion) was developed to capture mechanical properties in the linear region of the force-elongation curve (lines connecting 2 points along curves in FIGURE 3).…”

Section: Tendon Mechanical Propertiesmentioning

confidence: 99%

“…26 Surgery is costly in terms of financial resources, time off work due to weight-bearing restrictions, and risk of complications. 15,24 Moreover, even a year after surgery, many patients continue to report some pain and functional limitations. 15,24 Despite the severity and chronicity of this problem, there is little research to guide the development of new physical therapy interventions for IAT.…”

mentioning

confidence: 99%

“…After failure of conservative care, patients seeking operative care reported that pain limited their ability to walk and to work full time. 15 While the standard of care includes a trial of physical therapy, approximately half of patients with IAT progress to having surgery. 26 Surgery is costly in terms of financial resources, time off work due to weight-bearing restrictions, and risk of complications.…”

mentioning

confidence: 99%

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Altered Tendon Characteristics and Mechanical Properties Associated With Insertional Achilles Tendinopathy

Chimenti¹,

Flemister²,

Tome³

et al. 2014

J Orthop Sports Phys Ther

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A cross-sectional image was obtained 2 cm proximal to the tendon insertion. Echogenicity was quantified as the mean grayscale value for the central 1 cm of the entire depth of the tendon cross-section (FIGURES 1C and 1D). The grayscale value for a pixel could range from 0 (black) to 255 (white). The mean grayscale value for all pixels in the region of interest was quantified using ImageJ, with a lower value indicating greater pathology. All ultrasound images had the same gain setting of 56 and were collected at a 3-cm depth, so that differences in ultrasound settings would not influence the mean grayscale values between participants. Tendon Mechanical PropertiesThe combination of ultrasound imaging and dynamometry was used to measure tendon mechanical properties (strain, stiffness). Each participant's ankle was positioned and secured in a Biodex System 4 (Biodex Medical Systems, Inc, Shirley, NY) in sitting, with the seatback reclined to 45°, the chair height adjusted so that the tibia was parallel to the floor, and the hip in neutral adduction/abduction (FIGURE 2A). The participant's ankle was moved in the sagittal plane from 10° of plantar flexion to 10° of dorsiflexion at a rate of 5°/s, and the passive plantar flexion torque was recorded at a rate of 1000 Hz. Similar to previous studies, 5,8,18 ultrasound imaging was used to track the linear displacement of the gastrocnemius muscle-Achilles tendon junction (MTJ), with the probe at a fixed point on the calf (FIGURES 2B and 2C). A first set of 6 rotations was used for preconditioning, followed by a second set of 6 rotations, from which images were used to calculate tendon mechanical properties. B-mode ultrasound images were collected when the ankle was in (1) 10° of plantar flexion at the start and end of the second set and (2) 10° of dorsiflexion during the third, fourth, and fifth repetitions. The location of the MTJ in each ankle position was averaged, so that distance between the MTJ locations in 10° of plantar flexion and 10° of dorsiflexion could be calculated. A video was taken on the second repetition to confirm that the images captured the full range of MTJ displacement. Passive torque values from the third, fourth, and fifth repetitions of the second set were used for analysis. Participants were instructed to relax as the foot plate moved the ankle. To ensure that the condition was passive, the activity of the medial gastrocnemius and the anterior tibialis muscles was monitored by a 2-channel Bagnoli desktop electromyography system (Delsys Inc, Natick, MA). Single-differential surface electrodes (input impedance greater than 1015 Ω // 0.2 pF; common-mode rejection ratio, -92 dB; noise, 1.2 μV; preamplifier gain, 10 V/V  1%) were used. The contact material was 99.9% Ag, in the shape of 2 bars with contact dimensions of 10 × 1 mm and spaced 1 cm apart. The electrodes were placed over the motor point of the medial gastrocnemius and the anterior tibialis muscles. The raw electromyography signal was viewed using a 2-channel digitizing oscilloscope (Tektr...

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“…Nur in seltenen therapieresistenten Fällen vor allem jedoch bei Ossifikationen (Calcaneussporn) kann ein operativer Eingriff notwendig werden [6,12].…”

Section: Ansatznahe Erkrankungen Der Achillessehne N Insertionstendinoseunclassified

Verletzungen und Erkrankungen der Achillessehne im Sport

Goesele-Koppenburg¹

2006

Fuß & Sprunggelenk

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Surgical Management of Insertional Calcific Achilles Tendinosis With a Central Tendon Splitting Approach

Abstract: A central tendon splitting approach yielded good relief of pain with improved function, shoewear, and ability to work without painful postoperative scars.

Cited by 124 publications

References 16 publications

Surgery for Retrocalcaneal Bursitis: A Tendon-splitting versus a Lateral Approach

Surgery for Retrocalcaneal Bursitis: A Tendon-splitting versus a Lateral Approach

Altered Tendon Characteristics and Mechanical Properties Associated With Insertional Achilles Tendinopathy

Verletzungen und Erkrankungen der Achillessehne im Sport

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