Surgical treatment of ruptures of the Achilles tendon: a review of long-term results.

Abstract

Of these patients, 122 were available for follow-up examinations, on average 5.9 years (range 2.2-12.3 years) after the original injury. The operative procedure was carried out as described by Kirchmayr in 19176 utilizing non-resorbable suture material in all instances. This group consisted of 15 women and 107 men with an average age of 41.1 years (range 22.0-74.0 years).Postoperatively, the affected extremity was immobilized for 2 weeks in an long-leg cast in 300 of plantar flexion in the ankle, which was then reduced to 150 for the second two week period. For the final 2 weeks of a 6 week immobilization period a short-leg walking cast in neutral position was applied. For the following 3 months a heel elevation of 1.5 cm was prescribed. A programme of physical therapy was only necessary in isolated instances.Of the 122 patients available for follow-up examinations, 50 also completed a questionnaire concerning the subjective results. An ultrasound examination using the Siemens Sonolinee model with a 5.0 Mhz linear transducer was carried out on 71 patients (9 women, 62 men; average age 44 years). The examination was performed with the ankle in a neutral position. The classification of the internal structure of the Achilles tendon was carried out using a modification of the Thermann model3 and the 121

Augmented repair of acute Achilles tendon ruptures using gastrocnemius-soleus fascia

“…There were more reruptures in the conservative group, but infection complicated two of the surgically treated patients [12]. However, at the present time, many authors favour operative treatment for acute ruptures of the Achilles tendon [2,9,10,17,19,22].…”

Enhancement of tenogenic differentiation of human adipose stem cells by tendon-derived extracellular matrix

“…In cases of severe tendon injury, surgical treatments may be used to repair or replace the damaged tendon with autografts, allografts, xenografts, or prosthetic devices [5]. However, the clinical outcomes remain unsatisfactory due to limitations including donor site morbidity, high failure rates, risk of injury recurrence and limited long-term function recovery [6–8]. These limitations have spurred the development of tissue engineering strategies, which use a combination of cells, scaffolds and bioactive molecules, to treat tendon injuries [9–12].…”

What We Should Know Before Using Tissue Engineering Techniques to Repair Injured Tendons: A Developmental Biology Perspective

“…10 In addition, it has proved so far impossible to successfully re-create a functional insertion site of the tendon into bone. 11,12 To address these problems, attention has focused recently on the use of tissue engineering to generate replacement tendons. In theory, isolation of stem cell populations from a patient, and their conversion in culture into functional tendon tissue, would obviate both immune rejection and donor site morbidity associated with tendon grafting.…”