The blood supply of the calcaneal tendon

Carr, Andrew; Norris, S. H.

doi:10.1302/0301-620x.71b1.2914976

Cited by 299 publications

(183 citation statements)

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“…Lim et al [20] described a 3% rerupture rate, Haji et al [13] a 2.6% rate, and Amlang et al [3] a 3.2% rate. In contrast to these findings, we found no reruptures in our percutaneous repair group, and for the open group, our finding is similar to that reported in the literature [8,10,12]. Another of the most described complications for the percutaneous approach is sural nerve injury [13,20,21,23].…”

Section: Discussionsupporting

confidence: 89%

“…Two patients had wound dehiscence, and one had subsequent surgery. The cause of wound complication associated with open surgery is presumably owing to the poorly vascularized skin surrounding the Achilles tendon [8] and length of the incision compared to percutaneous surgery, exposing soft tissue and causing inevitably greater damage to it. Rerupture is a described complication of the percutaneous technique, with different rates reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

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Is Percutaneous Repair Better Than Open Repair in Acute Achilles Tendon Rupture?

Henríquez

Muñóz

Carcuro

et al. 2012

Clinical Orthopaedics &Amp; Related Research

116

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Background Open repair of Achilles tendon rupture has been associated with higher levels of wound complications than those associated with percutaneous repair. However, some studies suggest there are higher rerupture rates and sural nerve injuries with percutaneous repair. Questions/purposesWe compared the two types of repairs in terms of (1) function (muscle strength, ankle ROM, calf and ankle perimeter, single heel rise tests, and work return), (2) cosmesis (length scar, cosmetic appearance), and (3) complications. Patients and Methods We retrospectively reviewed 32 surgically treated patients with Achilles rupture: 17 with percutaneous repair and 15 with open repair. All patients followed a standardized rehabilitation protocol. The minimum followup was 6 months (mean, 18 months; range, 6-48 months).

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Is Percutaneous Repair Better Than Open Repair in Acute Achilles Tendon Rupture?

Henríquez

Muñóz

Carcuro

et al. 2012

Clinical Orthopaedics &Amp; Related Research

116

View full text Add to dashboard Cite

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“…The Achilles tendon receives its blood supply from three regions; the myotendinous junctions, osteotendinous junctions and the paratenon (Schatzker and Brånemark, 1969, Carr and Norris, 1989, O'Brien, 1997. It has been reported that the midportion of the Achilles tendon has a lower vascular supply compared with the rest of the tendon (Lagergren andLindholm, 1959, Carr andNorris, 1989).…”

Section: Circulationmentioning

confidence: 99%

“…It has been reported that the midportion of the Achilles tendon has a lower vascular supply compared with the rest of the tendon (Lagergren andLindholm, 1959, Carr andNorris, 1989). More recent studies have reported contradictory results.…”

Section: Circulationmentioning

confidence: 99%

Iontophoresis with or without dexamethazone in the treatment of acute Achilles tendon pain

Neeter

Thomeé

Silbernagel

et al. 2003

Scandinavian Med Sci Sports

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The purpose of this double‐blind study was to evaluate the effects of iontophoresis with dexamethazone to iontophoresis with saline solution on patients who had acute (less than 3 months) pain from the Achilles tendon, in terms of range of motion, muscular endurance, pain and symptoms. Twenty‐five patients (15 men and 10 women), aged between 18 and 76 years (mean = 38), were evaluated before and after 2 weeks of treatment with iontophoresis, as well as after 6 weeks, 3 and 6 months and 1 year. Two groups were treated for 2 weeks with iontophoresis for each treatment. Three ml of dexamethazone were used for the experiment group (n = 14) and 3 ml of saline solution for the control group (n = 11). Both groups then followed the same rehabilitation programme for 10 weeks. Good reliability was found for the toe‐raise and range of motion tests. Poor reliability was, however, found for the pain on palpation test, which was therefore excluded. No difference was found between or within groups for the toe‐raise test. Several significant improvements were seen in the experiment group but not in the control group, in the range of motion test, pain during and after physical activity, pain during walking and walking up and down stairs, morning stiffness and tendon swelling. Even though the small sample size limits the possibilities to draw definite conclusions, we conclude from the present study, using a double‐blind, randomised approach and a 1‐year follow‐up period, that positive effects from using iontophoresis with dexamethazone were found in the treatment of patients with acute Achilles tendon pain.

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“…Normally, avascular fibrocartilage is found on the tendon surface that is directed towards the pulley [36]. This concept has been supported by a number of morphological and experimental studies [3][4][5]13 for the development of overuse injuries and degenerative changes [6,12,18,19,22,38]. The reasons for the development of avascular zones in gliding regions of tendons are largely unknown.…”

Section: Introductionmentioning

confidence: 98%

Mechanical factors influence the expression of endostatin—an inhibitor of angiogenesis—in tendons

Pufe

Petersen

Kurz

et al. 2003

Journal Orthopaedic Research

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Avascular zones of tendons are predisposed for degenerative changes and spontaneous rupture. Therefore, we analyzed the expression of the endogenous angiogenesis inhibiting factor endostatin in human fetal and adult tendons by immunohistochemical and biochemical methods. Moreover, to elucidate factors involved in the regulation of vascularity, we exposed primary cultures of rat tendon cells to intermittent hydrostatic pressure (0.2 MPa, 0. I Hz for 24 h), and measured the endostatin content by ELISA and the effect of the conditioned medium to the proliferation o f human umbilical vein endothelial cells (HUVEC).In fetal tendons high endostatin levels could be quantified by ELISA whereas low levels were found in adult tissue. In fetal tendons endostatin could also be immunostained in endothelial cells but mainly in fibroblasts. In adult Achilles tendons endostatin immunostaining was restricted to endothelial cells. In the tibialis posterior tendon-as an example for "wrap around"-endostatin immunostaining remained positive in the fibrocartilage adjacent to the medial malleolus. Fibrochondrocytes of the type I1 collagen positive fibrocartilage were intensively stained with the endostatin antibody. Factor VIII immunostaining showed that this region was largely avascular. Monolayer cultures o f tendon cells released measurable amounts of endostatin into their culture supernatants. Application of intermittent hydrostatic pressure increased endostatin expression significantly. The conditioned media of tendon fibroblasts cultivated under intermittent hydrostatic pressure inhibited the proliferation of HUVEC in a dose dependent way. The spatial expression of endostatin in adult gliding tendons suggests that mechanical factors are involved in the regulation of this anti-angiogenic factor. In accordance, tendon cells exposed to intermittent hydrostatic pressure inhibit endothelial cell proliferation via humoral factors and produce endostatin. These findings support the view that the development and maintenance of avascular zones in tendons might be caused by a mechanically induced upregulation of anti-angiogenic factors.

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The blood supply of the calcaneal tendon

Cited by 299 publications

References 0 publications

Is Percutaneous Repair Better Than Open Repair in Acute Achilles Tendon Rupture?

Is Percutaneous Repair Better Than Open Repair in Acute Achilles Tendon Rupture?

Iontophoresis with or without dexamethazone in the treatment of acute Achilles tendon pain

Mechanical factors influence the expression of endostatin—an inhibitor of angiogenesis—in tendons

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