Aims.
Aims. Acquired heterotopic ossification (HO) is a debilitating disease characterized by abnormal extraskeletal bone formation within soft-tissues after injury. The exact pathogenesis of HO remains unknown. It was reported that BRD4 may contribute to osteoblastic differentiation. The current study aims to determine the role of BRD4 in the pathogenesis of HO and whether it could be a potential target for HO therapy. Methods.
While controversy remains as to the relative benefit of operative (OM) versus non-operative management (NOM) of Achilles tendon ruptures (ATR), few studies have examined the effect on high impact maneuvers such as jumping and hopping. The purpose of this study is to compare functional performance and musculotendinous morphology in patients following OM or NOM for acute ATR. Eligible patients were aged 18-65 years old with an ATR who underwent OM or NOM within three weeks of injury and were at least one-year post injury. Gastrocnemius muscle thickness and
Tendon is a bradytrophic and hypovascular tissue, hence, healing remains a major challenge. The molecular key events involved in successful repair have to be unravelled to develop novel strategies that reduce the risk of unfavourable outcomes such as non-healing, adhesion formation, and scarring. This review will consider the diverse pathophysiological features of tendon-derived cells that lead to failed healing, including misrouted differentiation (e.g. de- or transdifferentiation) and premature cell senescence, as well as the loss of functional progenitors. Many of these features can be attributed to disturbed cell-extracellular matrix (ECM) or unbalanced soluble mediators involving not only resident tendon cells, but also the cross-talk with immigrating immune cell populations. Unrestrained post-traumatic inflammation could hinder successful healing. Pro-angiogenic mediators trigger hypervascularization and lead to persistence of an immature repair tissue, which does not provide sufficient mechano-competence. Tendon repair tissue needs to achieve an ECM composition, structure, strength, and stiffness that resembles the undamaged highly hierarchically ordered tendon ECM. Adequate mechano-sensation and -transduction by tendon cells orchestrate ECM synthesis, stabilization by cross-linking, and remodelling as a prerequisite for the adaptation to the increased mechanical challenges during healing. Lastly, this review will discuss, from the cell biological point of view, possible optimization strategies for augmenting
Objectives. Inflammation of the retrocalcaneal bursa (RB) is a common clinical problem, particularly in professional athletes. RB inflammation is often treated with corticosteroid injections however a number of reports suggest an increased risk of
Aims. This prospective cohort study aims to determine if the size of
the tendon gap following acute rupture of the
Introduction and Objective.
Objectives. The aim of this study was to investigate the effect of hyperglycaemia on oxidative stress markers and inflammatory and matrix gene expression within tendons of normal and diabetic rats and to give insights into the processes involved in tendinopathy. Methods. Using tenocytes from normal Sprague-Dawley rats, cultured both in control and high glucose conditions, reactive oxygen species (ROS) production, cell proliferation, messenger RNA (mRNA) expression of NADPH oxidase (NOX) 1 and 4, interleukin-6 (IL-6), matrix metalloproteinase (MMP)-2, tissue inhibitors of matrix metalloproteinase (TIMP)-1 and -2 and type I and III collagens were determined after 48 and 72 hours in vitro. In an in vivo study, using diabetic rats and controls, NOX1 and 4 expressions in
Aims. The gold standard for percutaneous
Aim. Our collaborative study aims to demonstrate that acute partial
Insertional Achilles tendinitis with considerable degeneration that failed non-operative treatment typically requires tendon debridement and reattachment to bone. It is common practice for tendons to be reattached back with anchor sutures, but this poses a challenge to patients who are not able to afford them. Bony anchorage of tendons may be performed by passing sutures through tunnels, but the strength of repair compared to by using anchors is not known. We investigated the load at clinical and catastrophic failure of these two methods of reattachment. Sixteen paired
A total of seven patients (six men and one woman)
with a defect in the
We hypothesised that a minimally invasive peroneus
brevis tendon transfer would be effective for the management of
a chronic rupture of the
Aims. Our aim was to describe the mid-term appearances of the repair
process of the
The incidence of rupture of an
Tendon pathologies represent an unresolved clinical challenge where the patients suffer from pain and impaired mobility. One of the most frequently ruptured tendons is the
Objectives. The goals of this study were: 1) to determine if high-fat diet
(HFD) feeding in female mice would negatively impact biomechanical
and histologic consequences on the
Introduction: Tendon lengthening is an important cause of morbidity after Achilles tendon rupture. However, direct measurement of the tendon length is difficult. Ankle dorsiflexion has therefore been used as a surrogate measure, on the assumption that it is the
Early identification of patients at risk for impaired tendon healing and corresponding novel therapeutic approaches are urgent medical needs. This study aimed to clarify the role of CD3+ T-cells during acute
Objectives. After an injury, the biological reattachment of tendon to bone is a challenge because healing takes place between a soft (tendon) and a hard (bone) tissue. Even after healing, the transition zone in the enthesis is not completely regenerated, making it susceptible to re-injury. In this study, we aimed to regenerate
Summary Statement. Subject specific FE models of human
Surgical treatment of recurrent dislocation after total hip arthroplasty (THA) is challenging with often disappointing results. The influence of the posterior hip capsule is important, and restoration of its function is a major goal of treatment. We describe our experience using an
Introduction. Growing evidence in the literature suggests better clinical and functional outcomes and lower re-rupture rates with repair compared to non-operative treatment of ruptured
Tendon healing is a complex process that often results in compromised healing of the tendon tissue. It has recently been shown that temporal changes in the expression profile and the histological tissue quality of the tendons occur during the early healing process after acute Achilles tendon rupture. Whether these changes are accompanied by an altered healing process, is not yet known and was the aim of the present study. Tendon biopsies were obtained from 24 patients with acute Achilles tendon rupture at the time of surgery (2–9 days after rupture) and examined histologically as well as on RNA level. Histologically, the tendon architecture, the amount of aligned collagen, glycosaminoglycan and fat as well as the cellularity, vascularity and immune cell infiltration were determined. On RNA level the expression of markers for the modeling/remodeling (MMPs and TIMPs), collagens (1, 3, 5), tendon markers (scleraxis, tenomodulin), pro- and anti-inflammatory markers (IL-1beta, IL6, IL10, IL33, TNFa, TGF-beta1, COX2) and immune cell markers (CD3, CD68, CD80, CD206) were analyzed by Real-Time PCR. To determine the clinical outcome, the patients were followed up 12 months after the operation and the following scores were recorded: Subjective score, Tegner score, Visual Analog Scale (VAS) pain, VAS function, Matles Test,
Achilles tendon rupture may lead to significant functional deficits, which mechanisms are poorly understood. The primary aim was to investigate if the
Achilles tendinitis can result, through inflammatory procedures, to tendon degeneration with microtears and nodules. Current conservative or surgical treatment of this lesion proved to be not effective enough. The reason for this is the absence of sufficient oxygenation in the area. In this study we report the results of a novel technique which tries to improve local vascularity. We operated on 15 mature rabbits after they were anasthetized. Soleus fibers were trasplanted in the right
Introduction:. The insertion footprint of the different muscles tendon fascicles of the
Introduction and Objectives: Acute ruptures of the
Background. Recent meta-analyses have shown reduced re-rupture rates for the surgical management of Achilles ruptures. However percutaneous repair has been demonstrated to lead to improved function, patient satisfaction but greater complications than open repair. In the current economic climate, we believe it is reasonable to consider the financial cost of rupture management for both the patient and the provider. We aimed to determine the cost effectiveness of operative treatment of ruptures of the
The
Introduction: The acute rupture of
Thirteen patients with ruptures of the
Introduction: Neglected Achilles tendon ruptures are a management challenge. Several surgical techniques have been described. A two centre, two surgeon, two year longitudinal study was undertaken to report the results of reconstruction of neglected Achilles tendon rupture using a free autologous gracilis tendon graft. Methods: Fourteen patients underwent surgery for a neglected rupture of the
Introduction: As Achilles tendon ruptures are healing slowly, many attempts are made trying to improve the healing after injury. Rat experiments have shown that injection of platelets improves tendon healing. A clinical study on patients has also shown a better outcome after injecting platelets into the rupture area. Therefore we wanted to verify the effect of platelets by measuring the mechanical properties of the healing
Introduction. Exercise increases tendon collagen synthesis and cross-link formation. Exercise also increases the expression of TGF-β. 1. TGF-β. 1. may contribute to the upregulation of tendon collagen synthesis during exercise, but this relationship has not been established in vivo. The purpose of this study was to evaluate the effects of TGF-β. 1. receptor inhibition on tendon collagen. Materials and Methods. Male Wistar rats were divided into sedentary (SED, n = 9) or exercised (RUN, n=15) groups. Exercised animals completed four days of treadmill exercise (60 minutes/days). The peritendinous space of one
Background: The
Introduction. The dichotomy between surgical repair and conservative management of acute Achilles tendon ruptures has been eliminated through appropriate functional management. The orthoses used within functional management however, remains variable. Functional treatment works on the premise that the ankle/hindfoot is positioned in sufficient equinus to allow for early weight-bearing on a ‘shortened’
Introduction and purpose:
Purpose of the study: Wounds of the
Complete rupture of the
Hip arthroscopy rates continue to increase. As a result, there is growing interest in capsular management techniques. Without careful preservation and surgical techniques, failure of the repair result in capsular deficiency, contributing to iatrogenic instability and persistent post-operative pain. In this setting, capsular reconstruction may be indicated, however there is a paucity of objective evidence comparing surgical techniques to identify the optimal method. Therefore, the objective of this study was to evaluate the biomechanical effect of capsulectomy and two different capsular reconstruction techniques (iliotibial band [ITB] autograft and
Percutaneous repair of a ruptured
Percutaneous repair of a ruptured
Tendon disease causes widespread morbidity ranging from mild pain to catastrophic end-stage rupture. The pathophysiology of tendon disease is not certain. An overuse exercise model was developed using rats with the aim of developing tissue with histological, biochemical and biomechanical features similar to those in human tendinosis. Results indicate that the biological response to over-exercise of the rat
Estrogen fluctuations have been implicated in the soft tissue injury gender-bias due to the hormones effect on the viscoelastic properties. The isolated effect of estrogen on the mechanical behaviour of human tendon is unknown. The purpose of this study was to elucidate the effect of circulating levels of estrogen on the strain properties of the human
Background: The
We have reviewed 106 patients after treatment for spontaneous rupture of the
The