Functional ultrasound Elastography (FUSE) of Tendo Achilles is an ultrasound technique utilising controlled, measurable movement of the foot to non-invasively evaluate TA elastic and load-deformation properties. The study purpose is to assess Achilles tendons, paratenon and bursa mechanical properties in healthy volunteers and establish an outcome tool for TA treatment. Forty asymptomatic Achilles tendons of 20 healthy volunteers were recruited (10 men and 10 women, age range 18-55). One patient with Acute Achilles rupture scanned to evaluate the tendon gap. Each volunteer answered the Foot and Ankle Outcome Score (FAOS) and Victorian Institute Sport Assessment score (VISA-A) questionnaires. The Achilles Tendons were divided into three thirds (total 120 Proximal, middle and distal thirds). Three longitudinal images of each third were obtained using portable US scan device (Z.one, Zonare Medical System Inc., USA, 8.5 MHz). Images processing was achieved using a MatLAb software (developed by the research team) in parallel Oxford university computers. Each 1/3rd Achilles tendon under went the following scans:
Free hand US scan Free hand Compression decompression Elastography scan Dorsal Flexion elastography Planter flexion elastography Zonare real-time Elastography Elastography scan with the Oxford isometric dynamic foot and Ankle mover (OIDFA) B mode and elasticity images were derived from the raw ultrasound radio frequency data. The anatomical structures mechanical properties were evaluated by a quantitative score of different colours representing stiff tissue (blue) to more soft tissue (green, yellow, red).Purpose
Methods
Although mechanical stabilisation has been a hallmark of orthopaedic surgical management, orthobiologics are now playing an increasing role. Platelet-rich plasma (PRP) is a volume of plasma fraction of autologous blood having platelet concentrations above baseline. The platelet α granules are rich in growth factors that play an essential role in tissue healing, such as transforming growth factor-β, vascular endothelial growth factor, and platelet-derived growth factor. PRP is used in various surgical fields to enhance bone and soft-tissue healing by placing supraphysiological concentrations of autologous platelets at the site of tissue damage. The easily obtainable PRP and its possible beneficial outcome hold promise for new regenerative treatment approaches. The aim of this literature review was to describe the bioactivities of PRP, to elucidate the different techniques for PRP preparation, to review animal and human studies, to evaluate the evidence regarding the use of PRP in trauma and orthopaedic surgery, to clarify risks, and to provide guidance for future research.
