Aims. Functional rehabilitation has become an increasingly popular treatment for Achilles tendon rupture (ATR), providing comparably low re-rupture rates to surgery, while avoiding risks of surgical complications. Limited evidence exists on whether gap size should affect patient selection for this treatment option. The aim of this study was to assess if size of gap between ruptured
Tendinopathy is a debilitating musculoskeletal
condition which can cause significant pain and lead to complete rupture
of the
Objectives. This study aimed to evaluate the histological and mechanical features of
Objectives. Surgical marking during
To describe and analyze the mid-term functional outcomes of a large series of patients who underwent the Hoffer procedure for brachial plexus birth palsy (BPBP). All patients who underwent the Hoffer procedure with minimum two-year follow-up were retrospectively reviewed. Active shoulder range of movement (ROM), aggregate modified Mallet classification scores, Hospital for Sick Children Active Movement Scale (AMS) scores, and/or Toronto Test Scores were used to assess functional outcomes. Subgroup analysis based on age and level of injury was performed. Risk factors for subsequent humeral derotational osteotomy and other complications were also assessed. A total of 107 patients, average age 3.9 years (1.6 to 13) and 59% female, were included in the study with mean 68 months (24 to 194) follow-up.Aims
Methods
Objectives. Re-rupture is common after primary flexor
Aims. In the context of
Aims. Avulsion of the proximal hamstring
Aims. Posterior malleolar (PM) fractures are commonly associated with ankle fractures, pilon fractures, and to a lesser extent tibial shaft fractures. The tibialis posterior (TP)
In order to clarify the role of cytokines in the remodelling of the grafted
Aims. To systematically review the efficacy of split
Inability to actively supinate the forearm makes common activities of daily living and certain vocational activities awkward or impossible to perform. A total of 11 patients with deficient supination of the arm underwent transfer of the
Objectives. Emerging evidence indicates that tendon disease is an active process with inflammation that is critical to disease onset and progression. However, the key cytokines responsible for driving and sustaining inflammation have not been identified. Methods. We performed a systematic review of the literature using MEDLINE (U.S. National Library of Medicine, Bethesda, Maryland) in March 2017. Studies reporting the expression of interleukins (ILs), tumour necrosis factor alpha (TNF-α) and interferon gamma in diseased human
Aims. The conventionally described mechanism of distal biceps
Aims. A revision for periprosthetic joint infection (PJI) in total hip arthroplasty (THA) has a major effect on the patient’s quality of life, including walking capacity. The objective of this case control study was to investigate the histological and ultrastructural changes to the gluteus medius
1. A series of experiments on adult rabbits was carried out in which a
1. The normal vascular anatomy of flexor
Objectives. Recently, the field of tissue engineering has made numerous advances towards achieving artificial
Aims. Acute distal biceps
Aims. The purpose of this study was to identify the changes in untreated long head of the biceps brachii
Aims. The aim of this systematic review and meta-analysis is to evaluate differences in functional outcomes and complications between single- (SI) and double-incision (DI) techniques for the treatment of distal biceps
In recent years, the plantaris
Objectives. The long head of the biceps (LHB) is often resected in shoulder surgery and could therefore serve as a cell source for tissue engineering approaches in the shoulder. However, whether it represents a suitable cell source for regenerative approaches, both in the inflamed and non-inflamed states, remains unclear. In the present study, inflamed and native human LHBs were comparatively characterized for features of regeneration. Methods. In total, 22 resected LHB
Objectives. The objective of this study was to determine if the use of fascia lata as a
Flat foot due to rupture of the tibialis posterior
Injuries to the quadriceps muscle group are common in athletes performing high-speed running and kicking sports. The complex anatomy of the rectus femoris puts it at greatest risk of injury. There is variability in prognosis in the literature, with reinjury rates as high as 67% in the severe graded proximal tear. Studies have highlighted that athletes can reinjure after nonoperative management, and some benefit may be derived from surgical repair to restore function and return to sport (RTS). This injury is potentially career-threatening in the elite-level athlete, and we aim to highlight the key recent literature on interventions to restore strength and function to allow early RTS while reducing the risk of injury recurrence. This article reviews the optimal diagnostic strategies and classification of quadriceps injuries. We highlight the unique anatomy of each injury on MRI and the outcomes of both nonoperative and operative treatment, providing an evidence-based management framework for athletes. Cite this article:
Aims. Since long-term outcome of teres major
We reviewed the records of 107 consecutive patients who had undergone surgery for disruption of the knee extensor mechanism to test whether an association existed between rupture of the quadriceps
Objectives. Tranexamic acid (TXA) is an anti-fibrinolytic medication commonly used to reduce perioperative bleeding. Increasingly, topical administration as an intra-articular injection or perioperative wash is being administered during surgery. Adult soft tissues have a poor regenerative capacity and therefore damage to these tissues can be harmful to the patient. This study investigated the effects of TXA on human periarticular tissues and primary cell cultures using clinically relevant concentrations. Methods.
An understanding of the remodelling of
Little is known about the increase in length of
Latissimus dorsi
We dissected 12 fresh-frozen leg specimens to
identify the insertional footprint of each fascicle of the Achilles tendon
on the calcaneum in relation to their corresponding muscles. A further
ten embalmed specimens were examined to confirm an observation on
the retrocalcaneal bursa. The superficial part of the insertion
of the Achilles tendon is represented by fascicles from the medial
head of the gastrocnemius muscle, which is inserted over the entire
width of the inferior facet of the calcaneal tuberosity. In three
specimens this insertion was in continuity with the plantar fascia
in the form of periosteum. The deep part of the insertion of the
Achilles
The piriformis muscle is an important landmark
in the surgical anatomy of the hip, particularly the posterior approach
for total hip replacement (THR). Standard orthopaedic teaching dictates
that the
We split 100 porcine flexor
We investigated the effect of mitomycin-C on the reduction of the formation of peritendinous fibrous adhesions after
We describe a new surgical technique for the
treatment of lacerations of the extensor
The purpose of this anatomical study was to explore the morphological variations of the semitendinosus and gracilis
Operative fixation is the treatment of choice for a rupture of the distal
This study reports the application of a novel method for quantitatively determining differences in the mechanical properties of healthy and torn rotator cuff tissues. In order to overcome problems of stress risers at the grip-tendon interface that can obscure mechanical measurements of small
We carried out lacerations of 50%, followed by trimming, in ten turkey flexor
We have undertaken an in vivo assessment of the tissue metabolism and cellular activity in torn
This pilot study reports the clinical outcomes
of a combination of partial subscapularis
Objectives . The effects of disease progression and common tendinopathy treatments
on the tissue characteristics of human rotator cuff
We have used Fourier transform infrared spectroscopy (FTIR) to characterise the chemical and structural composition of the
Thrombin has many biological properties similar to those of growth factors. In a previous study, we showed that thrombin improves healing of the rat tendo Achillis. Low molecular weight heparin (LMWH) inhibits the activity and the generation of thrombin. We therefore considered that LMWH at a thromboprophylactic dose might inhibit
We studied the vascular pattern of human posterior tibial
A total of 38 relapsed congenital clubfeet (16 stiff, 22 partially correctable) underwent revision of soft-tissue surgery, with or without a bony procedure, and transfer of the
Despite recent advances in arthroscopic rotator cuff repair, re-tear rates remain high. New methods to improve healing rates following rotator cuff repair must be sought. Our primary objective was to determine if adjunctive bone marrow stimulation with channelling five to seven days prior to arthroscopic cuff repair would lead to higher Western Ontario Rotator Cuff (WORC) scores at 24 months postoperatively compared with no channelling. A prospective, randomized controlled trial was conducted in patients undergoing arthroscopic rotator cuff repair. Patients were randomized to receive either a percutaneous bone channelling of the rotator cuff footprint or a sham procedure under ultrasound guidance five to seven days prior to index surgery. Outcome measures included the WORC, American Shoulder and Elbow Surgeons (ASES), and Constant scores, strength, ultrasound-determined healing rates, and adverse events.Aims
Methods
1. Tendon grafts, in order to survive, have to develop a blood supply from their immediate environment. This causes adhesions. 2. Their final range of movement is therefore a sum of the length to which these vascular adhesions will stretch, and the range of movement of the normal tissues to which the
We performed a biomechanical and histological study to clarify the effect of stress enhancement on the in situ frozen-thawed patellar
We have studied cellular and vascular changes in different stages of full thickness tears of the rotator cuff. We examined biopsies from the supraspinatus
We released the infraspinatus
We examined the mechanical properties of Vicryl (polyglactin 910) mesh in vitro and assessed its use in vivo as a novel biomaterial to attach
1. Small indian ink marks were made at intervals along the length of
We compared the biological characteristics of extrinsic fibroblasts infiltrating the patellar
Most cases of club foot (congenital talipes equinovarus) respond to non-operative treatment but resistant cases may need surgery. It is broadly accepted that lengthening of tendo Achillis, the
We reviewed 11 patients who had been treated between January 1986 and June 1994 for severe foot injuries by
Despite widespread use of radiofrequency (RF) shrinkage, there have been no animal studies on the effects of post-operative immobilisation on the histological properties of the shrunken tissue. We have therefore examined the role of post-operative immobilisation after RF shrinkage with special emphasis on the histological properties of collagenous tissue. One patellar
We examined macroscopically and microscopically 55 cadaver rotator-cuff
We treated surgically 16 shoulders with an isolated traumatic rupture of the subscapularis
Blood flow in intact
1. A series of 149 consecutive cases of flexor tendon grafting in the fingers and thumb is reviewed and the results are analysed. A description of the technique which has evolved from this experience is given. 2. Replacement of a divided flexor digitorum profundus in the presence of an intact sublimis
This study evaluates the position of the long
head of biceps
1. The descriptive anatomy of the tendinous component of the subclavius muscle is amplified. 2. The subclavius
We report 22 patients (19 women and three men) of mean age 20.8 years who had painful snapping sensations in the groin. Most were able to reproduce the click by extending the affected hip from a flexed, abducted and externally rotated position and most were tender in the adductor triangle. Plain radiographs and an arthrogram were normal. A clinical diagnosis of subluxation of the iliopsoas
Previous perfusion studies of the rotator cuff have demonstrated an area of hypovascularity in the distal part of the supraspinatus
Ochronosis, the musculoskeletal manifestation of alkaptonuria, is known to lead to degenerative changes of the spine and weight-bearing joints. Symptoms related to degeneration of
1. A modified technique of
1. Pain at the front of the radial side of the wrist may be caused by various lesions of the
A lesion similar to that described by Bankart in recurrent dislocation of the shoulder was seen in seven patients with recurrent dislocation of the peroneal
The use of volar locking compression plates for the treatment of fractures of the distal radius is becoming increasingly popular because of the stable biomechanical construct, less soft-tissue disturbance and early mobilisation of the wrist. A few studies have reported complications such as rupture of flexor
We report four patients with a mean age of 17 years (14 to 22) with external rotation injuries of the knee in slight flexion. Radiographs showed a small fragment in the area of the lateral femoral condyle. At operation, the fragment, consisting of the femoral insertion of the popliteus, was anatomically reduced and fixed. At a mean follow-up of 35 months all the knees had an excellent function score. An isolated lesion of the popliteus often presents as a
We used demineralised bone matrix (DBM) to augment re-attachment of
We report ten cases of rupture of the distal part of the
Patella infera may occur after reconstruction of the anterior cruciate ligament (ACL), high tibial osteotomy and total knee replacement (TKR). Restriction of movement of the knee and pain may result. Our aim was to compare the incidence and to assess the effects of patella infera after TKR and unicompartmental knee replacement (UKR). We reviewed radiographs of the knees of 84 patients who had had either TKR or UKR as part of a randomised, controlled trial. The length of the patellar
Chronic non-specific tenosynovitis of the posterior tibial
In 14 rabbits we determined the origin of the cells effecting healing of the
We studied a cohort of 26 diabetic patients with chronic ulceration under the first metatarsal head treated by a modified Jones extensor hallucis longus and a flexor hallucis longus transfer. If the first metatarsal was still plantar flexed following these two transfers, a peroneus longus to the peroneus brevis
Two men, aged 21 and 50 years, were seen with ossification of the patellar
The formation of restrictive adhesions around the musculotendinous unit after injury is one of the most vexing processes faced by the surgeon. In flexor
Ten cases of post-traumatic recurrent dislocation of the peroneal
Simple decompression of the extensor
The effects of splintage, suture and excision of the
We studied changes in patellar
Subcutaneous rupture of the
The imaging techniques available to aid the diagnosis of ruptures of tendo Achillis, the rotator cuff and the
We performed MRI on 16 patients who had had reconstruction of the anterior cruciate ligament (ACL) with a mid-third bone-patellar-tendon-bone autograft. Our aim was to assess the
Patella infera can cause knee pain and lead to patellofemoral osteoarthritis. Treatment is usually unsatisfactory. We describe a case of severe patella infera after operative treatment for fracture of the patella. We used Ilizarov external fixation and gradual lengthening of the patellar
Experiments have been performed on rabbits and sheep which demonstrate that pure carbon, in a flexible and filamentous form of great strength, can be used successfully to induce the formation of new
We have investigated the effects of the intra-operative application of a combination of hyaluronic acid and amniotic membrane on adhesions in the flexor
Congenital dislocation of the peroneal
This is a retrospective study of primary repairs of flexor pollicis longus in 16 children under 15 years of age. Patients with injuries to the median or ulnar nerve at the wrist, crush injuries, skin loss or fracture were excluded. Repairs were carried out within 24 hours using a modified Kessler technique. The mean follow-up was for two years. The final results were evaluated using the criteria of Buck-Gramko and Tubiana. They were good or excellent in all except one patient who had a secondary
Giant-cell tumour of the
We aimed to determine the distribution of the ABO and Rh blood groups in 832 patients with a
We describe a new method of stabilising a painful unstable sternoclavicular joint using the sternocleidomastoid
Traumatic rupture of the
Giant cell tumours (GCT) of the synovium and
tendon sheath can be classified into two forms: localised (giant
cell tumour of the
Surgical repair of posterosuperior rotator cuff
tears has a poorer outcome and a higher rate of failure compared
with repairs of supraspinatus tears. In this prospective cohort
study 28 consecutive patients with an irreparable posterosuperior
rotator cuff tear after failed conservative or surgical treatment
underwent teres major