Article

Achilles tendon disorders: Etiology and epidemiology

Department of Orthopaedic Surgery, Tampere University Hospital, Tampere, Finland.
Foot and Ankle Clinics of North America (Impact Factor: 0.84). 07/2005; 10(2):255-66. DOI: 10.1016/j.fcl.2005.01.013
Source: PubMed

ABSTRACT The Achilles tendon is the strongest tendon in the human body. Because most Achilles tendon injuries take place in sports and there has been a general increase in popularity of sporting activities, the number and incidence of the Achilles tendon overuse injuries and complete, spontaneous ruptures has increased in the industrialized countries during the last decades. The most common clinical diagnosis of Achilles overuse injuries is tendinopathy. The basic etiology of the Achilles tendinopathy is known to be multi-factorial. Although histopathologic studies have shown that ruptured Achilles tendons have clear degenerative changes before the rupture, many Achilles tendon ruptures take place suddenly without any preceding signs or symptoms.

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Available from: Tero A H Järvinen, Jul 25, 2015
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    • "Achilles tendinopathy, including tendon rupture, occur at a rate of about 250,000 per year in the US alone (Jarvinen et al., 2005; Pennisi, 2002). The mechanism of tendinopathy and rupture is complex and thought to be influenced by tendon geometry, material-strength, sex, disease and genetics. "
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    ABSTRACT: Achilles tendon injuries including rupture are one of the most frequent musculoskeletal injuries, but the mechanisms for these injuries are still not fully understood. Previous in vivo and experimental studies suggest that tendon rupture mainly occurs in the tendon mid-section and predominantly more in men than women due to reasons yet to be identified. Therefore we aimed to investigate possible mechanisms for tendon rupture using finite element (FE) analysis. Specifically, we have developed a framework for generating subject-specific FE models of human Achilles tendon. A total of ten 3D FE models of human Achilles tendon were generated. Subject-specific geometries were obtained using ultrasound images and a mesh morphing technique called Free Form Deformation. Tendon material properties were obtained by performing material optimization that compared and minimized difference in uniaxial tension experimental results with model predictions. Our results showed that both tendon geometry and material properties are highly subject-specific. This subject-specificity was also evident in our rupture predictions as the locations and loads of tendon ruptures were different in all specimens tested. A parametric study was performed to characterize the influence of geometries and material properties on tendon rupture. Our results showed that tendon rupture locations were dependent largely on geometry while rupture loads were more influenced by tendon material properties. Future work will investigate the role of microstructural properties of the tissue on tendon rupture and degeneration by using advanced material descriptions.
    Journal of Biomechanics 10/2014; DOI:10.1016/j.jbiomech.2014.10.001
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    • "s , and paratenonitis are all reserved for specific histopathologic conditions of the tendon , which , in fact , may not be known by the treating clinician . Several authors have suggested that tendinopathy is a better term for clinicians to use in describing tendon pain as it is histopathologic neutral ( Cook , Khan , Maffulli , & Purdam , 2000 ; Jarvinen et al . , 2005 ; Khan et al . , 2002 ; Khan , Cook , Taunton , & Bonar , 2000 ; Maffulli , Khan , & Puddu , 1998 ; Stasinopoulos & Johnson , 2006 ) ."
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    ABSTRACT: Overuse related tendon pain is a significant problem in sport and can interfere with and, in some instances, end an athletic career. This article includes a consideration of the biology of tendon pain including a review of tendon anatomy and histopathology, risk factors for tendon pain, semantics of tendon pathology, and the pathogenesis of tendon pain. Evidence is presented to guide the physical therapist in clinical decision-making regarding the examination of and intervention strategies for athletes with tendon pain.
    Physical therapy in sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine 02/2012; 13(1):3-10. DOI:10.1016/j.ptsp.2011.06.004
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    • "nen et al . , 2005 ) . Men have a higher prevalence of Achilles tendinopathy than women do before menopause ( Scott and Ashe , 2006 ) , probably due to a greater level of exercise . One study showed that forty - one percent of patients who had had an Achilles tendinopathy developed symptoms in the contralateral leg during an 8 - year follow - up ( Jarvinen et al . , 2005 ) . The natural history of Achilles tendinopathy remains unclear : around 30% of Achilles tendinopathies , which are resistant to conservative management undergo operative management ( Maffulli et al . , 2003 ; Paavola et al . , 2000 ) . About one third of sports injuries treated in sports clinics concern the knees and one quarter of at"
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    ABSTRACT: Tendinopathy is characterized by pain in the tendon and impaired performance sometimes associated with swelling of the tendon. Its diagnosis is usually clinical but ultrasonography and magnetic resonance imaging can refine the diagnosis. Tendinopathy is highly prevalent and is one of the most frequently self reported musculoskeletal diseases in physical workers and sports people. Nevertheless, it is very difficult to carry out general epidemiologic studies on tendinopathy because of the varying sports cultures and sports habits in different countries. The aetiology of tendinopathy seems to be multi-factorial, involving intrinsic and extrinsic factors. The role of inflammation is still debated but the absence of inflammatory cells does not mean that inflammatory mediators are not implicated. Different theories have been advanced to explain pain and chronicity mechanisms, but these mechanisms remain largely unknown. "Conventional" treatments are generally employed empirically to fight pain and inflammation but they do not modify the histological structure of the tendon. However, these treatments are not completely satisfactory and the recurrence of symptoms is common. Currently, eccentric training remains the treatment of choice for tendinopathy, even though some studies are contradictory. Moreover, many interesting new treatments are now being developed to treat tendinopathy, but there is little evidence to support their use in clinical practice.
    Journal of sports science & medicine 06/2011; 10(2):238-253.
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