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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    ABSTRACT: Augmented soft tissue mobilization (ASTM) has been used to treat Achilles tendinopathy and is thought to promote collagen fiber realignment and hasten tendon regeneration. The objective of this study was to evaluate the biomechanical and histological effects of ASTM therapy on rabbit Achilles tendons after enzymatically induced injury. This study was a non-human bench controlled research study using a rabbit model. Both Achilles tendons of 12 rabbits were injected with collagenase to produce tendon injury simulating Achilles tendinopathy. One side was then randomly allocated to receive ASTM, while the other received no treatment (control). ASTM was performed on the Achilles tendon on postoperative days 21, 24, 28, 31, 35, and 38. Tendons were harvested 10 days after treatment and examined with dynamic viscoelasticity and light microscopy. Cross-sectional area in the treated tendons was significantly greater than in controls. Storage modulus tended to be lower in the treated tendons but elasticity was not significantly increased. Loss modulus was significantly lower in the treated tendons. There was no significant difference found in tangent delta (loss modulus/storage modulus). Microscopy of control tendons showed that the tendon fibers were wavy and type III collagen was well stained. The tendon fibers of the augmented soft tissue mobilization treated tendons were not wavy and type III collagen was not prevalent. Biomechanical and histological findings showed that the Achilles tendons treated with ASTM had better recovery of biomechanical function than did control tendons. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.
    Journal of Manipulative and Physiological Therapeutics 01/2015; 12(2). DOI:10.1016/j.jmpt.2014.12.003 · 1.25 Impact Factor
  • ORS; 01/2015
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    ABSTRACT: The purpose of this study was to compare outcomes of different minimally invasive techniques for reconstruction of Achilles tendon re-ruptures. We prospectively enrolled 21 patients undergoing minimally invasive reconstruction using a transfer of the ipsilateral peroneus brevis (PB) (five patients) or the free ipsilateral semitendinosus tendon (ST) graft with or without interference screw fixation (ten and six patients, respectively). We assessed the maximum calf circumference and isometric plantar flexion strength before surgery and at the last follow up. The Achilles tendon total rupture score (ATRS) and number of single-leg heel lifts on the affected leg were evaluated at the last follow up. The median follow up was 39 months. The outcome of surgery was excellent/good in 17 (81 %) of 21 patients. In the operated leg, the maximum calf circumference and isometric plantar flexion strength were significantly improved after surgery (P < 0.0001). The average ATRS was 86 (range 79-92), and the average number of single-legged heel lifts was 33 (range 11-48). No further re-ruptures were recorded. Minimally invasive ipsilateral PB transfer and free ipsilateral ST graft with or without interference screw fixation are safe and effective procedures to reconstruct the Achilles tendon after a re-rupture, providing a significant improvement of the symptoms and function in the mid term.
    International Orthopaedics 02/2015; 39(4). DOI:10.1007/s00264-015-2686-x · 2.02 Impact Factor


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May 28, 2014