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| 112. |
- Granath, Martin, et al.
(författare)
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A Regenerated Achilles Tendon with Good Function One Year After Total Extirpation Due to Infection – A Case Report
- 2022
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Ingår i: International Medical Case Reports Journal. - : Dove Medical Press. - 1179-142X. ; 15, s. 219-223
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Tidskriftsartikel (refereegranskat)abstract
- Background: Delayed Achilles tendon ruptures leaving large defects are difficult to treat, and the potential for tendon regeneration is thought to be limited. Furthermore, post-operative wound healing problems, sometimes including infections, can be challenging to treat and negatively affect rehabilitation.Case Presentation: This 74-year-old lady suffered from insertional Achilles tendinopathy. After treatment with a local cortisone injection, she sustained a total insertional Achilles tendon rupture. This rupture was treated conservatively, and after treatment the Achilles re-ruptured in the insertional area. The rupture was then treated with re-insertion into the calcaneal insertion. Early in the post-operative period the patient sustained a deep surgical wound infection and sepsis. Because of poor effect of treatment with antibiotics, and total tendon destruction, the whole Achilles was extirpated. After extirpation there was immobilization in a cast followed by mobilization and gradually increased loading. At a one-year follow-up, the patient was walking without a limp, could do heel-raise halfway up standing on one leg, there was a palpable Achilles tendon and ultrasound scanning showed a structure very similar to a slightly thickened and tendinopathic Achilles tendon. There was an obvious regeneration of the whole Achilles tendon, and the tendon function was surprisingly good.Conclusion: This case study clearly shows the regeneration potential in the Achilles tendon and provides significant knowledge of importance for clinicians dealing with Achilles tendon injuries.
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| 113. |
- Hoksrud, Aasne, et al.
(författare)
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Color Doppler ultrasound findings in patellar tendinopathy (jumper's knee).
- 2008
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Ingår i: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 36:9, s. 1813-1820
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Recent studies have revealed structural changes with neovessels in patients with jumper's knee and Achilles tendinopathy, and treatment with sclerosing injections has shown promising clinical results. PURPOSE: To study the prevalence of neovascularization and structural tendon changes on color Doppler ultrasound examination in elite athletes with clinical symptoms of jumper's knee and to examine the ultrasound characteristics of the tendon after sclerosing injection treatment with polidocanol. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: The authors recruited patients among elite athletes with a clinical diagnosis of jumper's knee who participated in a previous randomized clinical trial. The patients recorded knee function using the Victorian Institute of Sport Assessment score. Patients were examined by color Doppler ultrasound at baseline and, for patients with structural changes and neovascularization who received sclerosing treatment, after treatment. RESULTS: Sixty-three patients (11 women and 52 men) with 79 symptomatic tendons were studied. The ultrasound examination revealed that neovascularization was present in 48 of the 79 tendons (60%). Of 33 patients (43 tendons) who received sclerosing injections, 29 patients (37 tendons, 86%) were examined 37 (19 to 53) weeks after their final sclerosing injections. Of these, 7 tendons (18.9%) had no change in neovascularization after treatment, 21 tendons (56.8%) had less neovascularization, and 9 tendons (24.3%) had more visible neovascularization. There were no significant differences in the change in Victorian Institute of Sport Assessment score between patients who had less, more, or unchanged neovascularization after treatment (analysis of variance, P = .9). CONCLUSION: About two thirds of patients with jumper's knee can be expected to have structural tendon changes with neovascularization. There was no relationship between changes in ultrasound characteristic and knee function after sclerosing treatment.
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| 114. |
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| 115. |
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| 116. |
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| 117. |
- Jonsson, Per, 1968-, et al.
(författare)
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Superior results with eccentric compared to concentric quadriceps training in patients with jumper's knee : a prospective randomised study
- 2005
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 39:11, s. 847-850
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Tidskriftsartikel (refereegranskat)abstract
- Background:A recent study reported promising clinical results using eccentric quadriceps training on a decline board to treat jumper’s knee (patellar tendinosis).Methods:In this prospective study, athletes (mean age 25 years) with jumper’s knee were randomised to treatment with either painful eccentric or painful concentric quadriceps training on a decline board. Fifteen exercises were repeated three times, twice daily, 7 days/week, for 12 weeks. All patients ceased sporting activities for the first 6 weeks. Age, height, weight, and duration of symptoms were similar between groups. Visual analogue scales (VAS; patient estimation of pain during exercise) and Victorian Institute of Sport Assessment (VISA) scores, before and after treatment, and patient satisfaction, were used for evaluation.Results:In the eccentric group, for 9/10 tendons patients were satisfied with treatment, VAS decreased from 73 to 23 (p<0.005), and VISA score increased from 41 to 83 (p<0.005). In the concentric group, for 9/9 tendons patients were not satisfied, and there were no significant differences in VAS (from 74 to 68, p<0.34) and VISA score (from 41 to 37, p<0.34). At follow up (mean 32.6 months), patients in the eccentric group were still satisfied and sports active, but all patients in the concentric group had been treated surgically or by sclerosing injections.Conclusions:In conclusion, eccentric, but not concentric, quadriceps training on a decline board, seems to reduce pain in jumper’s knee. The study aimed to include 20 patients in each group, but was stopped at the half time control because of poor results achieved in the concentric group.
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| 118. |
- Kalawy, Hatem, et al.
(författare)
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New objective findings after whiplash injuries: High blood flow in painful cervical soft tissue : An ultrasound pilot study
- 2013
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Ingår i: Scandinavian Journal of Pain. - : Elsevier. - 1877-8860 .- 1877-8879. ; 4:4, s. 173-179
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe presence of high blood flow in the structurally abnormal and painful regions of tendinosis, but not in the normal pain-free tendons, was recently confirmed by colour Doppler (CD) ultrasound (US). Biopsies from the regions with high blood flow demonstrated the presence of sympathetic and sensitive nerve fibres juxtapositioned to neovessels. Grey-scale US and CD are reliable methods used to evaluate structural homogeneity, thickness, and blood flow in the peripheral tendons. The aim of this study was to utilize CD to qualitatively evaluate for the presence of abnormal high blood flow in paravertebral tissues after whiplash injuries in patients with chronic neck pain.MethodsTwenty patients with chronic neck pain after whiplash-associated disorder (WAD) and 20 pain-free control subjects were included in the study. The same experienced radiologist performed all grey-scale US and CD examinations.ResultsMore regions with high blood flow were observed in the patient group than in the control group. At all levels, the high blood flow pattern was detected at the enthesis of the spinous processes and bilaterally juxtapositioned to the facet joints.ConclusionAll regions identified by the patients as painful and tender corresponded to the positive high blood flow found during the CD examination.ImplicationsThese findings document increased blood-flow/neovascularisation at insertions of neck muscles which may indicate that there are pathological neovascularisation with accomanying pain- and sympathetic nerves, similar to what has been found in Achilles-tendinosis. These findings promise that similar treatments that now is successful with Achilles tendinosis, may be effective in the WAD-painful muscle insertions of the neck.
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