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| 2. |
- Aspenberg, Per, et al.
(författare)
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Substantial creep in healing human Achilles tendons : A pilot study
- 2015
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Ingår i: MLTJ Muscles, Ligaments and Tendons Journal. - Rome, Italy : C I C Edizioni Internazionali. - 2240-4554. ; 5:3, s. 151-155
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: healing after rupture of the Achilles tendon can be described in terms of mechanical properties of the new-formed tissue, constituting the tendon callus. In previous human studies, the elastic modulus and the density remained almost constant during 3 months after mobilization started, and then improved up to one year. So far, time-dependent deformation of the healing human tendon has not been reported.Methods: in a series of 16 patients, operated with Achilles tendon suture, we implanted tantalum beads into the tendon and measured the distance between them repeatedly during 3 min of constant loading, using an ordinary image intensifier. The patients unloaded their leg for 30 min before the test. To avoid bias, all images were investigated in a randomized and blinded order.Results: total strain during 3 min of constant loading at 7 weeks post injury amounted to 5%, and at 19 weeks to 3%. About half of the strain, after the loading was applied, occurred during the second and third min. Considerable strain also occurred just before loading, when the patient was told that a load would be applied, but before this was actually done.Conclusion: the measurements were crude, and this study should be seen as a pilot. Still, viscoelastic properties seem to dominate the mechanical behavior the healing Achilles tendon from start of mobilization to 19 weeks, at least when tested after 30 min rest. This deserves further studies with more precise methods.
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| 3. |
- Blomgran, Parmis, 1985-, et al.
(författare)
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Cox-2 inhibition and the composition of inflammatory cell populations during early and mid-time tendon healing
- 2017
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Ingår i: Muscles, ligaments and Tendons journal. - Rome, Italy : CIC Edizioni Internazionali. - 2240-4554. ; 7:2, s. 223-229
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Tidskriftsartikel (refereegranskat)abstract
- Background: During early tendon healing, the cells within the regenerating tissue are, to a large part, inflammatory leukocytes (CD45+). In a rat Achilles tendon healing model, the inflammation resolves between 5 and 10 days. In the same model, Cox inhibitors (NSAIDs) impair healing when given during the first 5 days, but have a positive effect if given later. We tested the hypothesis that a Cox inhibitor would exert these effects by influencing inflammation, and thereby the composition of the inflammatory cell subpopulations.Methods: Achilles tendon transection was performed in 44 animals. Animals were randomized to either parecoxib or saline injections. Healing was evaluated by mechanical testing day 7 after surgery and by flow cytometry day 3 and 10.Results: Cross-sectional area, peak force and stiffness were reduced by parecoxib 31, 33, and 25% respectively (p=0.005, p=0.002, and p=0.005). By flow cytometry, there was a strong effect of time (p<0.001) on virtually all inflammatory cell subpopulations (CD45, CD11b, CD68, CCR7, CD163, CD206, CD3, CD4), but no significant effect of parecoxib at any time point.Conclusion: The results suggest that the negative effects of Cox inhibitors on tendon healing might be exerted mainly via mechanisms not directly related to inflammatory cells.
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| 4. |
- Blomgran, Parmis, et al.
(författare)
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Role of Macrophages During early Achilles Tendon Healing
- 2021
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Ingår i: MLTJ-MUSCLES LIGAMENTS AND TENDONS JOURNAL. - : EDRA SPA. - 2240-4554. ; 11:1, s. 15-21
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Tidskriftsartikel (refereegranskat)abstract
- Background. Macrophages are a heterogeneous cell population that plays an important role in the initiation of the inflammatory response to trauma as well as its resolution during healing. However, their role during Achilles tendon healing is unclear. The aim of this study was to investigate if macrophage reduction by using clodronate liposome inject ion would influence the mechanical properties of the healing tendon. Methods. The right Achilles tendon of 46 rats were transected and left to heal spontaneously (day 0). The reduction of macrophages during the inflammatory phase of tendon healing was studied by injecting clodronate liposomes day - 3, - 1 and 1. To study the early remodeling phase, clodronate was injected day 3, 5 and 7. The controls received saline and the rats were evaluated by mechanical testing day 7 and 12, respectively. Results. Clodronate injections during the inflammatory phase increased transverse area (p = 0.006) and stiffness (p = 0.044) day 7. In contrast, no significant effects were seen at day 12. Flow cytometry evaluation confirmed reduction of mature and polarized macrophages. Conclusions. Reduction of macrophages during the inflammatory phase of Achilles tendon healing influenced the mechanical properties, suggesting a regulatory role of macrophages during this phase.
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| 5. |
- Brorsson, Annelie, 1963, et al.
(författare)
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The injured limb presents lower values in foot structure measurements 6 years after an achilles tendon rupture
- 2021
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Ingår i: Muscles, Ligaments and Tendons Journal. - : Edra SpA. - 2240-4554. ; 11:4, s. 694-703
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Tidskriftsartikel (refereegranskat)abstract
- Background. It is not known if foot structure may change after an Achilles tendon rupture and if a possible change may have an impact on lower limb function. The primary aim of the study was to explore the difference in foot structure between injured and healthy limb and between two treatment groups, at mean 6 years after an Achilles tendon rupture. A secondary aim was to explore if the differences in foot structure correlated with functional and clinical outcome. Methods. Ninety patients (15 women) with the mean (SD) age of 49 (9) years were evaluated. They had all been randomized to be treated with (n = 45) or without (n = 45) surgery. Foot structure was evaluated with Navicular Drop (Ndrop) and Drift (Ndrift), Longitudinal Arch Angle (LAA) and standing Dorsiflexion with knee straight and bent (DFstraight) and (DFbent). Calf muscle performance was evaluated with Single-leg standing heel-rise test and tendon length with ultrasound. For Patient-reported outcome measurements, Achilles tendon Total Rupture Score (ATRS) and Physical Activity Scale (PAS) were used. Both limbs were evaluated and the limb symmetry index (LSI (%) = injured/healthy × 100) was calculated. Results. In all patients, the injured limb demonstrated lower values (injured/healthy) in Ndrift (6.0/6.7 mm, p = 0.034), Ndrop (6.6/7.4 mm, p = 0.32) and DFbent (44/46°, p < 0.001). In the group treated with surgery, there was significant difference between limbs in DFbent (44/46°, p = 0.002). In the non-surgically treated group, the injured limb demonstrated significantly lower values in Ndrift (6.0/7.4 mm, p = 0.005), Ndrop (6.9/8.2 mm, p = 0.005) and DFbent (44/46°, p = 0.008). There was no difference between treatment groups in LSI-values. Conclusions. An Achilles tendon rupture seems to have an impact on foot structure long time after the injury. There is a need to clarify if the injury influences both feet and if there is a difference between treatment groups.
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| 6. |
- Carmont, Michael R, 1972, et al.
(författare)
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No difference in achilles tendon resting angle, patient-reported outcome or heel-rise height index between non-and early-weightbearing the first year after an achilles tendon rupture
- 2020
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Ingår i: Muscles, Ligaments and Tendons Journal. - : Edra SpA. - 2240-4554. ; 10, s. 651-658
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Tidskriftsartikel (refereegranskat)abstract
- © 2020, CIC Edizioni Internazionali s.r.l.. All rights reserved. Background. Patient-reported outcome scores and comparable re-rupture rates in randomized controlled trials have not shown a definitive benefit for operative treatment after acute Achilles tendon rupture. This, together with the increasing rupture rates in the older age group has led to non-operative treatment being increasingly used. Objective. This study aimed to determine the variation in Achilles Tendon Resting Angle (ATRA) together with patient reported and functional outcome, with non-operative management of the ruptured Achilles tendon using two different regimes, which have been shown to offer low re-rupture rates. Methods. This is a non-randomised cohort comparison of Achilles tendon rupture patients managed with Non-Weight-Bearing (NWB) for 6 weeks vs. Early Weight-Bearing (EWB). The NWB-group received a cast in plantar flexion for 2 weeks followed by 6 weeks in a controlled ankle motion boot with incremental diminishing plantar flexion. The EWB-group received an initial anterior protective plaster slab in plantar flexion followed by 6 weeks of weight-bearing on the meta-tarsal heads, with an anterior shell restricting dorsiflexion. Results. At 12 months after the injury there were no differences in any of the variables between the two treatment groups. The NWB-group compared to the EWB-group reported at mean (SD) for ATRA-9.8˚ (4.6˚) versus-11.4˚ (5˚), p=0.32, for Achilles tendon Total Rupture Score (ATRS) 87 (10) versus 79 (19), p=0.43 and for Heel-Rise Height Index (HRHI) 71% (19%) versus 59% (13%), p=0.13. Conclusions. The two methods of non-operative treatment studied lead to increased relative ATRA following injury, however, patients report only minor limitation in terms of outcome. Patients had almost a third less heel-rise height compared with the non-injured ankle.
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| 7. |
- Napoli, Roberto, et al.
(författare)
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Cross Cultural Adaptation and Multi Centric Validation of The Italian Version of The Tegner Activity Scale
- 2023
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Ingår i: Muscles, Ligaments and Tendons Journal. - : EDRA S.p.A. - 2240-4554. ; 13:1, s. 156-162
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Tidskriftsartikel (refereegranskat)abstract
- Background. This study aims to adapt the Tegner Activity Scale (TAS) to Italian language and establish its reliability and validity in patients after anterior cruciate ligament reconstruction. It was hypnotized the Italian version of the TAS have acceptable psychometric properties for use with the Italian population.Methods. This is an observational multicenter study. The Tegner Activity Scale was translated and culturally adapted according to the Beaton guidelines. A web-based survey was conducted to evaluate the construct validity: 62 patients were included in the study. Spearman’s rank correlation coefficient (r) between the TAS and the Short Form 36 (SF-36) subscales and the International Knee Documentation Committee (IKDC) was used to evaluate construct validity. The patients completed the TAS again one week after their first submission, and the intraclass correlation coefficient was used to calculate the test-retest reliability.Results. The correlation coefficient showed moderate correlation with the SF-36 Physical Function domain (r = 0.41; p = 0.001) and weak correlation with the IKDC (r = 0.3; p = 0.02). Correlations with the other SF-36 subscales were very weak and not statistically significant. Test-retest reliability (0.68, 95%CI 0.43-0.83) ranged from good to excellent.Conclusions. The Italian version of the Tegner Activity Scale is a valid instrument to assess a patient’s level of sporting activity after anterior cruciate ligament reconstruction. Cultural adaptation of this scale is fundamental to make this instrument comparable throughout scientific literature.
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| 8. |
- Nielsen, Rasmus Oestergaard, et al.
(författare)
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Collagen content in the vastus lateralis and the soleus muscle following a 90-day bed rest period with or without resistance exercises
- 2015
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Ingår i: MLTJ - Muscles Ligaments and Tendons Journal. - : Edra SpA. - 2240-4554. ; 5:4, s. 305-309
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: spaceflight seems associated with deterioration of the function of the skeletal muscles. Since muscle collagen is critical for muscle function, an improved understanding of the content of the muscle collagen during long-term inactivity seems important. Bed-rest with in-bed resistance training serves as a proxy for the conditions in space. Therefore, ground-based studies may improve the understanding of the consequences of long-term inactivity.Purpose: the purpose is to compare the change in collagen protein in the vastus lateralis (VL) and the soleus (SOL) muscle amongst persons exposed to a 90-day bed rest with or without resistance exercise.Methods: an explorative analysis was completed based on data from a randomized, controlled trial.The intervention group (BRE, SOL n=4, VL n=8) performed supine-based squat exercises, whereas the controls (BE, SOL n=6, VL n=12) remained inactive during follow-up. Muscle biopsies from vastus lateralis and soleus were taken at baseline(pre) and after 90-days’ follow-up (post). Muscle collagen (μg collagen/mg protein) was quantified. Two-way repeated measurements ANOVA was used to compare the interaction between the intervention (BRE/BR) and time (pre/post) for each muscle.Results: the collagen content of VL was similar between pre and post in the BRE group (-3.8 μg collagen/mg protein [95% CI: -22.0; 14.4], p=0.68) while it rose amongst individuals in the BR group (14.9 μg collagen/mg protein [95% CI: -0.01; 29.7], p=0.05). The difference of 18.66 [95% CI: -6.5; 43.9] between BRE and BR across time was, however, not significant (p=0.14). No significant reduction in SOL muscle collagen content was observed from pre to post in the BR group (-9.3 μg collagen/mg protein [95% CI: -24.9; 6.4], p=0.25) or in the BRE group (-6.5 μg collagen/mg protein [95% CI: -25.6; 12.6], p=0.50). There was no difference in the effect of BR versus BRE over time (mean difference -2.78 μg collagen/mg protein[95% CI: -29.7; 24.1], p=0.82).Conclusion: muscle collagen content in the VL or SOL muscle does not seem to differ after a 90-day bed rest period with or without squat exercises.
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| 9. |
- Sandberg, Olof, et al.
(författare)
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Influence of a lower leg brace on traction force in healthy and ruptured Achilles tendons
- 2015
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Ingår i: MLTJ Muscles, Ligaments and Tendons Journal. - Rome, Italy : C I C Edizioni Internazionali. - 2240-4554. ; 5:2, s. 63-67
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: we investigated how ruptured Achilles tendons are loaded in a brace. There is an ongoing discussion whether patients should be recommended to bear weight on the injuredlimb. However, little is known about the effects of bracing on tensional loading of the healing Achilles tendon: it is uncertain if load-bearing actually stresses the Achilles tendon inside a brace.Methods: we measured plantar flexion moment inside the brace, in order to estimate tensional loading of the tendon, by use of an insole with pressure transducers.Results: after wearing the brace for 1 hour, young healthy individuals reduced their maximum flexion moment during gait by half. Patients with Achilles tendon rupture showed no measurable flexion moment during gait with the brace, 4 or 7 weeks after injury. Only when specifically instructed, they could produce a considerable plantar flexion moment. We noted that gait speed with the brace at 4 weeks correlated with a heel-raise functional test at 1 year: the higher the spontaneous gait speed, the less the functional difference between the injured and the uninjured leg (r2=0.68; p=0.002).Conclusion: the correlation with gait speed suggests that the patients’ general physical aptness has an impact on the end result.
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| 10. |
- Stöckl, A., et al.
(författare)
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Practical and conceptual analysis of wingsuit base flight
- 2020
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Ingår i: Muscles, Ligaments and Tendons Journal. - : Edra SpA. - 2240-4554. ; 10:2, s. 257-268
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Tidskriftsartikel (refereegranskat)abstract
- Background. Fixed object parachuting, commonly known as BASE (Building, Antenna, Span, Earth) Jumping, was revolutionized by the introduction of wingsuits in the 1990s. Wingsuit BASE Jumping (WSBJ) has since surged both in overall popularity, and more recently, in its contribution to the rising rate of BASE fatalities. Risks associated with WSBJ and its position within the broader BASE community have been explored in previous work. However, the practical considerations of a nominal wingsuit flight, the aero-dynamic underpinnings of WSBJ, and discussions regarding the pilot’s decision-making processes and in-flight goals are nearly absent from the current literature.Methods. This expert opinion article was developed through years of experience in the BASE environment and analysis of in-flight altimetry and glide data from both the authors and through contributors in the wingsuit BASE community. Previous authors’ rigorous investigations and thorough work on safe, high-performance WSBJ are also discussed.Results. This concept article takes a very practical approach to WSBJ, walking through the optimal procedure for a safe jump from exit to parachute deployment.Conclusions. Strong conceptual foundation, focus on technique, lessons from relevant accidents, and emergency planning all contribute to a successful wingsuit BASE jump.
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