Chronic Achilles Tendon Disorders

Maffulli, Nicola; Via, Alessio Giai; Oliva, Francesco

doi:10.1016/j.csm.2015.06.010

Cited by 101 publications

(73 citation statements)

References 52 publications

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“…It is different from the acute Achilles tendon rupture in pathophysiology. Chronic Achilles tendon ruptures with large gaps may lead to ankle dysfunction [1–3, 20, 21]. If the gap of rupture is bridged by scar tissue, ankle weakness and gait disturbances may occur due to severely infiltrated fat composition [7].…”

Section: Discussionmentioning

confidence: 99%

Surgical Strategy for the Chronic Achilles Tendon Rupture

Lin

Yang

Yin

et al. 2016

BioMed Research International

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Background. Chronic Achilles tendon rupture is usually misdiagnosed and treated improperly. This study aims to better understand the treatment of chronic Achilles tendon rupture. Methods. Patients who were not able to perform a single-limb heel rise were chosen. Pre- and postoperative magnetic resonance imaging (MRI) were conducted. By evaluating the presence or absence of Achilles tendon stumps and the gap length of rupture, V-Y advancement, gastrocnemius fascial turndown flap, or flexor halluces longus tendon transfer were selected for tendon repair. The function of ankle and foot was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores and Achilles Tendon Total Rupture Score (ATRS). Results. Twenty-nine patients were followed up. One patient had superficial incision infection, which was healed after debridement and oral antibiotics. Three months postoperatively, MRI showed some signs of inflammation, which disappeared at one or two years postoperatively. All patients were able to perform a single-limb heel rise. Mean AOFAS scores and ATRS scores were increased at the latest follow-up. Conclusion. Surgical options can be determined by evaluating the presence of the Achilles tendon stumps and the gap length, which can avoid using the nearby tendon and yield satisfactory functional results.

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Section: Discussionmentioning

confidence: 99%

Surgical Strategy for the Chronic Achilles Tendon Rupture

Lin

Yang

Yin

et al. 2016

BioMed Research International

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“…Les ruptures aiguës du tendon d'Achille surviennent fréquemment lors des activités sportives de haut niveau ou de loisirs (Aktas, 2007 ;Maffulli, 2015 ;Assal, 2007). Le nombre et l'incidence de ces lésions tendineuses, en général, ont augmenté sensiblement au cours des dernières décennies.…”

Section: Discussionunclassified

“…Leppilahti a estimé cette incidence dans la population générale à 8 pour 100.000 cas (Leppilahti, 1998). Ces lésions peuvent également s'observer sur terrain pathologique sous-jacent et constituer une entité particulière de ruptures dégénératives [Maffulli, 2015 ;Benjilali, 2012 ;Assal, 2007 ;Assal, 2007 ;Maffulli, 2011 ;Longo, 2009 ;Colné, 2011). Dans le cas de notre patiente, la rupture est survenue sur terrain diabétique de découverte inaugurale (glycémie à 2.69g/l).…”

Section: Discussionunclassified

“…Chez notre patiente et pour d'autres auteurs (Newnham, 1991 ;Longo 2009), cette prophylaxie n'est pas systématique. Le protocole de rééducation le plus communément utilisé est l'immobilisation avec un plâtre suro-pédieux en équin pendant 4 semaines, le pied en position plus neutre pendant 4 semaines supplémentaires (Maffulli, 2015 ;Longo, 2009). Quelle que soit la technique utilisée, l'immobilisation pour le traitement des ruptures du tendon calcanéen est obligatoire et se fait en deux étapes.…”

Section: Discussionunclassified

“…Elle peut survenir dans un contexte non traumatique, notamment suite à certaines maladies telles que le lupus érythémateux disséminé, la polyarthrite rhumatoïde, l'insuffisance rénale chronique, l'hyperparathyoïdie secondaire, le diabète et la prise de corticoïdes ou de fluoroquinolones (Zakaria, 2014 ;Maffulli, 2015 ;Benjilali, 2012 ;Assal, 2007 ;Newnham, 1991 ;Tezeren, 2006 ;Spoendlin, 2016). Son incidence augmente à travers le monde et est estimée à 18 pour 100.000 personnes (Leppilahti, 1998).…”

Section: Introductionunclassified

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Rupture Spontanee Du Tendon D’achille Sur Terrain Diabetique : A Propos Du Cas

Adakal

Moussa

Mohamed

et al. 2018

ESJ

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Achilles Tendon Rupture (ATR) is a frequently described lesion in sports traumatology. It can occur following certain chronic or systemic diseases. We reported a case of a 48-year-old woman, a teacher by profession, who was consulting for lameness. Anamnesis found during a walk, a brutal sensation of blow on the heel with cowardice and sharp pain at the elective point imposing upon the resting of the patient. Clinical examination noted an increased spontaneous dorsiflexion of the affected ankle, depression corresponding to the tendon continuity solution, and a positive Thompson test. The diagnosis of Achilles Tendon Rupture was made. The patient was operated 2 weeks later by open surgery. A simple suture kept by a plaster splint was performed (the ankle in equinus). Functional rehabilitation was done for 6 weeks, and walking was allowed at the 6th week. In the absence of minimally invasive surgery, conventional surgery can provide good results in case of spontaneous Achilles Tendon Rupture at the cost of rigorous monitoring of the patient.European Scientific Journal February 2018 edition Vol.14, No.6 ISSN: 1857 -7881 (Print) e -ISSN 1857-7431 296 Keywords: Achilles tendon, Thompson's test, rupture of the tendon RésuméLa rupture du tendon d'Achille (RTA) est une lésion fréquente en pathologie du sport. Elle peut survenir suite à certaines maladies chroniques ou systémiques. Nous rapportons le cas d'une femme âgée de 48 ans, enseignante, qui consultait pour boiterie. L'interrogatoire retrouvait à l'esquisse d'une marche, une sensation brutale de coup sur le talon avec lâchage et douleur vive au point électif imposant la mise au repos de la patiente. L'examen clinique montrait une dorsiflexion spontanée augmentée de la cheville atteinte, une dépression correspondant à la solution de continuité du tendon et un test de Thompson positif. Le diagnostic de rupture de tendon d'Achille était posé. La patiente était opérée 2 semaines après par une chirurgie à ciel ouvert. Une suture simple maintenue d'une attelle plâtrée a été réalisée, la cheville en équin. Une rééducation fonctionnelle était faite pendant 6 semaines. La marche était autorisée à la 6 ème semaine. À défaut de la chirurgie mini-invasive, la chirurgie classique peut donner des résultats satisfaisants en cas de RSTA au prix d'un suivi rigoureux du patient.

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Intratendon delivery of leukocyte‐rich platelet‐rich plasma at early stage promotes tendon repair in a rabbit Achilles tendinopathy model

Jiang

et al. 2020

J Tissue Eng Regen Med

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Tendinopathy is a great obstacle in clinical practice due to its poor regenerative capacity. The influence of different stages of tendinopathy on effects of leukocyte‐rich platelet‐rich plasma (Lr‐PRP) has not been elucidated. The aim of this study is to investigate the optimal time point for delivery of Lr‐PRP on tendinopathy. A tendinopathy model was established by local collagenase injection on the rabbit Achilles tendon. Then after collagenase induction, following treatments were applied randomly on the lesion: (a) 200 μl of Lr‐PRP at 1 week (PRP‐1 group), (b) 200 μl of saline at 1 week (Saline‐1 group), (c) 200 μl of Lr‐PRP at 4 weeks (PRP‐2 group), and (d) 200 μl of saline at 4 weeks (Saline‐2 group). Six weeks after collagenase induction, outcomes were assessed by magnetic resonance imaging, cytokine quantification, gene expression, histology, and transmission electron microscopy. Our results demonstrated that PRP‐1 group had the least cross‐sectional area and lesion percent of the involved tendon, as well as the lowest signal intensity in magnetic resonance imaging among all groups. However, the PRP‐2 group showed larger cross‐sectional area than saline groups. Enzyme‐linked immunosorbent assay indicated that PRP‐1 group had a higher level of interleukin‐10 but lower level of interleukin‐6 when compared with PRP‐2 and saline groups. Meanwhile, the highest expression of collagen (Col) 1 in PRP‐1 and Col 3, matrix metalloproteinase (MMP)‐1, and MMP‐3 in PRP‐2 was found. Histologically, the PRP‐1 showed better general scores than PRP‐2, and no significant difference was found between the PRP‐2 and saline groups. For transmission electron microscopy, PRP‐1 had the largest mean collagen fibril diameter, and the PRP‐2 group showed even smaller mean collagen fibril diameter than saline groups. In conclusion, intratendon delivery of Lr‐PRP at early stage showed beneficial effect for repair of tendinopathy but not at late stage. For translation of our results to clinical circumstances, further studies are still needed.

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Chronic Achilles Tendon Disorders

Cited by 101 publications

References 52 publications

Surgical Strategy for the Chronic Achilles Tendon Rupture

Surgical Strategy for the Chronic Achilles Tendon Rupture

Rupture Spontanee Du Tendon D’achille Sur Terrain Diabetique : A Propos Du Cas

Intratendon delivery of leukocyte‐rich platelet‐rich plasma at early stage promotes tendon repair in a rabbit Achilles tendinopathy model

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