Novel Surgical Technique and Early Kinesiotherapy for Acute Achilles Tendon Rupture

Jielile, Jiasharete; Sabirhazi, Gulnur; Chen, Jiangtao; Aldyarhan, Kayrat; Zheyiken, Jangannuer; Zhao, Qian; Bai, Jingping

doi:10.3113/fai.2012.1119

Cited by 15 publications

(12 citation statements)

References 31 publications

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“…mobilization; furthermore, there is a high prevalence of repeated rupture following nonoperative treatment. 3,4 This is in agreement with the Kazakh traditional medicine theory, 5 which uses 6 factors-kengistik tugyr (space), turak tugyr (place), zharyk tugyr (light), karanggy tugyr (dark), ystyk tugyr (heat), and suwik tugyr (cold)-to describe movement, stillness, phenomenon, essence, and increases and decreases in natural heat energy, respectively. In Kazakh traditional medicine theory, postoperative early mobilization (EM), which includes movements of the ankle joint without postoperative fixation or orthosis, uses dynamic mechanical forces and tension to promote accelerated tendon healing.…”

supporting

confidence: 82%

“…The detailed procedure is available else-where. [4][5][6]8,9,11 The PCI group and EM group were performed as described previously. For the EM group, the frequency of movement (squatting and standing cycles) was approximately 150±15 times per day.…”

Section: Animals and Proceduresmentioning

confidence: 99%

“…5 In an effort to reduce the time to functional recovery, EM has been advocated by several research groups that have consistently shown a shorter time to full recovery, better plantar flexion strength, and a new adaptive overall volume regeneration of the Achilles tendon compared with immobilization until adequate healing has occurred. 4,6,7 Healing of the Achilles tendon is a complex and lengthy process that involves gene regulation and protein expression, in addition to cell mobilization and proliferation. It is a mechanism that constitutes a full systems biology approach, with distinct histological changes that show the critical roles during each stage of healing.…”

mentioning

confidence: 99%

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Early Ankle Mobilization Promotes Healing in a Rabbit Model of Achilles Tendon Rupture

Jielile¹,

Asilehan²,

Wupuer³

et al. 2016

Orthopedics

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The use of early mobilization of the ankle joint without orthosis in the treatment of Achilles tendon rupture has been advocated as the optimal management. The goal of this study was to compare outcomes in a postoperative rabbit model of Achilles tendon rupture between early mobilization and immobilized animals using a differential proteomics approach. In total, 135 rabbits were randomized into the control group (n=15), the postoperative cast immobilization (PCI) group (n=60), and the early mobilization (EM) group (n=60). A rupture of the Achilles tendon was created in each animal model and repaired microsurgically, and tendon samples were removed at 3, 7, 14, and 21 days postoperatively. Proteins were separated using 2-dimensional polyacrylamide gel electrophoresis and identified using peptide mass fingerprinting, tandem mass spectrometry, NCBI database searches, and bioinformatics analyses. A series of differentially expressed proteins were identified between groups, some of which may play an important role in Achilles tendon healing. Notable candidate proteins that were upregulated in the EM group were identified, such as CRMP-2, galactokinase 1, tropomyosin-4, and transthyretin. The healing of ruptured Achilles tendons appears to be affected at the level of protein expression with the use of early mobilization. The classic postoperative treatment of Achilles tendon rupture with an orthosis ignored the self-protecting instinct of humans. With a novel operative technique, the repaired tendon can persist the load that comes from traction in knee and ankle joint functional movement. In addition, kinesitherapy provided an excellent experimental outcome via a mechanobiological mechanism.

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supporting

confidence: 82%

Section: Animals and Proceduresmentioning

confidence: 99%

mentioning

confidence: 99%

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Early Ankle Mobilization Promotes Healing in a Rabbit Model of Achilles Tendon Rupture

Jielile¹,

Asilehan²,

Wupuer³

et al. 2016

Orthopedics

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“…＃References 1 -12, 14, 16 -18, 25 -28, 30 -36, 38 -40, 42 -46, 48, 50 -54, 57, 58, 60, 62 -68, 72, 73, 75 -77, 80 -86, 88 -…”

mentioning

confidence: 99%

Defining Components of Early Functional Rehabilitation for Acute Achilles Tendon Rupture: A Systematic Review

Zellers

Christensen

Kjær

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background: Early functional rehabilitation is frequently discussed in treating Achilles tendon rupture. A consistent definition of what constitutes early functional rehabilitation has not been established across the literature, despite studies supporting its efficacy. A standardized definition would be helpful to pool data across studies, allow for between-study comparisons, and ultimately work toward developing clinical guidelines. Purpose: To define early functional rehabilitation (including when it is initiated and what it entails) when used to treat Achilles tendon rupture and to identify outcome measures for evaluating the effect of treatment. Study Design: Systematic review; Level of evidence, 4. Methods: Ovid MEDLINE, EMBASE, PEDro, CINAHL, and Cochrane databases were searched for relevant studies. Eligibility criteria for selecting studies consisted of randomized controlled trials, cohort studies, and case series (≥10 participants) including weightbearing or exercise-based interventions within 8 weeks after Achilles tendon rupture. Results: A total of 174 studies published between 1979 and 2018 were included. Studies were rated a median (interquartile range [IQR]) of 17 (15-20) on the Downs & Black checklist and included 9098 participants. Early functional rehabilitation incorporated weightbearing (95%), range of motion (73%), and isometric/strengthening exercises (50%). Weightbearing was initiated within the first week, whereas exercise (eg, ankle range of motion, strengthening, whole-body conditioning) was initiated in the second week. Initiation of exercises varied based on whether treatment was nonsurgical (mean, 3.0 weeks; IQR, 2.0-4.0 weeks) or simple (mean, 2.0 weeks; IQR, 0.0-2.3 weeks) or augmented surgical repair (mean, 0.5 weeks; IQR, 0.0-2.8 weeks) ( P = .017). Functional outcomes including ankle range of motion (n = 84) and strength (n = 76) were reported in 130 studies. Other outcome domains included patient-reported outcomes (n = 89), survey-based functional outcomes (n = 50), and tendon properties (n = 53). Conclusion: Early functional rehabilitation includes weightbearing and a variety of exercise-based interventions initiated within the first 2 weeks after acute Achilles tendon rupture/repair. Because early functional rehabilitation has lacked a standardized definition, interventions and outcome measures are highly variable, and pooling data across studies should be done with attention paid to what was included in the intervention and how treatment was assessed.

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“…Achilles tendon were exposed by two separate longitudinal incisions, which resembled a scythe or letter "J" (Fig. 2) 17 . If necessary, two 3-4 cm connective incisions around the Kager's triangle and extended to the tendon rupture site were permitted.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Clinical Outcomes in Patients With Minimally Invasive Surgical Approach Combined With Plantar Tendon Transfer Repairing Neglected Achilles Tendon Rupture Compared to the Conventional Approach of V-Y Tendon Plasty: A Retrospective Study With Two Years Follow-Up

Cai

Liu

et al. 2021

Preprint

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Background Unlike acute Achilles tendon rupture (AATR), neglected Achilles tendon rupture (NATR) requires usually tendon grafting procedures for repair tendon defects caused by removing scar tissue. The conventional open surgery of V-Y tendon plasty and minimally invasive technique with plantar tendon transfer had been described, but the long-term efficacy between the two techniques still needs further certification. Methods Between February 1, 2008, and July 31, 2018. All of 46 patients with neglected Achilles tendon rupture, 25 patients in group A (21 males and 4 females; age, 34.28 ± 6.97 years) underwent the conventional operation of V-Y tendon plasty, and 21 patients in group B (14 males and 7 females; age, 35.29 ± 7.42 years) were treated by the minimally invasive technique. Two years follow-up was performed for the functional recovery with examinations of the Achilles tendon rupture score (ATRS), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hind-Foot Scale Score, dorsiflexion, calf circumference, and heel raise test. Results Patient characteristics between the two groups were similar. The functional score of ATRS and AOFAS in Group B was higher than patients in group A at postoperative months 3, 6, and 12, while there is no difference at month 24. In group A, there were three patients exposed to soft tissue infections (two superficial infections and one deep infection) and one case with tendon exposure. In group B, a patient with tendon re-rupture was observed. There was no difference in dorsiflexion and calf circumference at follow-up two years and the much better recovery in heel raise test group B than A. Conclusions Two different techniques produced a significant functional improvement, and return to sports. However, this study demonstrated that the minimally invasive technique was recommended for patients with a tendon defect less than 6 cm and who have an urgent demand to return to the sports.

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Novel Surgical Technique and Early Kinesiotherapy for Acute Achilles Tendon Rupture

Abstract: Postoperative early kinesiotherapy treatment following Pa-bone surgical technique resulted in excellent clinical outcomes and contributed to the overall reconstruction of the Achilles tendon.

Cited by 15 publications

References 31 publications

Early Ankle Mobilization Promotes Healing in a Rabbit Model of Achilles Tendon Rupture

Early Ankle Mobilization Promotes Healing in a Rabbit Model of Achilles Tendon Rupture

Defining Components of Early Functional Rehabilitation for Acute Achilles Tendon Rupture: A Systematic Review

Clinical Outcomes in Patients With Minimally Invasive Surgical Approach Combined With Plantar Tendon Transfer Repairing Neglected Achilles Tendon Rupture Compared to the Conventional Approach of V-Y Tendon Plasty: A Retrospective Study With Two Years Follow-Up

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