Postoperative Rehabilitation Protocols for Achilles Tendon Ruptures

Suchak, Amar A.; Spooner, Carol; Reid, Duncan; Jomha, Nadr M.

doi:10.1097/01.blo.0000203458.05135.74

Cited by 107 publications

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“…Achilles tendon ruptures are common sports injuries. [1][2][3] According to the estimations of Suchak et al, 4 up to 2500 Achilles tendon ruptures occur in a small country like Switzerland each year. During healing, the ruptured tendon forms a functional tendon regenerat within 6-8 weeks but despite intensive remodeling over the following months, complete regeneration of the tendon is never achieved.…”

Section: Introductionmentioning

confidence: 99%

Ex vivo adenoviral transfer of bone morphogenetic protein 12 (BMP-12) cDNA improves Achilles tendon healing in a rat model

et al. 2008

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The aim of our study was to evaluate the histological and biomechanical effects of BMP-12 gene transfer on the healing of rat Achilles tendons using a new approach employing a genetically modified muscle flap. Biopsies of autologous skeletal muscle were transduced with a type-five, first-generation adenovirus carrying the human BMP-12 cDNA (Ad.BMP-12) and surgically implanted around experimentally transected Achilles tendons in a rat model. The effect of gene transfer on healing was evaluated by mechanical and histological testing after 1, 2, 4 and 8 weeks. One week after surgery, the maximum failure load of the healing tendons was significantly increased in the BMP-12 group, compared with the controls, and the tendon stiffness was significantly higher at 1, 2 and 4 weeks. Moreover, the size of the rupture callus was increased in the presence of BMP-12 and there was evidence of accelerated remodeling of the lesion in response to BMP-12. Histological examination showed a much more organized and homogeneous pattern of collagen fibers at all time points in lesions treated with the BMP-12 cDNA muscle graft. Both single fibrils and the collagen fibers had a greater diameter, with a higher degree of collagen crimp than the collagen of the control groups. This was confirmed by sirius red staining in conjunction with polarized light microscopy, which showed a higher shift of small yellow-green fibers to strong yelloworange fibers after 2, 4 and 8 weeks in the presence of BMP-12 cDNA. There was also an earlier shift from fibroblasts to fibrocytes within the healing tendon, with less fat cells present in the tendons of the BMP-12 group compared with the controls. Treatment with BMP-12 cDNA-transduced muscle grafts thus produced a promising acceleration and improvement of tendon healing, particularly influencing early tissue regeneration, leading to quicker recovery and improved biomechanical properties of the Achilles tendon. Further development of this approach could have clinical applications.

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Section: Introductionmentioning

confidence: 99%

Ex vivo adenoviral transfer of bone morphogenetic protein 12 (BMP-12) cDNA improves Achilles tendon healing in a rat model

et al. 2008

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“…This can be attributed to the fact that lack of visualization and nonanatomic end to end apposition in percutaneous technique results in healing by deposition of fibrous tissue. 21 This fibrous tissue has been shown to be collagen type 3 and not the normal type 2 collagen and structurally weaker, and hence more prone to re rupture. 22 Our series showed excellent results with our functional results being at par if not better than others, including both open and minimally invasive techniques.…”

Section: Discussionmentioning

confidence: 99%

Novel Semi-open Technique for Repair of Acute Rupture of Achilles Tendon

Sobti¹,

Mohrir²,

Agarwala³

2015

Journal of Foot and Ankle Surgery (Asia Pacific)

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Background:The most common complication of open repair of Achilles tendon is skin necrosis and wound problems, especially in the distal part, where the blood supply to the skin is precarious. Minimally invasive and percutaneous techniques have become popular as they overcome this problem but these techniques put the sural nerve at risk and have high incidence of rerupture. We have devised a semi-open technique, which incorporates the advantages of both techniques and at the same time avoids their complications. The aim of this study was to evaluate the outcome of this technique.

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“…Additionally, there is no evidence to show that early weight-bearing and active range of motion exercise increase re-rupture or infection rate after Achilles tendon repairs (Suchak et al 2006).…”

Section: Examples Of Studies Related To Achilles Tendon Proceduresmentioning

confidence: 99%

Proprioceptive and Functional Exercises After Ankle Surgery

Kaya¹,

Yüksel²,

Turhan³

et al. 2015

Sports Injuries

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Postoperative Rehabilitation Protocols for Achilles Tendon Ruptures

Abstract: Therapeutic Study, Level II (Systematic review of Level II studies or Level I studies with inconsistent results).

Cited by 107 publications

References 0 publications

Ex vivo adenoviral transfer of bone morphogenetic protein 12 (BMP-12) cDNA improves Achilles tendon healing in a rat model

Ex vivo adenoviral transfer of bone morphogenetic protein 12 (BMP-12) cDNA improves Achilles tendon healing in a rat model

Novel Semi-open Technique for Repair of Acute Rupture of Achilles Tendon

Proprioceptive and Functional Exercises After Ankle Surgery

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