Spontaneous major tendon ruptures in patients on chronic hemodialysis

Tsourvakas, Stefanos; Alexandropoulos, Christos; Gouvalas, K.; Gimtsas, Christos; Tsianas, Nikolaos; Founta, Paraskevi

doi:10.1007/s00590-004-0213-7

Cited by 2 publications

(3 citation statements)

References 14 publications

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“…In our population, virtually all patients exhibited tendon calcification, similar to Tsourvakas et al. 59 and Wu et al., 61 who found ectopic calcification and there were calcifications in the ruptured end of the tendon in all patients. Extra-skeletal calcification can also affect vessels, leading to hypovascularization and ischemia.…”

Section: Discussionsupporting

confidence: 88%

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Patellar and quadriceps tendon rupture are associated with hip fracture in hemodialysis patients with severe hyperparathyroidism

Pichone,

Juvencio,

Crespo

et al. 2024

JBMR Plus

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Spontaneous rupture of the patellar (PTR) and quadriceps (QTR) tendon are infrequent. Systemic diseases such as diabetes mellitus, chronic kidney disease and secondary hyperparathyroidism (SHPT) are risk factors. The present cohort study aimed to evaluate risk factors associated with tendon rupture in hemodialysis (HD) patients with SHPT, as well as outcomes including surgical complications, re-ruptures and fracture. Baseline clinical, laboratorial data and radiographs were analyzed. Patients were followed up from March 2012 to March 2020. One-hundred thirty-one patients (≥18 years of age, on HD ≥ 6 months, with SHPT) were included. Incidence rates of PTR and QTR were 2.3 and 1.7/10000 HD patients/year, respectively. The mean age of patients with tendon rupture was 44.0 ± 11.2 years. These patients exhibited higher serum levels of phosphorus (6.3 ± 1.5 mg/dL vs 5.6 ± 1.1 mg/dL; p = 0.005), parathyroid hormone (2025.7 ± 667.6 pg/mL vs 1728.4 ± 684.8 pg/mL; p = 0.035), and C-reactive-protein (35.4 ± 32.9 mg/dL vs 17 ± 24.5 mg/dL; p = 0.002) compared to the group without tendon rupture. The mean follow-up was 56.7 ± 27.1 months. No patient required a new surgical approach or experienced re-rupture. Of all patients, 31% experienced hip fracture: 50% in the group with rupture (29.5 ± 17.4 months after the tendon rupture) vs 26% without tendon rupture (p = 0.015). After adjustment, the hazard ratio for hip fracture was 2.87 (CI 95% 1.27–6.49; p = 0.012). Patients with SHPT and high levels of phosphorus, parathyroid hormone, and inflammatory markers were at greater risk for tendon rupture. Surgical complication rates were low. However, results suggest that tendon rupture of knee extensor mechanism in hemodialysis patient with SHPT should be regarded as a “red flag” for future hip fracture.

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Section: Discussionsupporting

confidence: 88%

“…Among samples analyzed in our study, none exhibited amyloid deposits, similar to that found in other study. 59 Consistent with Jones et al. 41 and De Franco et al., 64 we believe that amyloid and tendon ruptures are not necessarily correlated, although both occur in patients who have been undergoing dialysis for many years.…”

Section: Discussionsupporting

confidence: 84%

Patellar and quadriceps tendon rupture are associated with hip fracture in hemodialysis patients with severe hyperparathyroidism

Pichone,

Juvencio,

Crespo

et al. 2024

JBMR Plus

View full text Add to dashboard Cite

show abstract

“…3 Sagittal MRI images of the elbow showing complete rupture with proximal retraction of the distal triceps tendon (medial (a) and lateral (b) parts). Note the large gap, filled with fluid, between the distal end of the tendon and the olecranon [47,77] used a figure-of-eight tension band wire to protect the transosseous repair. Lee [22] reported successful direct suture of the tendon to the soft tissues and periosteum attached to the olecranon without transfixing the bone.…”

Section: Treatment Modalitiesmentioning

confidence: 99%