Ultrasound diagnosis and percutaneous treatment of Achilles tendon tethering: a case series

He, Lulu; Genin, Jason; Delzell, Patricia B.

doi:10.1007/s00256-016-2416-5

Cited by 12 publications

(10 citation statements)

References 5 publications

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“…In n = 18 cases (9%), communication to the anterior talofibular ligament (ATFL) was found as prolongation or extension of the superior peroneal retinaculum fibers over the external outline of the lateral malleolus to the superior part of the ATFL (Figs. 3,4,5,6).…”

Section: Resultsmentioning

confidence: 99%

“…The KFP is an adipose structure located between the Achilles tendon, the flexor hallucis longus (FHL) and the calcaneus [8,28]. Due to the KFP's close relation to the Achilles tendon, it can be involved in traumatic changes in the tendon's midportion as well as the entheses or other conditions like a tumor or infection [11,22,26], but the connections can provide stability [5,10]. The relatively large size of the KFP enables its individual parts to have different functions and exhibit slightly different 1 3 mechanical functions and a slightly different sort of pathology [3,15,28].…”

Section: Introductionmentioning

confidence: 99%

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The Kager’s fat pad radiological anatomy revised

Szaro

Polaczek²,

Ciszek

2020

Surg Radiol Anat

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Purpose The aim of the study was to map connections within the Kager’s fat pad between the structures which limit it. Methods A retrospective re-review of 200 ankle magnetic resonance imaging (MRI) examination was conducted. Connections within the Kager’s fat pad between the superior peroneal retinaculum, the fibulotalocalcaneal ligament, the posterior talocalcaneal ligament, the flexor hallucis longus, the paratenon of the Achilles tendon, the flexor retinaculum and bones were studied and a model of the connections was constructed. Results The superior peroneal retinaculum was directly connected with the fibulotalocalcaneal ligament in 85.5% of cases, the lateral part of the paratenon in 82.5%, the processus posterior tali in 78.5%, the posterior talofibular ligament in 32%, the flexor retinaculum in 29.5% and the anterior talofibular ligament in 9%. The fibulotalocalcaneal ligament was connected with the paratenon (on the medial side 88.5%, on the lateral side 68.5%), the flexor retinaculum in 70%, the posterior process of the talus in 79%, the osteofibrosus tunnel for the flexor hallucis longus in 53%, the posterior talofibular ligament in 43.5% and the calcaneofibular ligament in 10.5%. The posterior talocalcaneal ligament was connected with the fibulotalocalcaneal ligament in 71%, with the osteofibrosus tunnel for the flexor hallucis longus in 76.5%, with the flexor retinaculum in 70%. The plantaris tendon showed projection to the crural fascia in 34 of % cases. Conclusion In the Kager’s fat pad there are present more connections than previously reported. All the connections unit at the level of the posterior process of the talus.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Kager’s fat pad radiological anatomy revised

Szaro

Polaczek²,

Ciszek

2020

Surg Radiol Anat

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“…In February 2016, a case series of three patients received platelet-rich plasma, prolotherapy, anesthetic and steroid injected in or around the Achilles tendon [5]. All three patients received hydrodissection during each injection procedure.…”

Section: Discussionmentioning

confidence: 99%

Hydrodissection of an Achilles Tendinopathy on a Professional Athlete

Jones¹,

Brolinson²,

Patton³

et al. 2017

MOJOR

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We report a case of Achilles tendinosis that was treated with a high volume, hydrodissection visualized by conventional B-mode ultrasound. Prior MRI revealed a thickened right Achilles tendon with a small defect. Ultrasound examination showed a thickened Achilles tendon with physical exam revealing a prominent Haglund's deformity, mild fusiform swelling and pain along the posterior Achilles (Figure 1 & 2). The condition had been poorly responsive to standard management including protected ambulation in a cam walker boot, anti-inflammatory medication, modalities and therapeutic exercise, as well as a platelet rich plasma injection. We suggest using high volume ultrasound guided injection adjacent to (anterior to) the Achilles tendon as an adjunct to treat this difficult clinical syndrome.

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“…32 The use of stem cells is being investigated in animal models. 35 Other ultrasound-guided percutaneous tendon treatments include tendon scraping and hydrodissection, 36,37 as well as micro-resection of pathologic tissue using ultrasonic energy. 38 The relative efficacies of these various treatments are largely unknown.…”

Section: Tendon Treatmentsmentioning

confidence: 99%

Ultrasound-Guided Percutaneous Tenotomy

Jacobson

Kim

Brigido

2016

Semin Musculoskelet Radiol

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Of the many treatment options for tendinopathy, percutaneous tenotomy has been used throughout the body with success. With this procedure, a needle is repeatedly passed into the abnormal tendon with the goal of converting a chronic degenerative process to an acute inflammatory condition that will progress to tendon healing. Ultrasound guidance for this procedure is essential to ensure that the abnormal region of the tendon is accurately targeted. The treatment has few contraindications, and negligible complications have been described. This article reviews the rationale behind tenotomy for the treatment of tendinopathy and the ultrasound-guided technique. The current literature comparing the results of tenotomy to other percutaneous tendon treatments is also reviewed, although many of the other tendon injection treatments incorporate tenotomy as part of the procedure.

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Ultrasound diagnosis and percutaneous treatment of Achilles tendon tethering: a case series

Cited by 12 publications

References 5 publications

The Kager’s fat pad radiological anatomy revised

The Kager’s fat pad radiological anatomy revised

Hydrodissection of an Achilles Tendinopathy on a Professional Athlete

Ultrasound-Guided Percutaneous Tenotomy

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