Vascular changes in the ruptured achilles tendon and paratenon

Abstract

Thirty patients with ruptures of the Achilles tendon were studied. There were 21 men and 9 women with an average age of 36 years. Specimens from the tendon and paratenon in 24 were examined histologically. Tissue samples of 20 were studied by electron microscopy. Marked degenerative, obliterative and/or inflammatory vascular changes were found in all the ruptured tendons and their paratenon. Our findings indicate that poor vascularity play a role in the aetiology of rupture of the Achilles tendon.

Accelerated Achilles tendon healing with interleukin-1 receptor antagonist protein in rabbits

“…Thirty-five percent of the central tendon part's blood supply goes through the paratendon (12,13), which was dissected and compromised during tenotomy. The reason for this lies in the fact that at the muscle tendon junction capillaries and arterioles located between muscle fibers are entering between the secondary tendon fibers bundles (fascicules) and do not pass deeper than the first third of the tendon (14).…”

Achilles tendon rupture and sciatica: a possible correlation.

“…4 Alternatively, there may be general collagen abnormality aVecting both disc and tendon, making them both prone to disruption in some individuals.…”

“…2 3 Vascular alterations can play a role in the degenerative process preceding Achilles tendon rupture. 4 Previous studies have also shown that, in fresh samples of ruptured Achilles tendons, there is a pathological increase in the content of type III collagen. 5 Alterations in Achilles tendons and intervertebral disc biochemistry have also been hypothesised to be important in causing pathological changes eventually leading to rupture and prolapse respectively.…”

“…When a tear occurs at the radial wall, the ECU tendon may come to lie on its ulnar groove superficial to the torn fibroosseous sheath, preventing any chance of healing. Burkhart et al 3 and Rayan 4 suggested that acute injuries can be treated by cast immobilisation with the forearm in pronation and the wrist in radial deviation, although they have had no experience with treating acute dislocation of the ECU tendon. Rowland 5 , however, operated on an acute case and found that there was a considerable gap between the torn edges of the fibro-osseous sheath no matter in what position the wrist was placed.…”

BMP treatment for improving tendon repair Studies on rat and rabbit Achilles tendons

“…Most theories are based on mechanical and degenerative factors. Degeneration of tendon tissue is a consistent fi nding (Kvist et al 1992). When a tendon ruptures, various pre-existing degenerative changes may be found, including hypoxic degeneration, lipomatotis, mucoid degeneration, calcifi cation and occasionally necrosis.…”