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Am J Sports Med
McKay Orthopaedic Laboratory, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Published: August 2021
Background: Achilles tendon rupture diagnosis is frequently missed, leading to the development of a chronic rupture that requires surgical intervention to remove scar tissue and return the elongated Achilles tendon to appropriate functional length. The limited scar resection (LSR) intervention strategy may provide an advantage over other techniques, as it is less invasive and nondestructive to other tissues, although there is little evidence comparing outcomes between intervention strategies.
Hypothesis: The LSR technique would be a viable treatment option for chronic Achilles tendon ruptures and would perform comparably with a more clinically accepted procedure, the gastrocnemius fascial turndown (GFT), in postintervention functional outcome measures and tendon mechanical and histological properties.
Study Design: Controlled laboratory study.
Methods: Chronic Achilles tendon ruptures were induced in the right hindlimb of Sprague-Dawley rats by Achilles tendon transection without repair, immobilization in dorsiflexion, and 5 weeks of cage activity. Animals were randomly divided between the intervention strategy groups (LSR and GFT), received 1 week of immobilization in plantarflexion, and were sacrificed at 3 or 6 weeks postintervention. In vivo functional outcome measures (gait kinetics, passive joint function, tendon vascular perfusion) were quantified during healing, and tendon mechanical and histological properties were assessed postsacrifice.
Results: When compared with the GFT, the LSR technique elicited a faster return to baseline in gait kinetics, although there were few differences between groups or with healing time in other functional outcome measures (passive joint function and vascular perfusion). Quasi-static mechanical properties were improved with healing in both surgical intervention groups, although only the LSR group showed an improvement in fatigue properties between 3 and 6 weeks postintervention. Histological properties were similar between intervention strategies, except for decreased cellularity in the LSR group at 6 weeks postintervention.
Conclusion: The LSR technique is a viable surgical intervention strategy for a chronic Achilles tendon rupture in a rodent model, and it performs similarly, if not better, when directly compared with a more clinically accepted surgery, the GFT.
Clinical Relevance: This study supports the increased clinical use of the LSR technique for treating chronic Achilles tendon rupture cases.
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http://dx.doi.org/10.1177/03635465211023096 | DOI Listing |
J Orthop Res
March 2025
Mechanical & Biomedical Engineering, Boise State University, Boise, Idaho, USA.
There is limited understanding of how mechanical signals regulate tendon development. The nucleus has emerged as a major regulator of cellular mechanosensation via the linker of nucleoskeleton and cytoskeleton (LINC) protein complex. Specific roles of LINC in tenogenesis have not been explored.
View Article and Find Full Text PDFActa Biomater
March 2025
Technological Innovation Division, Foundation for Applied Medical Research (FIMA), University of Navarra (UNAV), Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Department of Biomedical Sciences, School of Health Sciences, Universidad CEU Cardenal Herrera, Valencia, Spain. Electronic address:
Tendon injuries present substantial challenges in clinical settings, where traditional treatments often lead to suboptimal outcomes, including scar tissue formation, reduced strength, limited range of motion, and re-ruptures. These difficulties primarily arise from the complex hierarchical structure of tendons and their limited healing capacity. Tissue engineering offers promising solutions for tendon regeneration and muscle-to-bone reconnection, typically through the use of biodegradable scaffolds that mimic the extracellular matrix of tendons, thereby supporting cell growth and tissue formation.
View Article and Find Full Text PDFBiomater Adv
March 2025
State Key Laboratory of Trauma, Burn and Combined Injury, Department of Orthopedics/Sports Medicine Center, First Affiliated Hospital of Army Medical University, Chongqing 400038, China; Foot, Ankle and Hand Surgery Department, Shenzhen Second People's Hospital, Shenzhen 518035, China. Electronic address:
Insertional Achilles tendinopathy (IAT) is a highly prevalent overuse injury affecting the foot and ankle in clinical settings. Currently, the primary management approach is conservative treatment. Platelet-rich plasma-derived exosomes (PRP-Exos) effectively preserve essential growth factors and other vital components inherent in PRP, thereby optimizing overall treatment outcomes.
View Article and Find Full Text PDFInt J Mol Sci
March 2025
Department of Orthopedics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, School of Medicine, Pusan National University, Yangsan 56012, Republic of Korea.
The application of light-emitting diode (LED)-dependent photobiomodulation (PBM) in promoting post-tendon injury healing has been recently reported. Despite establishing a theoretical basis for ligament restoration through PBM, identifying effective LED wavelength combinations and ensuring safety in animal models remain unresolved challenges. In our previous study, we demonstrated that combined irradiation at 630 nm and 880 nm promotes cell proliferation and migration, which are critical processes during the early stage of tendon healing in human-derived tendon fibroblasts.
View Article and Find Full Text PDFWearable Technol
February 2025
Neuromuscular Robotics Laboratory, Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands.
Research in lower limb wearable robotic control has largely focused on reducing the metabolic cost of walking or compensating for a portion of the biological joint torque, for example, by applying support proportional to estimated biological joint torques. However, due to different musculotendon unit (MTU) contractile speed properties, less attention has been given to the development of wearable robotic controllers that can steer MTU dynamics directly. Therefore, closed-loop control of MTU dynamics needs to be robust across fiber phenotypes, that is ranging from slow type I to fast type IIx in humans.
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