High voltage pulsed current in collagen realignment, synthesis, and angiogenesis after Achilles tendon partial rupture

ABSTRACT Objective To verify the efficacy of high voltage pulsed current in collagen realignment and synthesis and in angiogenesis after the partial rupturing of the Achilles tendon in rats. Method Forty male Wistar rats were randomized into four groups of 10 animals each: sham, cathodic stimulation, anodic stimulation, and alternating stimulation. Their Achilles tendons were submitted to direct trauma by a free-falling metal bar. Then, the treatment was administered for six consecutive days after the injury. In the simulation group, the electrodes were positioned on the animal, but the device remained off for 30 minutes. The other groups used a frequency of 120 pps, sensory threshold, and the corresponding polarity. On the seventh day, the tendons were removed and sent for histological slide preparation for birefringence and Picrosirius Red analysis and for blood vessel quantification. Results No significant difference was observed among the groups regarding collagen realignment (types I or III collagen) or quantity of blood vessels. Conclusion High voltage pulsed current for six consecutive days was not effective in collagen realignment, synthesis, or angiogenesis after the partial rupturing of the Achilles tendon in rats.

Can transcutaneous electrical nerve stimulation improve achilles tendon healing in rats?

BACKGROUND: Tendon injury is one of the most frequent injuries in sports activities. TENS is a physical agent used in the treatment of pain but its influence on the tendon's healing process is unclear. OBJECTIVE: To evaluate the influence of TENS on the healing of partial rupture of the Achilles tendon in rats. METHOD: Sixty Wistar rats were submitted to a partial rupture of the Achilles tendon by direct trauma and randomized into six groups (TENS or Sham stimulation) and the time of evaluation (7, 14, and 21 days post-injury). Burst TENS was applied for 30 minutes, 6 days, 100 Hz frequency, 2 Hz burst frequency, 200 µs pulse duration, and 300 ms pulse train duration. Microscopic analyses were performed to quantify the blood vessels and mast cells, birefringence to quantify collagen fiber alignment, and immunohistochemistry to quantify types I and III collagen fibers. RESULTS: A significant interaction was observed for collagen type I (p=0.020) where the TENS group presented lower percentage in 14 days after the lesion (p=0.33). The main group effect showed that the TENS group presented worse collagen fiber alignment (p=0.001) and lower percentage of collagen III (p=0.001) and the main time effect (p=0.001) showed decreased percentage of collagen III at 7 days (p=0.001) and 14 days (p=0.001) after lesion when compared to 21 days. CONCLUSIONS: Burst TENS inhibited collagen I and III production and impaired its alignment during healing of partial rupture of the Achilles tendon in rats.

Experimental model of Achilles tendon injury in rats

PURPOSE: To describe an effective experimental model to study the Achilles tendon healing. METHODS: Forty male Rattus norvegicus albinus, Wistar lineage adult male weighing 250 to 300g were used for this experiment and thirty were surgically submitted to bilateral partial transverse section of the Achilles tendon. The right tendon was treated with radio waves (RF) whereas the left tendon served as control. On the third postoperative day, the rats were divided into four experimental groups consisting of ten rats each which were treated with monopolar RF adjusted to 650 kHz and 2w, for two minutes twice a week and a group of normal animals without any intervention, until they were sacrificed on the 7th, 14th and 28th days, respectively. Tendons were weighed and collagen quantification was evaluated by hydroxyprolin content. RESULTS: Significant reduction in collagen content on day 7, 14 and 28 was related to control experiment to normal tendon (7 days, p<0.01; 14 e 28 days, p<0.05). CONCLUSION: The experimental model has been effective and available to be used to study Achilles tendon healing. .

Rupturas del tendon rotuliano / Patellar tendon rupture

El objetivo del siguiente trabajo es comparar los resultados obtenidos con 2 técnicas quirúrgicas diferentes en pacientes deportistas con rupturas intrasustancia del tendón rotuliano y realizar una revisión del tema. Se evaluaron retrospectivamente 7 (siete) pacientes con rupturas del tendón rotuliano, tratados entre julio de 2000 y julio de 2005 en el Hospital de Agudos Donación F. Santojanni y en la práctica privada, en forma quirúrgica y temprana.Se utilizaron 2 técnicas quirúrgicas diferentes: Anclajes con arpones y sutura directa con refuerzo de tendon semitendinoso. Los pacientes fueron evaluados postoperatoriamente mediante el score de Lysholm y el retorno a la actividad deportiva. El seguimiento postoperatorio fue de 14 meses con un rango entre 7 y 34 meses. Seis pacientes retornaron a la actividad habitual (resultado excelente). El paciente restante obtuvo un resultado pobre con limitación de la flexión de rodilla de 15º comparada con la rodilla contralateral. Se concluye que el tratamiento quirúrgico en el período agudo independientemente de la técnica utilizada es fundamental para un resultado exitoso.

Biomechanical properties of the biceps-labral complex submitted to mechanical stress

OBJETIVO: Determinar as propriedades biomecânicas do complexo labrum-glenóide bicipital superior submetido ao estresse mecânico contínuo ou repetitivo (repentino).

Lesão do tendão flexor: sutura na região avascular ou vascularizada? Estudo biomecânico e histopatológico em coelhos / The flexor tendon lesion: suture in the region avascular or vasculanized? Biomechamical and histopathological study in rabbits

Há dúvidas em relação à melhor localização da sutura no reparo da lesão do tendão flexor dos dedos da mão, uma vez que o ponto central colocado na região dorsal vascularizada, apesar de gerar maior resistência que o ponto na região palmar, poderia, entretanto, interferir no suprimento sangüíneo do tendão. O objetivo da presente investigação foi avaliar, por meio da biomecânica e histopatologia, o efeito da sutura central na região de tendão normal vascularizada e na região de tendão fibrocartilaginoso avascular, no processo de cicatrização do tendão flexor profundo dos dedos do pé do coelho. Foram estudados 83 coelhos submetidos à sutura central tipo Kessler na região de tendão normal (grupo TN) e na região de tendão fibrocartilaginoso (grupo FC), completada com sutura periférica circunferêncial contínua. Após a cirurgia, o membro operado foi imobilizado pelo período de três semanas. Os animais foram sacrificados no período imediato, duas, três e seis semanas de pós-operatório. Concluiu-se que a colocação da sutura central na região de tendão normal vascularizada ou fibrocartilaginosa avascular não apresenta diferenças em relação aos aspectos biomecânicos e histopatológicos na cicatrização do tendão flexor profundo dos dedos do pé do coelho...

Tratamiento de la ruptura del tendón de Aquiles, en deportistas con prótesis de Leeds-Keio / Repair of the Achilles-tendon rupture by the Leeds-Keio prosthesis in athletes

El tratamiento de las rupturas totales del tendón de Aquiles es aún un tema de discusión, no queda duda que en pacientes que no realizan ninguna actividad física importante el tratamiento puede ser poco agresivo. Sin embargo en deportistas se debe garantizar la pronta rehabilitación y reintegración al deporte, eliminando el riesgo de una ruptura interativa. Desde 1975 se ha realizado la reparación de las rupturas totales de tendón de Aquiles en deportistas con sutura reforzada con el peroneo lateral corto con la técnica Pérez-Teufer y después con plastías artificiales. En este trabajo presentamos una serie de 29 pacientes, todos ellos deportistas de práctica habitual, que sufrieron durante la misma ruptura de su tendón de Aquiles. Se realizó la reconstrucción mediante una plastía con injerto sintético Leeds-Keio. Gracias a la solidez y a la resistencia que ofrece este montaje se pudo iniciar la rehabilitación en el postoperatorio inmediato. Todos los pacientes con excepción de uno volvieron a practicar su deporte al mismo nivel y en su mismo puesto entre el tercero y cuarto mes después de la cirugía. En esta serie no se presentaron complicaciones graves, ni rupturas

Lesåo espontânea do tendåo fibular curto: Relato de caso / Spontaneous lesions of fibular brevis tendon case report

Os autores apresentam um caso de ruptura espontânea do tendåo do músculo fibular curto em um paciente do sexo feminino de 48 anos de idade. A intençåo dessa apresentaçåo se deve à raridade do caso, pois é mais comum a lesåo do tendåo fibular longo. Såo discutidos a clínica da lesåo, seus aspectos fisiopatológicos e seu tratamento

Ruptura cerrada de tendón distal del bíceps braquial informe de cuatro casos: revisión multicéntrica / Closed reupture of the biceps brachii distal tendon, report of four cases: Multicentric review

Se analizaron cuatro casos de ruptura cerrada del tendón distal de bíceps braquial tratados de 1982 a 1990 en el Hospital ABC. Tres individuos del sexo masculino de 48, 51 y 52 años de edad se lesionaron el miembro torácico derecho (dominante) al cargar un objeto pesado y fueron tratados con la técnica quirúrgica ideada por Boyd y Anderson. El cuarto de 52 años se lesionó por un mecanismo de tracción violenta durante actividades de equitación.

An experimental study of healing of the partially severed flexor tendon in chickens

There is a lack of clinical and experimental studies of the treatment of incompletely transected tendons. The controversy concerning the source of flexor tendon nutrients is of important clinical concern in healing of the injured tendon; thus, the flexor tendon blood supply has cited as a reason for using specific tendon suture techniques, and as a rationale for preserving the superficialis tendon and its vincula during tendon repair surgery. Our knowledge of the normal physiology of digital flexor tendons and the mechanism of their healing process is deficient. The aim of this study was to investigate the relative importance of the synovial fluid and the blood supply respectively for the healing of partially severed flexor tendons. We observed the sequential histological and vascular changes which occur in healing of the partial lacerations in the dorsal and plantar aspects of the tendons. We observed the vascularities of the two partially severed tendon groups after injection of microfil and india ink through the femoral artery. In the healing process there was no sequential histological difference between the dorsal and the plantar severed tendons. The vascularity patterns of the healing tendons were significantly increased and the hypervascularity of dorsal severed tendons was greater than that of plantar severed tendons. Partially severed tendons were completely healed without surgical repair with dense collagen fibers without adhesion in most cases. We concluded from this study that the blood vessels appeared to play a significant role in the healing of the severed flexor tendons. An intact synovial environment did not seem to be required for healing of the severed tendon. It is not necessary to surgically repair the partially severed tendon for prevention of rupture and adhesion.