PubMed · 6120155
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I M Siegel. 1981. Triceps surae tether.. https://pubmed.ncbi.nlm.nih.gov/6120155/
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The increase in leisure-sports has not only brought an escalation in the number of sports-related injuries presenting to orthopaedists, but has also aroused interest for diagnosis and treatment of these injuries in sports-oriented and -interested physicians. The primary treatment in the sports arena remains simple: rest, ice, compression, elevation. The introduction of innovative imaging techniques beside conventional clinical and radiological examinations has facilitated differentiated diagnosis and has led to changes in the treatment of sports-related injuries. While a conservative approach has become established for the treatment of isolated injuries to the collateral ligaments in the knee, ligament ruptures of the ankle and also for certain injuries of the acromioclavicular joint, the complex tears of ligaments in the knee as well as ruptures of the Achilles tendon remain a domain of surgical treatment. Diagnostic and operative arthroscopy has replaced open surgery in the treatment of knee and shoulder trauma to hasten the restitution of proprioception, muscle power and rehabilitation especially in athletes. Some points relevant to the occurrence of sports accidents should be observed for the prevention of these injuries.
A study was conducted to evaluate the tissue response to a xenogeneic biomaterial when this material was used to repair an experimentally induced Achilles tendon defect in the dog. Twenty dogs had a 1.5 cm segmental defect of the Achilles tendon created surgically which was then repaired with acellular connective tissue derived from porcine small intestinal submucosa (SIS). The animals were sacrificed at 1, 2, 4, 8, 12, 16, 24, and 48 weeks and the neotendons examined for uniaxial longitudinal tensile strength, morphologic appearance, hydroxyproline (collagen) content, and disappearance of the originally implanted SIS material over time. The contralateral normal Achilles tendons served as controls as did four additional dogs that had a 1.5 cm segmental Achilles tendon defect created surgically without subsequent surgical repair with SIS. Results showed the SIS remodeled neotendons to be stronger than the musculotendinous origin or the boney insertion (> 1000 N) by 12 weeks after surgery and to consist of organized collagen-rich connective tissue similar to the contralateral normal tendons. The four dogs in which no SIS was implanted showed inferior strength at the comparable time points of 4, 8, 12, and 16 weeks. Immunohistochemical studies suggest that the SIS biomaterial becomes degraded within the first eight weeks and serves as a temporary scaffold around which the body deposits appropriate and organized connective tissue. SIS is a promising biomaterial worthy of further investigation for orthopedic soft tissue applications.
To determine whether the echo time of magnetic resonance gradient-echo and spin-echo imaging sequences may be important for the occurrence of high signal strength from tendon with pathological alterations, imaging sequences with sufficient spatial resolution and very short echo times were developed for whole-body imagers with standard gradient system. The sequences were applied on the Achilles tendons of five healthy volunteers and seven patients with achillodynia. Some affected regions inside tendon, probably corresponding with tissue with subtle edema in the collagen bundles were only revealed in images recorded with very short echo times TE < 5 ms, whereas stronger affections and protons in liquids between the fiber bundles were also shown in images with longer echo times TE > 10 ms. Gradient-echo methods allow shorter echo times than spin-echo techniques for a given gradient system of the imager and given spatial resolution. So minimum echo time gradient-echo sequences should be used for sensitive imaging of tendon alterations, because no considerable signal dephasing due to susceptibility effects were found in tendon.