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At least 19 recordsLinked to original sources
PubMed1976

[Experimental single-stage reconstruction of the tendon sheath and flexor tendon (free tendon graft, using a vein for sheath on the flexor tendon in dogs)].

In dog experiments the flexor tendons of the 2nd toe together with their tendon sheaths have been extirpated by the authors. Then on the place of the tendon sheath complex-resembling the human hand's "no man's land" -for the substitution of the tendon sheath-free inautotransplants with long vein-segments have been grafted in one sitting. Resuming the results of the macroscopic and light microscopic examinations carried out in definite times it has been found by the authors that while the vein segment was revascularized in the course of one or two weeks, the regeneration of the tendon transplant was slightly retarded. Between the vein and the tendon but adhesion of medium degree were found. The possibilities of the clinical use of the method are discussed.

Animals↗
PubMed2025

How Does Tendon Region, Donor, and the Presence of Disease Affect Protein Composition of the Achilles Tendon?

BACKGROUND: Response to treatment for tendinopathy is variable, which may reflect variability in underlying etiology and capacity for the tendon to respond to treatment. Understanding variability in tendon protein composition may help improve our understanding of the mechanistic underpinnings of painful tendon degeneration and inform treatment targets. QUESTIONS/PURPOSES: (1) What factors (tendon region, individual characteristics, presence of disease) contribute to protein compositional (proteomic) and structural variation in human Achilles tendons? (2) What compositional changes characterize tendinopathy, and what protein interactions might contribute to tendon degeneration? (3) How does diabetes influence tendon composition, and what mechanisms might underlie tendon dysfunction in individuals with diabetes? METHODS: In this exploratory, cross-sectional study, human Achilles tendon specimens were obtained from individuals with (diabetes group, n = 5) or without diabetes (control group, n = 5) undergoing lower extremity amputation and from individuals undergoing tendon debridement surgeries for tendinopathy (tendinopathy group, n = 8). Specimens were collected between 2019 and 2023. Protein abundances were quantified and analyzed using mass spectrometry, hierarchical clustering, and principal component analysis. To evaluate the role of tendon region and donor on tendon protein compositional variability, we assessed proteomic differences between three regions in nontendinopathic tendons from three individuals. To identify the contribution of disease (that is, presence of tendinopathy or diabetes) on protein composition, we compared tendons from the tendinopathy (n = 8 [2 males, 6 females], mean &#xb1; SD age 48 &#xb1; 11 years), diabetes (n = 5 [3 males, 2 females], age 54 &#xb1; 9 years), and control (n = 5 [3 males, 2 females], age 42 &#xb1; 12 years) groups. Proteomic differences associated with tendinopathy and diabetes were further examined using functional enrichment and protein-protein interaction network analysis. RESULTS: Variability in tendon protein composition was primarily from presence of disease, followed by donor and then tendon region. Protein composition distinguished tendons with tendinopathy from controls, with 311 proteins differentially expressed (152 overexpressed and 159 underexpressed; fold change &#x2265; 1.5, p < 0.05) and higher Bonar scores indicating greater degeneration (mean &#xb1; SD Bonar score tendinopathy group 8.6 &#xb1; 1.2 versus control group 2.1 &#xb1; 0.7; p = 0.01). Pathway analysis identified dysregulation in extracellular matrix remodeling (TIMP1, MMP3, MMP10), inflammatory response (TNF-&#x3b1;, EGFR1), and metabolic reprogramming. Tendons from individuals with diabetes exhibited minimal proteomic changes compared with the control group, with 66 differentially expressed proteins (31 overexpressed and 35 underexpressed; fold change &#x2265; 1.5, p < 0.05) with no histopathologic differences between diabetes and control group tendons (mean &#xb1; SD Bonar score diabetes group 3.4 &#xb1; 1.0 versus control group 2.1 &#xb1; 0.7; p = 0.19). Tendons in the diabetes group showed reductions in Type I collagen, enrichment of pathways associated with fibrosis and metabolic dysfunction, and inflammatory pathways associated with &#x3b1; 6 &#x3b2; 4 integrin. CONCLUSION: Our findings indicate that Achilles tendon composition primarily differs based on disease etiology, with tendinopathy showing extensive extracellular matrix disruption and inflammatory activity, whereas tendons from individuals with diabetes exhibit more subtle compositional changes. This distinction suggests that tendinopathy may require targeted interventions addressing tissue remodeling and inflammation, whereas diabetes may predispose tendons to injury but not directly result in degeneration. Understanding these protein compositional variations can help refine hypotheses about disease progression, treatment response, and potential therapeutic targets. CLINICAL RELEVANCE: While proteomic analysis is not currently a part of routine clinical assessment, these findings provide a framework for identifying protein markers that may aid in early diagnosis or patient stratification to improve treatment alignment. Future studies could determine whether these proteomic changes correlate with treatment response and further inform our understanding of early-stage degeneration from chronic disease. By bridging molecular findings with clinical presentation, this study lays the groundwork for future research on precision medicine approaches for tendon disorders, with the long-term goal of tailoring treatment based on both biological and symptomatic characteristics.

Humans↗
PubMed1979

[An experimental study on repair and restoration of gliding function of the injured flexor tendon of the finger. Part 6: A mode of vascularization of the grafted tendon within the pseudosheath (author's transl)].

The so-called two-stage procedure has been used in the reconstructive surgery for the severely injured flexor tendon of the finger. However, only little has been known as to vascularity of the grafted tendon within the pseudosheath. In order to clarify this problem, a series of experimental studies were carried out using young chickens. First, the flexor tendon of the fourth digit of chicken with its sheath was replaced by a silicone rod. The distal end of the rod was sutured to the stump of the flexor digitorum profundus and the proximal end left free. Then, in ten to sixteen weeks, upon removal of the rod, the flexor digitorum profundus of the third digit was grafted through into the newly formed pseudosheath. The paw was immobilized with plaster case in moderate flexion for three weeks, then the chicken was allowed to walk freely. At the different time intervals, starting from the third day to the fifteen weeks after surgery, a mode of vascularization of the grafted tendon and its surrounding tissue was examined microangiographically. The vessels appear at the area of proximal and distal stump of the grafted tendon a week postoperatively, and additional vessels appear at the contact area of the pseudosheath and the grafted tendon two weeks postoperatively. These vessels formed mutual anastomosis in five to six weeks. With time, the vessels connecting between the epitenon and the pseudosheath gradually enlarge and assemble together to form vascular bundles, so that the appearance of the structure becomes similar to that of the mesotenon. Three weeks postoperatively, the vessels appeared in the grafted tendon, and grew gradually so that these vessels ran through the full length of the grafted tendon in five to six weeks. About ten weeks, the vascularity of the grafted tendon is more abundant than that of the normal tendon, but diminished gradually so as to resemble that of the normal tendon at the fifteeth week. Thus, the growth of the vessels of the tendon grafted by two-stage procedure is delayed by two weeks compared with that by the primary tendon grafting.

Animals↗
PubMed1979

Achilles tendon repair with the plantaris tendon compared with repair using polyglycol threads.

Therapeutic results in 56 surgically treated patients with rupture of the Achilles tendon are presented. Results with repair using plantaris tendon and by suture of polyglycol threads are compared in 41 patients in a long-term followup study. Although 54 patients returned to their pre-accident physical activity, in all cases residual phenomena like calf atrophy, thickening of tendon, and tendon excursion were analyzed. The use of synthetic absorbable threads shortens the convalescence period. Covering the repair site with the fanned plantaris tendon seems to help to avoid painful adhesions with the skin.

Achilles Tendon↗
PubMed1976

[Reconstruction of the injured flexor tendon in the proximal half of the "no man's land" by a modified method (tendon sheath reconstruction using a vein graft)].

On the basis of long years' experiences the "no man's land" has been divided by the author into 2 parts: the proximal and the distal part. For the treatment of the flexor tendon lesions occurred in the distal part of the author advocates his method already published: in the "tendon sheath" formed from the vein its "bridging" by free tendon transplant. If the lesion occurred in the proximal part, the formation of a long "tendon sheath" from a vein and then its "bridging" by long tendon transplant are advocated by the author.

Adult↗
PubMed1977

Flexor tendon graft through intact superficialis tendon.

During a 14-year period, the flexor profundus mechanism was reconstructed with a free tendon graft in 25 fingers. The graft was passed either through or alongside the intact superficialis tendon. Five of the profundus tendons had ruptured, and 21 had been severed. One patient was under 10 years of age and only three were over 21 years of age. The result was considered to be satisfactory if the finger flexed to 3.2 cm or less of the mid-palm, had at lease 20 degrees of voluntary flexion of the distal joint, and lacked no more than 30 degrees of extension of the proximal interphalangeal joint. Additionally, to be satisfactory, the combined loss of extension of the proximal interphalangeal and distal interphalangeal joints ahd to be 40 degrees or less for an index or middle finger, and 60 degrees or less for a ring or little finger. Using these criteria, 20 patients were satisfactory, four were unsatisfactory, and one was unchanged. Selected patients who are between the ages of 10 and 21 years will benefit from this operation, providing that the finger had limber joints and minimal scar, and the superficialis tendon flexes the proximal interphalangeal joint at least 80 degrees.

Adolescent↗
PubMed1978

[Simultaneous bilateral avulsion of the quadriceps and Achilles tendons in 1 limb and of the patellar tendon in the other in a hyperparathyroid patient on chronic hemodialysis].

A case of simultaneous rupture of three tendons is reported in a patient who had suffered a bilateral nephrectomy six years earlier and was on chronic haemodialysis. The quadriceps tendon and the patellar tendon were repaired surgically. The rupture of the tendo Achillis was left untreated. Six days later a parathyroidectomy was performed; nine months later recovery was excellent. A review of the literature has been made. The role of hyperparathyroidism in the strength of the bone-tendon junction is discussed.

Achilles Tendon↗
PubMed1977

Results of surgical treatment of rupture of the Achilles tendon with use of the plantaris tendon.

During the period from January 1968 to June 1974, 21 patients were subjected to surgical repair of a ruptured Achilles tendon in the Eindhoven Deaconess Hospital. In 19 of them, the plantaris tendon was used as autogenous suturing material. Followup examination revealed 'excellent' or 'good' results in 19 cases. In one case, the result was classified as 'bad' because of a fistula still present at the time of the follow-up, although functionally the patient was not handicapped. In view of the above, we regard the technique with use of the plantaris tendon for reconstruction of the ruptured Achilles tendon as reliable and worthy of recommendation.

Achilles Tendon↗
PubMed1977

The vascularization and structure of the human digital tendon sheath as related to flexor tendon function. An angiographic and histological study.

The gliding surfaces of the flexor tendons and the tendon sheath are delicate structures of the complex digital flexor system. Beside the fibrous parts, the tendon sheath also exhibits membranous synovial components, which represent a dialysing membrane producing a plasma ultrafiltrate--the synovial fluid. In this study, interest was focused on the vascularization of the synovial sheath. By a microangiographic method it was demonstrated that this membrane is richly vascularized and that the vascular plexus is in continuity on the outside of the fibrous pulleys. The friction surfaces of the system--the inside of the pulleys and the surface of the flexor tendons--are devoid of vessels, and here a differentiation into chondrocyte-like cells is observed. It is suggested that these tissue areas, in analogy to joint cartilage, are nourished by diffusion from the synovial fluid, and that the flexor system can be regarded as a specialized joint, sliding longitudinally and exhibiting an extremely large range of motion.

Angiography↗
PubMed1978

[Suture of flexor tendons and substitution of flexor tendons in the "no-man's land" in children].

From 1969 to 1976, there were 14 primary, 10 secondary one-stage, and 14 secondary two-stage repairs of injured flexor tendons in the so-called 'no-man's-land'. Functional results of these three operational methods are compared in this paper and show that, in children, flexor tendons in uncomplicated wounds can be sutured primarily, even in the 'no-man's-land'. Flexor tendons in complicated wounds also may be primarily sutured, but not as effectively. In the latter case, according to the results under review, secondary two-stage repair, not secondary one-stage repair, must be applied.

Child↗
PubMed1979

[Functional results after reconstruction of severed flexor tendons by means of free flexor tendon grafts].

From 93 free flexor tendon grafts which have been performed in the years 1959--1976 because of flexor tendon laceration 85% could be reinvestigated after 6 years 10 months (average intervall). Three reinvestigation schemes for classification of the functional results were used (VERDAN/MICHON 1961, McKENZIE 1967, BUCK-GRAMCKO 1976). This had the advantage that marked differences in the classification schemes could be demonstrated. With 56% of very good and 22% of good results according to the classification of McKENZIE or 30% of very good and 26% of good results according to the classification of BUCK-GRAMCKO the results of free flexor tendon graft in the area of the thumb are significantly better than those in the fingers. In addition the relationship between the objective reinvestigation results of the operation and the subjective results appraised by the patients is demonstrated and shows that BUCK-GRAMCKO's classification comes closest to the patients evaluation.

Humans↗
PubMed1977

Deformity of the foot following anterior transfer of the posterior tibial tendon and lengthening of the Achilles tendon for spastic equinovarus.

Twenty-four children with spastic equinovarus deformity due to cerebral palsy were treated by anterior transfer of the posterior tibial tendon and Achilles tendon lengthening. In five patients, the operation was performed on both sides, making a total of 29 feet available for evaluation after an average follow-up of five years. Only 38 per cent of the results were graded "good" or "satisfactory." Sixty-two per cent were rated as "poor" because of valgus, calcaneus or equinus deformity severe enough to require re-operation. The post-operative deformity was generally evident one or more years after surgery, often progressive, and more disabling as well as more difficult to correct than the original condition. Although the percentage of acceptable results was considerably higher for hemiplegic patients than for others in the study, we conclude that in this group and in all other categories of spastic patients anterior transfer of the posterior tibial tendon should not be performed.

Achilles Tendon↗
PubMed1979

Phosphopeptides and gamma-carboxyglutamic acid-containing peptides in calcified turkey tendon: their absence in uncalcified tendon.

Uncalcified samples of turkey tendon obtained prior to calcification, and other samples from areas of tendon that never calcify, contain little or no O-phosphoserine [Ser(P)], O-phosphothreonine [Thr(P)] and gamma-carboxyglutamic acid (Gla). Significant amounts of all three of these Ca2+-binding amino acids, which are found in EDTA-extractable, non-collagenous proteins, are detected coincident with the onset of mineralization of a tendon and increase in concentration as mineralization proceeds.

1-Carboxyglutamic Acid↗
PubMed1979

Vascular anatomy of flexor tendons. I. Vincular system and blood supply of the profundus tendon in the digital sheath.

The detailed blood supply of the flexor tendons in the digital canal was studied in 35 fresh human hands by means of an India ink-latex vascular injection technique. The specimens were examined by first exposing the pulley system, followed by examination of the intact tendon which had been rendered transparent by immersion in a solution of tributyl and tricresyl phosphate. Five annular and three cruciform pulleys were shown. There were five types of long vincula to the profundus (VLP) and three types of long vincula to the superficialis (VLS). The vincular systems of index and little fingers were symmetrical. Occasionally, neither the VLP nor the VLS was found in either the long or the ring fingers. The vincula received blood supply from four transverse branches of the digital arteries. A volar avascular area of the profundus tendon was seen in the cleared cross-sections, and the cross-over zone of its intrinsic vessels was found to be at the midproximal phalanx.

Adolescent↗
PubMed1977

[Results of animal experiments on alloplastic tendon replacements using the Bader tendon prosthesis].

Based on our experimental results with the Bader tendon prosthesis, encouraging results for alloplastic tendon replacement were obtained. However a general recommendation for its clinical use cannot be given. Over a period of 4-6 weeks of immobilization healing of the artificial tendon with inflammation could be observed. In the biopsies we found the equivalent of connective tissue attachment between vital tissue and the alloplastic material. We could not clarify whether this connection would endure strain. The pronounced adhesions between the anstomosis and surrounding tissue make later function questionable.

Animals↗
PubMed1977

[Structure and configuration of human tendons. II. Development of tendon structure during ontogenesis].

In infants born in the 24th--30th weeks of the gravidity the praenatal development and the process of the organization of the tendinous structure have been examined by the authors. By means of photo- and polarization microscopic examinations it was found that the tendon of the flexor hand muscles (M. flexor carpi radialis, M. flexor digitorum comm.) shows mature tendinous structure earlier, than the tendons of the flexor muscles of the lower extremity (M. semitendinosus femoris, M. triceps surae). The tendons of the extensor muscles of the lower extremity (M. quadriceps femoris, M. tibialis ant.) are underdeveloped and inordinate in the foetal life--their structure develops only during the postnatal life.

Hand↗