Common Calcanean Tendon Research Articles

Effect of calcanean bone‐tunnel orientation for teno‐osseous repair in a canine common calcanean tendon avulsion model

ObjectiveTo determine the influence of bone‐tunnel anchoring technique on teno‐osseous repair of the common calcanean tendon (CCT) in dogs.Study designRandomized, ex vivo, biomechanical.PopulationForty‐two skeletally mature canine hindlimbs.MethodsCanine hindlimbs were dissected to produce a model simulating avulsion of the CCT and accessory tendons from the calcaneus. Hindlimbs were randomized to 1 of 3 anchoring techniques (n = 14/group): a single transverse tunnel (TT), vertical tunnels (VT), or modified bone tunnels (MT) for teno‐osseous repair in a 3‐loop‐pulley (3LP) pattern using 0 USP polypropylene. Yield, peak and failure loads, construct stiffness, loads to produce a 3 mm teno‐osseous gap, and failure modes were compared between groups.ResultsThe only difference detected consisted of TT constructs yielding at loads 25% higher than MT constructs (P = .027).ConclusionAlthough yield loads were lower in MT constructs than other groups, the bone‐tunnel anchoring techniques tested here did not appear to influence the biomechanical properties or gapping characteristics of teno‐osseous repairs in this canine CCT avulsion model.Clinical significanceAll drilling techniques and bone‐tunnel orientations tested in the study reported here offer viable options to reattach the CCT to the calcaneus. Surgeons should evaluate how bone‐tunnel orientation may affect placement of adjunctive fixation methods to stabilize the talocrural joint after primary CCT repair in dogs.

Suturing Achilles tendon and mesh simultaneously in augmented repair resists gap formation foremost: an experimental study

BackgroundThe common calcanean tendon (Achilles tendon) is the strongest and largest tendon and is one of the most commonly affected by spontaneous rupture. Different suture techniques are used to repair the tendon rupture. We compare the biomechanical properties of three different modalities of suture pattern in a mechanical experiment in rabbits with the purpose of evaluating the use of polypropylene mesh augmentation for Achilles tendon repair to find out the best surgical option.MethodsThe study tests single cycle to failure tensile strength characteristics of three different combinations of the 3-loop pulley (3-LP) suture technique with polypropylene mesh, and statistically compares the biomechanical properties as the maximum load at failure for all 3-LP repair.ResultsThe normal Achilles tendon—control group—failed at a mean load of 25.5 + 13.6; the experimental groups failed at a significantly lower load (p < 0.001), with the group of 3-LP suture with polypropylene mesh included in the suture being the more similar to controls, but all the groups exhibited statistically significant differences with regard to normal tendons (p < 0.001). The distance at which each group failed was also significant between control and experimental groups (p < 0.001) with the exception of the suture-only group and the group with the mesh over the suture (p = 0.15).ConclusionResults from this study suggest that incorporating the mesh within the suture provides benefit to the Achilles tendon repair by improving strength and resistance to pull through. However, further in vivo studies will be necessary to confirm these results and incorporate this technique to the routine human and veterinary surgery.

Anatomy and histology of the rabbit common calcanean tendon.

Despite the great progress in the field of tendon injuries and chronic tendinopathies in recent years, treatment of these conditions is still challenging. Research utilising animal models is crucial for further advancement in tendon research, with the rabbit being a commonly used species in this field. The objective of the present study was to comprehensively describe the macro- and microanatomy of the common calcanean tendon (tendo Achillei), together with associated structures. Eight female New Zealand rabbits were subjected to anatomical dissection and histologic analysis, revealing significant species-specific features. The soleus muscle presented a thin, spindle shape with no tendon of insertion and attached directly to the lateral gastrocnemius muscle. Therefore, it does not contribute to the formation of the common calcanean tendon. The calcaneal tendon of the semitendinosus muscle was identified as a strong tendinous band at the medial side of the medial gastrocnemius muscle and the superficial digital flexor muscle and tendon distally. The saphenous artery was accompanied by the medial saphenous vein and characteristic accessory medial saphenous vein. The complex structure of the paratendinous connective tissue is described, with the paratenon being contiguous with the epitenon of the individual tendons and epimysium of associated muscles. At the level of the calcaneal tuber, the retromalleolar fat pad was identified, adhering to the cranial surface of the conjoint gastrocnemius tendon. Histologic studies confirmed the presence of the subtendinous calcaneal bursa of superficial digital flexor tendon and the bursa of calcaneal tendon.

High-field magnetic resonance imaging of a normal anatomy of the rabbit commoncalcanean tendon.

The aim of the study was to evaluate the visualization of the rabbit common calcanean tendon and adjacent structures in the high-field magnetic resonance imaging (MRI) of 1.5 T field strength and to compare the results with those previously obtained for the low-field MRI (0.25 T). Eight New Zealand rabbits were used in the post-mortem study and the results indicate that the high-field MRI provides more detailed images only in transverse scans, where the outer outline of the tendon was visualized more accurately. Other analysed structures were imaged with a resolution comparable to the low-field MRI.

Clinical outcomes after common calcanean tendon rupture repair in dogs with a loop-suture tenorrhaphy technique and autogenous leukoreduced platelet-rich plasma.

To report outcomes of dogs with common calcanean tendon (CCT) ruptures treated with a platelet-rich plasma (PRP) enhanced nonabsorbable loop-suture technique. Retrospective case series. Client-owned dogs (n = 12). Medical records (2015-2017) of dogs with CCT ruptures repaired with a loop-suture tenorrhaphy and autogenous leukoreduced PRP were reviewed for signalment, history, type of injury, treatment, and clinical follow-up. Outcomes were assessed by functional anatomic measurements and Canine Orthopedic Index (COI) scores transformed to percentages, with 100% representing no problems. Twelve tendons were treated. Two dogs had major complications that were successfully revised. Follow-up was available in 11 of 12 dogs, with a median time of 12 months (range, 4-36), including COI for 11 dogs and anatomic measurements for 6 dogs. Anatomic measurements did not differ between treated and normal contralateral limbs (midthigh muscle mass P > .99, cranial tibial muscle mass P = .37, CCT diameter P = .08, tibiotarsal joint angle P > .99). Owners scored function (COI) as 96.4% (range, 93.3%-97.8%) and quality of life as 94.6% (range, 92%-98.2%). Loop-suture tenorrhaphy with application of autogenous leukoreduced PRP at the repair site resulted in restoration of functional anatomic measurements, high COI, and client satisfaction. Loop-suture tenorrhaphy with local application of autogenous leukoreduced PRP appears to offer an acceptable option to treat CCT injuries in dogs.

Evaluation of Carbon Fiber and Bovine Pericardium Implantation in Tenorrhaphy of Common Calcanean Tendon Rupture in Goats

Evaluation of Carbon Fiber and Bovine Pericardium Implantation in Tenorrhaphy of Common Calcanean Tendon Rupture in Goats

Evaluation of Carbon Fiber and Bovine Pericardium Implantation in Tenorrhaphy of Common Calcanean Tendon Rupture in Goats

Common calcanean tenorrhaphy was carried out on right hind limbs of 18 goats after removal of two cm segment from the tendon using linen (nylon) No. one and locking loop suture pattern alone (group I) or together with carbon fibers implantation (group II) or with bovine pericardial flap (group III). Surgery was done under epidural analgesia and the tibiotarsal joint of the operated limb was immobilized using cortical screw 3.5mm with application of full limb plaster cast. Post-operative healing of the tendon was monitored through clinical observation, ultra-sonographic, macroscopic and microscopic examinations at intervals (3, 9, 12 weeks) post operatively. With the use of bovine pericardial flap, the operated animals showed earlier improvement compared with the others. Bovine pericardial flap also induced early tendon healing and better organization of tendon fibers.

Ultrasonography and Low-field Magnetic Resonance Imaging of the Common Calcanean Tendon in a Rabbit Model for Tendinopathy Research: a Descriptive Study of Normal Anatomy.

In spite of recent advances in treatment protocols, tendinopathies continue to challenge orthopaedists and surgeons. Due to the complexity of both tendon injuries and the healing processes, animal models are essential for addressing fundamental questions in tendinopathy research. Diagnostic imaging could contribute to the evaluation of animal models, thus providing information, which could be translated to human tendinopathies. The objective of our study was to evaluate in situ appearance of the rabbit common calcanean tendon with ultrasonography and magnetic resonance imaging. Additionally, we sought to assess and compare the feasibility and usefulness of these techniques in a rabbit model while focusing on the imaging of the particular structures involved in calcaneal tendon disorders. Eight California rabbits were used for post-mortem sonographic and low-field magnetic resonance examination. Morphometry was performed on longitudinal sonograms and sagittal MRI scans. The craniocaudal diameter of the tendon was measured at four points of interest. Ultrasonography and magnetic resonance provided good visualisation of the tendon origin, the paratenon and the pre-Achilles fat pad. Magnetic resonance images presented in more detail the structure of the calcaneal insertion. Both modalities failed to visualise the individual components of the common calcanean tendon and the bursa of the calcaneal tendon. Statistical analysis of measurements obtained showed that the craniocaudal diameter of the common calcanean tendon in a rabbit increases significantly with a growing length from the calcaneal tuber. Both magnetic resonance and ultrasonography are feasible, and should be considered complementary, not alternative imaging techniques in a rabbit common calcanean tendon model.

Rabbit common calcanean tendon as an animal model: ultrasonographic anatomy and morphometry.

The aim of the present study was to evaluate usefulness of ultrasonography in assessment of rabbit common calcanean tendon, to describe its ultrasonographic anatomy and to perform morphometric analysis of this structure. Fifteen skeletally-matured New Zealand rabbits were used in the study. Ultrasonographic examinations of common calcanean tendon (CCT) were performed in longitudinal and transverse planes from caudal approach. Sagittal diameters of superficial digital flexor tendon and CCT were measured on longitudinal scans. Sagittal and transverse diameter, cross-sectional area and perimeter of the CCT were assessed on transverse scans. Statistical analysis was performed using StatisticaPL software (StatSoft®, Poland). In longitudinal images structure of CCT was clearly visualised. Its superficial hypoechoic part corresponds to superficial digital flexor tendon and deeper hyperechoic to gastrocnemius tendon. In transverse images cross-sectional area presented varied echotexture. Proximally, CCT was rounded in transverse section and became slightly wider and flattered distally. Statistical analysis showed no differences between results obtained from right and left hindlimb (p > 0.05). Measurements of sagittal diameter of CCT obtained in transverse planes were significantly higher than sagittal diameter measurements obtained in longitudinal plane in corresponding locations (p < 0.001). All performed measurements showed a growing trend with the increasing distance from the calcaneal tuber. Ultrasonography is suitable technique for assessment of CCT in a rabbit model and provides satisfactory images for morphometrical evaluation.

Assessment and treatment of diseases of the common calcanean tendon in dogs

This article reviews the pathogenesis of common calcanean tendon disease along with discussing clinical signs, grading, diagnostic imaging, external coaptation and surgical management. Immobilisation and aftercare are also described.

Ability to work and owner satisfaction following surgical repair of common calcanean tendon injuries in working dogs in New Zealand

AIM: To report the long-term outcome (return to work and owner satisfaction) following surgical treatment of common calcanean tendon (Achilles tendon) injuries in working dogs in New Zealand. METHODS: Ten New Zealand Huntaway or Heading dogs (working Collies) with complete or partial tears of the common calcanean tendon, were treated using locking-loop suturing and casting, with (7) or without (3), a calcaneo-tibial screw. All dogs were actively in work on sheep or cattle farms at the time of injury, and return to work was the desired outcome. Ability to work and owner satisfaction were investigated using a telephone questionnaire at a mean followup interval of 14.6 months. RESULTS: Overall, 7/10 dogs returned to full or substantial levels of work. Post-operative complications occurred in two dogs that did not return to full or substantial levels of work. Moderate persistent lameness (score 3 on a scale of 0–5) was present in 2/7 dogs that returned to full or substantial levels of work, equating to a 71% good-to-excellent functional outcome within this group. Seven owners felt the financial investment in opting for surgical repair was worthwhile. A screw and cast method of rigid immobilisation was thought to be superior to casting alone. CONCLUSIONS: Surgical treatment of common calcanean tendon injury in working dogs carries a good prognosis if an appropriate tenorrhaphy technique is used and rigid immobilisation is achieved for 6 weeks. Care must be taken to limit post-operative complications. CLINICAL RELEVANCE: This study justifies the use of surgical repair of such injuries in the working dog even when return to work is the only acceptable outcome.

REPARAÇÃO DO TENDÃO CALCÂNEO EM CÃES

O calcâneo é um dos tendões que sofrem traumatismos com maior freqüência em cães. Independente da causa, se a lesão não for tratada, pode evoluir comprometendo permanentemente sua função. Quando houver significativa perda de segmento, o tratamento pode tornar-se um dilema para o cirurgião. O processo de cicatrização requer manipulação cirúrgica atraumática para minimizar complicações como aderência, cicatriz exuberante ou não união. Nesta revisão, são abordados aspectos da reparação e uso de enxerto, especialmente no tendão calcâneo de cães.