Non-traumatic Tendon Research Articles

Spontaneous Rupture of the Knee Extensor Apparatus in a Chronic Renal Failure Patient: A Case Report

This summary discusses the rare occurrence of non-traumatic bilateral rupture of the knee extensor apparatus. This pathology involves spontaneous rupture of the quadriceps et patellar tendons in both knees without a history of recent trauma. Non-traumatic tendon ruptures, particularly bilateral cases, are uncommon and may be associated with underlying systemic or metabolic conditions such as diabetes or renal failure, which can contribute to tendon fragility. Management typically involves surgical repair of the ruptured tendons followed by intensive rehabilitation to restore knee function and strength. Close monitoring is essential to identify potential complications and optimize long-term outcomes.

EVALUATION OF TENDON PATHOLOGIES OF HAND AND FOOT BY SONOGRAPHY AND MRI - A COMPARATIVE STUDY

Background And Aims: Traumatic and non-traumatic tendon lesions are common at the hand and foot. For the diagnosis, therapy management, and long-term prognosis of tendon lesions, a detailed understanding of the complex anatomy and knowledge of typical injury patterns is crucial for both radiologists and clinicians. The aim of the study was to evaluate the various non-traumatic or traumatic pathologies of the tendon of the hand and foot by USG and MRI. Materials And Methods: In this cross-sectional study, 50 patients referred from various departments of Silchar Medical College and Hospital to the department of Radiology for pain and swelling of the hand and foot, as well as hand and foot injuries following trauma, were evaluated with USG and MRI. USG examination done by using SAMSUNG PRESTIGE RS-80A via high frequency probes. MRI evaluation was carried out on SIEMENS TIM AVANTO 1.5T Scanner. Results: In our study, the 20-30 year age group had the highest number of cases, accounting for 26% of all cases. The right side was mainly involved, constituting 68% of pathologies (34/50). Our study included 50 patients with an age range of 10 to 61 years, with 24 males (48%) and 26 females (52%)—a slight predominance of females over males in our study. Thus, the male-to-female ratio in our study was 1: 0.92. In our study, we found that the sensitivity, specicity, and accuracy of the USG assessment of tendon pathologies of the hand and foot were 94.3%, 98.2%, and 95.1%, respectively. MRI and US are imaging modalities that allow for anatomi Conclusion: c evaluation of tendons as well as the identication of tendon pathologies. Tenosynovitis can be diagnosed and treated quickly using high-quality sonographic exams.

Sonography of tendon pathology in the hand and wrist.

Traumatic and non-traumatic tendon lesions are common at the wrist and hand. For the diagnosis, therapy management, and long-term prognosis of tendon lesions, a detailed understanding of the complex anatomy and knowledge of typical injury patterns is crucial for both radiologists and clinicians. Improvements in high-resolution ultrasound are producing high-quality images of the superficial tendinous and peritendinous structures. Thus, ultrasound is a valuable first-choice tool for visualizing traumatic, inflammatory, and degenerative conditions of the extensor and flexor tendons, particularly with the advantage of possible dynamic examination. The additional use of duplex-Doppler and power Doppler ultrasound imaging is recommended for detection of tenosynovitis in overuse injury, inflammatory disease, infection, and after traumatic conditions. In traumatic tendon injuries, knowing the precise injury zone is important for treatment decision-making. In cases of tendon rupture, the radiologist should report the tear type (i.e., complete or partial-thickness) and assess the degree of tendon retraction and associated avulsion injury, including the degree of fragment displacement. The function of intact flexor tendons may be impaired by thickening, strain, or rupture of corresponding annular pulleys. This review describes in detail the typical ultrasound imaging features of common pathologies of hand and wrist tendons, including annular pulley lesions.

Reinsertion of distal biceps ruptures with a single anterior approach: analysis of 14 cases using tension-slide technique and interference screw.

Background:Several techniques of surgical repair of biceps tendon ruptures are described in literature. Cortical button repair have shown minimal loss of elbow flexion, supination and strength. In this retrospective study we report the outcomes in terms of elbow function and complications of tension-slide technique and interference screw.Matherials and methods:14 patients with complete distal biceps tendon rupture were included in the retrospective study and treated with the same tension-slide technique (BicepsButton® - Arthrex, Inc, Naples, Florida) evaluating the clinical and functional outcomes and the complication rate with a follow-up average of 18 months.Results:The flexion recovered compare to the healthy contralateral was 96% (min 115° - max 135°; average 128°), the extension was 97% (min: -2° - max 15°; average 4°), the supination was 90% (min 20° - max 90°; average 75°), the pronation was 95% (min 15° - max 90°; average 76°). The mean Disabilities of Arm, Shoulder and Hand (DASH) score was 8.1 ± 10.5 and Mayo Elbow Performance Score overall (MEPS) score was 97.6 ± 8.2. Two patients had LABCN paresthesia, one case, treated 2 months after injury, had posterior interosseus nerve palsy. One patient had heterotopic ossification at the radiological examination without consequences for the clinical performances. No case of non-traumatic tendon re-rupture and no case of ROM deficiency > 20%. In all case the cortical button remains well positioned and no case of osteolysis were reported.Conclusions:Distal biceps tendon repair with BicepsButton® system seems to be a safe, relyable and reproducible technique providing excellent clinical, functional and radiological outcomes. Comparing with other techniques the BicepsButton® system has the advantages of the single approach procedures, the reduction of surgical time and risk of heterotopic ossifications. (www.actabiomedica.it)

Clinical implications of the association between fluoroquinolones and tendon rupture: The magnitude of the effect with and without corticosteroids.

To estimate the relative, absolute and attributable risk of non-traumatic tendon rupture, at various sites, associated with use of fluoroquinolones, with and without concomitant corticosteroids. We conducted cohort and nested case-control studies among fluoroquinolone users in the United Kingdom Clinical Practice Research Datalink Gold. We estimated the excess risk (cohort analysis) and odds ratios (ORs) (case control) of tendon rupture by fluoroquinolone (current, recent and past use versus unexposed) and corticosteroid (current versus unexposed) use. Among 740926 patients with a fluoroquinolone prescription, 3957 cases of tendon rupture were identified. The excess risk due to current fluoroquinolone use was low: any tendon rupture 3.73 (95% confidence interval, CI, 2.08-5.39) per 10000 person-years (PY) and Achilles tendon rupture 2.91 (1.71-4.11) per 10000 PY. The excess risk of any tendon rupture was much higher for current concomitant fluoroquinolone and corticosteroid use versus corticosteroids alone: 21.2 (11.3-31.2) per 10000 PY. In the case-control, OR (95% CI) among current fluoroquinolone users versus unexposed patients was elevated: any tendon rupture 1.60 (1.22-2.09), Achilles tendon 2.71 (1.76-4.17) and bicep tendon 1.53 (0.85-2.73). The risk of any tendon rupture was higher among women (OR 2.27 [1.54-3.34]), patients aged 60+ (OR 2.42 [1.74-3.37]), and concomitant corticosteroid use (OR 6.64 [3.99-11.1]). Fluoroquinolones increase the risk of Achilles tendon rupture and, to a lesser extent, bicep tendon rupture, but the attributable risk is low. The risk is materially increased with concomitant use of corticosteroids.

Complete Achilles tendon rupture after local infiltration of corticosteroids in the treatment of deep retrocalcaneal bursitis.

Complete rupture of the Achilles tendon is relatively rare, but it is an injury of considerable clinical relevance. A common cause of non-traumatic tendon rupture is local corticosteroid infiltration. Corticosteroid injections may start a degenerative process resulting in partial rupture and subsequent complete rupture of the tendon due to a direct toxic effect, because corticosteroids inhibit production of extracellular matrix collagen and also because of poor local vascularization. This paper describes the case of a patient who presented with complete rupture of the Achilles tendon shortly after administration of local corticosteroid injections in the treatment of deep retrocalcaneal bursitis. This confirms that corticosteroid treatment which is not correctly and accurately administered may be a factor contributing to major injury. It demonstrates that the physician must take all necessary precautions when administering corticosteroid infiltration. It is particularly important that corticosteroid injection is performed under ultrasound guidance which permits visualization of the needle tip and therefore exact identification of the injection site.

Morphological and biomechanical studies on the common calcaneal tendon in dogs

Spontaneous rupture at the distal part of the gastrocnemius tendon (GT) is the second most common non-traumatic tendon injury in dogs, whereas the other strands of the common calcaneal tendon do not seem to have a predisposition to rupture. In order to discover why we investigated the common calcaneal tendons of 63 dogs microscopically and biomechanically. Both the gastrocnemius and superficial digital flexor tendon (SFT) had multiple low vascularized fibrocartilaginous areas within their distal course as opposed to regular parallel fibered areas in the proximal tendon areas. Biomechanical testing revealed that the distal sections in both tendons show a 50% and 70% lower tensile strength (F(max)/kg BW) than the proximal sections (p<0.01), respectively. On the contrary, tensile load (F(max)/mm(2)) only differed minimally between proximal and distal sections in both tendons (8% and 9%, respectively), whereas the tensile load of the distal gastrocnemius tendon is 35% lower than of the distal superficial flexor tendon (p<0.01). To the authors' knowledge, this is the first study to experimentally show that there are different biomechanical properties within the same tendon. The maximum load to failure is lower in the GT compared to the SFT within the same dog which explains its higher incidence of rupture in the field. The avascular fibrocartilaginous structure in the distal gastrocnemius tendon seems to play a further role in the pathogenesis of spontaneous rupture.

Ultrasound imaging of non-traumatic lesions of wrist and hand tendons

Non-traumatic tendon lesions are common and diverse at the wrist and hand. Improvements in high-resolution ultrasound (US) are producing increasingly high-quality images of superficial structures, thus expanding the indications for this imaging modality as a tool for investigating musculoskeletal disorders. The objective of this work is to provide an update on the uses and performance of US in non-traumatic tendon disorders of the wrist and hand. The relevant anatomy is reviewed, and the normal and abnormal ultrasound scan features are described in detail, with attention not only to the tendons but also to closely related structures such as synovial sheaths and bands. The contribution of US to the evaluation of each of the most common disorders is discussed.

Fluoroquinolone use and the change in incidence of tendon ruptures in the Netherlands.

Shortly after their introduction, fluoroquinolones were associated with reports of tendinitis and tendon rupture. During the past years, the number of reports has risen, possibly because of an increased use of fluoroquinolones. In this study, we describe the use of fluoroquinolones in the Dutch community and the possible public health effects of an association between fluoroquinolone use and tendon ruptures. In the PHARMO drug database we identified all prescriptions for fluoroquinolones in the period 1991-1996. The incidence of fluoroquinolone use was expressed as the number of fluoroquinolone episodes per 1000 inhabitants in one year, and extrapolated to the Dutch population after standardisation on age and gender. The annual incidence of non-traumatic tendon ruptures in the period 1991-1996 was calculated with data from the nation-wide hospital registry. The expected number of fluoroquinolone attributable tendon ruptures was calculated on the basis of the use of fluoroquinolones, the number of non-traumatic tendon ruptures and an assumed relative risk of 1.5-10. In 1996, approximately 251,000 patients experienced 318,000 episodes of fluoroquinolone use in the Netherlands. Females used more often fluoroquinolones than males, and the number of episodes increased exponentially with age. In the period 1991 through 1996, the absolute number of fluoroquinolone episodes increased by 160%, from 122,000 to 318,000. The absolute number of hospitalised tendon ruptures increased with 28%, from 768 in 1991 to 984 in 1996. Assuming a relative risk of 1.5 to 10.0, 1 to 15 tendon ruptures could be attributed to fluoroquinolone use in 1996. Only 7% of the observed increase could be attributed to the increased use of fluoroquinolones. If the total increase of hospitalised non-traumatic tendon ruptures would be attributable to the increase in fluoroquinolone use, this would mean that the risk of non traumatic tendon ruptures to fluoroquinolones would be more than 250 times the risk during non-use. In the Netherlands, a large simultaneous increase in non-traumatic tendon ruptures and fluoroquinolone use was observed in the period between 1991 to 1996. Assuming a relative risk of 1.5 to 10.0 for tendon ruptures during fluoroquinolone use, only 0.5 to 7% of the increase in non-traumatic tendon ruptures could be attributed to the increased fluoroquinolone use. The increase in the incidence of non-traumatic hospitalised tendon ruptures in the Netherlands is not likely to be explained solely by the increased use of fluoroquinolones.