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Sample records for biceps brachii tendon

  1. Long head of the biceps brachii tendon: unenhanced MRI versus direct MR arthrography

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    Tadros, Anthony S.; Huang, Brady K. [University of California, Department of Radiology, San Diego, CA (United States); Wymore, Lucas; Hoenecke, Heinz; Fronek, Jan [Scripps Clinic, Department of Orthopedic Surgery, La Jolla, CA (United States); Chang, Eric Y. [VA San Diego Healthcare System, Radiology Service, San Diego, CA (United States); University of California, Department of Radiology, San Diego, CA (United States)

    2015-09-15

    We sought to determine the diagnostic accuracy of unenhanced MRI and direct MR arthrography (MRA) for evaluation of the intra-articular long head of the biceps brachii tendon (LHBT) using arthroscopy as the gold standard. A retrospective review of patients who underwent shoulder MRI (n = 132) and MRA (n = 67) within 12 months prior to arthroscopy was performed. MR images were independently reviewed by two blinded musculoskeletal radiologists. Routinely recorded arthroscopic photos/videos were reviewed by an orthopedic surgeon. The LHBT was graded as normal, tendinosis, partial thickness tear less or greater than 50 %, and complete tear. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for tendinosis and tear detection were calculated. MRI correctly diagnosed fewer normal LHBTs compared to MRA (39-54 % versus 74-84 %, respectively; p < 0.005). MRI and MRA did not differ significantly in the diagnosis of tendinosis (18-36 % and 15-38 %, respectively; p > 0.05) and tears (75-83 % and 64-73 %, respectively; p > 0.05). For tendinosis, MRI versus MRA showed 18-36 % and 15-38 % sensitivity, 69-79 % and 83-91 % specificity, 22-28 % and 18-50 % PPV, 74-76 % and 80-86 % NPV, and 61-64 % and 70-81 % accuracy; respectively. For tears, MRI versus MRA showed 75-83 % and 64-73 % sensitivity, 73-75 % and 82-91 % specificity, 66-69 % and 41-62 % PPV, 82-87 % and 92-94 % NPV, and 74-78 % and 79-88 % accuracy; respectively. No significant difference was found between unenhanced MRI and direct MRA for the detection of tendinosis and tears of LHBTs. (orig.)

  2. Long head of the biceps brachii tendon: unenhanced MRI versus direct MR arthrography

    International Nuclear Information System (INIS)

    Tadros, Anthony S.; Huang, Brady K.; Wymore, Lucas; Hoenecke, Heinz; Fronek, Jan; Chang, Eric Y.

    2015-01-01

    We sought to determine the diagnostic accuracy of unenhanced MRI and direct MR arthrography (MRA) for evaluation of the intra-articular long head of the biceps brachii tendon (LHBT) using arthroscopy as the gold standard. A retrospective review of patients who underwent shoulder MRI (n = 132) and MRA (n = 67) within 12 months prior to arthroscopy was performed. MR images were independently reviewed by two blinded musculoskeletal radiologists. Routinely recorded arthroscopic photos/videos were reviewed by an orthopedic surgeon. The LHBT was graded as normal, tendinosis, partial thickness tear less or greater than 50 %, and complete tear. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for tendinosis and tear detection were calculated. MRI correctly diagnosed fewer normal LHBTs compared to MRA (39-54 % versus 74-84 %, respectively; p < 0.005). MRI and MRA did not differ significantly in the diagnosis of tendinosis (18-36 % and 15-38 %, respectively; p > 0.05) and tears (75-83 % and 64-73 %, respectively; p > 0.05). For tendinosis, MRI versus MRA showed 18-36 % and 15-38 % sensitivity, 69-79 % and 83-91 % specificity, 22-28 % and 18-50 % PPV, 74-76 % and 80-86 % NPV, and 61-64 % and 70-81 % accuracy; respectively. For tears, MRI versus MRA showed 75-83 % and 64-73 % sensitivity, 73-75 % and 82-91 % specificity, 66-69 % and 41-62 % PPV, 82-87 % and 92-94 % NPV, and 74-78 % and 79-88 % accuracy; respectively. No significant difference was found between unenhanced MRI and direct MRA for the detection of tendinosis and tears of LHBTs. (orig.)

  3. Distal biceps brachii tendon repair: a systematic review of patient outcome determination using modified Coleman methodology score criteria.

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    Nyland, John; Causey, Brandon; Wera, Jeff; Krupp, Ryan; Tate, David; Gupta, Amit

    2017-07-01

    This systematic literature review evaluated the methodological research design quality of studies that evaluated patient outcomes following distal biceps brachii tendon repair and developed evidence-based recommendations for future patient clinical outcomes research. Following the preferred reporting items for systematic reviews and meta-analyses criteria, and using "biceps brachii", "tendon", "repair" and "outcome assessment" search terms, the CINAHL, Academic Search Premier and MEDLINE databases were searched from January 1960-October 2015. The modified Coleman methodology score (MCMS) served as the primary outcome measure. Descriptive statistical analysis was performed for composite and component MCMS and for patient outcome assessment methodology use frequency. A total of 93 studies were evaluated. Overall MCMS was low (57.1 ± 14). Only 12 (12.9 %) had prospective cohort or randomized controlled trial designs. There was a moderate relationship between publication year and MCMS (r = 0.53, P research study methodological scores improved on average since 2008, generally low MCMS scores, retrospective designs, lack of eccentric elbow flexor or supinator strength testing, and poorly described surgical and rehabilitation descriptions remain commonplace. These findings decrease clinical study validity and generalizability. III.

  4. Rare muscular variations identified in a single cadaveric upper limb: a four-headed biceps brachii and muscular elevator of the latissimus dorsi tendon.

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    Moore, Colin W; Rice, Charles L

    2018-03-01

    Supernumerary or accessory heads of the biceps brachii are persistent muscular structures which can vary in number and location in the arm. Variations in other arm muscles, such as the coracobrachialis, can accompany supernumerary biceps brachii musculature in the upper limb. In this case report, we describe two rare muscular variants in a single adult male: a four-headed biceps brachii and the muscular elevator of the latissimus dorsi tendon. Additionally, accessory muscles of the brachialis and flexor digiti minimi brevis were identified in the upper limb. To our knowledge, the muscular variants identified here are considered rare, and their co-occurrence in a single upper limb has not been described previously. Also, a four-headed biceps brachii consisting of both the infero-medial and infero-lateral humeral heads has not been described previously to our knowledge. We postulate that the simultaneous appearance of several muscular variations may indicate a signaling disruption in embryogenesis during muscle patterning of the ventral limb bud. Knowledge of variant musculature in the arm is important for surgeons and clinicians as these muscles and their aberrant innervation patterns can complicate surgical procedures and may compress arteries and nerves producing upper limb pain and paresthesia. The clinical, functional and embryological implications of the upper limb variants are discussed.

  5. Measurement of the tendon of the biceps brachii after tenotomy: study on cadavers

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    Anderson Cunha Machado

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVE: To evaluate the influence of elbow and forearm range of motion on the distal excursion of the long head of the biceps (LHB. METHODS: The distal excursion of the LHB after tenotomy of the shoulders of eight cadavers was ascertained by measuring the distance between a point marked out on the LHB, 3 cm from the anterolateral border of the acromion, and its position at different degrees of elbow flexion, using a digital pachymeter. The measurements at elbow flexion of 135°, 90°, 45° and 0° were noted: these angles were established using a goniometer. The measurements were made with the forearm in neutral, supination and pronation positions. RESULTS: Differences between the mean measurements of the distal excursion of the LHB (total sample were observed between the degrees of elbow flexion ( p< 0.01. However, no statistical differences were observed between the different forearm positions, between the sides, genders and ages of the cadavers studied. CONCLUSION: Progressive extension of the elbow caused progressive distal excursion of the LHB, but without interference in the forearm position, gender, side or age of the cadavers studied.

  6. Repair of distal biceps brachii tendon assessed with 3-T magnetic resonance imaging and correlation with functional outcome

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    Alemann, Guillaume; Dietsch, Emmanuel [University Hospital of Besancon, Department of Musculoskeletal Imaging, Besancon (France); Gallinet, David; Obert, Laurent [University Hospital of Besancon, Department of Orthopedic Surgery, Besancon (France); Kastler, Bruno; Aubry, Sebastien [University Hospital of Besancon, Department of Musculoskeletal Imaging, Besancon (France); Franche Comte University, I4S Laboratory-EA 4268-IFR 133, Besancon (France)

    2015-05-01

    Objectives were to study the MRI appearance of the repaired distal biceps tendon (DBT), anatomically reinserted, and to search for a correlation between tendon measurements and functional results. Twenty-five patients (mean age, 49 ± 4.9 years old) who benefited from 3-T MRI follow-up of the elbow after surgical reinsertion of the DBT were retrospectively included and compared to a control group (n = 25; mean age, 48 ± 10 years old). MRI was performed during the month of clinical follow-up and on average 22 months after surgery. Delayed complications (secondary avulsion, new rupture), intratendinous osteoma, tendinous signal on T1-weighted (T1{sub w}) and fat-suppressed proton density-weighted (FS-PD{sub w}) images as well as DBT measurements were recorded. The maximum isometric elbow flexion strength (MEFS) and range of motion of the elbow were assessed. Repaired DBT demonstrated a heterogeneous but normally fibrillar structure. Its low T1{sub w} signal was less pronounced than that of normal tendons, and the FS-PD{sub W} image signal was similar to that of T1{sub w} images. MRI detected seven osteomas (Se = 53 % vs. plain radiography), one textiloma and one secondary avulsion. Repaired DBT measurements were significantly correlated with MEFS (dominant arm R2: 0.38; nondominant arm R2: 0.54); this correlation involved the insertion surface (Δ = -75.7 mm{sup 2}, p = 0.046), transverse diameter (Δ = -2.6 mm, p = 0.018), anteroposterior diameter at the level of the radial head (Δ = -3.9 mm, p = 0.001) and DBT cross-sectional area (Δ = -50.2 mm{sup 2}, p = 0.003). The quality of functional outcome after anatomical elbow rehabilitation of DBT correlates with the extent of tendinous hypertrophy during the healing process. (orig.)

  7. Repair of distal biceps brachii tendon assessed with 3-T magnetic resonance imaging and correlation with functional outcome

    International Nuclear Information System (INIS)

    Alemann, Guillaume; Dietsch, Emmanuel; Gallinet, David; Obert, Laurent; Kastler, Bruno; Aubry, Sebastien

    2015-01-01

    Objectives were to study the MRI appearance of the repaired distal biceps tendon (DBT), anatomically reinserted, and to search for a correlation between tendon measurements and functional results. Twenty-five patients (mean age, 49 ± 4.9 years old) who benefited from 3-T MRI follow-up of the elbow after surgical reinsertion of the DBT were retrospectively included and compared to a control group (n = 25; mean age, 48 ± 10 years old). MRI was performed during the month of clinical follow-up and on average 22 months after surgery. Delayed complications (secondary avulsion, new rupture), intratendinous osteoma, tendinous signal on T1-weighted (T1 w ) and fat-suppressed proton density-weighted (FS-PD w ) images as well as DBT measurements were recorded. The maximum isometric elbow flexion strength (MEFS) and range of motion of the elbow were assessed. Repaired DBT demonstrated a heterogeneous but normally fibrillar structure. Its low T1 w signal was less pronounced than that of normal tendons, and the FS-PD W image signal was similar to that of T1 w images. MRI detected seven osteomas (Se = 53 % vs. plain radiography), one textiloma and one secondary avulsion. Repaired DBT measurements were significantly correlated with MEFS (dominant arm R2: 0.38; nondominant arm R2: 0.54); this correlation involved the insertion surface (Δ = -75.7 mm 2 , p = 0.046), transverse diameter (Δ = -2.6 mm, p = 0.018), anteroposterior diameter at the level of the radial head (Δ = -3.9 mm, p = 0.001) and DBT cross-sectional area (Δ = -50.2 mm 2 , p = 0.003). The quality of functional outcome after anatomical elbow rehabilitation of DBT correlates with the extent of tendinous hypertrophy during the healing process. (orig.)

  8. Evaluation of the results from arthroscopic tenodesis of the long head of the biceps brachii on the tendon of the subscapularis muscle

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    Marcelo Baggio

    2016-04-01

    Full Text Available OBJECTIVES: The aim of this study was to evaluate the results from arthroscopic tenodesis of the long head of the biceps brachii (LHBB on the tendon of the subscapularis muscle, with regard to the presence of pain, subscapularis lesion, presence of Popeye's sign and patient satisfaction. METHODS: A prospective cohort study was conducted on 32 patients with LHBB lesions, through preoperative interviews and physical examinations, which were repeated six months after the operation. The main variables studied were the belly press, bear hug and lift-off tests, Popeye's sign, anterior pain and satisfaction. The data were entered into Epi Info 3.5.4 and SPSS 18.0. In order to investigate the variables of interest, the chi-square, Student t and Kruskal-Wallis tests were used. The confidence interval was 95% and p values less than 0.05 were taken to be statistically significant. RESULTS: 32 patients of median age 57.5 years were evaluated. Anterior pain was reported by one interviewee after the operation. The tests for evaluating subscapularis lesions did not show any damage to this musculature after the surgery. Popeye's sign was negative in all the patients. The patient satisfaction rate reached 90.6% of the interviewees. CONCLUSION: This study showed that the new surgical technique described here presented excellent performance, without any subscapularis lesion and without identifying Popeye's sign. Only 3.1% of the patients had complaints of residual pain. The high level of satisfaction among the patients after the surgery confirms the results presented.

  9. Arthrography of the biceps tendon

    International Nuclear Information System (INIS)

    Ahovuo, J.; Linden, H.; Hovi, I.; Paavolainen, P.; Bjoerkenheim, J.M.

    1988-01-01

    The purpose of this study was to analyse the factors having an influence on the arthrographic imaging of the biceps tendon. The study comprised 174 patients suffering from chronic shoulder pain. They underwent conventional shoulder arthrography with sodium meglumine metrizoate or metrizamide as a contrast medium. In the patients with a full-thickness tear of the rotator cuff, the biceps tendon sheath failed to fill with contrast medium more often than in those with an intact tendinous cuff. Metrizamide filled the biceps tendon sheath more readily than sodium meglumine metrizoate in patients with a full-thickness tear of the ortator cuff. The volume of the contrast medium injected had no influence on the imaging of the biceps tendon. (orig.)

  10. US Findings of Biceps Tendinitis: Cross Sectional Area Measurements of Long Head of Biceps Brachii

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    Shin, Jong Soo; Seo, Kyung Mook; Lee, Hwa Yeon; Song, In Sup [ChungAng University College of Medicine, Seoul (Korea, Republic of); Yoo, Seung Min [Bundang Cha Hospital, Bundang (Korea, Republic of)

    2009-12-15

    The purpose of this study was to describe typical sonographic findings in patients with biceps tendinitis. Seventy five patients who had been clinically diagnosed with biceps tendinitis were included. Of the 75, 37 were male, 38 were female, and their mean age was 56 {+-} 9.74. The patients complained of shoulder pain and ultrasonography was performed for bilateral shoulders in all patients. The cross sectional area of the biceps tendon was measured. The status of fluid collection around the biceps tendon and accompanying rotator cuff disease were also investigated. The cross sectional areas of the diseased biceps tendon were 0.18 {+-} 0.09 cm2 (range: 0.07-0.42), and the areas of the normal side was 0.11 {+-} 0.05 cm2 (0.03-0.24). The cross sectional area of the diseased biceps tendon was 0.075 {+-} 0.062 cm2 greater, on average, than the uninvolved site (p < 0.01). Thirty six patients(48%) had fluid collection around the inflamed biceps tendon, and 30 patients had accompanied rotator cuff disease. During US examination of the shoulder in patients complaining of shoulder pain, if the cross sectional area of the biceps tendon in the painful shoulder is asymmetrically and larger than the contralateral tendon, biceps tendonitis is suggested

  11. US Findings of Biceps Tendinitis: Cross Sectional Area Measurements of Long Head of Biceps Brachii

    International Nuclear Information System (INIS)

    Shin, Jong Soo; Seo, Kyung Mook; Lee, Hwa Yeon; Song, In Sup; Yoo, Seung Min

    2009-01-01

    The purpose of this study was to describe typical sonographic findings in patients with biceps tendinitis. Seventy five patients who had been clinically diagnosed with biceps tendinitis were included. Of the 75, 37 were male, 38 were female, and their mean age was 56 ± 9.74. The patients complained of shoulder pain and ultrasonography was performed for bilateral shoulders in all patients. The cross sectional area of the biceps tendon was measured. The status of fluid collection around the biceps tendon and accompanying rotator cuff disease were also investigated. The cross sectional areas of the diseased biceps tendon were 0.18 ± 0.09 cm2 (range: 0.07-0.42), and the areas of the normal side was 0.11 ± 0.05 cm2 (0.03-0.24). The cross sectional area of the diseased biceps tendon was 0.075 ± 0.062 cm2 greater, on average, than the uninvolved site (p < 0.01). Thirty six patients(48%) had fluid collection around the inflamed biceps tendon, and 30 patients had accompanied rotator cuff disease. During US examination of the shoulder in patients complaining of shoulder pain, if the cross sectional area of the biceps tendon in the painful shoulder is asymmetrically and larger than the contralateral tendon, biceps tendonitis is suggested

  12. Ultrasound demonstration of distal biceps tendon bifurcation: normal and abnormal findings

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    Tagliafico, Alberto; Capaccio, Enrico; Derchi, Lorenzo E.; Martinoli, Carlo; Michaud, Johan

    2010-01-01

    We demonstrate the US appearance of the distal biceps tendon bifurcation in normal cadavers and volunteers and in those affected by various disease processes. Three cadaveric specimens, 30 normal volunteers, and 75 patients were evaluated by means of US. Correlative MR imaging was obtained in normal volunteers and patients. In all cases US demonstrated the distal biceps tendon shaped by two separate tendons belonging to the short and long head of the biceps brachii muscle. Four patients had a complete rupture of the distal insertion of the biceps with retraction of the muscle belly. Four patients had partial tear of the distal biceps tendon with different US appearance. In two patients the partial tear involved the short head of the biceps brachii tendon, while in the other two patients, the long head was involved. Correlative MR imaging is also presented both in normal volunteers and patients. US changed the therapeutic management in the patients with partial tears involving the LH of the biceps. This is the first report in which ultrasound considers the distal biceps tendon bifurcation in detail. Isolated tears of one of these components can be identified by US. Knowledge of the distal biceps tendon bifurcation ultrasonographic anatomy and pathology has important diagnostic and therapeutic implications. (orig.)

  13. Biceps brachii muscle oxygenation in electrical muscle stimulation.

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    Muthalib, Makii; Jubeau, Marc; Millet, Guillaume Y; Maffiuletti, Nicola A; Ferrari, Marco; Nosaka, Kazunori

    2010-09-01

    The purpose of this study was to compare between electrical muscle stimulation (EMS) and maximal voluntary (VOL) isometric contractions of the elbow flexors for changes in biceps brachii muscle oxygenation (tissue oxygenation index, TOI) and haemodynamics (total haemoglobin volume, tHb = oxygenated-Hb + deoxygenated-Hb) determined by near-infrared spectroscopy (NIRS). The biceps brachii muscle of 10 healthy men (23-39 years) was electrically stimulated at high frequency (75 Hz) via surface electrodes to evoke 50 intermittent (4-s contraction, 15-s relaxation) isometric contractions at maximum tolerated current level (EMS session). The contralateral arm performed 50 intermittent (4-s contraction, 15-s relaxation) maximal voluntary isometric contractions (VOL session) in a counterbalanced order separated by 2-3 weeks. Results indicated that although the torque produced during EMS was approximately 50% of VOL (P<0.05), there was no significant difference in the changes in TOI amplitude or TOI slope between EMS and VOL over the 50 contractions. However, the TOI amplitude divided by peak torque was approximately 50% lower for EMS than VOL (P<0.05), which indicates EMS was less efficient than VOL. This seems likely because of the difference in the muscles involved in the force production between conditions. Mean decrease in tHb amplitude during the contraction phases was significantly (P<0.05) greater for EMS than VOL from the 10th contraction onwards, suggesting that the muscle blood volume was lower in EMS than VOL. It is concluded that local oxygen demand of the biceps brachii sampled by NIRS is similar between VOL and EMS.

  14. Calcific tendinitis of the long head of the biceps brachii distal to the glenohumeral joint: plain film radiographic findings.

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    Goldman, A B

    1989-11-01

    Calcific tendinitis is a painful condition related to deposition of hydroxyapatite crystals; it favors large joints. The shoulder, specifically the tendons of the rotator cuff and the insertion of the long head of the biceps on the superior glenoid rim, is a well-recognized location for this abnormality. The purpose of this article is to describe a second site of calcific tendinitis of the biceps, distal to the joint and corresponding to the junction of the tendon and muscle. Radiographs in 119 cases of calcific tendinitis of the shoulder, obtained between 1980 and 1988, were reviewed. Twenty had calcific tendinitis in the region of the tendon of the long head of the biceps (nine at the glenoid insertion and 11 adjacent to the humeral shaft). All 11 patients with calcific tendinitis at the more distal site had a small, homogeneous deposit adjacent to the proximal humeral shaft. The densities in these 11 cases followed the normal course of the tendon of the long head of the biceps and were therefore medial to the proximal humeral shaft on the internal rotation view, lateral to the proximal humeral shaft on the external rotation view, and anterior to the proximal humeral shaft on the axillary projection. The major differential diagnosis of calcific tendinitis of the tendon of the long head of the biceps is loose bodies trapped in the biceps tendon sheath. Although the position of the soft-tissue densities in these two entities is similar, loose bodies have an appearance of bone, and their source (degenerative arthritis or recurrent dislocations) is usually apparent. A site of calcific tendinitis distal to the glenohumeral joint that is detectable on plain films is reviewed. Accurate diagnosis depends on understanding the anatomy of the tendon of the long head of the biceps brachii. The clinical charts of the 11 patients also are summarized, with emphasis on the association between the roentgen finding and bicipital tendinitis and impingement syndrome.

  15. Prolonged passive static stretching-induced innervation zone shift in biceps brachii.

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    Ye, Xin; Beck, Travis W; Wages, Nathan P

    2015-05-01

    The purpose of this study was to examine the influence of a bout of repeated and prolonged passive static stretching on the innervation zone (IZ) location of the human biceps brachii muscle. Eleven men performed 12 sets of 100-s passive stretches on their biceps brachii. Before (Pre) and immediately after (Post) the stretching intervention, isometric strength was tested during the maximal voluntary contractions (MVCs) of the forearm flexors. The subjects also performed several separate isometric forearm flexion muscle actions at 30%, 50%, and 70% of their predetermined MVCs for examining the locations of the IZ at different contraction intensities. The IZ was identified through multi-channel surface electromyographic (EMG) recordings from a linear electrode array. The stretching intervention induced an average of 10% isometric strength loss for the forearm flexors (mean±SD: Pre-MVC vs. Post-MVC=332.12±59.40 N vs. 299.53±70.51 N; p<0.001). In addition, the average IZ shift was nearly 4.5 mm in average in the proximal direction. However, this shift was not specific to the contraction intensity. We believe that the IZ shift was caused by the elongation of the entire muscle-tendon unit in the proximal direction. Therefore, caution should be taken when using surface EMG technique to examine possible changes in the EMG variables after a stretching protocol, as these variables can be contaminated by the shift of the IZ.

  16. Evaluation of the effectiveness of kinesiotaping in reducing delayed onset muscle soreness of the biceps brachii

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    Boguszewski Dariusz

    2016-07-01

    Full Text Available biological regeneration in athletes. The aim of this study was to evaluate the effectiveness of the application of lymphatic kinesiotaping in reducing delayed onset muscle soreness of biceps brachii.

  17. TWITCH PARAMETERS IN TRANSVERSAL AND LONGITUDINAL BICEPS BRACHII RESPONSE

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    Boštjan Šimunič

    2010-01-01

    Full Text Available Assessment of the contractile properties of skeletal muscles is continuing to be an important issue and a difficult task methodologically. Longitudinal direction of skeletal muscle contraction blurs intrinsic muscle belly contractile properties with many factors. This study evaluates and explains contractile properties such as: delay time (Td, contraction time (Tc, half relaxation time (Tr and maximal amplitude (Dm extracted from twitch transversal response and compare them with torque response. In fifteen healthy males (age 23.7 ± 3.4 years isometric twitch transversal and torque responses were simultaneously recorded during graded electrically elicited contractions in the biceps brachii muscle. The amplitude of electrical stimulation was increased in 5 mA steps from a threshold up to a maximal response. The muscles’ belly transversal response was measured by a high precision mechanical displacement sensor while elbow joint torque was calculated from force readings. Results indicate a parabolic relation between the transversal displacement and the torque Dm. A significantly shorter Tc was found in transversal response without being correlated to torque Tc (r = -0.12; > 0.05. A significant correlation was found between torque Tc and the time occurrence of the second peak in the transversal response (r = 0.83; < 0.001. Electrical stimulation amplitude dependant variation of the Tc was notably different in transversal than in torque response. Td was similar at submaximal and maximal responses but larger in transversal at just above threshold contractions. Tr has a similar linear trend in both responses, however, the magnitude and the slope are much larger in the transversal response. We could conclude that different mechanisms affect longitudinal and transversal twitch skeletal muscle deformations. Contractile properties extracted from the transversal response enable alternative insights into skeletal muscle contraction mechanics.

  18. Complete rupture of the long head of the biceps tendon and the distal biceps tendon

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    Pieter J. Oberholzer

    2014-12-01

    Full Text Available The most common injury to the biceps muscle is rupture of the long head of the biceps tendon. A tear can occur proximally, distally or at the musculotendinous junction. Two cases are discussed, in both of which the patients felt a sudden sharp pain in the upper arm, at the shoulder and elbow respectively, and presented with a biceps muscle bump (Popeye deformity.

  19. Tenodesis of the long head of the biceps brachii for chronic bicipital tendinitis. Long-term results.

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    Becker, D A; Cofield, R H

    1989-03-01

    Fifty-four shoulders in fifty-one patients were followed for an average of thirteen years (range, two to twenty-three years) after surgical tenodesis of the long head of the biceps brachii for the treatment of chronic tendinitis. At an average of six months postoperatively, in all but three shoulders (forty-eight patients) some benefit was evident. However, after a longer follow-up, a satisfactory result was achieved in only twenty-eight shoulders (approximately 50 per cent). About one-third of the shoulders continued to be pain-free, and in eight shoulders (15 per cent) an additional operation was performed. Tenodesis of the long head of the biceps tendon, therefore, was not an effective treatment for tendinitis over the long term.

  20. EFFECT OF THE SHOULDER POSITION ON THE BICEPS BRACHII EMG IN DIFFERENT DUMBBELL CURLS

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    Taian M.M. Vieira

    2009-03-01

    Full Text Available Incline Dumbbell Curl (IDC and Dumbbell Preacher Curl (DPC are two variations of the standard Dumbbell Biceps Curl (DBC, generally applied to optimize biceps brachii contribution for elbow flexion by fixing shoulder at a specific angle. The aim of this study is to identify changes in the neuromuscular activity of biceps brachii long head for IDC, DPC and DBC exercises, by taking into account the changes in load moment arm and muscle length elicited by each dumbbell curl protocol. A single cycle (concentric-eccentric of DBC, IDC and DPC, was applied to 22 subjects using a submaximal load of 40% estimated from an isometric MVC test. The neuromuscular activity of biceps brachii long head was compared by further partitioning each contraction into three phases, according to individual elbow joint range of motion. Although all protocols elicited a considerable level of activation of the biceps brachii muscle (at least 50% of maximum RMS, the contribution of this muscle for elbow flexion/extension varied among exercises. The submaximal elbow flexion (concentric elicited neuro muscular activity up to 95% of the maximum RMS value during the final phase of IDC and DBC and 80% for DPC at the beginning of the movement. All exercises showed significant less muscle activity for the elbow extension (eccentric. The Incline Dumbbell Curl and the classical Dumbbell Biceps Curl resulted in similar patterns of biceps brachii activation for the whole range of motion, whereas Dumbbell Preacher Curl elicited high muscle activation only for a short range of elbow joint angle

  1. Rupture of the long tendon of the biceps brachi muscle. An unusual case related to use of the pneumatic tourniquet.

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    Logel, R J

    1976-01-01

    Tourniquet paralysis, arterial spasm, aneurysm formation, and the post-ischemic hand syndrome are all complications of penumatic tourniquet use in surgery of the extremities. This is a case report of another complication of tourniquet use, rupture of the long tendon of the biceps brachii muscle. Some underlying pathologic or degenerative condition usually exists before rupture can occur. Both rheumatoid arthritis and local corticosteroid injections into the long tendon of the biceps probably accounted for weakening the tensile strength of the tendon and subsequent rupture in the case described.

  2. Solitary cysticercosis of the biceps brachii in a vegetarian: a rare and unusual pseudotumor

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    Abdelwahab, Ibrahim Fikry [Department of Radiology, New York Methodist Hospital Affiliated with Weill Medical College of Cornell University, 506 Sixth Street, Brooklyn, NY 11215 (United States); Klein, Michael J. [Department of Pathology, Mount Sinai Medical Center, 1 Gustave Levy Place, New York, NY 10029 (United States); Hermann, George [Department of Radiology, Mount Sinai Medical Center, 1 Gustave Levy Place, New York, NY 10029 (United States); Abdul-Quader, Mohammed [Department of Radiology, Columbia Presbyterian Medical Center, 177 Fort Washington Avenue, New York, NY 10032 (United States)

    2003-07-01

    We report a 40-year-old man with cysticercosis presenting as a solitary tumor in the biceps brachii muscle. Physical examination revealed an intramuscular mass and magnetic resonance imaging suggested a cyst. The histologic diagnosis was a cysticercus. Such solitary presentation of muscular cysticercosis is extremely rare with only a handful of sporadic reports in the literature. (orig.)

  3. Solitary cysticercosis of the biceps brachii in a vegetarian: a rare and unusual pseudotumor

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    Abdelwahab, Ibrahim Fikry; Klein, Michael J.; Hermann, George; Abdul-Quader, Mohammed

    2003-01-01

    We report a 40-year-old man with cysticercosis presenting as a solitary tumor in the biceps brachii muscle. Physical examination revealed an intramuscular mass and magnetic resonance imaging suggested a cyst. The histologic diagnosis was a cysticercus. Such solitary presentation of muscular cysticercosis is extremely rare with only a handful of sporadic reports in the literature. (orig.)

  4. Biceps brachii can add to performance of tasks requiring supination in cerebral palsy patients

    NARCIS (Netherlands)

    de Bruin, M.; Veeger, H.E.J.; Kreulen, M.; Smeulders, M.J.C.; Bus, S.A.

    2013-01-01

    The aim of this study was to assess whether cerebral palsy patients can use biceps brachii for supination during movement tasks requiring supination and pronation. 3D upper extremity kinematic and EMG-data of 12 patients (mean age 13. y 8. mo. ±. 36. mo) were compared to 10 healthy age-matched

  5. Biceps brachii can add to performance of tasks requiring supination in cerebral palsy patients

    NARCIS (Netherlands)

    de Bruin, M.; Veeger, H. E. J.; Kreulen, M.; Smeulders, M. J. C.; Bus, S. A.

    2013-01-01

    The aim of this study was to assess whether cerebral palsy patients can use biceps brachii for supination during movement tasks requiring supination and pronation. 3D upper extremity kinematic and EMG-data of 12 patients (mean age 13 y 8 mo ± 36 mo) were compared to 10 healthy age-matched controls.

  6. Nonoperative treatment of distal biceps brachii musculotendinous partial rupture: a report of two cases.

    Science.gov (United States)

    López-Zabala, I; Fernández-Valencia, J A

    2013-01-01

    Musculotendinous ruptures of the distal biceps brachii are extremely rare injuries whose clinical presentation is similar to distal biceps avulsion. We describe two cases of patients who suffered a distal biceps brachii musculotendinous partial rupture. The first patient was playing soccer as goalkeeper and experienced sudden pain while throwing the ball overhead with his left arm. The second patient experienced sudden pain while weightlifting with his right arm. The mechanism of injury was the same in the two cases, as both involved glenohumeral elevation with elbow extension and forearm supination. Neither of these two patients underwent surgical repair or rehabilitation, and both had perfect scores of 100 on the Mayo Clinic Performance Index for the Elbow at one-year followup.

  7. An unusual metastasis of lung adenocarcinoma: Biceps brachii muscle

    Directory of Open Access Journals (Sweden)

    Muzaffer Sariaydin

    2016-01-01

    Full Text Available Skeletal muscle metastasis of nonsmall cell lung carcinoma (NSCLC is a rare occurrence, and the most effective treatment modality is currently unknown. In this case presentation, we report a patient with NSCLC who underwent palliative radiotherapy for biceps muscle metastasis of NSLCS. Our case was a 49-year-old woman who had lung adenocarcinoma with biceps muscle metastasis. She had been followed up for 2 years due to Stage IV lung adenocarcinoma from whom a biopsy was taken from a painful mass in right arm that was found to be compatible with metastasis of lung adenocarcinoma. She had palliative radiotherapy for her painful mass and systemic chemotherapy was planned. After palliative radiotherapy, the pain originating from the metastatic mass in right biceps muscle alleviated. Palliative radiotherapy can be a valuable treatment option for cases with skeletal muscle metastasis.

  8. Diagnostic value of US, CT arthrography, and 0.5-T MR imaging of lesions of the biceps tendon

    International Nuclear Information System (INIS)

    Saez, F.; Elizagaray, E.; Pena, J.M.; Ferrero, A.; Azkuna, I.; Larrea, L.

    1990-01-01

    This paper evaluates the role of US, CT-arthrography, and MR imaging in lesions in the tendon of the long head of the biceps brachii and bicipital groove. One hundred fifty-four patients with painful shoulder were prospectively studied by means of US and axial CT-arthrography, and 45 of them were also examined with 0.5-T MR imaging. Fifty-three (34.4%) patients showed biceps tendon or bicipital groove abnormalities; including 34 bicipital groove bone spurs, 31 cases of tendinitis, eight intraarticular ruptures, four subluxations, and eight medial dislocations

  9. Absence of musculocutaneous nerve and accessory head of biceps brachii: a case report

    Directory of Open Access Journals (Sweden)

    Arora L

    2005-01-01

    Full Text Available During dissection of a 55-year-old female cadaver, we observed that three nerve roots contributed to the formation of Median nerve in her right upper limb. Along with this variation, absence of Musculocutaneous nerve was noticed. The muscles of front of arm i.e. Biceps Brachii, Brachialis and Coracobrachialis received their nerve supply from Median nerve. The Lateral cutaneous nerve of forearm was derived from Median nerve. Also an accessory head of Biceps Brachii muscle was present in the right arm of the same cadaver. It is extremely important to be aware of these variations while planning a surgery in the region of axilla or arm as these nerves are more liable to be injured during operations.

  10. Autoradiographic visualization of extrajunctional acetylcholine receptors in whole human biceps brachii muscle

    International Nuclear Information System (INIS)

    Askmark, H.; Gillberg, P.-G.; Aquilonius, S.-M.

    1985-01-01

    The morphological distribution of acetylcholine receptors in the whole biceps brachii muscle from a patient with amyotrophic lateral sclerosis (ALS) and from a control patient was studied by in vitro autoradiography with 3 H-alpha-bungarotoxin alphaBtx). In ALS, 3 H-alpha-Btx binding occurred over the entire muscle, while in the control case the binding was restricted to the motor end-plate region. (author)

  11. Disorders of the long head of the biceps tendon.

    Science.gov (United States)

    Sethi, N; Wright, R; Yamaguchi, K

    1999-01-01

    Without a clear understanding of the functional role of the biceps tendon, treatment recommendations have been a subject of controversy. An objective review of the available information would suggest that some humeral head stability may be imparted through the tendon. However, the magnitude of this function is likely to be small and possibly insignificant. In contrast, the symptomatic significance of the long head of the biceps is less controversial, and it has become increasingly recognized as an important source of persistent shoulder pain when not specifically addressed. When present, persistent pain from the long head of the biceps is likely to have more negative functional consequences than loss of the tendon itself. Given these concerns, evaluation and treatment of patients with long head of the biceps disorders should be individualized, based on the likelihood that biceps-related pain will resolve. Although not universally accepted, we recommend tenodesis of the long head of the biceps in those cases in which there are either chronic inflammatory or structural changes, which would make it unlikely that the pain would resolve. These clinical situations in which tenodesis would be required include greater than 25% partial thickness tearing of the tendon, chronic atrophic changes of the tendon, any luxation of the biceps tendon from the bicipital groove, any disruption of associated bony or ligamentous anatomy of the bicipital groove that would make autotenodesis likely (i.e., 4-part fracture), and any significant reduction or atrophy of the size of the tendon that is more than 25% of the normal tendon width. Relative indications for biceps tenodesis also include biceps disease in the context of a failed decompression for rotator cuff tendinitis. It should be emphasized that routine tenodesis is not recommended during operative treatment for the rotator cuff. Rather, we avoid tenodesis whenever it is believed that inflammatory changes to the biceps tendon are

  12. Analysis of the Biceps Brachii Muscle by Varying the Arm Movement Level and Load Resistance Band

    Directory of Open Access Journals (Sweden)

    Nuradebah Burhan

    2017-01-01

    Full Text Available Biceps brachii muscle illness is one of the common physical disabilities that requires rehabilitation exercises in order to build up the strength of the muscle after surgery. It is also important to monitor the condition of the muscle during the rehabilitation exercise through electromyography (EMG signals. The purpose of this study was to analyse and investigate the selection of the best mother wavelet (MWT function and depth of the decomposition level in the wavelet denoising EMG signals through the discrete wavelet transform (DWT method at each decomposition level. In this experimental work, six healthy subjects comprised of males and females (26 ± 3.0 years and BMI of 22 ± 2.0 were selected as a reference for persons with the illness. The experiment was conducted for three sets of resistance band loads, namely, 5 kg, 9 kg, and 16 kg, as a force during the biceps brachii muscle contraction. Each subject was required to perform three levels of the arm angle positions (30°, 90°, and 150° for each set of resistance band load. The experimental results showed that the Daubechies5 (db5 was the most appropriate DWT method together with a 6-level decomposition with a soft heursure threshold for the biceps brachii EMG signal analysis.

  13. Analysis of the Biceps Brachii Muscle by Varying the Arm Movement Level and Load Resistance Band

    Science.gov (United States)

    Abdullah, Shahrum Shah; Jali, Mohd Hafiz

    2017-01-01

    Biceps brachii muscle illness is one of the common physical disabilities that requires rehabilitation exercises in order to build up the strength of the muscle after surgery. It is also important to monitor the condition of the muscle during the rehabilitation exercise through electromyography (EMG) signals. The purpose of this study was to analyse and investigate the selection of the best mother wavelet (MWT) function and depth of the decomposition level in the wavelet denoising EMG signals through the discrete wavelet transform (DWT) method at each decomposition level. In this experimental work, six healthy subjects comprised of males and females (26 ± 3.0 years and BMI of 22 ± 2.0) were selected as a reference for persons with the illness. The experiment was conducted for three sets of resistance band loads, namely, 5 kg, 9 kg, and 16 kg, as a force during the biceps brachii muscle contraction. Each subject was required to perform three levels of the arm angle positions (30°, 90°, and 150°) for each set of resistance band load. The experimental results showed that the Daubechies5 (db5) was the most appropriate DWT method together with a 6-level decomposition with a soft heursure threshold for the biceps brachii EMG signal analysis. PMID:29138687

  14. Extraarticular variants of the long head of the biceps brachii: a reminder of embryology.

    Science.gov (United States)

    Audenaert, Emmanuel A; Barbaix, Erik J; Van Hoonacker, Petrus; Berghs, Bart M

    2008-01-01

    Developmental anomalies of the long head of the biceps tendon are rare and have been described in the literature mainly dealing with anatomy and embryology. Because most basic embryologic research on this topic was conducted before 1966, a literature search was performed from archived anatomy textbooks and manuscript references. These data were compared with the scarce case descriptions of developmental anomalies of the long head of the biceps tendon. An additional case illustration from our own experience was provided. From the literature, it appears that during the embryologic phase of development, a staged migration of the long head of the biceps tendon occurs from a position between the fibrous capsule and synovial layer to an intraarticular position. Recent anatomic and arthroscopic case reports have shown that interruption of this migration can occur in any of these stages. Given the recent increase in arthroscopic shoulder surgery, anomalies of the long head of the biceps tendon will be encountered more frequently. Knowledge of their existence and origin can help in evaluating unexpected anatomic variations or the absence of the biceps tendon in preoperative medical imaging or during an arthroscopic procedure.

  15. Biceps brachii long head overactivity associated with elbow flexion contracture in brachial plexus birth palsy.

    Science.gov (United States)

    Sheffler, Lindsey C; Lattanza, Lisa; Sison-Williamson, Mitell; James, Michelle A

    2012-02-15

    The etiology of elbow flexion contracture in children with brachial plexus birth palsy remains unclear. We hypothesized that the long head of the biceps brachii muscle assists with shoulder stabilization in children with brachial plexus birth palsy and that overactivity of the long head during elbow and shoulder activity is associated with an elbow flexion contracture. Twenty-one patients with brachial plexus birth palsy-associated elbow flexion contracture underwent testing with surface electromyography. Twelve patients underwent repeat testing with fine-wire electromyography. Surface electrodes were placed on the muscle belly, and fine-wire electrodes were inserted bilaterally into the long and short heads of the biceps brachii. Patients were asked to perform four upper extremity tasks: elbow flexion-extension, hand to head, high reach, and overhead ball throw. The mean duration of muscle activity in the affected limb was compared with that in the contralateral, unaffected limb, which was used as a control. Three-dimensional motion analysis, surface dynamometry, and validated function measures were used to evaluate upper extremity kinematics, elbow flexor-extensor muscle imbalance, and function. The mean activity duration of the long head of the biceps brachii muscle was significantly higher in the affected limb as compared with the contralateral, unaffected limb during hand-to-head tasks (p = 0.02) and high-reach tasks (p = 0.03). No significant differences in mean activity duration were observed for the short head of the biceps brachii muscle between the affected and unaffected limbs. Isometric strength of elbow flexion was not significantly higher than that of elbow extension in the affected limb (p = 0.11). Overactivity of the long head of the biceps brachii muscle is associated with and may contribute to the development of elbow flexion contracture in children with brachial plexus birth palsy. Elbow flexion contracture may not be associated with an elbow

  16. Supernumerary head of biceps brachii and branching pattern of the musculocutaneous nerve

    Directory of Open Access Journals (Sweden)

    Mohan Basavaraj Angadi

    2016-01-01

    Full Text Available During routine dissection by medical undergraduates, third head of the biceps brachii muscle was found on the left side of a 75-year-old male cadaver in a total of 48 arms dissected in Department of Anatomy Armed Forces Medical College, Pune. Biceps brachii is a muscle of arm having two heads hence the name. The most frequent variation of the muscle is in the number of heads with a prevalence range of 9.1-22.9%. The origin of the supernumerary head in this case was from the humerus, between the insertion of the coracobrachialis and the upper part of the origin of the brachialis, and also from the medial intermuscular septum. The supernumerary head joined the common belly. It was supplied by the musculocutaneous nerve which after emerging from brachialis pierced it near the middle and terminated by finally supplying the biceps belly. In our study, 2.08% (1 of 48 of male cadavers were found to have the third head of biceps. The incidence of this variation can be as much as 10% as, shown in previous studies on Indian population, as reported in standard textbooks of anatomy.

  17. REHABILITATION OF A SURGICALLY REPAIRED RUPTURE OF THE DISTAL BICEPS TENDON IN AN ACTIVE MIDDLE AGED MALE: A CASE REPORT

    Science.gov (United States)

    Sayers, Stephen P.; LaFontaine, Tom; Scheussler, Scott

    2012-01-01

    Background: Complete rupture of the distal tendon of the biceps brachii is relatively rare and there is little information to guide therapists in rehabilitation after this injury. The purposes of this case report are to review the rehabilitation concepts used for treating such an injury, and discuss how to modify exercises during rehabilitation based on patient progression while adhering to physician recommended guidelines and standard treatment protocols. Case Presentation: The patient was an active 38‐year old male experienced in weight‐training. He presented with a surgically repaired right distal biceps tendon following an accident on a trampoline adapted with a bungee suspension harness. The intervention focused on restoring range of motion and strengthening of the supporting muscles of the upper extremity without placing undue stress on the biceps brachii. Outcomes: The patient was able to progress from a moderate restriction in ROM to full AROM two weeks ahead of the physician's post‐operative orders and initiate a re‐strengthening protocol by the eighth week of rehabilitation. At the eighth post‐operative week the patient reported no deficits in functional abilities throughout his normal daily activities with his affected upper extremity. Discussion: The results of this case report strengthen current knowledge regarding physical therapy treatment for a distal biceps tendon repair while at the same time providing new insights for future protocol considerations in active individuals. Most current protocols do not advocate aggressive stretching, AROM, or strengthening of a surgically repaired biceps tendon early in the rehabilitation process due to the fear of a re‐rupture. In the opinion of the authors, if full AROM can be achieved before the 6th week of rehabilitation, initiating a slow transition into light strengthening of the biceps brachii may be possible. Level of evidence: 4‐Single Case report PMID:23316429

  18. Surgical treatment of distal biceps tendon rupture: a case report

    Directory of Open Access Journals (Sweden)

    Cristina N. Cozma

    2017-11-01

    Full Text Available Objectives. Distal biceps tendon rupture affects the functional upperextremity movement, impairing supination and flexion strength. According to age, profession and additional risks treatment might be nonoperative or surgical. Methods. We describe the case of a 43 years old male patient who sustained an injury to his right distal biceps and was diagnosed with acute right distal biceps rupture. Surgical treatment was decided and biceps tendon was reinserted to the radius tuberosity using a combination of a cortical button fixation associated with an interference screw. Results. Postoperative functional result was favorable with no complications and with no movement limitation after one month. Conclusions. When possible, distal biceps tendon repair should be realized surgically because this permits restoring of the muscle strength to near normal levels with no loss of motion. Nerve complications are common; therefore the surgery should be realized by experienced upper extremity surgeons.

  19. Myosin heavy chain composition of single fibres from m. biceps brachii of male body builders

    DEFF Research Database (Denmark)

    Klitgaard, H; Zhou, M.-Y.; Richter, Erik

    1990-01-01

    The myosin heavy chain (MHC) composition of single fibres from m. biceps brachii of young sedentary men (28 +/- 0.4 years, mean +/- SE, n = 4) and male body builders (25 +/- 2.0 years, n = 4) was analysed with a sensitive one-dimensional electrophoretic technique. Compared with sedentary men...... expression of MHC isoforms within histochemical type II fibres of human skeletal muscle with body building. Furthermore, in human skeletal muscle differences in expression of MHC isoforms may not always be reflected in the traditional histochemical classification of types I, IIa, IIb and IIc fibres....

  20. Histochemistry profile of the biceps brachii muscle fibres of capuchin monkeys (Cebus apella, Linnaeus, 1758

    Directory of Open Access Journals (Sweden)

    CHF Bortoluci

    Full Text Available A general analysis of the behaviour of “Cebus” shows that when this primate moves position to feed or perform another activity, it presents different ways of locomotion. This information shows that the brachial biceps muscle of this animal is frequently used in their locomotion activities, but it should also be remembered that this muscle is also used for other development activities like hiding, searching for objects, searching out in the woods, and digging in the soil. Considering the above, it was decided to research the histoenzimologic characteristics of the brachial biceps muscle to observe whether it is better adpted to postural or phasic function. To that end, samples were taken from the superficial and deep regions, the inserts proximal (medial and lateral and distal brachial biceps six capuchin monkeys male and adult, which were subjected to the reactions of m-ATPase, NADH-Tr. Based on the results of these reactions fibres were classified as in Fast Twitch Glycolitic (FG, Fast Twitch Oxidative Glycolitic (FOG and Slow Twitc (SO. In general, the results, considering the muscle as a whole, show a trend of frequency FOG> FG> SO. The data on the frequency were studied on three superficial regions FOG=FG>SO; the deep regions of the inserts proximal FOG=FG=SO and inserting the distal FOG>FG=SO. In conclusion, the biceps brachii of the capuchin monkey is well adapted for both postural and phasic activities.

  1. Histochemistry profile of the biceps brachii muscle fibres of capuchin monkeys (Cebus apella, Linnaeus, 1758).

    Science.gov (United States)

    Bortoluci, C H F; Simionato, L H; Rosa Junior, G M; Oliveira, J A; Lauris, J R P; Moraes, L H R; Rodrigues, A C; Andreo, J C

    2014-08-01

    A general analysis of the behaviour of "Cebus" shows that when this primate moves position to feed or perform another activity, it presents different ways of locomotion. This information shows that the brachial biceps muscle of this animal is frequently used in their locomotion activities, but it should also be remembered that this muscle is also used for other development activities like hiding, searching for objects, searching out in the woods, and digging in the soil. Considering the above, it was decided to research the histoenzimologic characteristics of the brachial biceps muscle to observe whether it is better adpted to postural or phasic function. To that end, samples were taken from the superficial and deep regions, the inserts proximal (medial and lateral) and distal brachial biceps six capuchin monkeys male and adult, which were subjected to the reactions of m-ATPase, NADH-Tr. Based on the results of these reactions fibres were classified as in Fast Twitch Glycolitic (FG), Fast Twitch Oxidative Glycolitic (FOG) and Slow Twitc (SO). In general, the results, considering the muscle as a whole, show a trend of frequency FOG> FG> SO. The data on the frequency were studied on three superficial regions FOG=FG>SO; the deep regions of the inserts proximal FOG=FG=SO and inserting the distal FOG>FG=SO. In conclusion, the biceps brachii of the capuchin monkey is well adapted for both postural and phasic activities.

  2. Surgical treatment of partial biceps tendon ruptures at the elbow.

    Science.gov (United States)

    Dellaero, David T; Mallon, William J

    2006-01-01

    We present the treatment and results of a consecutive series of 7 patients (mean age, 42.7 years) with partial ruptures of the distal biceps tendon. All injuries occurred as the result of either heavy labor or weightlifting. Diagnosis in all cases was made with magnetic resonance imaging. After failure of conservative therapy, the patients were treated with repair of the distal biceps tendon. Mean follow-up was 30.6 months (range, 25-39 months). Results were uniformly good, with all patients satisfied with the outcome. All patients maintained their preoperative range of motion, with none reporting significant postoperative pain. The only complication was transient neurapraxias of the lateral antebrachial cutaneous nerve in 2 cases. We conclude that patients presenting with chronic pain in the cubital fossa should be evaluated for possible partial biceps tendon tear. If the diagnosis of partial tendon tear is made, surgical repair is a safe and effective method of treatment.

  3. Motor unit properties of biceps brachii in chronic stroke patients assessed with high-density surface EMG

    NARCIS (Netherlands)

    Kallenberg, L.A.C.; Hermens, Hermanus J.

    2009-01-01

    The aim of this study was to investigate motor unit (MU) characteristics of the biceps brachii in post-stroke patients, using high-density surface electromyography (sEMG). Eighteen chronic hemiparetic stroke patients took part. The Fugl-Meyer score for the upper extremity was assessed. Subjects

  4. Relation between location of a motor unit in the human biceps brachii and its critical firing levels for different tasks

    NARCIS (Netherlands)

    Gielen, C.C.A.M.; Haar Romeny, B.M. ter; Gon, J.J.D. van der

    1984-01-01

    Critical firing levels (CFLs) of single motor units (MUs) in the long head of the human biceps brachii muscle were determined in combinations of two isometric tasks: flexion of the elbow, supination of the lower arm, and exorotation of the humerus, as well as the corresponding antagonistic tasks.

  5. Tendinopathy of the long head of the biceps tendon: histopathologic analysis of the extra-articular biceps tendon and tenosynovium

    Directory of Open Access Journals (Sweden)

    Streit JJ

    2015-03-01

    Full Text Available Jonathan J Streit,1 Yousef Shishani,1 Mark Rodgers,2 Reuben Gobezie1 1The Cleveland Shoulder Institute, 2Department of Pathology, University Hospitals of Cleveland, Cleveland, OH, USA Background: Bicipital tendinitis is a common cause of anterior shoulder pain, but there is no evidence that acute inflammation of the extra-articular long head of the biceps (LHB tendon is the root cause of this condition. We evaluated the histologic findings of the extra-articular portion of the LHB tendon and synovial sheath in order to compare those findings to known histologic changes seen in other tendinopathies. Methods: Twenty-six consecutive patients (mean age 45.4±13.7 years underwent an open subpectoral biceps tenodesis for anterior shoulder pain localized to the bicipital groove. Excised tendons were sent for histologic analysis. Specimens were graded using a semiquantitative scoring system to evaluate tenocyte morphology, the presence of ground substance, collagen bundle characteristics, and vascular changes. Results: Chronic inflammation was noted in only two of 26 specimens, and no specimen demonstrated acute inflammation. Tenocyte enlargement and proliferation, characterized by increased roundness and size of the cell and nucleus with proteoglycan matrix expansion and myxoid degenerative changes, was found in all 26 specimens. Abundant ground substance, collagen bundle changes, and increased vascularization were visualized in all samples. Conclusion: Anterior shoulder pain attributed to the biceps tendon does not appear to be due to an inflammatory process in most cases. The histologic findings of the extra-articular portion of the LHB tendon and synovial sheath are similar to the pathologic findings in de Quervain tenosynovitis at the wrist, and may be due to a chronic degenerative process similar to this and other tendinopathies of the body. Keywords: biceps tendinitis, biceps tendinopathy, tenosynovium, anterior shoulder pain, long head biceps

  6. A study of biceps brachii muscle: Anatomical considerations and clinical implications

    Directory of Open Access Journals (Sweden)

    Vaishaly Kishore Bharambe

    2015-01-01

    Full Text Available Context: Biceps brachii muscle (BBm is a very variable muscle, the variations being associated with a variety of clinical conditions. This study delves on anatomical variations in this muscle, possible phylogenic causes for their frequency and their clinical importance. Aims: The aim was to study anatomy of bicep brachii muscle, its variations and their clinical importance. Subjects and Methods: A total of 60 upper limbs preserved in 10% formalin were dissected meticulously to study anatomical details of the BBm. Results: The incidence of variation in anatomy of BBm was 15%, with incidence being 11.6% and 3.3% among male and female cadavers studied, respectively. Variation was unilateral in 10% and bilateral in 3.3%. The incidence of third head was 13.3% out of which 3.3% took origin from the capsule of the shoulder joint, 8.3% from humerus, and 1.6% from brachialis muscle. Incidence of extra bellies of insertion was found to be 1.6%. A 3.3% incidence was observed in the nerve supply. Conclusions: Variations in BBm are a reflection of its late development in human phylum. The extra bellies can cause neurovascular compression, change the kinematics at the elbow joint and be misinterpreted as tears of muscle on magnetic resonance imaging. They should be watched for in the shoulder as well as elbow joint surgeries. The authors suggest that the extra bellies of BBm instead of being labeled as third, fourth or fifth heads, can be classified as those of origin and insertion and bellies of origin be referred to clearly as capsular, humeral or brachial heads.

  7. Tendinopathy of the long head of the biceps tendon: histopathologic analysis of the extra-articular biceps tendon and tenosynovium

    OpenAIRE

    Shishani, Yousef; Streit,Jonathan; Rodgers,Mark; Gobezie,Reuben

    2015-01-01

    Jonathan J Streit,1 Yousef Shishani,1 Mark Rodgers,2 Reuben Gobezie1 1The Cleveland Shoulder Institute, 2Department of Pathology, University Hospitals of Cleveland, Cleveland, OH, USA Background: Bicipital tendinitis is a common cause of anterior shoulder pain, but there is no evidence that acute inflammation of the extra-articular long head of the biceps (LHB) tendon is the root cause of this condition. We evaluated the histologic findings of the extra-articular portion of the LHB tendon an...

  8. Attrition tendinitis of long head of biceps brachii in relation to humeral head osteonecrosis: case report.

    Science.gov (United States)

    Wiesler, Ethan R; Sarlikiotis, Thomas; Mavrogenis, Andreas F; Kokkalis, Zinon T

    2013-01-01

    This case report identifies a 41-year-old male patient who developed anterior shoulder pain in the setting of humeral head osteonecrosis. As a consequence of the cartilage degeneration, multiple loose bodies formed and migrated into the bicipital tendon sheath, causing attrition tendinitis, which was a feature of the clinical presentation. The patient was treated by a combination of arthroscopic glenohumeral joint debridement and open tenodesis of the biceps using a suture anchor. Follow-up revealed asymptomatic shoulder function by 18 months. This is the first report in the literature of bicipital tendinitis in the context of avascular necrosis of the shoulder.

  9. Tendinopathy of the long head of the biceps tendon: histopathologic analysis of the extra-articular biceps tendon and tenosynovium.

    Science.gov (United States)

    Streit, Jonathan J; Shishani, Yousef; Rodgers, Mark; Gobezie, Reuben

    2015-01-01

    Bicipital tendinitis is a common cause of anterior shoulder pain, but there is no evidence that acute inflammation of the extra-articular long head of the biceps (LHB) tendon is the root cause of this condition. We evaluated the histologic findings of the extra-articular portion of the LHB tendon and synovial sheath in order to compare those findings to known histologic changes seen in other tendinopathies. Twenty-six consecutive patients (mean age 45.4±13.7 years) underwent an open subpectoral biceps tenodesis for anterior shoulder pain localized to the bicipital groove. Excised tendons were sent for histologic analysis. Specimens were graded using a semiquantitative scoring system to evaluate tenocyte morphology, the presence of ground substance, collagen bundle characteristics, and vascular changes. Chronic inflammation was noted in only two of 26 specimens, and no specimen demonstrated acute inflammation. Tenocyte enlargement and proliferation, characterized by increased roundness and size of the cell and nucleus with proteoglycan matrix expansion and myxoid degenerative changes, was found in all 26 specimens. Abundant ground substance, collagen bundle changes, and increased vascularization were visualized in all samples. Anterior shoulder pain attributed to the biceps tendon does not appear to be due to an inflammatory process in most cases. The histologic findings of the extra-articular portion of the LHB tendon and synovial sheath are similar to the pathologic findings in de Quervain tenosynovitis at the wrist, and may be due to a chronic degenerative process similar to this and other tendinopathies of the body.

  10. A new method for elbow arthrodesis for soft-tissue coverage: The use of biceps brachii muscle flap

    Directory of Open Access Journals (Sweden)

    Soysal Bas

    2018-01-01

    Full Text Available Elbow arthrodesis is a rarely applied and difficult procedure that is performed to reduce extremity pain and prevent amputation in various clinical states. Infection, nonunion, plate-screw exposition, and skin loss are the major complications of this procedure. In this report, a new reconstruction technique with biceps brachii muscle flap was presented in a case of elbow arthrodesis performed with three operations.

  11. Simultaneous bilateral distal biceps tendon repair: case report

    Directory of Open Access Journals (Sweden)

    Thiago Medeiros Storti

    Full Text Available ABSTRACT Simultaneous bilateral rupture of the distal biceps tendon is a rare clinical entity, seldom reported in the literature and with unclear therapeutic setting. The authors report the case of a 39-year-old white man who suffered a simultaneous bilateral rupture while working out. When weightlifting with elbows at 90° of flexion, he suddenly felt pain on the anterior aspect of the arms, coming for evaluation after two days. He presented bulging contour of the biceps muscle belly and ecchymosis in the antecubital fossa, extending distally to the medial aspect of the forearm, as well as a marked decrease of supination strength and pain in active elbow flexion. MRI confirmed the rupture with retraction of the distal biceps bilaterally. The authors opted for performing the tendon repairs simultaneously through the double incision technique and fixation to the bicipital tuberosity with anchors. The patient progressed quite well, with full return to labor and sports activities, being satisfied with the result after two years of surgery. In the literature search, few reports of simultaneous bilateral rupture of the distal biceps were retrieved, with only one treated in the acute phase of injury. Therefore, the authors consider this procedure to be a good option to solve this complex condition.

  12. Simultaneous bilateral distal biceps tendon repair: case report.

    Science.gov (United States)

    Storti, Thiago Medeiros; Paniago, Alexandre Firmino; Faria, Rafael Salomon Silva

    2017-01-01

    Simultaneous bilateral rupture of the distal biceps tendon is a rare clinical entity, seldom reported in the literature and with unclear therapeutic setting. The authors report the case of a 39-year-old white man who suffered a simultaneous bilateral rupture while working out. When weightlifting with elbows at 90° of flexion, he suddenly felt pain on the anterior aspect of the arms, coming for evaluation after two days. He presented bulging contour of the biceps muscle belly and ecchymosis in the antecubital fossa, extending distally to the medial aspect of the forearm, as well as a marked decrease of supination strength and pain in active elbow flexion. MRI confirmed the rupture with retraction of the distal biceps bilaterally. The authors opted for performing the tendon repairs simultaneously through the double incision technique and fixation to the bicipital tuberosity with anchors. The patient progressed quite well, with full return to labor and sports activities, being satisfied with the result after two years of surgery. In the literature search, few reports of simultaneous bilateral rupture of the distal biceps were retrieved, with only one treated in the acute phase of injury. Therefore, the authors consider this procedure to be a good option to solve this complex condition.

  13. Systematics of injuries of the rotator cuff and biceps tendon

    International Nuclear Information System (INIS)

    Breitenseher, M.J.; Pones, M.; Breitenseher, J.B.

    2015-01-01

    Injuries of the rotator cuff and the biceps tendon demonstrate different patterns, which can be recognized clinically and radiologically. These patterns are impingement syndrome with additional trauma, isolated trauma of the rotator cuff and shoulder dislocation causing rotator cuff tears. Furthermore, it is clinically crucial to evaluate the extent of a rotator cuff injury. Magnetic resonance imaging (MRI) is the modality of choice to differentiate these patterns. (orig.) [de

  14. Load type influences motor unit recruitment in biceps brachii during a sustained contraction.

    Science.gov (United States)

    Baudry, Stéphane; Rudroff, Thorsten; Pierpoint, Lauren A; Enoka, Roger M

    2009-09-01

    Twenty subjects participated in four experiments designed to compare time to task failure and motor-unit recruitment threshold during contractions sustained at 15% of maximum as the elbow flexor muscles either supported an inertial load (position task) or exerted an equivalent constant torque against a rigid restraint (force task). Subcutaneous branched bipolar electrodes were used to record single motor unit activity from the biceps brachii muscle during ramp contractions performed before and at 50 and 90% of the time to failure for the position task during both fatiguing contractions. The time to task failure was briefer for the position task than for the force task (P=0.0002). Thirty and 29 motor units were isolated during the force and position tasks, respectively. The recruitment threshold declined by 48 and 30% (P=0.0001) during the position task for motor units with an initial recruitment threshold below and above the target force, respectively, whereas no significant change in recruitment threshold was observed during the force task. Changes in recruitment threshold were associated with a decrease in the mean discharge rate (-16%), an increase in discharge rate variability (+40%), and a prolongation of the first two interspike intervals (+29 and +13%). These data indicate that there were faster changes in motor unit recruitment and rate coding during the position task than the force task despite a similar net muscle torque during both tasks. Moreover, the results suggest that the differential synaptic input observed during the position task influences most of the motor unit pool.

  15. Discharge characteristics of biceps brachii motor units at recruitment when older adults sustained an isometric contraction.

    Science.gov (United States)

    Pascoe, Michael A; Holmes, Matthew R; Enoka, Roger M

    2011-02-01

    The purpose of this study was to compare the discharge characteristics of motor units recruited during an isometric contraction that was sustained with the elbow flexor muscles by older adults at target forces that were less than the recruitment threshold force of each isolated motor unit. The discharge times of 27 single motor units were recorded from the biceps brachii in 11 old adults (78.8 ± 5.9 yr). The target force was set at either a relatively small (6.6 ± 3.7% maximum) or large (11.4 ± 4.5% maximum) difference below the recruitment threshold force and the contraction was sustained until the motor unit was recruited and discharged action potentials for about 60 s. The time to recruitment was longer for the large target-force difference (P = 0.001). At recruitment, the motor units discharged repetitively for both target-force differences, which contrasts with data from young adults when motor units discharged intermittently at recruitment for the large difference between recruitment threshold force and target force. The coefficient of variation (CV) for the first five interspike intervals (ISIs) increased from the small (18.7 ± 7.9) to large difference (35.0 ± 10.2%, P = 0.008) for the young adults, but did not differ for the two target force differences for the old adults (26.3 ± 14.7 to 24.0 ± 13.1%, P = 0.610). When analyzed across the discharge duration, the average CV for the ISI decreased similarly for the two target-force differences (P = 0.618) in old adults. These findings contrast with those of young adults and indicate that the integration of synaptic input during sustained contractions differs between young and old adults.

  16. The repeated-bout effect: influence on biceps brachii oxygenation and myoelectrical activity.

    Science.gov (United States)

    Muthalib, Makii; Lee, Hoseong; Millet, Guillaume Y; Ferrari, Marco; Nosaka, Kazunori

    2011-05-01

    This study investigated biceps brachii oxygenation and myoelectrical activity during and following maximal eccentric exercise to better understand the repeated-bout effect. Ten men performed two bouts of eccentric exercise (ECC1, ECC2), consisting of 10 sets of 6 maximal lengthening contractions of the elbow flexors separated by 4 wk. Tissue oxygenation index minimum amplitude (TOI(min)), mean and maximum total hemoglobin volume by near-infrared spectroscopy, torque, and surface electromyography root mean square (EMG(RMS)) during exercise were compared between ECC1 and ECC2. Changes in maximal voluntary isometric contraction (MVC) torque, range of motion, plasma creatine kinase activity, muscle soreness, TOI(min), and EMG(RMS) during sustained (10-s) and 30-repeated isometric contraction tasks at 30% (same absolute force) and 100% MVC (same relative force) for 4 days postexercise were compared between ECC1 and ECC2. No significant differences between ECC1 and ECC2 were evident for changes in torque, TOI(min), mean total hemoglobin volume, maximum total hemoglobin volume, and EMG(RMS) during exercise. Smaller (P < 0.05) changes and faster recovery of muscle damage markers were evident following ECC2 than ECC1. During 30% MVC tasks, TOI(min) did not change, but EMG(RMS) increased 1-4 days following ECC1 and ECC2. During 100% MVC tasks, EMG(RMS) did not change, but torque and TOI(min) decreased 1-4 days following ECC1 and ECC2. TOI(min) during 100% MVC tasks and EMG(RMS) during 30% MVC tasks recovered faster (P < 0.05) following ECC2 than ECC1. We conclude that the repeated-bout effect cannot be explained by altered muscle activation or metabolic/hemodynamic changes, and the faster recovery in muscle oxygenation and activation was mainly due to faster recovery of force.

  17. Fibroma of the tendon sheath of the long head of the biceps tendon

    International Nuclear Information System (INIS)

    Maeseneer, Michel de; Shahabpour, Maryam; Isacker, Tom van; Lenchik, Leon; Caillie, Marie-Astrid van

    2014-01-01

    Fibroma of the tendon sheath is a benign tumor that is less common than giant cell tumor of the tendon sheath. Both tumors may present as a painless, slowly enlarging mass. Radiological findings may be similar for both tumors. Histologically, fibroma of the tendon sheath lacks the hemosiderin-laden macrophages that are typical for giant cell tumor of the tendon sheath. We report on a 49-year-old woman with fibroma of the tendon sheath of the long head of the biceps tendon. In our case, on MR images, we observed band-like hypointense areas centrally in the tumor, mild patchy contrast enhancement, and most importantly, no decrease of signal intensity on gradient echo images. These characteristics reflected histological findings. (orig.)

  18. Electromyographic, cerebral and muscle hemodynamic responses during intermittent, isometric contractions of the biceps brachii at three submaximal intensities

    Directory of Open Access Journals (Sweden)

    Yagesh eBhambhani

    2014-06-01

    Full Text Available This study examined the electromyographic, cerebral and muscle hemodynamic responses during intermittent isometric contractions of biceps brachii at 20%, 40% and 60% of maximal voluntary contraction (MVC. Eleven volunteers completed two minutes of intermittent isometric contractions (12/min at an elbow angle of 90° interspersed with three minutes rest between intensities in systematic order. Surface electromyography (EMG was recorded from the right biceps brachii and near infrared spectroscopy (NIRS was used to simultaneously measure left prefrontal and right biceps brachii oxyhemoglobin (HbO2, deoxyhemoglobin (HHb and total hemoglobin (Hbtot. Transcranial Doppler ultrasound was used to measure middle cerebral artery velocity (MCAv bilaterally. Finger photoplethysmography was used to record beat-to-beat blood pressure and heart rate. EMG increased with force output from 20% to 60% MVC (P0.05. MCAv increased from rest to exercise but was not different among intensities (P>0.05. Force output correlated with the root mean square EMG and changes in muscle HbO2 (P0.05 at all three intensities. Force output declined by 8% from the 1st to the 24th contraction only at 60% MVC and was accompanied by systematic increases in RMS, cerebral HbO2 and Hbtot with a levelling off in muscle HbO2 and Hbtot. These changes were independent of alterations in mean arterial pressure. Since cerebral blood flow and oxygenation were elevated at 60% MVC, we attribute the development of fatigue to reduced muscle oxygen availability rather than impaired central n

  19. Motor unit recruitment in human biceps brachii during sustained voluntary contractions.

    Science.gov (United States)

    Riley, Zachary A; Maerz, Adam H; Litsey, Jane C; Enoka, Roger M

    2008-04-15

    The purpose of the study was to examine the influence of the difference between the recruitment threshold of a motor unit and the target force of the sustained contraction on the discharge of the motor unit at recruitment. The discharge characteristics of 53 motor units in biceps brachii were recorded after being recruited during a sustained contraction. Some motor units (n = 22) discharged action potentials tonically after being recruited, whereas others (n = 31) discharged intermittent trains of action potentials. The two groups of motor units were distinguished by the difference between the recruitment threshold of the motor unit and the target force for the sustained contraction: tonic, 5.9 +/- 2.5%; intermittent, 10.7 +/- 2.9%. Discharge rate for the tonic units decreased progressively (13.9 +/- 2.7 to 11.7 +/- 2.6 pulses s(-1); P = 0.04) during the 99 +/- 111 s contraction. Train rate, train duration and average discharge rate for the intermittent motor units did not change across 211 +/- 153 s of intermittent discharge. The initial discharge rate at recruitment during the sustained contraction was lower for the intermittent motor units (11.0 +/- 3.3 pulses s(-1)) than the tonic motor units (13.7 +/- 3.3 pulses s(-1); P = 0.005), and the coefficient of variation for interspike interval was higher for the intermittent motor units (34.6 +/- 12.3%) than the tonic motor units (21.2 +/- 9.4%) at recruitment (P = 0.001) and remained elevated for discharge duration (34.6 +/- 9.2% versus 19.1 +/- 11.7%, P motor units were recorded at two different target forces below recruitment threshold (5.7 +/- 1.9% and 10.5 +/- 2.4%). Each motor unit exhibited the two discharge patterns (tonic and intermittent) as observed for the 53 motor units. The results suggest that newly recruited motor units with recruitment thresholds closer to the target force experienced less synaptic noise at the time of recruitment that resulted in them discharging action potentials at more regular

  20. Comparison between maximal lengthening and shortening contractions for biceps brachii muscle oxygenation and hemodynamics.

    Science.gov (United States)

    Muthalib, Makii; Lee, Hoseong; Millet, Guillaume Y; Ferrari, Marco; Nosaka, Kazunori

    2010-09-01

    Eccentric contractions (ECC) require lower systemic oxygen (O2) and induce greater symptoms of muscle damage than concentric contractions (CON); however, it is not known if local muscle oxygenation is lower in ECC than CON during and following exercise. This study compared between ECC and CON for changes in biceps brachii muscle oxygenation [tissue oxygenation index (TOI)] and hemodynamics [total hemoglobin volume (tHb)=oxygenated-Hb+deoxygenated-Hb], determined by near-infrared spectroscopy over 10 sets of 6 maximal contractions of the elbow flexors of 10 healthy subjects. This study also compared between ECC and CON for changes in TOI and tHb during a 10-s sustained and 30-repeated maximal isometric contraction (MVC) task measured immediately before and after and 1-3 days following exercise. The torque integral during ECC was greater (P<0.05) than that during CON by approximately 30%, and the decrease in TOI was smaller (P<0.05) by approximately 50% during ECC than CON. Increases in tHb during the relaxation phases were smaller (P<0.05) by approximately 100% for ECC than CON; however, the decreases in tHb during the contraction phases were not significantly different between sessions. These results suggest that ECC utilizes a lower muscle O2 relative to O2 supply compared with CON. Following exercise, greater (P<0.05) decreases in MVC strength and increases in plasma creatine kinase activity and muscle soreness were evident 1-3 days after ECC than CON. Torque integral, TOI, and tHb during the sustained and repeated MVC tasks decreased (P<0.01) only after ECC, suggesting that muscle O2 demand relative to O2 supply during the isometric tasks was decreased after ECC. This could mainly be due to a lower maximal muscle mass activated as a consequence of muscle damage; however, an increase in O2 supply due to microcirculation dysfunction and/or inflammatory vasodilatory responses after ECC is recognized.

  1. Bilateral congenital absence of the long head of the biceps tendon

    Energy Technology Data Exchange (ETDEWEB)

    Koplas, Monica C. [Cleveland Clinic, Imaging Institute/HB6, Cleveland, OH (United States); Winalski, Carl S. [Cleveland Clinic, Imaging Institute/A21, Cleveland, OH (United States); Ulmer, William H. [Orthopedic and Spine Specialists, York, PA (United States); Recht, Michael [NYU Langone Medical Center, Department of Radiology, New York, NY (United States)

    2009-07-15

    Absence of the long head of the biceps tendon is a rare anomaly particularly when it occurs bilaterally. We present the magnetic resonance and arthroscopy findings in a patient with bilateral congenital absence of the long head of the biceps who presented with bilateral shoulder pain. Identification of a shallow or absent intertubercular groove may aid in differentiating congenital absence of the long head of the biceps from a traumatic tendon rupture. (orig.)

  2. Comparison between electrically evoked and voluntary isometric contractions for biceps brachii muscle oxidative metabolism using near-infrared spectroscopy.

    Science.gov (United States)

    Muthalib, Makii; Jubeau, Marc; Millet, Guillaume Y; Maffiuletti, Nicola A; Nosaka, Kazunori

    2009-09-01

    This study compared voluntary (VOL) and electrically evoked isometric contractions by muscle stimulation (EMS) for changes in biceps brachii muscle oxygenation (tissue oxygenation index, DeltaTOI) and total haemoglobin concentration (DeltatHb = oxygenated haemoglobin + deoxygenated haemoglobin) determined by near-infrared spectroscopy. Twelve men performed EMS with one arm followed 24 h later by VOL with the contralateral arm, consisting of 30 repeated (1-s contraction, 1-s relaxation) isometric contractions at 30% of maximal voluntary contraction (MVC) for the first 60 s, and maximal intensity contractions thereafter (MVC for VOL and maximal tolerable current at 30 Hz for EMS) until MVC decreased approximately 30% of pre-exercise MVC. During the 30 contractions at 30% MVC, DeltaTOI decrease was significantly (P < 0.05) greater and DeltatHb was significantly (P < 0.05) lower for EMS than VOL, suggesting that the metabolic demand for oxygen in EMS is greater than VOL at the same torque level. However, during maximal intensity contractions, although EMS torque (approximately 40% of VOL) was significantly (P < 0.05) lower than VOL, DeltaTOI was similar and tHb was significantly (P < 0.05) lower for EMS than VOL towards the end, without significant differences between the two sessions in the recovery period. It is concluded that the oxygen demand of the activated biceps brachii muscle in EMS is comparable to VOL at maximal intensity.

  3. Reliability of near-infrared spectroscopy for measuring biceps brachii oxygenation during sustained and repeated isometric contractions.

    Science.gov (United States)

    Muthalib, Makii; Millet, Guillaume Y; Quaresima, Valentina; Nosaka, Kazunori

    2010-01-01

    We examine the test-retest reliability of biceps brachii tissue oxygenation index (TOI) parameters measured by near-infrared spectroscopy during a 10-s sustained and a 30-repeated (1-s contraction, 1-s relaxation) isometric contraction task at 30% of maximal voluntary contraction (30% MVC) and maximal (100% MVC) intensities. Eight healthy men (23 to 33 yr) were tested on three sessions separated by 3 h and 24 h, and the within-subject reliability of torque and each TOI parameter were determined by Bland-Altman+/-2 SD limits of agreement plots and coefficient of variation (CV). No significant (P>0.05) differences between the three sessions were found for mean values of torque and TOI parameters during the sustained and repeated tasks at both contraction intensities. All TOI parameters were within+/-2 SD limits of agreement. The CVs for torque integral were similar between the sustained and repeated task at both intensities (4 to 7%); however, the CVs for TOI parameters during the sustained and repeated task were lower for 100% MVC (7 to 11%) than for 30% MVC (22 to 36%). It is concluded that the reliability of the biceps brachii NIRS parameters during both sustained and repeated isometric contraction tasks is acceptable.

  4. Evaluation of the Effusion within Biceps Long Head Tendon Sheath Using Ultrasonography

    Science.gov (United States)

    Park, In; Lee, Hyo-Jin; Kim, Sung-Eun; Bae, Sung-Ho; Lee, Kwang-Yeol; Park, Kwang-Sun

    2015-01-01

    Background Many shoulder diseases are related to glenohumeral joint synovitis and effusion. The purpose of the present study is to detect effusion within the biceps long head tendon sheath as the sign of glenohumeral joint synovitis using ultrasonography, and to evaluate the clinical meaning of effusion within the biceps long head tendon sheath. Methods A consecutive series of 569 patients who underwent ultrasonography for shoulder pain were reviewed retrospectively and ultimately, 303 patients were included. The authors evaluated the incidence and amount of the effusion within the biceps long head tendon sheath on the ultrasonographic short axis view. Furthermore, the authors evaluated the correlation between the amount of effusion within the biceps long head tendon sheath and the range of motion and the functional score. Results The effusion within the biceps long head tendon sheath was detected in 58.42% of the patients studied: 69.23% in adhesive capsulitis, 56.69% in rotator cuff tear, 41.03% in calcific tendinitis, and 33.33% in biceps tendinitis. The average amount of the effusion within the biceps long head tendon sheath was 1.7 ± 1.6 mm, and it was measured to be the largest in adhesive capsulitis. The amount of effusion within biceps long head tendon sheath showed a moderate to high degree of correlation with the range of motion, and a low degree of correlation with the functional score and visual analogue scale for pain in each type of shoulder disease. Conclusions The effusion within the biceps long head tendon sheath is closely related to the range of motion and clinical scores in patients with painful shoulders. Ultrasonographic detection of the effusion within the biceps long head tendon sheath might be a simple and easy method to evaluate shoulder function. PMID:26330958

  5. Triceps brachii tendon: anatomic-MR imaging study in cadavers with histologic correlation

    International Nuclear Information System (INIS)

    Belentani, Clarissa; Pastore, Daniel; Wangwinyuvirat, Mani; Dirim, Berna; Trudell, Debra J.; Resnick, Donald; Haghighi, Parviz

    2009-01-01

    The purpose of this cadaveric study was to describe the normal MR anatomy of the triceps brachii tendon (TBT) insertion, to correlate the findings with those seen in anatomic sections and histopathologic analysis, and to review triceps tendon injuries. Twelve cadaveric elbows were used according to institution guidelines. T1-weighted spin-echo MR images were acquired in three planes. Findings on MR imaging were correlated with those derived from anatomic and histologic study. On MR images, the TBT had a bipartite appearance as it inserted on olecranon in all specimens. The insertion of the medial head was deeper than that of the long and lateral heads and was mainly muscular at its insertion, with a small amount of the tendon blending with the muscle distally, necessitating histologic analysis to determine if there was tendon blending with the muscle at the site of insertion and if the medial head inserted together with the common tendon or as a single unit. At histopathologic analysis, the three heads of the triceps tendon had a common insertion on the olecranon. The bipartite aspect of the tendon that was identified in the MR images was not seen by histologic study, indicating that there was a union of the medial and common tendons just before they inserted into bone. TBT has a bipartite appearance on MR images and inserts on olecranon as a single unit. (orig.)

  6. Triceps brachii tendon: anatomic-MR imaging study in cadavers with histologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Belentani, Clarissa [University of California, Department of Radiology, San Diego, CA (United States); Pastore, Daniel; Wangwinyuvirat, Mani; Dirim, Berna; Trudell, Debra J.; Resnick, Donald [University of California, Department of Radiology, San Diego, CA (United States); University of California, VA Medical Center, San Diego, CA (United States); Haghighi, Parviz [University of California, VA Medical Center, San Diego, CA (United States); University of California, Department of Histology, San Diego (United States)

    2009-02-15

    The purpose of this cadaveric study was to describe the normal MR anatomy of the triceps brachii tendon (TBT) insertion, to correlate the findings with those seen in anatomic sections and histopathologic analysis, and to review triceps tendon injuries. Twelve cadaveric elbows were used according to institution guidelines. T1-weighted spin-echo MR images were acquired in three planes. Findings on MR imaging were correlated with those derived from anatomic and histologic study. On MR images, the TBT had a bipartite appearance as it inserted on olecranon in all specimens. The insertion of the medial head was deeper than that of the long and lateral heads and was mainly muscular at its insertion, with a small amount of the tendon blending with the muscle distally, necessitating histologic analysis to determine if there was tendon blending with the muscle at the site of insertion and if the medial head inserted together with the common tendon or as a single unit. At histopathologic analysis, the three heads of the triceps tendon had a common insertion on the olecranon. The bipartite aspect of the tendon that was identified in the MR images was not seen by histologic study, indicating that there was a union of the medial and common tendons just before they inserted into bone. TBT has a bipartite appearance on MR images and inserts on olecranon as a single unit. (orig.)

  7. Immediate effects of acupuncture on biceps brachii muscle function in healthy and post-stroke subjects

    Directory of Open Access Journals (Sweden)

    Fragoso Ana

    2012-03-01

    Full Text Available Abstract Background The effects of acupuncture on muscle function in healthy subjects are contradictory and cannot be extrapolated to post-stroke patients. This study evaluated the immediate effects of manual acupuncture on myoelectric activity and isometric force in healthy and post-stroke patients. Methods A randomized clinical trial, with parallel groups, single-blinded study design, was conducted with 32 healthy subjects and 15 post-stroke patients with chronic hemiparesis. Surface electromyography from biceps brachii during maximal isometric voluntary tests was performed before and after 20-min intermittent, and manual stimulation of acupoints Quchi (LI11 or Tianquan (PC2. Pattern differentiation was performed by an automated method based on logistic regression equations. Results Healthy subjects showed a decrease in the root mean-squared (RMS values after the stimulation of LI11 (pre: 1.392 ± 0.826 V; post: 0.612 ± 0.0.320 V; P = 0.002 and PC2 (pre: 1.494 ± 0.826 V; post: 0.623 ± 0.320 V; P = 0.001. Elbow flexion maximal isometric voluntary contraction (MIVC was not significantly different after acupuncture stimulation of LI11 (pre: 22.2 ± 10.7 kg; post: 21.7 ± 9.5 kg; P = 0.288 or PC2 (pre: 18.8 ± 4.6 kg; post: 18.7 ± 6.0 kg; P = 0.468. Post-stroke patients did not exhibit any significant decrease in the RMS values after the stimulation of LI11 (pre: 0.627 ± 0.335 V; post: 0.530 ± 0.272 V; P = 0.187 and PC2 (pre: 0.601 ± 0.258 V; post: 0.591 ± 0.326 V; P = 0.398. Also, no significant decrease in the MIVC value was observed after the stimulation of LI11 (pre: 9.6 ± 3.9 kg; post: 9.6 ± 4.7 kg; P = 0.499 or PC2 (pre: 10.7 ± 5.6 kg; post: 10.2 ± 5.3 kg; P = 0.251. Different frequency of patterns was observed among healthy subjects and post-stroke patients groups (χ2 = 9.759; P = 0.021. Conclusion Manual acupuncture provides sufficient neuromuscular stimuli to promote immediate changes in motor unit gross recruitment without

  8. Repair of the torn distal biceps tendon by endobutton fixation

    Directory of Open Access Journals (Sweden)

    Ravi K Gupta

    2012-01-01

    Full Text Available Background: A number of techniques have been described to reattach the torn distal biceps tendon to the bicipital tuberosity. We report a retrospective analysis of single incision technique using an endobutton fixation in sports persons. Materials and Methods: The present series include nine torn distal biceps tendons in eight patients, fixed anatomically to the radial tuberosity with an endobutton by using a single incision surgical technique; seven patients had suffered the injuries during contact sports. The passage of the endobutton was facilitated by using a blunt tipped pin in order to avoid injury to the posterior interosseous nerve. The patients were evaluated by Disabilities of the Arm, Shoulder and Hand (DASH score and Mayo elbow score. Results: The average age of the patients was 27.35 years (range 21-42 years. Average follow-up was 41.5 months (range 24-102 months. The final average flexion extension arc was 0°-143°, while the average pronation and supination angles were 77° (range 70°-82° and 81° (range 78°-85°, respectively at the last followup. All the patients had a Disabilities of the Arm, Shoulder and Hand (DASH score of 0 and a Mayo elbow score of 100 each. All the seven active sports persons were able to get back to their respective game. There was no nerve injury or any other complication. Conclusions: The surgical procedure used by us is a simple, safe and reproducible technique giving minimal morbidity and better cosmetic results.

  9. The effect of electrical stimulation of the corticospinal tract on motor units of the human biceps brachii

    DEFF Research Database (Denmark)

    Petersen, Nicolas Caesar; Taylor, Janet L; Gandevia, Simon C

    2002-01-01

    In healthy human subjects, descending motor pathways including the corticospinal tract were stimulated electrically at the level of the cervicomedullary junction to determine the effects on the discharge of motoneurones innervating the biceps brachii. Post-stimulus time histograms (PSTHs) were...... constructed for 15 single motor units following electrical stimulation of the corticospinal tract and for 11 units following electrical stimulation of large diameter afferents at the brachial plexus. Responses were assessed during weak voluntary contraction. Both types of stimulation produced a single peak...... in the two conditions when the intensity of the stimulation was adjusted so that responses of the same size could be compared. Estimates of the descending conduction velocity and measurements of presumed peripheral conduction time suggest that there is less than 0.5 ms for spinal events (including synaptic...

  10. Analysis of progression of fatigue conditions in biceps brachii muscles using surface electromyography signals and complexity based features.

    Science.gov (United States)

    Karthick, P A; Makaram, Navaneethakrishna; Ramakrishnan, S

    2014-01-01

    Muscle fatigue is a neuromuscular condition where muscle performance decreases due to sustained or intense contraction. It is experienced by both normal and abnormal subjects. In this work, an attempt has been made to analyze the progression of muscle fatigue in biceps brachii muscles using surface electromyography (sEMG) signals. The sEMG signals are recorded from fifty healthy volunteers during dynamic contractions under well defined protocol. The acquired signals are preprocessed and segmented in to six equal parts for further analysis. The features, such as activity, mobility, complexity, sample entropy and spectral entropy are extracted from all six zones. The results are found showing that the extracted features except complexity feature have significant variations in differentiating non-fatigue and fatigue zone respectively. Thus, it appears that, these features are useful in automated analysis of various neuromuscular activities in normal and pathological conditions.

  11. Pathology and prognosis of proximal-type cervical spondylotic amyotrophy: new assessment using compound muscle action potentials of deltoid and biceps brachii muscles.

    Science.gov (United States)

    Imajo, Yasuaki; Kato, Yoshihiko; Kanchiku, Tsukasa; Suzuki, Hidenori; Taguchi, Toshihiko

    2011-04-01

    Case studies of patients with cervical spondylotic amyotrophy (CSA) used compound muscle action potentials (CMAPs) of deltoid and biceps brachii muscles. To discuss pathology and prognosis from the magnetic resonance imaging (MRI) and CMAPs of deltoid and biceps brachii muscles. CSA is a rare type of cervical spondylotic disorder. Selective lesions in ventral nerve roots (VNR) or anterior horns (AH) have been proposed to explain the pathology of CSA, but these are not well understood. Conservative therapy was performed in 21 patients with the proximal-type CSA. Patients were classified into two groups: 13 with incomplete recovery of deltoid and biceps brachii muscle strength (Group 1) and 8 with complete recovery (Group 2). All underwent MRI. Erb-point-stimulated CMAPs were recorded in the deltoid and biceps. Measurements of CMAPs included negative-peak amplitude from the baseline to peak. The percentage amplitude of CMAPs was calculated in contrast to the opposite side. Sagittal T2-weighted MRI showed spinal cord compression in all patients from Group 1 and in four patients from Group 2. Deltoid muscle CMAPs: Three patients from Group 1 and all eight patients from Group 2 had a CMAPs' amplitude on the normal side that was greater than 10 mV. Biceps brachii muscle CMAPs: four patients from Group 1 and four patients from Group 2 had a CMAPs' amplitude on the normal side that was greater than 10 mV. Patients with a CMAPs amplitude on the normal side that exceeded 10 mV had no impingement of the AH. A CMAPs' amplitude that exceeded 10 mV on the normal side and a CMAPs' amplitude of more than 50% on the affected side compared with the normal side indicated slight involvement of VNR. These patients were able to fully recover function.

  12. Increased muscle belly and tendon stiffness in patients with Parkinson's disease, as measured by myotonometry.

    Science.gov (United States)

    Marusiak, Jarosław; Jaskólska, Anna; Budrewicz, Sławomir; Koszewicz, Magdalena; Jaskólski, Artur

    2011-09-01

    Based on Davis's law, greater tonus of the muscle belly in individuals with Parkinson's disease can create greater tension in the tendon, leading to structural adjustment and an increase in tendon stiffness. Our study aimed to separately assess passive stiffness in the muscle belly and tendon in medicated patients with Parkinson's disease, using myotonometry. We tested 12 patients with Parkinson's disease and 12 healthy matched controls. Passive stiffness of muscle belly and tendon was estimated by myotonometry, electromyography, and mechanomyography in relaxed biceps and triceps brachii muscles. Compared with controls, patients with Parkinson's disease had higher stiffness in the muscle belly and tendon of the biceps brachii and in the tendon of the triceps brachii. In patients with Parkinson's disease, there was a positive correlation between muscle belly stiffness and parkinsonian rigidity in the biceps brachii. Patients with Parkinson's disease have higher passive stiffness of the muscle belly and tendon than healthy matched controls. Copyright © 2011 Movement Disorder Society.

  13. Driving Sodium-Potassium Pumps With An Oscillating Electric Field: Effects On Muscle Recovery In The Human Biceps Brachii

    Science.gov (United States)

    Bovyn, Matt; Chen, Wei; Lanes, Olivia; Mast, Jason

    2013-03-01

    Dr. Chen has developed a technique called synchronization modulation, which uses an oscillating electric field to increase the rate at which the sodium-potassium pumps in the cell membrane work. Because the sodium-potassium pump is integral in the recovery of skeletal muscle fibers after an action potential, we investigated the effects of applying synchronization modulation to muscles which had already undergone fatigue due to repeated action potentials during exercise. Fatigue was induced in human subjects' biceps brachii through isometric contraction. Surface electromyography measurements of fatigue index were used to quantify how the muscle recovered over the minutes following fatigue, both when synchronization modulation was applied and when it was absent. The preliminary results were inconclusive, but it is hoped that in later work it will be shown that applying synchronization modulation is effective in increasing the rate at which the muscle recovers to its initial state. This would demonstrate not only that synchronization modulation can be successfully applied to human muscle, but also that it has many potential applications in sports medicine and novel disease treatments. Work done as part of an REU program at the University of South Florida

  14. Ultrasound shear wave elastography in the assessment of passive biceps brachii muscle stiffness: influences of sex and elbow position.

    Science.gov (United States)

    Chen, Johnson; O'Dell, Michael; He, Wen; Du, Li-Juan; Li, Pai-Chi; Gao, Jing

    To assess differences in biceps brachii muscle (BBM) stiffness as evaluated by ultrasound shear wave elastography (SWE). The passive stiffness of the BBM was quantified with shear wave velocity (SWV) measurements obtained from 10 healthy volunteers (5 men and 5 women, mean age 50years, age range 42-63 years) with the elbow at full extension and 30° flexion in this IRB-approved study. Potential differences between two depths within the muscle, two elbow positions, the two arms, and sexes were assessed by using two-tailed t-test. The reproducibility of SWV measurements was tested by using intraclass correlation coefficient (ICC). Significantly higher passive BBM stiffness was found at full elbow extension compared to 30° of flexion (p≤0.00006 for both arms). Significantly higher passive stiffness in women was seen for the right arm (p=0.04 for both elbow positions). Good correlation of shear wave velocity measured at the different depths. The ICC for interobserver and intraobserver variation was high. SWE is a reliable quantitative tool for assessing BBM stiffness, with differences in stiffness based on elbow position demonstrated and based on sex suggested. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Brachial biceps tendon injuries in young female high-level tennis players.

    Science.gov (United States)

    Tsur, A; Gillson, S

    2000-06-01

    To evaluate brachial biceps tendon lesions in four young female tennis players who complained about anterior shoulder pain on their dominant side. Medical and sport's activity history, palpation of the painful zone, Ghilchrist (palm-up) test, and brachial biceps contraction against resistance were performed. The two girls who suffered from mild tenderness in the bicipital groove and over the anterior aspect of the upper arm and the shoulder joint, had tendinitis of the long biceps head. The two girls who suffered from severe tenderness just under the groove, had a partial tear in the long head of the biceps. Ghilchrist test was positive in all girls. Tennis players can have shoulder pain without clear history of trauma. Pain occurred probably as a result of technical errors or use of inadequate equipment.

  16. Partial tears of the distal biceps tendon: MR appearance and associated clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Williams, B.D.; Schweitzer, M.E.; Weishaupt, D.; Miller, L.S. [Thomas Jefferson Univ., Philadelphia, PA (United States). Dept. of Radiology; Lerman, J. [Lerman Imaging, Brooklyn, NY (United States); Rubenstein, D.L. [Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Rosenberg, Z.S. [Dept. of Diagnostic Radiology, New York Univ. Medical Center, NY (United States)

    2001-10-01

    Purpose: To describe the magnetic resonance (MR) appearance and associated clinical findings of partial distal biceps tendon tears. Design: Twenty elbow MR images at 1.5 T, performed over a 7 year period, were reviewed for an appearance of partial tears in the distal biceps. These images were assessed by two musculoskeletal radiologists for the extent of: (a) abnormal signal intensity within the tendon, and the presence of (b) bicipitoradial bursitis, and (c) bony microavulsive injury of the radial tuberosity. Medical records for nine of the 20 cases were reviewed for the clinical findings of ecchymosis, trauma, sensation of a ''pop'', loss of function, and acuity of onset. Results: Twenty partial distal biceps tendon tears were seen. All displayed an abnormally increased signal in the distal biceps tendon. Three of 20 (15%) showed a 25% to 50% tear, ten of 20 (50%) showed a 50% tear, and seven of 20 (35%) showed a 75% to 90% tear. Bicipitoradial bursitis was seen in 11 of 20 (55%) cases. Bony microavulsive injury of the radial tuberosity was observed in 10 of 20 (50%). Of the nine cases reviewed for associated clinical findings, surprisingly, only three (33%) experienced an acute traumatic episode with an abrupt onset of pain. An insidious onset was reported in four of nine (44%). Sensation of a ''pop'' was recorded in only two of nine (22%) cases. Ecchymosis and loss of function were not seen in any of the cases. Finally, surgical conformation was obtained for three cases. Conclusion: Partial distal biceps tendon tears have a characteristic MR appearance, demonstrate little functional deficit, and may be attritional in their etiology due to the observation of a low number of patients reporting trauma or an acute onset. (orig.)

  17. Partial tears of the distal biceps tendon: MR appearance and associated clinical findings

    International Nuclear Information System (INIS)

    Williams, B.D.; Schweitzer, M.E.; Weishaupt, D.; Miller, L.S.; Rubenstein, D.L.; Rosenberg, Z.S.

    2001-01-01

    Purpose: To describe the magnetic resonance (MR) appearance and associated clinical findings of partial distal biceps tendon tears. Design: Twenty elbow MR images at 1.5 T, performed over a 7 year period, were reviewed for an appearance of partial tears in the distal biceps. These images were assessed by two musculoskeletal radiologists for the extent of: (a) abnormal signal intensity within the tendon, and the presence of (b) bicipitoradial bursitis, and (c) bony microavulsive injury of the radial tuberosity. Medical records for nine of the 20 cases were reviewed for the clinical findings of ecchymosis, trauma, sensation of a ''pop'', loss of function, and acuity of onset. Results: Twenty partial distal biceps tendon tears were seen. All displayed an abnormally increased signal in the distal biceps tendon. Three of 20 (15%) showed a 25% to 50% tear, ten of 20 (50%) showed a 50% tear, and seven of 20 (35%) showed a 75% to 90% tear. Bicipitoradial bursitis was seen in 11 of 20 (55%) cases. Bony microavulsive injury of the radial tuberosity was observed in 10 of 20 (50%). Of the nine cases reviewed for associated clinical findings, surprisingly, only three (33%) experienced an acute traumatic episode with an abrupt onset of pain. An insidious onset was reported in four of nine (44%). Sensation of a ''pop'' was recorded in only two of nine (22%) cases. Ecchymosis and loss of function were not seen in any of the cases. Finally, surgical conformation was obtained for three cases. Conclusion: Partial distal biceps tendon tears have a characteristic MR appearance, demonstrate little functional deficit, and may be attritional in their etiology due to the observation of a low number of patients reporting trauma or an acute onset. (orig.)

  18. Coexistence of a pectoralis quartus muscle, a supernumerary head of biceps brachii muscle and an accessory head of flexor digitorum profundus muscle.

    Science.gov (United States)

    Song, Halim; Kim, Jinu; Yoon, Sang-Pil

    2018-05-26

    Although anatomical variations in the upper limb are frequent, coexistence of multiple combined variations is rare. During a routine educational dissection at Jeju National University Medical School, three muscular variations were found in a 75-year-old Korean male cadaver, in which a supraclavicular cephalic vein was also found in ipsilateral upper extremity during skinning (Go et al., 2017). Here we describe characteristics of the pectoralis quartus muscle, the supernumerary head of biceps brachii muscle and an accessory head of flexor digitorum profundus muscle, and discuss their coexistence from morphological and embryological points of view.

  19. Degeneration of the long biceps tendon: comparison of MRI with gross anatomy and histology.

    Science.gov (United States)

    Buck, Florian M; Grehn, Holger; Hilbe, Monika; Pfirrmann, Christian W A; Manzanell, Silvana; Hodler, Jürg

    2009-11-01

    The objective of our study was to relate alterations in biceps tendon diameter and signal on MR images to gross anatomy and histology. T1-weighted, T2-weighted fat-saturated, and proton density-weighted fat-saturated spin-echo sequences were acquired in 15 cadaveric shoulders. Biceps tendon diameter (normal, flattened, thickened, and partially or completely torn) and signal intensity (compared with bone, fat, muscle, and joint fluid) were graded by two readers independently and in a blinded fashion. The distance of tendon abnormalities from the attachment at the glenoid were noted in millimeters. MRI findings were related to gross anatomic and histologic findings. On the basis of gross anatomy, there were six normal, five flattened, two thickened, and two partially torn tendons. Reader 1 graded nine diameter changes correctly, missed two, and incorrectly graded four. The corresponding values for reader 2 were seven, one, and five, respectively, with kappa = 0.75. Histology showed mucoid degeneration (n = 13), lipoid degeneration (n = 7), and fatty infiltration (n = 6). At least one type of abnormality was found in each single tendon. Mucoid degeneration was hyperintense compared with fatty infiltration on T2-weighted fat-saturated images and hyperintense compared with magic-angle artifacts on proton density-weighted fat-saturated images. MRI-based localization of degeneration agreed well with histologic findings. Diameter changes are specific but not sensitive in diagnosing tendinopathy of the biceps tendon. Increased tendon signal is most typical for mucoid degeneration but should be used with care as a sign of tendon degeneration.

  20. Free Biceps Tendon Autograft to Augment Arthroscopic Rotator Cuff Repair

    OpenAIRE

    Obma, Padraic R.

    2013-01-01

    Arthroscopic rotator cuff repairs have become the standard of treatment for all sizes of tears over the past several years. Current healing rates reported in the literature are quite good, but improving the healing potential of rotator cuff repairs remains a challenging problem. There has been an increase recently in the use of augmentation of rotator cuff repairs with xenografts or synthetics for large and massive tears. Biceps tenodesis is often indicated as part of the treatment plan while...

  1. Detection of surface electromyography recording time interval without muscle fatigue effect for biceps brachii muscle during maximum voluntary contraction.

    Science.gov (United States)

    Soylu, Abdullah Ruhi; Arpinar-Avsar, Pinar

    2010-08-01

    The effects of fatigue on maximum voluntary contraction (MVC) parameters were examined by using force and surface electromyography (sEMG) signals of the biceps brachii muscles (BBM) of 12 subjects. The purpose of the study was to find the sEMG time interval of the MVC recordings which is not affected by the muscle fatigue. At least 10s of force and sEMG signals of BBM were recorded simultaneously during MVC. The subjects reached the maximum force level within 2s by slightly increasing the force, and then contracted the BBM maximally. The time index of each sEMG and force signal were labeled with respect to the time index of the maximum force (i.e. after the time normalization, each sEMG or force signal's 0s time index corresponds to maximum force point). Then, the first 8s of sEMG and force signals were divided into 0.5s intervals. Mean force, median frequency (MF) and integrated EMG (iEMG) values were calculated for each interval. Amplitude normalization was performed by dividing the force signals to their mean values of 0s time intervals (i.e. -0.25 to 0.25s). A similar amplitude normalization procedure was repeated for the iEMG and MF signals. Statistical analysis (Friedman test with Dunn's post hoc test) was performed on the time and amplitude normalized signals (MF, iEMG). Although the ANOVA results did not give statistically significant information about the onset of the muscle fatigue, linear regression (mean force vs. time) showed a decreasing slope (Pearson-r=0.9462, pfatigue starts after the 0s time interval as the muscles cannot attain their peak force levels. This implies that the most reliable interval for MVC calculation which is not affected by the muscle fatigue is from the onset of the EMG activity to the peak force time. Mean, SD, and range of this interval (excluding 2s gradual increase time) for 12 subjects were 2353, 1258ms and 536-4186ms, respectively. Exceeding this interval introduces estimation errors in the maximum amplitude calculations

  2. Simultaneous bilateral distal biceps tendon rupture during a preacher curl exercise: a case report.

    Science.gov (United States)

    Rokito, Andrew S; lofin, Ilya

    2008-01-01

    Complete rupture of the distal biceps tendon is a rare injury, the overwhelming majority occurring in the dominant arm of males during the fourth to sixth decades of life. Simultaneous bilateral rupture of the distal biceps tendon is an extremely rare occurrence, with only three cases reported in the literature. This unusual injury occurred in a recreational weightlifter during a preacher curl exercise. In this particular case, a 6-week delay in presentation necessitated a staged procedure in which a primary repair was feasible in one elbow, while reconstruction using allograft tissue was required in the contralateral elbow. Satisfactory results for both elbows were achieved, with return to weightlifting by one year following surgery.

  3. Tendon patch grafting using the long head of the biceps for irreparable massive rotator cuff tears

    International Nuclear Information System (INIS)

    Sano, Hirotaka; Itoi, Eiji; Mineta, Mitsuyoshi; Kita, Atsushi

    2010-01-01

    Surgical treatment of massive rotator cuff tears is challenging for shoulder surgeons. The purpose of this study was to investigate both clinical outcomes and cuff integrity after tendon patch grafting using the long head of the biceps (LHB) tendon for irreparable massive rotator cuff tears. A short deltoid splitting approach was used to expose the torn cuff tendon stump. After tenodesis of the LHB tendon, its intraarticular portion was resected. If the size of the harvested tendon was smaller than that of the cuff defect, it was split into two layers. Then, the LHB tendon was sutured to the remnant cuff tendons and fixed to the footprint using the transosseous suture technique. A total of 14 patients (12 men, 2 women; average age 64 years) underwent this procedure. The average postoperative follow-up period was 28 months (range 12-51 months). Active elevation angle of the shoulder as well as the Japanese Orthopaedic Association (JOA) score were assessed before surgery and at the time of follow-up. Postoperative cuff integrity was assessed using T2-weighted magnetic resonance imaging (MRI). All cuff defects were successfully closed with this technique. Average active elevation angle improved from 69deg to 149deg. Total JOA score also improved from 54.7 points to 83.1 points. Thirteen shoulders showed no re-tearing on T2-weighted MRI; a minor discontinuity of the repaired cuff tendon was observed in the other shoulder. The LHB tendon is available in case tenodesis or tenotomy is needed. The resected tendon may be used as a graft for rotator cuff repair without any additional skin incision, which could reduce both the surgical invasion and the risk of infection. The LHB tendon patch grafting may be one of the useful options for surgical treatment of irreparable massive rotator cuff tears. (author)

  4. Assessment of instability of the long head of the biceps tendon by MRI

    International Nuclear Information System (INIS)

    Spritzer, C.E.; Collins, A.J.; Cooperman, A.; Speer, K.P.

    2001-01-01

    Objective. To determine whether MRI can identify instability of the long head of the biceps tendon (LBT) in the rotator interval.Design and patients. A retrospective review was carried out of 19 patients, all arthroscopically examined, nine of whom had surgically confirmed instability of the LBT.Results. A LBT perched on the lesser tuberosity correctly indicated all nine cases of instability with one false positive. In six of seven cases where the LBT was oval in shape, no instability of the biceps tendon existed, whereas LBT instability was present in eight of 12 patients with a flat long head of the biceps tendon. In seven of eight acutely angled intertubercular sulci there was no instability of the LBT while eight of 11 obtusely angled sulci were associated with LBT instability. By consensus impression, instability of the LBT could be determined with 67% sensitivity, 90% specificity, 86% positive predictive value, and 75% negative predictive value.Conclusions. A flat LBT perched on the lesser tuberosity with an obtusely angled intertubercular sulcus suggests the diagnosis of instability of the LBT in the correct clinical setting. (orig.)

  5. Biceps tendinitis caused by an osteochondroma in the bicipital groove: a rare cause of shoulder pain in a baseball player.

    Science.gov (United States)

    Onga, Takafumi; Yamamoto, Tetsuji; Akisue, Toshihiro; Marui, Takashi; Kurosaka, Masahiro

    2005-02-01

    Tendinitis of the long head of the biceps brachii muscle is commonly seen in athletes who do repetitive overhead motions. Common causes of biceps tendinitis include impingement syndrome, subluxation of the biceps tendon, and attrition tendinitis, whereas biceps tendinitis secondary to a bone neoplasm is rare. A case of biceps tendinitis caused by an osteochondroma arising in the left humeral bicipital groove in a 25-year-old male baseball player is reported. The tumor was hook-shaped, originated from the inferomedial portion of the humeral lesser tubercle, and surrounded the biceps tendon. Symptoms of increasing pain and inability to throw resulted from direct irritation of the biceps tendon by the tumor. Total excision of the tumor relieved the symptoms within 3 weeks. To our knowledge, there have been no reported cases in the English-language literature of biceps tendinitis caused by an osteochondroma.

  6. Rupture of the Distal Biceps Tendon Combined with a Supinator Muscle Tear in a 51-Year-Old Woman: A Case Report

    OpenAIRE

    Nayyar, Samir; Quirno, Martin; Hasan, Saqib; Rybak, Leon; Meislin, Robert J.

    2011-01-01

    Distal biceps tendon rupture is a relatively uncommon occurrence in the general female population, and to our knowledge, has not been reported in association with a supinator muscle tear. We report a case of 51-year-old woman who experienced sharp pain in her forearm and elbow after lifting a heavy object. History and physical examination raised suspicion for a distal biceps tendon rupture. MRI imaging determined a combined distal biceps tendon tear with a supinator muscle tear with subsequen...

  7. Rupture of the Distal Biceps Tendon Combined with a Supinator Muscle Tear in a 51-Year-Old Woman: A Case Report

    Directory of Open Access Journals (Sweden)

    Samir Nayyar

    2011-01-01

    Full Text Available Distal biceps tendon rupture is a relatively uncommon occurrence in the general female population, and to our knowledge, has not been reported in association with a supinator muscle tear. We report a case of 51-year-old woman who experienced sharp pain in her forearm and elbow after lifting a heavy object. History and physical examination raised suspicion for a distal biceps tendon rupture. MRI imaging determined a combined distal biceps tendon tear with a supinator muscle tear with subsequent confirmation at surgery. Surgical repair was performed for the distal biceps tendon only through a single incision approach using the Endobutton technique.

  8. Differences in supraspinal and spinal excitability during various force outputs of the biceps brachii in chronic- and non-resistance trained individuals.

    Directory of Open Access Journals (Sweden)

    Gregory E P Pearcey

    Full Text Available Motor evoked potentials (MEP and cervicomedullary evoked potentials (CMEP may help determine the corticospinal adaptations underlying chronic resistance training-induced increases in voluntary force production. The purpose of the study was to determine the effect of chronic resistance training on corticospinal excitability (CE of the biceps brachii during elbow flexion contractions at various intensities and the CNS site (i.e. supraspinal or spinal predominantly responsible for any training-induced differences in CE. Fifteen male subjects were divided into two groups: 1 chronic resistance-trained (RT, (n = 8 and 2 non-RT, (n = 7. Each group performed four sets of ∼5 s elbow flexion contractions of the dominant arm at 10 target forces (from 10%-100% MVC. During each contraction, subjects received 1 transcranial magnetic stimulation, 2 transmastoid electrical stimulation and 3 brachial plexus electrical stimulation, to determine MEP, CMEP and compound muscle action potential (Mmax amplitudes, respectively, of the biceps brachii. All MEP and CMEP amplitudes were normalized to Mmax. MEP amplitudes were similar in both groups up to 50% MVC, however, beyond 50% MVC, MEP amplitudes were lower in the chronic RT group (p<0.05. CMEP amplitudes recorded from 10-100% MVC were similar for both groups. The ratio of MEP amplitude/absolute force and CMEP amplitude/absolute force were reduced (p<0.012 at all contraction intensities from 10-100% MVC in the chronic-RT compared to the non-RT group. In conclusion, chronic resistance training alters supraspinal and spinal excitability. However, adaptations in the spinal cord (i.e. motoneurone seem to have a greater influence on the altered CE.

  9. Rupture Following Biceps-to-Triceps Tendon Transfer in Adolescents and Young Adults With Spinal Cord Injury:

    Science.gov (United States)

    Merenda, Lisa A.; Rutter, Laure; Curran, Kimberly; Kozin, Scott H.

    2012-01-01

    Background: Tendon transfer surgery can restore elbow extension in approximately 70% of persons with tetraplegia and often results in antigravity elbow extension strength. However, we have noted an almost 15% rupture/attenuation rate. Objective: This investigation was conducted to analyze potential causes in adolescents/young adults with spinal cord injury (SCI) who experienced tendon rupture or attenuation after biceps-to-triceps transfer. Methods: Medical charts of young adults with SCI who underwent biceps-to-triceps transfer and experienced tendon rupture or attenuation were reviewed. Data collected by retrospective chart review included general demographics, surgical procedure(s), use and duration of antibiotic treatment, time from tendon transfer surgery to rupture/attenuation, and method of diagnosis. Results: Twelve subjects with tetraplegia (mean age, 19 years) who underwent biceps-to-triceps reconstruction with subsequent tendon rupture or attenuation were evaluated. Mean age at time of tendon transfer was 18 years (range, 14-21 years). A fluoroquinolone was prescribed for 42% (n=5) of subjects. Tendon rupture was noted in 67% (n=8), and attenuation was noted in 33% (n=4). Average length of time from surgery to tendon rupture/attenuation was 5.7 months (range, 3-10 months). Conclusion: Potential contributing causes of tendon rupture/attenuation after transfer include surgical technique, rehabilitation, co-contraction of the transfer, poor patient compliance, and medications. In this cohort, 5 subjects were prescribed fluoroquinolones that have a US Food and Drug Administration black box concerning tendon ruptures. Currently, all candidates for upper extremity tendon transfer reconstruction are counseled on the effects of fluoroquinolones and the potential risk for tendon rupture. PMID:23459326

  10. Augmentation of Distal Biceps Repair With an Acellular Dermal Graft Restores Native Biomechanical Properties in a Tendon-Deficient Model.

    Science.gov (United States)

    Conroy, Christine; Sethi, Paul; Macken, Craig; Wei, David; Kowalsky, Marc; Mirzayan, Raffy; Pauzenberger, Leo; Dyrna, Felix; Obopilwe, Elifho; Mazzocca, Augustus D

    2017-07-01

    The majority of distal biceps tendon injuries can be repaired in a single procedure. In contrast, complete chronic tears with severe tendon substance deficiency and retraction often require tendon graft augmentation. In cases with extensive partial tears of the distal biceps, a human dermal allograft may be used as an alternative to restore tendon thickness and biomechanical integrity. Dermal graft augmentation will improve load to failure compared with nonaugmented repair in a tendon-deficient model. Controlled laboratory study. Thirty-six matched specimens were organized into 1 of 4 groups: native tendon, native tendon with dermal graft augmentation, tendon with an attritional defect, and tendon with an attritional defect repaired with a graft. To mimic a chronic attritional biceps lesion, a defect was created by a complete tear, leaving 30% of the tendon's width intact. The repair technique in all groups consisted of cortical button and interference screw fixation. All specimens underwent cyclical loading for 3000 cycles and were then tested to failure; gap formation and peak load at failure were documented. The mean (±SD) load to failure (320.9 ± 49.1 N vs 348.8 ± 77.6 N, respectively; P = .38) and gap formation (displacement) (1.8 ± 1.4 mm vs 1.6 ± 1.1 mm, respectively; P = .38) did not differ between the native tendon groups with and without graft augmentation. In the tendon-deficient model, the mean load to failure was significantly improved with graft augmentation compared with no graft augmentation (282.1 ± 83.8 N vs 199.7 ± 45.5 N, respectively; P = .04), while the mean gap formation was significantly reduced (1.2 ± 1.0 mm vs 2.7 ± 1.4 mm, respectively; P = .04). The mean load to failure of the deficient tendon with graft augmentation (282.1 N) compared with the native tendon (348.8 N) was not significantly different ( P = .12). This indicates that the native tendon did not perform differently from the grafted deficient tendon. In a tendon

  11. A influência da mobilização articular nas tendinopatias dos músculos bíceps braquial e supra-espinal The influence of joint mobilization on tendinopathy of the biceps brachii and supraspinatus muscles

    Directory of Open Access Journals (Sweden)

    RI Barbosa

    2008-08-01

    Full Text Available As causas mais comuns de dor no ombro estão relacionadas às degenerações dos tendões da musculatura do manguito rotador. OBJETIVO: Verificar a influência da mobilização articular por meio dos movimentos acessórios do ombro na recuperação inicial de 14 pacientes com tendinopatia crônica dos mm. supra-espinal e/ou bíceps braquial. MÉTODOS: Foram comparados dois protocolos de tratamento, compostos da aplicação de ultra-som terapêutico na área do tendão afetado e de treinamento excêntrico na musculatura envolvida, acompanhados ou não de manobras de mobilização articular. Como métodos de avaliação foram utilizados os questionários de Constant e Disabilities of the Arm, Shoulder and Hand (DASH, no início e ao final do tratamento. RESULTADOS: Os resultados encontrados demonstraram que ambos os protocolos de tratamento foram eficazes na reabilitação dos pacientes, pois se obtiveram melhores resultados funcionais na aplicação dos questionários quando comparados o final com o início do tratamento para os pacientes (pThe most common causes of shoulder pain are related to degeneration of the tendons of the rotator cuff muscles. OBJECTIVE: To investigate the influence of joint mobilization by means of accessory movements of the shoulder during the early rehabilitation of 14 patients with chronic tendinopathy of the supraspinatus and/or biceps brachii muscles. METHODS: Two treatment protocols were compared: application of therapeutic ultrasound over the affected tendon area and eccentric training of the musculature involved, with or without joint mobilization maneuvers. The Constant and DASH (Disabilities of the Arm, Shoulder and Hand questionnaires were used as the assessment method, before and after the treatment. RESULTS: The results showed that both treatment protocols were effective for patient rehabilitation, since better functional results were obtained at the end of the treatment, in comparison with the beginning (p<0

  12. Reassessment of Non-Monosynaptic Excitation from the Motor Cortex to Motoneurons in Single Motor Units of the Human Biceps Brachii.

    Science.gov (United States)

    Nakajima, Tsuyoshi; Tazoe, Toshiki; Sakamoto, Masanori; Endoh, Takashi; Shibuya, Satoshi; Elias, Leonardo A; Mezzarane, Rinaldo A; Komiyama, Tomoyoshi; Ohki, Yukari

    2017-01-01

    Corticospinal excitation is mediated by polysynaptic pathways in several vertebrates, including dexterous monkeys. However, indirect non-monosynaptic excitation has not been clearly observed following transcranial electrical stimulation (TES) or cervicomedullary stimulation (CMS) in humans. The present study evaluated indirect motor pathways in normal human subjects by recording the activities of single motor units (MUs) in the biceps brachii (BB) muscle. The pyramidal tract was stimulated with weak TES, CMS, and transcranial magnetic stimulation (TMS) contralateral to the recording side. During tasks involving weak co-contraction of the BB and hand muscles, all stimulation methods activated MUs with short latencies. Peristimulus time histograms (PSTHs) showed that responses with similar durations were induced by TES (1.9 ± 1.4 ms) and CMS (2.0 ± 1.4 ms), and these responses often showed multiple peaks with the PSTH peak having a long duration (65.3% and 44.9%, respectively). Such long-duration excitatory responses with multiple peaks were rarely observed in the finger muscles following TES or in the BB following stimulation of the Ia fibers. The responses obtained with TES were compared in the same 14 BB MUs during the co-contraction and isolated BB contraction tasks. Eleven and three units, respectively, exhibited activation with multiple peaks during the two tasks. In order to determine the dispersion effects on the axon conduction velocities (CVs) and synaptic noise, a simulation study that was comparable to the TES experiments was performed with a biologically plausible neuromuscular model. When the model included the monosynaptic-pyramidal tract, multiple peaks were obtained in about 34.5% of the motoneurons (MNs). The experimental and simulation results indicated the existence of task-dependent disparate inputs from the pyramidal tract to the MNs of the upper limb. These results suggested that intercalated interneurons are present in the spinal cord and

  13. Reassessment of Non-Monosynaptic Excitation from the Motor Cortex to Motoneurons in Single Motor Units of the Human Biceps Brachii

    Science.gov (United States)

    Nakajima, Tsuyoshi; Tazoe, Toshiki; Sakamoto, Masanori; Endoh, Takashi; Shibuya, Satoshi; Elias, Leonardo A.; Mezzarane, Rinaldo A.; Komiyama, Tomoyoshi; Ohki, Yukari

    2017-01-01

    Corticospinal excitation is mediated by polysynaptic pathways in several vertebrates, including dexterous monkeys. However, indirect non-monosynaptic excitation has not been clearly observed following transcranial electrical stimulation (TES) or cervicomedullary stimulation (CMS) in humans. The present study evaluated indirect motor pathways in normal human subjects by recording the activities of single motor units (MUs) in the biceps brachii (BB) muscle. The pyramidal tract was stimulated with weak TES, CMS, and transcranial magnetic stimulation (TMS) contralateral to the recording side. During tasks involving weak co-contraction of the BB and hand muscles, all stimulation methods activated MUs with short latencies. Peristimulus time histograms (PSTHs) showed that responses with similar durations were induced by TES (1.9 ± 1.4 ms) and CMS (2.0 ± 1.4 ms), and these responses often showed multiple peaks with the PSTH peak having a long duration (65.3% and 44.9%, respectively). Such long-duration excitatory responses with multiple peaks were rarely observed in the finger muscles following TES or in the BB following stimulation of the Ia fibers. The responses obtained with TES were compared in the same 14 BB MUs during the co-contraction and isolated BB contraction tasks. Eleven and three units, respectively, exhibited activation with multiple peaks during the two tasks. In order to determine the dispersion effects on the axon conduction velocities (CVs) and synaptic noise, a simulation study that was comparable to the TES experiments was performed with a biologically plausible neuromuscular model. When the model included the monosynaptic-pyramidal tract, multiple peaks were obtained in about 34.5% of the motoneurons (MNs). The experimental and simulation results indicated the existence of task-dependent disparate inputs from the pyramidal tract to the MNs of the upper limb. These results suggested that intercalated interneurons are present in the spinal cord and

  14. Slap Lesions in Middle-aged Patients: Biceps Repair or Tenodesis? What Should We Perform for Long Biceps Tendon?

    Directory of Open Access Journals (Sweden)

    Sergi Sastre

    2015-12-01

    Conclusion: Biceps tenodesis is a feasible therapeutic alternative to anatomical repair for the treatment of SLAP lesions in middle-aged patients; the reinsertion failure rates for this type of lesion are rather discouraging due to the high percentage of revision surgeries that must be carried out after the primary intervention.

  15. Physical examination tests and imaging studies based on arthroscopic assessment of the long head of biceps tendon are invalid.

    Science.gov (United States)

    Jordan, Robert W; Saithna, Adnan

    2017-10-01

    The aim of this study was to evaluate whether glenohumeral arthroscopy is an appropriate gold standard for the diagnosis of long head of biceps (LHB) tendon pathology. The objectives were to evaluate whether the length of tendon that can be seen at arthroscopy allows visualisation of areas of predilection of pathology and also to determine the rates of missed diagnoses at arthroscopy when compared to an open approach. A systematic review of cadaveric and clinical studies was performed. The search strategy was applied to MEDLINE, PubMed and Google Scholar databases. All relevant articles were included. Critical appraisal of clinical studies was performed using a validated quality assessment scale. Five articles were identified for inclusion in the review. This included both clinical and cadaveric studies. The overall population comprised 18 cadaveric specimens and 575 patients. Out of the five included studies, three reported the length of LHB tendon visualised during arthroscopy and four reported the rate of missed LHB diagnosis. Cadaveric studies showed that the use of a hook probe allowed arthroscopic visualisation of between 34 and 48 % of the overall length of the LHB. In the clinical series, the rate of missed diagnoses at arthroscopy when compared to open exploration ranged between 33 and 49 %. Arthroscopy allows visualisation of only a small part of the extra-articular LHB tendon. This leads to a high rate of missed pathology in the distal part of the tendon. Published figures for sensitivities and specificities of common physical examination and imaging tests for LHB pathology that are based on arthroscopy as the gold standard are therefore invalid. In clinical practice, it is important to note that a "negative" arthroscopic assessment does not exclude a lesion of the LHB tendon as this technique does not allow visualisation of common sites of distal pathology. IV.

  16. Cadaveric Study of Insertional Anatomy of Distal Biceps Tendon and its Relationship to the Dynamic Proximal Radioulnar Space.

    Science.gov (United States)

    Bhatia, Deepak N; Kandhari, Vikram; DasGupta, Bibhas

    2017-01-01

    To quantify and assess the relationship between the insertional dimensions of the distal biceps tendon (DBT) and radioulnar space (RUS) in 3 rotational positions. We hypothesized that in all positions RUS would be adequate for the DBT and would remain adequate even after an incremental increase (1 to 3 mm) in tendon thickness. Eleven fresh-frozen cadaveric elbows were dissected; DBT dimensions and bicipital tuberosity measurements were performed and insertional footprints were quantified using a distal biceps footprint index. The RUS was measured at 3 levels of the bicipital tuberosity and in 3 positions of forearm rotation. We performed statistical analysis to analyze differences in RUS (positional and inter-level). In addition, significant differences between DBT thickness (native and incremental) and RUS were analyzed to identify potential sites of radioulnar impingement. The DBT had a mean length of 92 mm; thickness ranged from 2.9 to 6.1 mm. Three variations in DBT insertional footprint were observed and quantified. The RUS linear distance reduced significantly from a supinated to a pronated position at each of 3 bicipital tuberosity levels; the reduction was statistically significant at the lower tuberosity level (45%). Pronation RUS distance was adequate for native DBT thickness and was significantly less when DBT thickness increased by 2 and 3 mm. Radioulnar space reduces significantly from the supinated to the pronated position and is most evident in the lower aspect of the tuberosity. In addition, the RUS in pronation is inadequate for incremental increases in DBT thickness. Postoperative DBT impingement in the RUS may be prevented by avoiding techniques that increase the thickness of the tendon and by using a reattachment site at the proximal aspect of the tuberosity. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  17. The incidence of pathologic changes of the long head of the biceps tendon.

    Science.gov (United States)

    Murthi, A M; Vosburgh, C L; Neviaser, T J

    2000-01-01

    The incidence of primary and secondary bicipital tendinitis remains unknown. In our prospective study, 200 consecutive shoulders underwent arthroscopic subacromial decompression for impingement syndrome. A biceps tenodesis was performed in 80 shoulders (40%) featuring macroscopic degeneration of the long head of the biceps; rotator cuff tears were apparent in 91% of these shoulders, the mean patient age being 55 years. In each of 120 shoulders (60%), an extraarticular tenosynovectomy was performed, and histopathologic studies revealed chronic inflammation in 63% and fibrotic degeneration in 13% of the specimens; rotator cuff tears were evident in 70% (23% full thickness) of these cases, the mean patient age being 47 years. In addition, when glenohumeral arthritis was present, it was uniformly associated with pathologic biceps tenosynovium. In summary, the high incidence of chronic inflammation of the long head of the biceps in shoulders with benign-appearing intraarticular portions viewed arthroscopically is significant, and long head of the biceps disease should also be considered in patients with painful rotator cuff disease and arthritic shoulder conditions.

  18. Systematics of injuries of the rotator cuff and biceps tendon; Systematik der Verletzungen von Rotatorenmanschette und Bizepssehne

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, M.J. [Landesklinikum Horn, Institut fuer Radiologie und interventionelle Radiologie, Horn (Austria); Pones, M.; Breitenseher, J.B. [Medizinische Universitaet Wien, Univ.-Klinik fuer Radiodiagnostik, Wien (Austria)

    2015-03-01

    Injuries of the rotator cuff and the biceps tendon demonstrate different patterns, which can be recognized clinically and radiologically. These patterns are impingement syndrome with additional trauma, isolated trauma of the rotator cuff and shoulder dislocation causing rotator cuff tears. Furthermore, it is clinically crucial to evaluate the extent of a rotator cuff injury. Magnetic resonance imaging (MRI) is the modality of choice to differentiate these patterns. (orig.) [German] Bei der Verletzung von Rotatorenmanschette und Bizepssehne koennen verschiedene Muster klinisch und radiologisch erkannt werden. Diese Muster sind das Impingementsyndrom mit einem zusaetzlichen Trauma, das isolierte Trauma und die Verletzung der Rotatorenmanschette im Rahmen einer Schulterluxation. Darueber hinaus ist die Beurteilung des Ausmasses einer Verletzung von zentraler klinischer Relevanz. Die MRT kann die Differenzierung dieser Muster bestmoeglich durchfuehren. (orig.)

  19. Abnormal origins of the long head of the biceps tendon can lead to rotator cuff pathology: a report of two cases.

    Science.gov (United States)

    Zhang, Alan L; Gates, Cameron H; Link, Thomas M; Ma, C Benjamin

    2014-11-01

    Previous case reports have highlighted various anomalous origins of the long head of the biceps tendon (LHBT) that do not originate from the superior glenoid labrum or supraglenoid tubercle. Yet, these cases were all reported as incidental findings and were not thought to cause any significant shoulder pathology. We present the magnetic resonance (MR) imaging and clinical treatment of two cases where aberrant intra-articular origins of the long head of the biceps tendon from the anterior edge of the supraspinatus tendon may have contributed to symptomatic rotator cuff pathology. Arthroscopy confirmed MR findings of partial articular-sided supraspinatus lesions in close proximity to the anomalous origins and treatment with tenodesis of the LHBT successfully relieved symptoms. Although rare occurrences with subtle and potentially misleading imaging findings, it is important to be aware of aberrant origins of the LHBT that may contribute to concomitant rotator cuff pathology.

  20. Mapping the articular contact area of the long head of the biceps tendon on the humeral head.

    Science.gov (United States)

    Morris, Brent J; Byram, Ian R; Lathrop, Ray A; Dunn, Warren R; Kuhn, John E

    2014-01-01

    The purpose of this investigation was to calculate the contact surface area of the long head of the biceps (LHB) in neutral position and abduction. We sought to determine whether the LHB articulates with the humeral head in a consistent pattern comparing articular contact area in neutral position and abduction. Eleven fresh frozen matched cadaveric shoulders were analyzed. The path of the biceps tendon on the articular surface of the humeral head and the total articular surface were digitized using a MicronTracker 2 H3-60 three-dimensional optical tracker. Contact surface area was significantly less in abduction than in neutral position (P = 0.002) with a median ratio of 41% (36%, 47.5%). Ratios of contact area in neutral position to full articular surface area were consistent between left and right shoulders (rho = 1, P = 0.017) as were ratios of abduction area to full articular surface area (rho = 0.97, P = 0.005). The articular contact surface area is significantly greater in neutral position than abduction. The ratios of articular contact surface areas to total humeral articular surface areas have a narrow range and are consistent between left and right shoulders of the same cadaver.

  1. Common Peroneal Nerve Palsy with Multiple-Ligament Knee Injury and Distal Avulsion of the Biceps Femoris Tendon

    Directory of Open Access Journals (Sweden)

    Takeshi Oshima

    2015-01-01

    Full Text Available A multiple-ligament knee injury that includes posterolateral corner (PLC disruption often causes palsy of the common peroneal nerve (CPN, which occurs in 44% of cases with PLC injury and biceps femoris tendon rupture or avulsion of the fibular head. Approximately half of these cases do not show functional recovery. This case report aims to present a criteria-based approach to the operation and postoperative management of CPN palsy that resulted from a multiple-ligament knee injury in a 22-year-old man that occurred during judo. We performed a two-staged surgery. The first stage was to repair the injuries to the PLC and biceps femoris. The second stage involved anterior cruciate ligament reconstruction. The outcomes were excellent, with a stable knee, excellent range of motion, and improvement in the palsy. The patient was able to return to judo competition 27 weeks after the injury. To the best of our knowledge, this is the first case report describing a return to sports following CPN palsy with multiple-ligament knee injury.

  2. Mapping the Articular Contact Area of the Long Head of the Biceps Tendon on the Humeral Head

    Directory of Open Access Journals (Sweden)

    Brent J. Morris

    2014-01-01

    Full Text Available The purpose of this investigation was to calculate the contact surface area of the long head of the biceps (LHB in neutral position and abduction. We sought to determine whether the LHB articulates with the humeral head in a consistent pattern comparing articular contact area in neutral position and abduction. Eleven fresh frozen matched cadaveric shoulders were analyzed. The path of the biceps tendon on the articular surface of the humeral head and the total articular surface were digitized using a MicronTracker 2 H3-60 three-dimensional optical tracker. Contact surface area was significantly less in abduction than in neutral position (P=0.002 with a median ratio of 41% (36%, 47.5%. Ratios of contact area in neutral position to full articular surface area were consistent between left and right shoulders (rho=1, P=0.017 as were ratios of abduction area to full articular surface area (rho= 0.97, P=0.005. The articular contact surface area is significantly greater in neutral position than abduction. The ratios of articular contact surface areas to total humeral articular surface areas have a narrow range and are consistent between left and right shoulders of the same cadaver.

  3. MR imaging findings in flexed abducted supinated (FABS) position and clinical presentation following refixation of distal biceps tendon rupture using bioabsorbable suture anchors

    International Nuclear Information System (INIS)

    Marnitz, T.; Steffen, I.G.; Denecke, T.; Elgeti, F.A.; Spiegel, D.; Hug, K.; Hueper, M.; Gerhardt, C; Greiner, S.; Scheibel, M.

    2012-01-01

    Purpose: To correlate MRI findings after suture anchor repair of distal biceps tendons with symptoms. Materials and Methods: 24 men with 25 distal biceps tendon ruptures (one bilateral) treated with suture anchor repair were retrospectively included. Follow-up after a mean of 31 months (range, 12 - 74) included clinical examination and MRI. The pain level and flexion strength compared to the uninvolved arm were recorded. MRI was performed at 1.5 T obtaining FABS position images (both elbows in 7 patients) and evaluated for artifacts, signal abnormalities, and rerupture by two experienced readers in consensus and blinded to symptoms. Pain and loss of flexion strength > 20 % were tested against MRI findings as dichotomous data using Fisher's exact chi-square tests (p 0.05). There was a 2.7-fold mean increase of the tendon cross-sectional area on the repaired side compared to the uninvolved contralateral tendon (p = 0.02). Conclusion: We found good MRI visualization of postoperative tendons, but no correlation between symptoms and MRI signal abnormalities or rerupture. The increase in caliber of the repaired tendon might promote an impingement in pronation. (orig.)

  4. Diagnostic accuracy of 3T conventional shoulder MRI in the detection of the long head of the biceps tendon tears associated with rotator cuff tendon tears

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ro Woon; Choi, Soo-Jung; Ahn, Jae Hong; Shin, Dong Rock; Kang, Chae Hoon [University of Ulsan, College of Medicine, Department of Radiology, Asan Foundation, Gangneung Asan Hospital, Gangneung-si, Gangwon-do (Korea, Republic of); Lee, Man Ho [Andong Medical Center, Department of Radiology, Andong-si, Gyeongsangbuk-do (Korea, Republic of); Lee, Ki Won [University of Ulsan, College of Medicine, Department of Orthopedic Surgery, Asan Foundation, Gangneung Asan Hospital, Gangneung-si, Gangwon-do (Korea, Republic of)

    2016-12-15

    To evaluate the diagnostic performance (DP) of 3T (3 Tesla field strength) conventional shoulder magnetic resonance imaging (MRI) in detecting the long head of the biceps tendon (LHBT) tears in association with rotator cuff tendon tears. This study included 80 consecutive patients who underwent arthroscopic surgery for rotator cuff tendon tears. Two radiologists independently evaluated the preoperative 3T shoulder MRI for the presence of LHBT tears. The DP of MRI was evaluated using the results of arthroscopy as the reference standard. We also evaluated the DP of several MR signs of LHBT in detection of partial LHBT tears. Arthroscopic examination revealed 35 partial and 5 complete tears. According to the results of evaluation by reviewers 1 and 2, shoulder MRI exhibited sensitivities of 77.14 and 80 % and specificities of 71.11 and 73.33 % in detection of partial LHBT tears and sensitivities of 80 and 100 % and a specificity of 100% (both) in detection of complete LHBT tears. In detecting partial LHBT tears, increased T2 signal intensity of the LHBT exhibited high sensitivities (reviewers 1 and 2; 82.85 and 80 %, respectively) and the presence of intratendinous defects or C-signs exhibited the highest specificities (reviewers 1 and 2; 95.55 and 93.33 %, respectively), followed by abnormalities in shape and outer margins of the LHBT (reviewers 1 and 2; 91.11 and 82 %; 91.11 and 86.66 %, respectively). Non-contrast-enhanced 3T shoulder MRI is potentially highly accurate in detection of complete LHBT tears, but moderately accurate in detection of partial LHBT tears. (orig.)

  5. Diagnostic accuracy of 3T conventional shoulder MRI in the detection of the long head of the biceps tendon tears associated with rotator cuff tendon tears

    International Nuclear Information System (INIS)

    Lee, Ro Woon; Choi, Soo-Jung; Ahn, Jae Hong; Shin, Dong Rock; Kang, Chae Hoon; Lee, Man Ho; Lee, Ki Won

    2016-01-01

    To evaluate the diagnostic performance (DP) of 3T (3 Tesla field strength) conventional shoulder magnetic resonance imaging (MRI) in detecting the long head of the biceps tendon (LHBT) tears in association with rotator cuff tendon tears. This study included 80 consecutive patients who underwent arthroscopic surgery for rotator cuff tendon tears. Two radiologists independently evaluated the preoperative 3T shoulder MRI for the presence of LHBT tears. The DP of MRI was evaluated using the results of arthroscopy as the reference standard. We also evaluated the DP of several MR signs of LHBT in detection of partial LHBT tears. Arthroscopic examination revealed 35 partial and 5 complete tears. According to the results of evaluation by reviewers 1 and 2, shoulder MRI exhibited sensitivities of 77.14 and 80 % and specificities of 71.11 and 73.33 % in detection of partial LHBT tears and sensitivities of 80 and 100 % and a specificity of 100% (both) in detection of complete LHBT tears. In detecting partial LHBT tears, increased T2 signal intensity of the LHBT exhibited high sensitivities (reviewers 1 and 2; 82.85 and 80 %, respectively) and the presence of intratendinous defects or C-signs exhibited the highest specificities (reviewers 1 and 2; 95.55 and 93.33 %, respectively), followed by abnormalities in shape and outer margins of the LHBT (reviewers 1 and 2; 91.11 and 82 %; 91.11 and 86.66 %, respectively). Non-contrast-enhanced 3T shoulder MRI is potentially highly accurate in detection of complete LHBT tears, but moderately accurate in detection of partial LHBT tears. (orig.)

  6. Visualization of the extra-articular portion of the long head of the biceps tendon during intra-articular shoulder arthroscopy.

    Science.gov (United States)

    Festa, Anthony; Allert, Jesse; Issa, Kimona; Tasto, James P; Myer, Jonathan J

    2014-11-01

    To quantify the amount of the extra-articular long head of the biceps tendon (LHBT) seen during intra-articular shoulder arthroscopy by pulling the tendon into the joint with a probe through an anterior portal while viewing through a standard posterior portal. Intra-articular shoulder arthroscopy was performed on 10 forequarter cadaveric specimens. The extra-articular portion of the LHBT was evaluated by pulling the tendon into the joint with an arthroscopic probe inserted through an anterior portal. The tendon was marked at the pulley insertion on the humerus with a vascular clip before and after the tendon was pulled into the joint. An open deltopectoral approach was performed, and the amount of extra-articular tendon visualized was calculated as an absolute amount and in relation to nearby anatomic structures. An additional 1.9 cm (range, 1.4 to 2.6 cm) of extra-articular LHBT was viewed by pulling the tendon into the joint with an arthroscopic probe through an anterior portal during shoulder arthroscopy. This represented 30.8% of the extra-articular portion of the tendon, 47.7% of tendon in the bicipital groove, and 76.3% of the tendon that lies under the area from the pulley insertion to the distal edge of the transverse humeral ligament. During intra-articular shoulder arthroscopy, the extra-articular portion of the LHBT is incompletely visualized by pulling the tendon into the joint with a probe placed through an anterior portal while viewing through a standard posterior portal. An additional extra-articular portion of the LHBT may be viewed by pulling the tendon into the joint with an arthroscopic probe during shoulder arthroscopy. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  7. Absence of the musculocutaneous nerve with innervation of coracobrachialis, biceps brachii, brachialis and the lateral border of the forearm by branches from the lateral cord of the brachial plexus

    Science.gov (United States)

    NAKATANI, TOSHIO; TANAKA, SHIGENORI; MIZUKAMI, SHIGEKI

    1997-01-01

    Anomalies of the brachial plexus and its terminal branches are not uncommon. Variations in the course and branches of the musculocutaneous nerve have been noted (Clemente, 1985; Bergman et al. 1988) and its absence was reported by Le Minor (1990). Several anomalies were present in the left plexus of a 59-y-old Japanese man (Fig.). There were no anterior and posterior divisions of the middle trunk, although there were communications between the posterior, medial and lateral cords. The musculocutaneous nerve was absent (Le Minor, 1990) and the medial and lateral roots of the median nerve did not unite in the axillary fossa but in the upper arm about 5 cm distal to the lower border of latissimus dorsi (Adachi, 1928; Buch-Hansen, 1955). The hitherto unreported findings were branches arising directly from the lateral cord to supply coracobrachialis, both heads of biceps brachii and brachialis. The lateral cutaneous nerve of the forearm was derived from the lateral cord with a small contribution from the medial root of the median nerve. Since there were communications between the posterior cord (a continuation of the middle trunk) and the medial and lateral cords, it is theoretically possibly, but not proven, that the root values of branches innervating the flexor muscles of the arm and forearm and the skin of lateral border of the forearm were normal. PMID:9419004

  8. Evaluation of the clinical-functional results from repairing extensive rotator cuff injury with inclusion of the tendon of the long head of the biceps

    Directory of Open Access Journals (Sweden)

    Roberto Yukio Ikemoto

    2013-04-01

    Full Text Available OBJECTIVES: To assess the outcomes of the arthroscopic margin convergence of the posterior cuff to the biceps tendon. METHODS: From October 2003 to December 2007, 20 patients with massive rotator cuff tear which include the rotator interval were treated with arthroscopic margin convergence of the posterior cuff to biceps tendon. Sixteen patients were female and four were male. The mean age was 58.95 years old. The dominant side was affected in 16 cases (80%. The outcomes were analysed according to the UCLA Score with a minimum follow-up period of two years. RESULTS: The UCLA score improved, on average, 14 points (p < 0.001. Six patients had excellent results; nine good; three fair and two poor results. The mean improvement of forward flexion was 33º (p < 0.001, 3º of external rotation (p < 0.396 and two vertebral levels for internal rotation (p < 0.025. CONCLUSION: The arthroscopic margin convergence of the posterior cuff to the biceps tendon leads to satisfactory results.

  9. Biceps Tendon Lengthening Surgery for Failed Serial Casting Patients With Elbow Flexion Contractures Following Brachial Plexus Birth Injury.

    Science.gov (United States)

    Nath, Rahul K; Somasundaram, Chandra

    2016-01-01

    Assessment of surgical outcomes of biceps tendon lengthening (BTL) surgery in obstetric brachial plexus injury (OBPI) patients with elbow flexion contractures, who had unsuccessful serial casting. Serial casting and splinting have been shown to be effective in correcting elbow flexion contractures in OBPI. However, the possibilities of radial head dislocations and other complications have been reported in serial casting and splinting. Literature indicates surgical intervention when such nonoperative techniques and range-of-motion exercises fail. Here, we demonstrated a significant reduction of the contractures of the affected elbow and improvement in arm length to more normal after BTL in these patients, who had unsuccessful serial casting. Ten OBPI patients (6 girls and 4 boys) with an average age of 11.2 years (4-17.7 years) had BTL surgery after unsuccessful serial casting. Mean elbow flexion contracture was 40° before and 37° (average) after serial casting. Mean elbow flexion contracture was reduced to 8° (0°-20°) post-BTL surgical procedure with an average follow-up of 11 months. This was 75% improvement and statistically significant (P casting. These OBPI patients in our study had 75% significant reduction in elbow flexion contractures and achieved an improved and more normal length of the affected arm after the BTL surgery when compared to only 7% insignificant reduction and no improvement in arm length after serial casting.

  10. Biceps tendinitis and subluxation.

    Science.gov (United States)

    Patton, W C; McCluskey, G M

    2001-07-01

    Since the 17th century, the long head of the biceps tendon as a source of shoulder pain and its functional significance has been a source of debate. Although the term tendinitis is commonly used, overuse tendon injuries infrequently demonstrate inflammatory cells; instead, degenerative changes resulting from the failure of self-repair usually are found. Bicipital tendinitis or bicipital tenosynovitis is most often secondary to impingement beneath the coracoacromical arch. Primary bicipital tendinitis and tendinitis secondary to instability are possible, however. Through a careful history, physical examination, and appropriate imaging studies, the clinician can establish the diagnosis of disorders of the biceps tendon Arthroscopic evaluation greatly improves the diagnosis and treatment of biceps tendon and related shoulder pathology. Although the exact functional role of the biceps tendon remains incompletely defined, a growing body of evidence supports its role as a stabilizer of the glenohumeral joint. This stabilizing function should be incorporated into the treatment of biceps tendon disorders. Routine tenodesis has been replaced by a more individualized approach, taking into consideration physiologic age, activity level, expectations, and exact shoulder pathology present. New repair techniques are under development, and preservation of the biceps-labral complex is now preferred when possible.

  11. Achilles Tendonitis

    Science.gov (United States)

    ... almost impossible. Achilles tendonitis is a very common running injury. But it can also affect basketball players, dancers, ... Proximal Biceps Tendonitis Safety Tips: Basketball Safety Tips: Running Repetitive Stress Injuries Sports and Exercise Safety Dealing With Sports Injuries ...

  12. Direct lentiviral-cyclooxygenase 2 application to the tendon-bone interface promotes osteointegration and enhances return of the pull-out tensile strength of the tendon graft in a rat model of biceps tenodesis.

    Directory of Open Access Journals (Sweden)

    Charles H Rundle

    Full Text Available This study sought to determine if direct application of the lentiviral (LV-cyclooxygenase 2 (COX2 vector to the tendon-bone interface would promote osteointegration of the tendon graft in a rat model of biceps tenodesis. The LV-COX2 gene transfer strategy was chosen for investigation because a similar COX2 gene transfer strategy promoted bony bridging of the fracture gap during bone repair, which involves similar histologic transitions that occur in osteointegration. Briefly, a 1.14-mm diameter tunnel was drilled in the mid-groove of the humerus of adult Fischer 344 rats. The LV-COX2 or βgal control vector was applied directly into the bone tunnel and onto the end of the tendon graft, which was then pulled into the bone tunnel. A poly-L-lactide pin was press-fitted into the tunnel as interference fixation. Animals were sacrificed at 3, 5, or 8 weeks for histology analysis of osteointegration. The LV-COX2 gene transfer strategy enhanced neo-chondrogenesis at the tendon-bone interface but with only marginal effect on de novo bone formation. The tendon-bone interface of the LV-COX2-treated tenodesis showed the well-defined tendon-to-fibrocartilage-to-bone histologic transitions that are indicative of osteointegration of the tendon graft. The LV-COX2 in vivo gene transfer strategy also significantly enhanced angiogenesis at the tendon-bone interface. To determine if the increased osteointegration was translated into an improved pull-out mechanical strength property, the pull-out tensile strength of the LV-COX2-treated tendon grafts was determined with a pull-out mechanical testing assay. The LV-COX2 strategy yielded a significant improvement in the return of the pull-out strength of the tendon graft after 8 weeks. In conclusion, the COX2-based in vivo gene transfer strategy enhanced angiogenesis, osteointegration and improved return of the pull-out strength of the tendon graft. Thus, this strategy has great potential to be developed into an

  13. Proximal Biceps Tendonitis

    Science.gov (United States)

    ... you to have an X-ray , ultrasound, or magnetic resonance imaging (MRI) scan . How Can I Prevent ... to avoid using your injured arm for any lifting or reaching. Ice the affected area. Apply ice ...

  14. Instability of the long head of the biceps tendon in patients with rotator cuff tear: evaluation on magnetic resonance arthrography of the shoulder with arthroscopic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yusuhn; Lee, Joon Woo; Ahn, Joong Mo; Lee, Eugene; Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology, Seongnam-si, Gyeonggi-do (Korea, Republic of)

    2017-10-15

    To evaluate the diagnostic value of MR arthrography (MRA) in diagnosing instability of the LHBT in patients with rotator cuff tendon tear. The MR arthrograms of 101 patients were retrospectively reviewed and correlated with arthroscopic findings as the standard reference. Images were evaluated for (1) the integrity of the LHBT, (2) the position of the LHBT (subluxation/dislocation on axial images, inferior displacement on oblique sagittal image) and (3) the integrity of the biceps pulley (SGHL, supraspinatus and subscapularis tendon adjacent to the rotator interval). The integrity of the LHBT was correctly classified in 74.3% (75/101) and 66.3% (67/101) by readers 1 and 2, respectively. The diagnosis of LHBT instability could be made on axial images with a sensitivity of 82.6% and 73.9% and specificity of 69.9% and 87.7%, whereas the displacement sign on sagittal images had a sensitivity of 73.9% and 78.3% and a specificity of 64.4% and 61.6%, respectively. Assessing the integrity of the SGHL had a sensitivity of 60.9 and 93.3% and a specificity of 70.4 and 75.0%, respectively. By combining the different image findings, the accuracy in assessing LHBT instability was 80.9 and 90.5% with a sensitivity of 60.9 and 86.7% and specificity of 83.1 and 91.8%, respectively. Individual image findings may have a limited role in diagnosing LHBT instability in patients with rotator cuff tendon tear. The accuracy of MRA may be improved by assessing the integrity of the biceps pulley structures along with the position of the LHBT on both axial and sagittal images. (orig.)

  15. ARTHROSCOPIC CORRECTION OF THE INJURIES OF THE COMPLEX «TENDON OF THE BICEPS LONG HEAD - THE ARTICULAR LIP» IN TREATMENT OF PATIENTS WITH FULL-LAYER RUPTURES OF THE ROTATOR CUFF

    Directory of Open Access Journals (Sweden)

    S. Y. Dokolin

    2013-01-01

    Full Text Available Damage of the long head of the biceps at the place of attachment to the articular tubercle supraglenoidal lip of shoulder, to the entrance and throughout intertubercle furrows are common causes of pain and dysfunction of the shoulder joint. At the same clinical manifestations of the morphology of such lesions may be different. The current literature discusses various options of surgical correction of the biceps injury. Variety of methods of surgical treatment and the lack of consensus in support of their application in different patients in different types of injuries were the basis for the present study. A prospective analysis of the functional results of surgical treatment of the 34 - year’s patients with associated rotator cuff (SSP+ISP+SSC+ and the tendon of the biceps muscle in age from 34 to 75 years. Options for surgical correction of the damaged part of the biceps were: biceps tenotomy, biceps tenotomy with intraarticular tenodez of the shoulder to the head before entering intertubercle furrow, biceps tenotomy and extraarticular subpectorialtenodez to the proximal humerus is intertubercle interferrent screw groove, as well as its attachment to the tendon suture large pectoral muscle. Choice of surgical approach depended on the patient's age, level of daily physical activity, morphology and localization of lesions. The best results were obtained when the extra-articular subpectorialtenodez of long head of the biceps to the proximal humerus interferrent screw and suture fixation to the pectoralis major muscle, the average follow-up was 16,6 ± 4,7 months.

  16. Double profunda brachii artery

    OpenAIRE

    Gavishiddappa A Hadimani; Jyoti V Hadimani; Ishwar B Bagoji; Shardha Bai Rathod; Balappa M Bannur

    2016-01-01

    Brachial artery (BA) is a continuation of the axillary artery at the lower border of teres major. In the cubital fossa, BA divides into radial artery and ulnar artery as terminal branches. Large branch given from the BA in the upper part is profunda brachii artery. In the present case, we noticed double profunda brachii that arises from the BA. They are profunda brachii artery 1 and profunda brachii artery 2. Profunda brachii artery 1 arises in the proximal part of the BA and profunda brachii...

  17. Diagnosis and treatment of biceps tendinitis and tendinosis.

    Science.gov (United States)

    Churgay, Catherine A

    2009-09-01

    Biceps tendinitis is inflammation of the tendon around the long head of the biceps muscle. Biceps tendinosis is caused by degeneration of the tendon from athletics requiring overhead motion or from the normal aging process. Inflammation of the biceps tendon in the bicipital groove, which is known as primary biceps tendinitis, occurs in 5 percent of patients with biceps tendinitis. Biceps tendinitis and tendinosis are commonly accompanied by rotator cuff tears or SLAP (superior labrum anterior to posterior) lesions. Patients with biceps tendinitis or tendinosis usually complain of a deep, throbbing ache in the anterior shoulder. Repetitive overhead motion of the arm initiates or exacerbates the symptoms. The most common isolated clinical finding in biceps tendinitis is bicipital groove point tenderness with the arm in 10 degrees of internal rotation. Local anesthetic injections into the biceps tendon sheath may be therapeutic and diagnostic. Ultrasonography is preferred for visualizing the overall tendon, whereas magnetic resonance imaging or computed tomography arthrography is preferred for visualizing the intra-articular tendon and related pathology. Conservative management of biceps tendinitis consists of rest, ice, oral analgesics, physical therapy, or corticosteroid injections into the biceps tendon sheath. Surgery should be considered if conservative measures fail after three months, or if there is severe damage to the biceps tendon.

  18. Double profunda brachii artery

    Directory of Open Access Journals (Sweden)

    Gavishiddappa A Hadimani

    2016-01-01

    Full Text Available Brachial artery (BA is a continuation of the axillary artery at the lower border of teres major. In the cubital fossa, BA divides into radial artery and ulnar artery as terminal branches. Large branch given from the BA in the upper part is profunda brachii artery. In the present case, we noticed double profunda brachii that arises from the BA. They are profunda brachii artery 1 and profunda brachii artery 2. Profunda brachii artery 1 arises in the proximal part of the BA and profunda brachii artery 2 arises distal to the profunda brachii artery 1. Both the arteries run inferolaterally in the spiral groove along with radial nerve. Variations of profunda brachii artery are important during harvesting of the lateral arm flaps and may lead to inadvertent injury during percutaneous arterial catheterization or injection of drugs.

  19. Hypertrophy of the extra-articular tendon of the long head of biceps correlates with the location and size of a rotator cuff tear.

    Science.gov (United States)

    Takahashi, N; Sugaya, H; Matsuki, K; Miyauchi, H; Matsumoto, M; Tokai, M; Onishi, K; Hoshika, S; Ueda, Y

    2017-06-01

    The aim of this study was to assess hypertrophy of the extra-articular tendon of the long head of biceps (LHB) in patients with a rotator cuff tear. The study involved 638 shoulders in 334 patients (175 men, 159 women, mean age 62.6 years; 25 to 81) with unilateral symptomatic rotator cuff tears. The cross-sectional area (CSA) of the LHB tendon in the bicipital groove was measured pre-operatively in both shoulders using ultrasound. There were 154 asymptomatic rotator cuff tears in the contralateral shoulder. Comparisons were made between those with a symptomatic tear, an asymptomatic tear and those with no rotator cuff tear. In the affected shoulders, the CSAs were compared in relation to the location and size of the rotator cuff tear. The mean CSA was 21.0 mm 2 (4 to 71) in those with a symptomatic rotator cuff tear, 19.9 mm 2 (4 to 75) in those with an asymptomatic rotator cuff tear and 14.1 mm 2 (5 to 43) in those with no rotator cuff tear. The mean CSA in patients with both symptomatic and asymptomatic rotator cuff tears was significantly larger than in those with no rotator cuff tear (p cuff tear and those with an antero-superior cuff tear. Regardless of the symptoms, there was significant hypertrophy of the extra-articular LHB tendon in patients with a rotator cuff tear. The values were significantly related to the size of the tear. Cite this article: Bone Joint J 2017;99-B:806-11. ©2017 The British Editorial Society of Bone & Joint Surgery.

  20. Correlation of the SLAP lesion with lesions of the medial sheath of the biceps tendon and intra-articular subscapularis tendon

    Directory of Open Access Journals (Sweden)

    Bennett William

    2009-01-01

    Full Text Available Background: Superior labral anterior to posterior (SLAP lesions have been well described in the literature and are thought to be secondary to traction injuries to the biceps anchor and/or falls on the outstretched arm. The pulley has recently been described as a structure that aids in the prevention of biceps instability. The intra-articular subscapularis insertion (IASS has been noted to contribute to the robust nature of the medial sheath. The purpose of the study was to determine a potential correlation of SLAP lesions and pulley lesions with/without IASS lesions, (hereafter referred to as medial sheath as forces that can disrupt the biceps anchor and may also disrupt structures of the medial sheath or vice-versa. Materials and Methods: Three hundred and sixteen consecutive shoulder arthroscopies performed by one surgeon were reviewed retrospectively. Operative reports and arthroscopic pictures were carefully reviewed with particular attention paid to the labral and pulley pathology. Selection bias was noted as the author had never operated primarily for a Type 1 SLAP lesion. Following, however, and as such, the exclusion criteria, was a Type 1 SLAP. Results: There were a total of 30 SLAP lesions and a total of 126 medial sheath lesions. There were 13 patients who had both SLAP and medial sheath lesions. There were 17 patients who had a SLAP lesion without a medial sheath lesion. There were 96 medial sheath lesions without a SLAP. A comparison of rates between patients who had a medial sheath lesion with a SLAP and those who had a medial sheath lesion without a SLAP, for the 316 patients, and when tested with a Fisher exact test revealed that there was no statistical significance, P = 0.673. The prevalence of SLAP lesions in this population of 316 patients was 9.4%, Buford 1%, medial sheath lesions 39%, and SLAP and medial sheath lesions 4%. Interestingly, there were three Buford complexes, all associated with a SLAP and one Buford complex

  1. Tuberculose refratária disseminada com acometimento do tendão bicipital em paciente imunocompetente Disseminated refractary tuberculosis with biceps tendon involvement in an immunocompetent patient

    Directory of Open Access Journals (Sweden)

    Marcelo dos Reis Oliveira

    2009-06-01

    Full Text Available OBJETIVO: Relatar um caso raro de tuberculose disseminada em paciente imunocompetente, que evoluiu, durante o tratamento medicamentoso padrão, com envolvimento do tendão da porção longa do bíceps e da articulação do ombro. MÉTODOS: À primeira avaliação, o diagnóstico correto não foi feito e o paciente foi tratado com fisioterapia para tendinopatia do manguito rotador. Entretanto, apresentou rápida formação de massa na região anterior do terço proximal do braço e piora da dor. A punção da massa revelou líquido amarelado, cuja análise laboratorial confirmou tratar-se de infecção por M. tuberculosis. RESULTADOS: O paciente foi tratado com desbridamento cirúrgico e troca do esquema medicamentoso e evoluiu com resolução do quadro infeccioso e melhora completa da função do ombro direito. CONCLUSÃO: Devido a sua alta prevalência no Brasil, a tuberculose deve sempre ser considerada no diagnóstico diferencial dos casos de comprometimento crônico e progressivo das articulações, ossos, músculos, tendões e bursas, mesmo em indivíduos imunocompetentes.OBJECTIVE: The authors report a rare case of disseminated tuberculosis which had compromised the long head of biceps tendon and shoulder joint, during standard drug therapy. METHODS: On a first sight, the accurate diagnosis wasn't accomplished and the patient had been treated with physiotherapy for rotator cuff tear. However, the patient presented with a fast growing mass in anterior region of the proximal third of the arm, complaining of pain increase. Aspirative punction of the mass revealed a yellow fluid and the laboratorial analysis confirmed infection by M. Tuberculosis. The patient was treated with surgical debridement and his drug therapy was changed. RESULTS: Resolution of infectious status and complete shoulder function restoration was succeeded. CONCLUSION: Due to its high prevalence in Brazil, tuberculosis must always be considered as a possible cause of

  2. Biceps Autograft Augmentation for Rotator Cuff Repair : A Systematic Review

    NARCIS (Netherlands)

    Veen, Egbert J D; Stevens, Martin; Diercks, Ronald L

    Purpose: To improve surgical outcomes in patients with massive cuff defects, different techniques and augmentations are proposed. The biceps tendon is easily available as an autograft. Our aim was to conduct a qualitative systematic review of various methods and surgical techniques that use a biceps

  3. Clinical relevance of distal biceps insertional and footprint anatomy

    NARCIS (Netherlands)

    van den Bekerom, Michel P J; Kodde, Izaäk F.; Aster, Asir; Bleys, Ronald L A W; Eygendaal, Denise

    2016-01-01

    Purpose: The aim of this review was to present an overview, based on a literature search, of surgical anatomy for distal biceps tendon repairs, based on the current literature. Methods: A narrative review was performed using Pubmed/Medline using key words: Search terms were distal biceps,

  4. A meta-analysis comparing tenotomy and tenodesis for treating rotator cuff tears combined with long head of the biceps tendon lesions.

    Directory of Open Access Journals (Sweden)

    Xiliang Shang

    Full Text Available The purpose of this meta-analysis was to assess whether there were differences in the outcomes between tenotomy and tenodesis in treating LHBT lesions combined with rotator cuff repairs.Using Medline, Embase, and Cochrane, we searched for articles comparing tenotomy and tenodesis combined with rotator cuff repair which were published before April 2016 with the terms "biceps", "tenotomy", "tenodesis", and "rotator cuff". The controlled clinical studies that met the inclusion and exclusion criteria were assessed for quality of methodology by utilizing the Coleman score.On the basis of the inclusion and exclusion criteria, ten articles (903 patients were included in this meta-analysis. The Coleman score ranged between 40 and 89 in the included studies. The results showed that the incidence of the popeye sign (OR, 2.777, P = 0.000 were higher in tenotomy group compared with tenodesis group when concomitant rotator cuff repair. Statistically significant difference in favor of tenodesis was observed for Constant score (SMD, -0.230, P = 0.025. As for the arm cramping pain, patient satisfaction, VAS score, ASES score and UCLA increased score, the strength and the range of motion, there were no significant differences between tenodesis and tenotomy of the LHBT, corresponding to the currently available results in the literature.Based on this meta-analysis, both tenotomy and tenodesis are effective in pain relief and function improvement in patients with repairable rotator cuff tears. No significant differences in post-operative functional outcome between tenotomy and tenodesis for the treatment of LHBT lesions were observed except for a lower Constant score and higher risk of Popeye deformity in tenotomy.

  5. Simultaneous acute rotator cuff tear and distal biceps rupture in a strongman competitor.

    Science.gov (United States)

    George, Michael S

    2010-04-01

    Acute rotator cuff tear is commonly associated with tearing of the proximal biceps tendon, but has never been reported to occur simultaneously with a distal biceps tendon rupture. A 38-year-old right-hand-dominant strongman competitor attempted a 300-pound overhead axle press and experienced immediate pain in the right shoulder and elbow. He had no known systemic risk factors for tendon ruptures including hyperparathyroidism, hemodialysis, alcoholism, rheumatoid arthritis, statin medications, fluoroquinolones, and steroid use.Right shoulder magnetic resonance imaging (MRI) showed a full-thickness supraspinatus tear with 3 cm of retraction. There was minimal fatty infiltration of the supraspinatus on the sagittal cuts consistent with acute rupture. The subscapularis was intact. The long head of the biceps tendon had mild medial subluxation but was completely within the bicipital groove. Right elbow MRI showed a complete distal biceps tendon rupture. Thirteen days after his injury, the patient underwent arthroscopic supraspinatus repair and proximal biceps tenodesis. Distal biceps tendon repair was performed using the modified 2-incision muscle-splitting technique. At 24-month follow-up, the patient was pain free and had returned to full activity including weightlifting but had not returned to strongman competition.This is the first report of simultaneous acute full thickness ruptures of the rotator cuff and distal biceps tendon. This case report underscores the importance of a complete physical examination and a high index of suspicion for additional concomitant injuries, particularly in athletes with unusually high stresses to the body. Copyright 2010, SLACK Incorporated.

  6. Primary tendinitis of the long head of the biceps.

    Science.gov (United States)

    Post, M; Benca, P

    1989-09-01

    Seventeen patients with chronic painful shoulders who showed evidence of isolated bicipital tendinitis involving only the extracapsular, intertubercular portion of the long head of the biceps were chosen for surgical treatment when conservative treatment failed. The patients were thought to have primary bicipital tendinitis. The latter condition is secondary to other shoulder pathologies. Thirteen patients had tenodeses and four patients had transfer of the long head of the biceps to the origin of the conjoined tendon. Overall, excellent and good results were noted in 94% of both groups of patients when the long head of the biceps was tenodesed or transferred. Whether or not the long head of the biceps is a significant depressor of the humeral head requires further investigation.

  7. Acute distal biceps rupture in an adolescent weightlifter on chronic steroid suppression: a case report.

    Science.gov (United States)

    Ding, David Y; LaMartina, Joey A; Zhang, Alan L; Pandya, Nirav K

    2016-09-01

    Distal biceps tendon ruptures are uncommon events in the adult population and exceedingly rare in the adolescent population. To the best of our knowledge, this is the first and only report of a distal biceps tendon rupture in an adolescent with a history of chronic corticosteroid suppression. We present a case of a 17-year-old male on chronic corticosteroid suppression who underwent a successful distal biceps tendon repair after an acute rupture following weightlifting. At the 1-year follow-up, the patient reports full range of motion and strength, and is able to return to his preinjury activity level with sports and weightlifting. Acute distal biceps ruptures are uncommon injuries in the pediatric population, but may occur in conjunction with chronic corticosteroid use. Anatomic repair, when possible, can restore function and strength. level IV, case report.

  8. Tendon vibration attenuates superficial venous vessel response of the resting limb during static arm exercise

    Directory of Open Access Journals (Sweden)

    Ooue Anna

    2012-11-01

    Full Text Available Abstract Background The superficial vein of the resting limb constricts sympathetically during exercise. Central command is the one of the neural mechanisms that controls the cardiovascular response to exercise. However, it is not clear whether central command contributes to venous vessel response during exercise. Tendon vibration during static elbow flexion causes primary muscle spindle afferents, such that a lower central command is required to achieve a given force without altering muscle force. The purpose of this study was therefore to investigate whether a reduction in central command during static exercise with tendon vibration influences the superficial venous vessel response in the resting limb. Methods Eleven subjects performed static elbow flexion at 35% of maximal voluntary contraction with (EX + VIB and without (EX vibration of the biceps brachii tendon. The heart rate, mean arterial pressure, and rating of perceived exertion (RPE in overall and exercising muscle were measured. The cross-sectional area (CSAvein and blood velocity of the basilic vein in the resting upper arm were assessed by ultrasound, and blood flow (BFvein was calculated using both variables. Results Muscle tension during exercise was similar between EX and EX + VIB. However, RPEs at EX + VIB were lower than those at EX (P P vein in the resting limb at EX decreased during exercise from baseline (P vein at EX + VIB did not change during exercise. CSAvein during exercise at EX was smaller than that at EX + VIB (P vein did not change during the protocol under either condition. The decreases in circulatory response and RPEs during EX + VIB, despite identical muscle tension, showed that activation of central command was less during EX + VIB than during EX. Abolishment of the decrease in CSAvein during exercise at EX + VIB may thus have been caused by a lower level of central command at EX + VIB rather than EX. Conclusion Diminished central command induced by tendon

  9. Recruitment and Decruitment of Motor Units Activities of M. Biceps Brachii During Isovelocity Movements

    National Research Council Canada - National Science Library

    Okuno, Ryuhei

    2001-01-01

    ... (from 0 DEG to 120 DEG) of elbow joint angle with a surface electrode array. We identified action potensials of each moitor unit and detected recruitment and decruitment of the identified motor units...

  10. A comparison of physical examinations with musculoskeletal ultrasound in the diagnosis of biceps long head tendinitis.

    Science.gov (United States)

    Chen, Hung-Sheng; Lin, Shu-Hsien; Hsu, Yen-Hsia; Chen, Shih-Ching; Kang, Jiunn-Horng

    2011-09-01

    Provocative tests are useful in diagnosing biceps tendon tendinitis. This is the first study to establish the reliability of these tests by comparing the resuts with musculoskeletal ultrasound (US) findings. This study examined 125 patients (69 women and 56 men) and 143 shoulders with shoulder pain. Yergason's test, Speed's test and a bicipital groove tenderness test were performed and musculoskeletal US findings were used as standard reference. Biceps tendon tendinitis was diagnosed with US in 39.1% of the patients and, of those, 55.3% had coexisting rotator cuff injury. The sensitivity and specificity of Yergason's test were 32% and 78%, respectively. The sensitivity and specificity of Speed's test were 63% and 58%, respectively. In conclusion, all three tests are limited by poor sensitivity. US can be an image modality choice in diagnosing biceps pathology. Copyright © 2011 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  11. Diagnostic glenohumeral arthroscopy fails to fully evaluate the biceps-labral complex.

    Science.gov (United States)

    Taylor, Samuel A; Khair, M Michael; Gulotta, Lawrence V; Pearle, Andrew D; Baret, Nikolas J; Newman, Ashley M; Dy, Christopher J; O'Brien, Stephen J

    2015-02-01

    The purpose of this study was to define the limits of diagnostic glenohumeral arthroscopy and determine the prevalence and frequency of hidden extra-articular "bicipital tunnel" lesions among chronically symptomatic patients. Eight fresh-frozen cadaveric specimens underwent diagnostic glenohumeral arthroscopy with percutaneous tagging of the long head of the biceps tendon (LHBT) during maximal tendon excursion. The percentage of visualized LHBT was calculated relative to the distal margin of subscapularis tendon and the proximal margin of the pectoralis major tendon. Then, a retrospective review of 277 patients who underwent subdeltoid transfer of the LHBT to the conjoint tendon were retrospectively analyzed for lesions of the biceps-labral complex. Lesions were categorized by anatomic location (inside, junctional, or bicipital tunnel). Inside lesions were labral tears. Junctional lesions were LHBT tears visualized during glenohumeral arthroscopy. Bicipital tunnel lesions were extra-articular lesions hidden from view during standard glenohumeral arthroscopy. Seventy-eight percent of LHBT were visualized relative to the distal margin of the subscapularis tendon and only 55% relative to the proximal margin of the pectoralis major tendon. No portion of the LHBT inferior to the subscapularis tendon was visualized. Forty-seven percent of patients had hidden bicipital tunnel lesions. Scarring was most common and accounted for 48% of all such lesions. Thirty-seven percent of patients had multiple lesion locations. Forty-five percent of patients with junctional lesions also had hidden bicipital tunnel lesions. The only offending lesion was in the bicipital tunnel for 18% of patients. Diagnostic glenohumeral arthroscopy fails to fully evaluate the biceps-labral complex because it visualizes only 55% of the LHBT relative to the proximal margin of the pectoralis major tendon and did not identify extra-articular bicipital tunnel lesions present in 47% of chronically

  12. Rehabilitation of the elbow extension with motor imagery in a patient with quadriplegia after tendon transfer.

    Science.gov (United States)

    Grangeon, Murielle; Guillot, Aymeric; Sancho, Pierre-Olivier; Picot, Marion; Revol, Patrice; Rode, Gilles; Collet, Christian

    2010-07-01

    To test the effect of a postsurgical motor imagery program in the rehabilitation of a patient with quadriplegia. Crossover design with kinematic analysis. Rehabilitation Hospital of Lyon. Study approved by the local Human Research Ethics Committee. C6-level injured patient (American Spinal Injury Association Impairment Scale grade A) with no voluntary elbow extension (triceps brachialis score 1). The surgical procedure was to transfer the distal insertion of the biceps brachii onto the triceps tendon of both arms. The postsurgical intervention on the left arm included 10 sessions of physical rehabilitation followed by 10 motor imagery sessions of 30 minutes each. The patient underwent 5 sessions a week during 2 consecutive weeks. The motor imagery content included mental representations based on elbow extension involved in goal-directed movements. The rehabilitation period of the right arm was reversed, with motor imagery performed first, followed by physical therapy. The kinematics of upper-limb movements was recorded (movement time and variability) before and after each type of rehabilitation period. A long-term retention test was performed 1 month later. Motor imagery training enhanced motor recovery by reducing hand trajectory variability-that is, improving smoothness. Motor performance then remained stable over 1 month. Motor imagery improved motor recovery when associated with physical therapy, with motor performance remaining stable over the 1-month period. We concluded that motor imagery should be successfully associated with classic rehabilitation procedure after tendon transfer. Physical sessions may thus be shortened if too stressful or painful. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. Long bicipital tendon of the shoulder: normal anatomy and pathologic findings on MR imaging.

    Science.gov (United States)

    Erickson, S J; Fitzgerald, S W; Quinn, S F; Carrera, G F; Black, K P; Lawson, T L

    1992-05-01

    The tendon of the long head of the biceps muscle (long bicipital tendon) has a complex course from its muscle belly to its insertion onto the supraglenoid tubercle/glenoid labrum. It is stabilized by numerous tendinous and ligamentous structures and is, in turn, partly responsible for maintenance of normal glenohumeral function. In this report we describe the anatomy of this tendon, correlating high-resolution MR images with cryomicrotome sections. We illustrate typical MR findings in pathologic conditions affecting the long bicipital tendon sheath, the substance of the tendon, and finally the tendon position.

  14. Does Additional Biceps Augmentation Improve Rotator Cuff Healing and Clinical Outcomes in Anterior L-Shaped Rotator Cuff Tears? Clinical Comparisons With Arthroscopic Partial Repair.

    Science.gov (United States)

    Jeon, Yoon Sang; Lee, Juyeob; Kim, Rag Gyu; Ko, Young-Won; Shin, Sang-Jin

    2017-11-01

    The repair of anterior L-shaped tears is usually difficult because of the lack of anterior rotator cuff tendon to cover the footprint. The biceps tendon is usually exposed from the retracted anterolateral corner of the torn tendon and can be easily used to augment rotator cuff repair. Hypothesis/Purpose: This study compared the clinical outcomes of the biceps augmentation technique with those of partial tendon repair for the arthroscopic treatment of large anterior L-shaped rotator cuff tears to evaluate the role of additional biceps augmentation in tendon healing. We hypothesized that the biceps augmentation technique would lead to a lower rotator cuff tendon retear rate and provide satisfactory functional outcomes. Cohort study; Level of evidence, 3. This study included 64 patients with anterior L-shaped rotator cuff tears who underwent arthroscopic repair. Patients were divided into 2 groups: group A (31 patients) underwent repair of an anterior L-shaped tear combined with biceps augmentation, and group B (33 patients) had a partially repaired tendon whose footprint was exposed after repair without undue tension on the retracted tendon. Clinical evaluations were performed using the American Shoulder and Elbow Surgeons (ASES) score, Constant score, muscle strength, visual analog scale for pain, and patient satisfaction. Magnetic resonance imaging (MRI) was performed for tendon integrity at 6 months postoperatively. The mean period of follow-up was 29.1 ± 3.5 months (range, 24-40 months). The mean ASES and Constant scores significantly improved from 52.8 ± 10.6 and 43.2 ± 9.9 preoperatively to 88.2 ± 6.9 and 86.8 ± 6.2 at final follow-up in group A ( P rotation [ER]: 57.5 ± 9.9 to 86.8 ± 9.3; internal rotation [IR]: 68.1 ± 10.8 to 88.1 ± 8.4; P rotator cuff tendon on postoperative MRI. The retear rate between the 2 groups showed no significant difference ( P = .552). Regarding clinical outcomes, both groups had no significant difference in the ASES score

  15. Is nonoperative management of partial distal biceps tears really successful?

    Science.gov (United States)

    Bauer, Tyler M; Wong, Justin C; Lazarus, Mark D

    2018-04-01

    The current treatment of partial distal biceps tears is a period of nonoperative management, followed by surgery, if symptoms persist. Little is known about the success rate and outcomes of nonoperative management of this illness. We identified 132 patients with partial distal biceps tears through an International Classification of Diseases, Ninth Revision code query of our institution's database. Patient records were reviewed to abstract demographic information and confirm partial tears of the distal biceps tendon based on clinical examination findings and confirmatory magnetic resonance imaging (MRI). Seventy-four patients completed an outcome survey. In our study, 55.7% of the contacted patients who tried a nonoperative course (34 of 61 patients) ultimately underwent surgery, and 13 patients underwent immediate surgery. High-need patients, as defined by occupation, were more likely to report that they recovered ideally if they underwent surgery, as compared with those who did not undergo surgery (odds ratio, 11.58; P = .0138). For low-need patients, the same analysis was not statistically significant (P = .139). There was no difference in satisfaction scores between patients who tried a nonoperative course before surgery and those who underwent immediate surgery (P = .854). An MRI-diagnosed tear of greater than 50% was a predictor of needing surgery (odds ratio, 3.0; P = .006). This study has identified clinically relevant information for the treatment of partial distal biceps tears, including the following: the failure rate of nonoperative treatment, the establishment of MRI percent tear as a predictor of failing nonoperative management, the benefit of surgery for the high-need occupational group, and the finding that nonoperative management does not negatively affect outcome if subsequent surgery is necessary. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  16. Disorders of the long head of the biceps: tenotomy versus tenodesis.

    Science.gov (United States)

    Ribeiro, Fabiano Rebouças; Ursolino, André Petry Sandoval; Ramos, Vinicius Ferreira Lima; Takesian, Fernando Hovaguim; Tenor Júnior, Antonio Carlos; Costa, Miguel Pereira da

    2017-01-01

    Disorders of the long head of biceps tendon are common in clinical practice. Their causes could be degenerative, inflammatory, instability (subluxation or luxation) or traumatic. They are generally associated to other diseases of the shoulder, mainly rotator cuff injuries. Currently, there is controversy in the literature regarding the indications for surgical treatment and the choice of the best technique for each case, due to the possibility of esthetic deformity, loss of muscle strength, and residual pain. The objective of this study was to identify the indications for surgical treatment, the best surgical technique, and the advantages and disadvantages of each technique described in the orthopedic literature for the treatment of long head of biceps tendon injuries. A revision of the orthopedic medical literature on the following databases: Biblioteca Regional de Medicina (BIREME), Medline, PubMed, Cochrane Library and Google Scholar, comprising articles published in the period from 1991 to 2015.

  17. Bicep2. III. INSTRUMENTAL SYSTEMATICS

    International Nuclear Information System (INIS)

    Ade, P. A. R.; Aikin, R. W.; Bock, J. J.; Brevik, J. A.; Filippini, J. P.; Golwala, S. R.; Hildebrandt, S. R.; Barkats, D.; Benton, S. J.; Bischoff, C. A.; Buder, I.; Karkare, K. S.; Bullock, E.; Dowell, C. D.; Duband, L.; Fliescher, S.; Halpern, M.; Hasselfield, M.; Hilton, G. C.; Irwin, K. D.

    2015-01-01

    In a companion paper, we have reported a >5σ detection of degree scale B-mode polarization at 150 GHz by the Bicep2 experiment. Here we provide a detailed study of potential instrumental systematic contamination to that measurement. We focus extensively on spurious polarization that can potentially arise from beam imperfections. We present a heuristic classification of beam imperfections according to their symmetries and uniformities, and discuss how resulting contamination adds or cancels in maps that combine observations made at multiple orientations of the telescope about its boresight axis. We introduce a technique, which we call “deprojection,” for filtering the leading order beam-induced contamination from time-ordered data, and show that it reduces power in Bicep2's actual and null-test BB spectra consistent with predictions using high signal-to-noise beam shape measurements. We detail the simulation pipeline that we use to directly simulate instrumental systematics and the calibration data used as input to that pipeline. Finally, we present the constraints on BB contamination from individual sources of potential systematics. We find that systematics contribute BB power that is a factor of ∼10× below Bicep2's three-year statistical uncertainty, and negligible compared to the observed BB signal. The contribution to the best-fit tensor/scalar ratio is at a level equivalent to r = (3–6) × 10 −3

  18. Bicep2. III. INSTRUMENTAL SYSTEMATICS

    Energy Technology Data Exchange (ETDEWEB)

    Ade, P. A. R. [School of Physics and Astronomy, Cardiff University, Cardiff, CF24 3AA (United Kingdom); Aikin, R. W.; Bock, J. J.; Brevik, J. A.; Filippini, J. P.; Golwala, S. R.; Hildebrandt, S. R. [Department of Physics, California Institute of Technology, Pasadena, CA 91125 (United States); Barkats, D. [Joint ALMA Observatory, ESO, Santiago (Chile); Benton, S. J. [Department of Physics, University of Toronto, Toronto, ON (Canada); Bischoff, C. A.; Buder, I.; Karkare, K. S. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, MA 02138 (United States); Bullock, E. [Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455 (United States); Dowell, C. D. [Jet Propulsion Laboratory, Pasadena, CA 91109 (United States); Duband, L. [SBT, Commissariat à l’Energie Atomique, Grenoble (France); Fliescher, S. [Department of Physics, University of Minnesota, Minneapolis, MN 55455 (United States); Halpern, M.; Hasselfield, M. [Department of Physics and Astronomy, University of British Columbia, Vancouver, BC (Canada); Hilton, G. C.; Irwin, K. D., E-mail: csheehy@uchicago.edu [National Institute of Standards and Technology, Boulder, CO 80305 (United States); Collaboration: Bicep2 Collaboration; and others

    2015-12-01

    In a companion paper, we have reported a >5σ detection of degree scale B-mode polarization at 150 GHz by the Bicep2 experiment. Here we provide a detailed study of potential instrumental systematic contamination to that measurement. We focus extensively on spurious polarization that can potentially arise from beam imperfections. We present a heuristic classification of beam imperfections according to their symmetries and uniformities, and discuss how resulting contamination adds or cancels in maps that combine observations made at multiple orientations of the telescope about its boresight axis. We introduce a technique, which we call “deprojection,” for filtering the leading order beam-induced contamination from time-ordered data, and show that it reduces power in Bicep2's actual and null-test BB spectra consistent with predictions using high signal-to-noise beam shape measurements. We detail the simulation pipeline that we use to directly simulate instrumental systematics and the calibration data used as input to that pipeline. Finally, we present the constraints on BB contamination from individual sources of potential systematics. We find that systematics contribute BB power that is a factor of ∼10× below Bicep2's three-year statistical uncertainty, and negligible compared to the observed BB signal. The contribution to the best-fit tensor/scalar ratio is at a level equivalent to r = (3–6) × 10{sup −3}.

  19. Arthroscopic proximal versus open subpectoral biceps tenodesis with arthroscopic repair of small- or medium-sized rotator cuff tears.

    Science.gov (United States)

    Yi, Young; Lee, Jong-Myoung; Kwon, Seok Hyun; Kim, Jeong-Woo

    2016-12-01

    The study was aimed to compare arthroscopic proximal biceps tenodesis and open subpectoral biceps tenodesis in repair of small or medium rotator cuff tears. Eighty-five patients underwent biceps tenodesis with arthroscopic repair of a rotator cuff tear, and 66 patients were followed for median of 26.8 (18-42) months with ultrasonography were reviewed. The arthroscopic biceps tenodesis group included 34 cases, and the open subpectoral biceps group included 32 cases. Patients were evaluated using visual analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES), and constant scores. Rotator cuff repair and fixation of the biceps tendon were assessed by ultrasonography. Fixation failure and degree of deformity were evaluated by the pain in the bicipital groove and biceps apex distance (BAD). VAS score and tenderness at the bicipital groove decreased significantly in the open subpectoral group at 3 months postoperative. In both groups, the range of motion, ASES score, and constant score increased significantly (P tendinitis and using intra-bicipital groove tenodesis technique. III.

  20. A Review of Recent Advances in the Diagnosis and Treatment Modalities for Long Head of Bicep Tendinopathy

    Directory of Open Access Journals (Sweden)

    Robert B. Lewis

    2016-01-01

    Full Text Available This article reviews the assessment and management of the pathology of the long head of the biceps tendon, a disease commonly encountered by primary care physicians and orthopedic surgeons. We include a discussion of relevant anatomy, function, pathoanatomy, natural history of the disease, diagnostic methods, and treatment options. Recent literature on the function of the long head of the bicep (LHB is reviewed. Literature on our evolving understanding of the pathoanatomy behind LHB tendinopathy is discussed. We also discuss the effectiveness of current diagnostic and treatment modalities.

  1. Triceps brachii muscle reconstruction with a latissimus dorsi muscle flap in a dog.

    Science.gov (United States)

    Pavletic, Michael M; Kalis, Russell; Tribou, Patricia; Mouser, Pam J

    2015-01-15

    A 6-year-old spayed female Border Collie was examined for a severe deformity of the right forelimb. Three months prior to examination, the patient awkwardly fell off the couch and became acutely lame in the right forelimb, progressing to non-weight bearing over the following 72 hours. On physical examination, the dog carried the limb caudally against the thoracic wall, with the shoulder flexed and elbow in extension. The right triceps brachii muscle was atrophied and contracted, resulting in a resistant tension band effect that precluded manipulation of the right elbow joint. The physical changes in the triceps muscle were considered the primary cause of the patient's loss of limb function. Surgical treatment by means of elevation and transposition of the ipsilateral latissimus dorsi muscle was performed. The exposed triceps brachii muscles were transected 3 cm proximal to the tendons of insertion. Via a separate incision, the right latissimus dorsi muscle was elevated and tunneled subcutaneously beneath the interposing skin between the 2 surgical incisions. The muscle was then positioned and sutured to the proximal and distal borders of the divided triceps muscle group. Two weeks later, physical therapy was initiated. After 2 months, the patient regularly walked on the limb most of the time (9/10 steps). The surgical procedure for elevation and transposition of the latissimus dorsi muscle was relatively simple to perform. Physical therapy was an essential component to achieving the successful functional outcome in this case. This technique may be considered for treatment of similar patients in which the triceps muscle group is severely compromised.

  2. Bilateral Additional Slips of Triceps Brachii Forming Osseo‑Musculo ...

    African Journals Online (AJOL)

    Department of Anatomy, Melaka. Manipal Medical College,. Manipal University, Manipal,. Karnataka - 576 104, India. E-mail: mohandaskg@gmail.com. Introduction. Triceps brachii is a muscle of posterior compartment of the arm having medial, long and lateral heads and is an extensor of forearm at elbow joint. Its long ...

  3. Management of spastic hand by selective peripheral neurotomies

    African Journals Online (AJOL)

    Wael Fouad

    2011-08-20

    Aug 20, 2011 ... focalized on muscles that are under the control of a single or few peripheral nerves. Objective: This ... obtained by sectioning both afferents and efferents fibers of ... elbow, medial to the biceps brachii tendon; both median and.

  4. Influence of post-stroke spasticity on EMG-force coupling and force steadiness in biceps brachii.

    Science.gov (United States)

    Carlyle, Jennilee K; Mochizuki, George

    2018-02-01

    Individuals with spasticity after stroke experience a decrease in force steadiness which can impact function. Alterations in the strength of EMG-force coupling may contribute to the reduction in force steadiness observed in spasticity. The aim was to determine the extent to which force steadiness and EMG-force coupling is affected by post-stroke spasticity. This cross-sectional study involved individuals with upper limb spasticity after stroke. Participants were required to generate and maintain isometric contractions of the elbow flexors at varying force levels. Coefficient of variation of force, absolute force, EMG-force cross-correlation function peak and peak latency was measured from both limbs with surface electromyography and isometric dynamometry. Statistically significant differences were observed between the affected and less affected limbs for all outcome measures. Significant main effects of force level were also observed. Force steadiness was not statistically significantly correlated with EMG-force coupling; however, both force steadiness and absolute force were associated with the level of impairment as measured by the Chedoke McMaster Stroke Assessment Scale. Spasticity after stroke uncouples the relationship between EMG and force and is associated with reduced force steadiness during isometric contractions; however, these features of control are not associated in individuals with spasticity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. The origin of activity in the biceps brachii muscle during voluntary contractions of the contralateral elbow flexor muscles

    NARCIS (Netherlands)

    Zijdewind, Inge; Butler, Jane E.; Gandevia, Simon C.; Taylor, Janet L.

    During strong voluntary contractions, activity is not restricted to the target muscles. Other muscles, including contralateral muscles, often contract. We used transcranial magnetic stimulation (TMS) to analyse the origin of these unintended contralateral contractions (termed "associated"

  6. No Telescoping Effect with Dual Tendon Vibration.

    Directory of Open Access Journals (Sweden)

    Valeria Bellan

    Full Text Available The tendon vibration illusion has been extensively used to manipulate the perceived position of one's own body part. However, findings from previous research do not seem conclusive sregarding the perceptual effect of the concurrent stimulation of both agonist and antagonist tendons over one joint. On the basis of recent data, it has been suggested that this paired stimulation generates an inconsistent signal about the limb position, which leads to a perceived shrinkage of the limb. However, this interesting effect has never been replicated. The aim of the present study was to clarify the effect of a simultaneous and equal vibration of the biceps and triceps tendons on the perceived location of the hand. Experiment 1 replicated and extended the previous findings. We compared a dual tendon stimulation condition with single tendon stimulation conditions and with a control condition (no vibration on both 'upward-downward' and 'towards-away from the elbow' planes. Our results show a mislocalisation towards the elbow of the position of the vibrated arm during dual vibration, in line with previous results; however, this did not clarify whether the effect was due to arm representation contraction (i.e., a 'telescoping' effect. Therefore, in Experiment 2 we investigated explicitly and implicitly the perceived arm length during the same conditions. Our results clearly suggest that in all the vibration conditions there was a mislocalisation of the entire arm (including the elbow, but no evidence of a contraction of the perceived arm length.

  7. Magnetic Resonance Imaging Currently Fails to Fully Evaluate the Biceps-Labrum Complex and Bicipital Tunnel.

    Science.gov (United States)

    Taylor, Samuel A; Newman, Ashley M; Nguyen, Joseph; Fabricant, Peter D; Baret, Nikolas J; Shorey, Mary; Ramkumar, Prem; O'Brien, Stephen J

    2016-02-01

    To determine the diagnostic accuracy of magnetic resonance imaging (MRI) for biceps-labrum complex (BLC) lesions, including the extra-articular bicipital tunnel. A retrospective review of 277 shoulders with chronic refractory BLC symptoms that underwent arthroscopic subdeltoid transfer of the long head of the biceps tendon (LHBT) to the conjoint tendon was conducted. Intraoperative lesions were categorized as "inside" (labral tears and dynamic LHBT incarceration), "junctional" (LHBT partial tears, LHBT subluxation, and biceps chondromalacia), or "bicipital tunnel" (extra-articular bicipital tunnel scar/stenosis, loose bodies, LHBT instability, and LHBT partial tears) based on anatomic location. Attending radiologist-generated MRI reports were graded dichotomously as positive or negative for biceps and labral damage and then compared with intraoperative findings. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for MRI with respect to intraoperative findings. With regard to inside lesions, MRI had an overall sensitivity, specificity, PPV, and NPV for labrum lesions of 77.3%, 68.2%, 57.3%, and 84.5% respectively. The sensitivity, specificity, PPV, and NPV of MRI for junctional lesions were 43.3%, 55.6%, 73.1%, and 26.0%, respectively. For the bicipital tunnel, MRI had a sensitivity, specificity, PPV, and NPV of 50.4%, 61.4%, 48.7%, and 63.0%, respectively. MRI was unreliable for ruling out BLC lesions among chronically symptomatic patients, including when the bicipital tunnel was affected. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  8. Composite inflation confronts BICEP2 and PLANCK

    International Nuclear Information System (INIS)

    Karwan, Khamphee; Channuie, Phongpichit

    2014-01-01

    We examine observational constraints on single-field inflation in which the inflaton is a composite field stemming from a four-dimensional strongly interacting field theory. We confront the predictions with the Planck and very recent BICEP2 data. In the large non-minimal coupling regions, we discover for the minimal composite inflationary model that the predictions lie well inside the joint 68% CL for the Planck data, but is in tension with the recent BICEP2 observations. In the case of the glueball inflationary model, the predictions satisfy the Planck results. However, this model can produce a large tensor-to-scalar ratio consistent with the recent BICEP2 observations if the number of e-foldings is slightly smaller than the range commonly used. For a super Yang-Mills paradigm, we discover that the predictions satisfy the Planck data, and surprisingly a large tensor-to-scalar ratio consistent with the BICEP2 results can also be produced for an acceptable range of the number of e-foldings and of the confining scale. In the small non-minimal coupling regions, all of the models can satisfy the BICEP2 results. However, the predictions of the glueball and superglueball inflationary models cannot satisfy the observational bound on the amplitude of the curvature perturbation launched by Planck, and the techni-inflaton self-coupling in the minimal composite inflationary model is constrained to be extremely small

  9. Biomechanics of the Proximal Radius Following Drilling of the Bicipital Tuberosity to Mimic Cortical Button Distal Biceps Repair Technique.

    Science.gov (United States)

    Oak, Nikhil R; Lien, John R; Brunfeldt, Alexander; Lawton, Jeffrey N

    2018-05-01

    A fracture through the proximal radius is a theoretical concern after cortical button distal biceps fixation in an active patient. The permanent, nonossified cortical defect and medullary tunnel is at risk during a fall eliciting rotational and compressive forces. We hypothesized that during simulated torsion and compression, in comparison with unaltered specimens, the cortical button distal biceps repair model would have decreased torsional and compressive strength and would fracture in the vicinity of the bicipital tuberosity bone tunnel. Sixteen fourth-generation composite radius Sawbones models were used in this controlled laboratory study. A bone tunnel was created through the bicipital tuberosity to mimic the exact bone tunnel, 8 mm near cortex and 3.2 mm far cortex, made for the BicepsButton distal biceps tendon repair. The radius was then prepared and mounted on either a torsional or compression testing device and compared with undrilled control specimens. Compression tests resulted in average failure loads of 9015.2 N in controls versus 8253.25 N in drilled specimens ( P = .074). Torsional testing resulted in an average failure torque of 27.3 Nm in controls and 19.3 Nm in drilled specimens ( P = .024). Average fracture angle was 35.1° in controls versus 21.1° in drilled. Gross fracture patterns were similar in compression testing; however, in torsional testing all fractures occurred through the bone tunnel in the drilled group. There are weaknesses in the vicinity of the bone tunnel in the proximal radius during biomechanical stress testing which may not be clinically relevant in nature. In cortical button fixation, distal biceps repairs creates a permanent, nonossified cortical defect with tendon interposed in the bone tunnel, which can alter the biomechanical properties of the proximal radius during compressive and torsional loading.

  10. Anterior Interosseous Nerve Neuropraxia Secondary to Shoulder Arthroscopy and Open Subpectoral Long Head Biceps Tenodesis

    Directory of Open Access Journals (Sweden)

    Jeremiah T. Steed

    2017-01-01

    Full Text Available Arthroscopic rotator cuff tendon repair is a common elective procedure performed by trained orthopaedic surgeons with a relatively low complication rate. Specifically, isolated neuropraxia of the anterior interosseous nerve (AIN is a very rare complication of shoulder arthroscopy. An analysis of peer-reviewed published literature revealed only three articles reporting a total of seven cases that describe this specific complication following standard shoulder arthroscopic procedures. This article reports on three patients diagnosed with AIN neuropraxia following routine shoulder arthroscopy done by a single surgeon within a three-year period. All three patients also underwent open biceps tenodesis immediately following completion of the arthroscopic procedures. The exact causal mechanism of AIN neuropraxia following shoulder arthroscopy with biceps tenodesis is not known. This case report reviews possible mechanisms with emphasis on specific factors that make a traction injury the most likely etiology in these cases. We critically analyze our operating room setup and patient positioning practices in light of the existing biomechanical and cadaveric research to propose changes to our standard practices that may help to reduce the incidence of this specific postoperative complication in patients undergoing elective shoulder arthroscopy with biceps tenodesis.

  11. Iliopsoas Tendon Reformation after Psoas Tendon Release

    Directory of Open Access Journals (Sweden)

    K. Garala

    2013-01-01

    Full Text Available Internal snapping hip syndrome, or psoas tendonitis, is a recognised cause of nonarthritic hip pain. The majority of patients are treated conservatively; however, occasionally patients require surgical intervention. The two surgical options for iliopsoas tendinopathy are step lengthening of the iliopsoas tendon or releasing the tendon at the lesser trochanter. Although unusual, refractory snapping usually occurs soon after tenotomy. We report a case of a 47-year-old active female with internal snapping and pain following an open psoas tenotomy. Postoperatively she was symptom free for 13 years. An MRI arthrogram revealed reformation of a pseudo iliopsoas tendon reinserting into the lesser trochanter. The pain and snapping resolved after repeat iliopsoas tendon release. Reformation of tendons is an uncommon sequela of tenotomies. However the lack of long-term studies makes it difficult to calculate prevalence rates. Tendon reformation should be included in the differential diagnosis of failed tenotomy procedures after a period of symptom relief.

  12. MR arthrographic findings in tenosynovitis of the long bicipital tendon of the shoulder

    International Nuclear Information System (INIS)

    Gueckel, C.; Nidecker, A.

    1998-01-01

    Purpose. To assess the MR arthrographic findings of bicipital tenosynovitis in correlation with arthroscopy. Design and patients. The shoulder MR arthrographies of 500 consecutive patients were retrospectively analyzed for signs of bicipital tenosynovitis and associated pathologies. Forty patients (8%) had MR evidence of bicipital tenosynovitis, but only 17 (3%) with arthroscopic confirmation were included in the study. The MR findings in these patients were compared with those of 10 patients with rotator cuff lesions but arthroscopically normal long biceps tendons. MR arthrography was performed with 10-15 ml of a 250 mmol/l gadoterate meglumine (Gd-DOTA) solution injected under fluoroscopic guidance, and transaxial, oblique coronal and sagittal MR sequences were obtained. Results. All 17 patients showed one or more abnormal findings: signal increase in the tendon with or without fusiform distension was seen in 12, surface irregularities in six, adhesions in 11 and noncommunicating effusions of the tendon sheath in six. Associated abnormalities of the rotator cuff were present in 16 while the seventeenth patient had glenohumeral synovitis without rotator cuff pathology. MR arthrograms correlated with arthroscopic findings in the joint but comparison was not possible in the intertubercular groove portion of the biceps tendon. None of the 10 patients with an arthroscopically normal biceps tendon showed any of the MR findings of bicipital tenosynovitis. Conclusion. Bicipital tenosynovitis is detectable by MR arthrography. In most cases it is an associated finding of rotator cuff abnormalities and likely to have a similar etiology. When lesions of the anterior rotator cuff are recognized, the biceps tendon should be scrutinized for inflammatory changes. (orig.)

  13. MR arthrographic findings in tenosynovitis of the long bicipital tendon of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Gueckel, C. [Department of Radiology, University Hospital of Basel, Petersgraben 4, CH-4031 Basel (Switzerland); Nidecker, A. [MRI Institut Rebgasse, Untere Rebgasse 18, CH-4058 Basel (Switzerland)

    1998-01-01

    Purpose. To assess the MR arthrographic findings of bicipital tenosynovitis in correlation with arthroscopy. Design and patients. The shoulder MR arthrographies of 500 consecutive patients were retrospectively analyzed for signs of bicipital tenosynovitis and associated pathologies. Forty patients (8%) had MR evidence of bicipital tenosynovitis, but only 17 (3%) with arthroscopic confirmation were included in the study. The MR findings in these patients were compared with those of 10 patients with rotator cuff lesions but arthroscopically normal long biceps tendons. MR arthrography was performed with 10-15 ml of a 250 mmol/l gadoterate meglumine (Gd-DOTA) solution injected under fluoroscopic guidance, and transaxial, oblique coronal and sagittal MR sequences were obtained. Results. All 17 patients showed one or more abnormal findings: signal increase in the tendon with or without fusiform distension was seen in 12, surface irregularities in six, adhesions in 11 and noncommunicating effusions of the tendon sheath in six. Associated abnormalities of the rotator cuff were present in 16 while the seventeenth patient had glenohumeral synovitis without rotator cuff pathology. MR arthrograms correlated with arthroscopic findings in the joint but comparison was not possible in the intertubercular groove portion of the biceps tendon. None of the 10 patients with an arthroscopically normal biceps tendon showed any of the MR findings of bicipital tenosynovitis. Conclusion. Bicipital tenosynovitis is detectable by MR arthrography. In most cases it is an associated finding of rotator cuff abnormalities and likely to have a similar etiology. When lesions of the anterior rotator cuff are recognized, the biceps tendon should be scrutinized for inflammatory changes. (orig.) With 4 figs., 4 tabs., 22 refs.

  14. A functional-anatomical approach to the spine-pelvis mechanism: interaction between the biceps femoris muscle and the sacrotuberous ligament.

    Science.gov (United States)

    van Wingerden, J P; Vleeming, A; Snijders, C J; Stoeckart, R

    1993-10-01

    Summary. Sacroiliac joint dysfunction is often overlooked as a possible cause of low back pain. This is due to the use of reductionistic anatomical models. From a kinematic point of view, topographic anatomical models are generally inadequate since they categorize pelvis, lower vertebral column and legs as distinct entities. This functional-anatomical study focuses on the question whether anatomical connections between the biceps femoris muscle and the sacrotuberous ligament are kinematically useful. Forces applied to the tendon of the biceps femoris muscle, simulating biceps femoris muscle force, were shown to influence sacrotuberous ligament tension. Since sacrotuberous ligament tension influences sacroiliac joint kinematics, hamstring training could influence the sacroiliac joint and thus low back kinematics. The clinical implications with respect to 'short' hamstrings, pelvic instability and walking are discussed.

  15. Magnetic resonance imaging of the elbow. Part II: Abnormalities of the ligaments, tendons, and nerves

    Energy Technology Data Exchange (ETDEWEB)

    Kijowski, Richard; Tuite, Michael; Sanford, Matthew [University of Wisconsin Hospital, Department of Radiology, Madison, WI (United States)

    2005-01-01

    Part II of this comprehensive review on magnetic resonance imaging of the elbow discusses the role of magnetic resonance imaging in evaluating patients with abnormalities of the ligaments, tendons, and nerves of the elbow. Magnetic resonance imaging can yield high-quality multiplanar images which are useful in evaluating the soft tissue structures of the elbow. Magnetic resonance imaging can detect tears of the ulnar collateral ligament and lateral collateral ligament of the elbow with high sensitivity and specificity. Magnetic resonance imaging can determine the extent of tendon pathology in patients with medial epicondylitis and lateral epicondylitis. Magnetic resonance imaging can detect tears of the biceps tendon and triceps tendon and can distinguishing between partial and complete tendon rupture. Magnetic resonance imaging is also helpful in evaluating patients with nerve disorders at the elbow. (orig.)

  16. Faraday scaling and the Bicep2 observations

    CERN Document Server

    Giovannini, Massimo

    2014-01-01

    As repeatedly speculated in the past, the linear polarization of the Cosmic Microwave Background can be rotated via the Faraday effect. An economic explanation of the recent Bicep2 observations, not relying on long-wavelength tensor modes of the geometry, would stipulate that the detected B mode comes exclusively from a Faraday rotated E mode polarization. We show hereunder that this interpretation is ruled out by the existing upper limits on the B mode polarization obtained by independent experiments at observational frequencies much lower than the operating frequency of the Bicep2 experiment. We then derive the fraction of the observed B mode polarization ascribable to the Faraday effect and suggest a dedicated experimental strategy for its detection.

  17. A practical, evidence-based, comprehensive (PEC) physical examination for diagnosing pathology of the long head of the biceps.

    Science.gov (United States)

    Rosas, Samuel; Krill, Michael K; Amoo-Achampong, Kelms; Kwon, KiHyun; Nwachukwu, Benedict U; McCormick, Frank

    2017-08-01

    Clinical examination of the shoulder joint has gained attention as clinicians aim to use an evidence-based examination of the biceps tendon, with the desire for a proper diagnosis while minimizing costly imaging procedures. The purpose of this study is to create a decision tree analysis that enables the development of a clinical algorithm for diagnosing long head of biceps (LHB) pathology. A literature review of Level I and II diagnostic studies was conducted to extract characteristics of clinical tests for LHB pathology through a systematic review of PubMed, Medline, Ovid, and Cochrane Review databases. Tests were combined in series and parallel to determine sensitivities and specificities, and positive and negative likelihood ratios were determined for each combination using a subjective pretest probability. The "gold standard" for diagnosis in all included studies was arthroscopy or arthrotomy. The optimal testing modality was use of the uppercut test combined with the tenderness to palpation of the biceps tendon test. This combination achieved a sensitivity of 88.4% when performed in parallel and a specificity of 93.8% when performed in series. These tests used in combination optimize post-test probability accuracy greater than any single individual test. Performing the uppercut test and biceps groove tenderness to palpation test together has the highest sensitivity and specificity of known physical examinations maneuvers to aid in the diagnosis of LHB pathology compared with diagnostic arthroscopy (practical, evidence-based, comprehensive examination). A decision tree analysis aides in the practical, evidence-based, comprehensive examination diagnostic accuracy post-testing based on the ordinal scale pretest probability. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  18. Separation and estimation of muscle spindle and tension receptor populations by vibration of the biceps muscle in the frog.

    Science.gov (United States)

    Giszter, S F; Kargo, W J

    2002-10-01

    Frog spinal cord reflex behaviors have been used to test the idea of spinal primitives. We have suggested a significant role for proprioception in regulation of primitives. However the in vivo behavior of spindle and golgi tendon receptors in frogs in response to vibration are not well described and the proportions of these proprioceptors are not established. In this study, we examine the selectivity of muscle vibration in the spinal frog. The aim of the study was (1) to examine how hindlimb muscle spindles and GTO receptors are activated by muscle vibration and (2) to estimate the relative numbers of GTO receptors and spindle afferents in a selected muscle, for comparison with the mammal. Single muscle afferents from the biceps muscle were identified in the dorsal roots. These were tested in response to biceps vibration, intramuscular stimulation and biceps nerve stimulation. Biceps units were categorized into two types: First, spindle afferents which had a high conduction velocity (approximately 20-30 m/s), responded reliably (were entrained 1:1) to muscle vibration, and exhibited distinct pauses to shortening muscle contractions. Second, golgi tendon organ afferents, which had a lower conduction velocity (approximately 10-20 m/s), responded less reliably to muscle vibration at physiologic muscle lengths, but responded more reliably at extended lengths or with background muscle contraction, and exhibited distinct bursts to shortening muscle contractions. Vibration responses of these units were tested with and without muscle curarization. Ensemble (suction electrode) recordings from the dorsal roots were used to provide rough estimates of the proportions of the two muscle afferent types.

  19. Calcaneal tendon: imaging findings

    International Nuclear Information System (INIS)

    Montandon, Cristiano; Fonseca, Cristiano Rezio; Montandon Junior, Marcelo Eustaquio; Lobo, Leonardo Valadares; Ribeiro, Flavia Aparecida de Souza; Teixeira, Kim-Ir-Sen Santos

    2003-01-01

    We reviewed the radiological and clinical features of 23 patients with calcaneal tendon diseases, who were submitted to ultrasound or magnetic resonance imaging. The objective of this study was to characterize the lesions for a precise diagnosis of calcaneal tendon injuries. A wide range of calcaneal tendon diseases include degenerative lesions, inflammation of the peritendinous tissue such as peritendinitis and bursitis, and rupture. Imaging methods are essential in the diagnosis, treatment and follow-up of calcaneal tendon diseases. (author)

  20. Central Tendon Injuries of Hamstring Muscles: Case Series of Operative Treatment.

    Science.gov (United States)

    Lempainen, Lasse; Kosola, Jussi; Pruna, Ricard; Puigdellivol, Jordi; Sarimo, Janne; Niemi, Pekka; Orava, Sakari

    2018-02-01

    As compared with injuries involving muscle only, those involving the central hamstring tendon have a worse prognosis. Limited information is available regarding the surgical treatment of central tendon injuries of the hamstrings. To describe the operative treatment and outcomes of central tendon injuries of the hamstrings among athletes. Case series; Level of evidence, 4. Eight athletes (6 top level, 2 recreational) with central hamstring tendon injuries underwent magnetic resonance imaging and surgical treatment. The indication for surgery was recurrent (n = 6) or acute (n = 2) central hamstring tendon injury. All patients followed the same postoperative rehabilitation protocol, and return to play was monitored. Magnetic resonance imaging found a central tendon injury in all 3 hamstring muscles (long head of the biceps femoris, semimembranosus, and semitendinosus) with disrupted tendon ends. In acute and recurrent central tendon injuries, full return to play was achieved at 2.5 to 4 months. There were no adverse events during follow-up. Central tendon injuries of the hamstrings can be successfully repaired surgically after acute and recurrent ruptures.

  1. Central Tendon Injuries of Hamstring Muscles: Case Series of Operative Treatment

    Science.gov (United States)

    Lempainen, Lasse; Kosola, Jussi; Pruna, Ricard; Puigdellivol, Jordi; Sarimo, Janne; Niemi, Pekka; Orava, Sakari

    2018-01-01

    Background: As compared with injuries involving muscle only, those involving the central hamstring tendon have a worse prognosis. Limited information is available regarding the surgical treatment of central tendon injuries of the hamstrings. Purpose: To describe the operative treatment and outcomes of central tendon injuries of the hamstrings among athletes. Study Design: Case series; Level of evidence, 4. Methods: Eight athletes (6 top level, 2 recreational) with central hamstring tendon injuries underwent magnetic resonance imaging and surgical treatment. The indication for surgery was recurrent (n = 6) or acute (n = 2) central hamstring tendon injury. All patients followed the same postoperative rehabilitation protocol, and return to play was monitored. Results: Magnetic resonance imaging found a central tendon injury in all 3 hamstring muscles (long head of the biceps femoris, semimembranosus, and semitendinosus) with disrupted tendon ends. In acute and recurrent central tendon injuries, full return to play was achieved at 2.5 to 4 months. There were no adverse events during follow-up. Conclusion: Central tendon injuries of the hamstrings can be successfully repaired surgically after acute and recurrent ruptures. PMID:29479545

  2. Tendon Transfer Surgery

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is ... Hand Therapist? Media Find a Hand Surgeon Home Anatomy ... DESCRIPTION The tendon is the strong cord at either end of a muscle that is attached to bone. Tendons , combined with ...

  3. Tendon surveillance requirements - average tendon force

    International Nuclear Information System (INIS)

    Fulton, J.F.

    1982-01-01

    Proposed Rev. 3 to USNRC Reg. Guide 1.35 discusses the need for comparing, for individual tendons, the measured and predicted lift-off forces. Such a comparison is intended to detect any abnormal tendon force loss which might occur. Recognizing that there are uncertainties in the prediction of tendon losses, proposed Guide 1.35.1 has allowed specific tolerances on the fundamental losses. Thus, the lift-off force acceptance criteria for individual tendons appearing in Reg. Guide 1.35, Proposed Rev. 3, is stated relative to a lower bound predicted tendon force, which is obtained using the 'plus' tolerances on the fundamental losses. There is an additional acceptance criterion for the lift-off forces which is not specifically addressed in these two Reg. Guides; however, it is included in a proposed Subsection IWX to ASME Code Section XI. This criterion is based on the overriding requirement that the magnitude of prestress in the containment structure be sufficeint to meet the minimum prestress design requirements. This design requirement can be expressed as an average tendon force for each group of vertical hoop, or dome tendons. For the purpose of comparing the actual tendon forces with the required average tendon force, the lift-off forces measured for a sample of tendons within each group can be averaged to construct the average force for the entire group. However, the individual lift-off forces must be 'corrected' (normalized) prior to obtaining the sample average. This paper derives the correction factor to be used for this purpose. (orig./RW)

  4. Ultrasound of the elbow with emphasis on detailed assessment of ligaments, tendons, and nerves

    International Nuclear Information System (INIS)

    De Maeseneer, Michel; Brigido, Monica Kalume; Antic, Marijana; Lenchik, Leon; Milants, Annemieke; Vereecke, Evie; Jager, Tjeerd; Shahabpour, Maryam

    2015-01-01

    Highlights: •Medial and lateral tendons: the different muscles forming these tendons can be followed up to the insertion. The imaging anatomy is reviewed. •Medial and lateral ligaments: the anatomy is complex and specialized imaging planes and arm positions are necessary for accurate assessment. •Biceps tendon: the anatomy of the distal biceps and lacertus fibrosus are discussed and illustrated with cadaveric correlation. •US imaging of the nerves about the elbow and visualization of the possible compression points is discussed. -- Abstract: The high resolution and dynamic capability of ultrasound make it an excellent tool for assessment of superficial structures. The ligaments, tendons, and nerves about the elbow can be fully evaluated with ultrasound. The medial collateral ligament consists of an anterior and posterior band that can easily be identified. The lateral ligament complex consists of the radial collateral ligament, ulnar insertion of the annular ligament, and lateral ulnar collateral ligament, easily identified with specialized probe positioning. The lateral ulnar collateral ligament can best be seen in the cobra position. On ultrasound medial elbow tendons can be followed nearly up to their common insertion. The pronator teres, flexor carpi radialis, palmaris longus, and flexor digitorum superficialis can be identified. The laterally located brachioradialis and extensor carpi radialis longus insert on the supracondylar ridge. The other lateral tendons can be followed up to their common insertion on the lateral epicondyle. The extensor digitorum, extensor carpi radialis brevis, extensor digiti minimi, and extensor carpi ulnaris can be differentiated. The distal biceps tendon is commonly bifid. For a complete assessment of the distal biceps tendon specialized views are necessary. These include an anterior axial approach, medial and lateral approach, and cobra position. In the cubital tunnel the ulnar nerve is covered by the ligament of Osborne

  5. Ultrasound of the elbow with emphasis on detailed assessment of ligaments, tendons, and nerves

    Energy Technology Data Exchange (ETDEWEB)

    De Maeseneer, Michel, E-mail: Michel.demaeseneer@uzbrussel.be [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); Brigido, Monica Kalume, E-mail: Mbrigido@med.umich.edu [Department of Radiology, University of Michigan, Ann Arbor, MI (United States); Antic, Marijana, E-mail: Misscroa@gmail.com [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); Lenchik, Leon, E-mail: Llenchik@wakehealth.edu [Department of Radiology, Wake Forest University, Winston-Salem, NC (United States); Milants, Annemieke, E-mail: Annemieke.Milants@gmail.com [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium); Vereecke, Evie, E-mail: Evie.Vereecke@kuleuven-kulak.be [Department of Anatomy, KULAK, Katholieke Universiteit Leuven, Campus Kortrijk, Kortrijk (Belgium); Jager, Tjeerd [Aalsters Stedelijk Ziekenhuis, Aalst (Belgium); Shahabpour, Maryam, E-mail: Maryam.Shahabpour@uzbrussel.be [Department of Radiology, Universitair Ziekenhuis Brussel, Brussels (Belgium)

    2015-04-15

    Highlights: •Medial and lateral tendons: the different muscles forming these tendons can be followed up to the insertion. The imaging anatomy is reviewed. •Medial and lateral ligaments: the anatomy is complex and specialized imaging planes and arm positions are necessary for accurate assessment. •Biceps tendon: the anatomy of the distal biceps and lacertus fibrosus are discussed and illustrated with cadaveric correlation. •US imaging of the nerves about the elbow and visualization of the possible compression points is discussed. -- Abstract: The high resolution and dynamic capability of ultrasound make it an excellent tool for assessment of superficial structures. The ligaments, tendons, and nerves about the elbow can be fully evaluated with ultrasound. The medial collateral ligament consists of an anterior and posterior band that can easily be identified. The lateral ligament complex consists of the radial collateral ligament, ulnar insertion of the annular ligament, and lateral ulnar collateral ligament, easily identified with specialized probe positioning. The lateral ulnar collateral ligament can best be seen in the cobra position. On ultrasound medial elbow tendons can be followed nearly up to their common insertion. The pronator teres, flexor carpi radialis, palmaris longus, and flexor digitorum superficialis can be identified. The laterally located brachioradialis and extensor carpi radialis longus insert on the supracondylar ridge. The other lateral tendons can be followed up to their common insertion on the lateral epicondyle. The extensor digitorum, extensor carpi radialis brevis, extensor digiti minimi, and extensor carpi ulnaris can be differentiated. The distal biceps tendon is commonly bifid. For a complete assessment of the distal biceps tendon specialized views are necessary. These include an anterior axial approach, medial and lateral approach, and cobra position. In the cubital tunnel the ulnar nerve is covered by the ligament of Osborne

  6. FIBRILLINS IN TENDON

    Directory of Open Access Journals (Sweden)

    Betti Giusti

    2016-10-01

    Full Text Available Tendons among connective tissue, mainly collagen, contain also elastic fibres made of fibrillin 1, fibrillin 2 and elastin that are broadly distributed in tendons and represent 1-2% of the dried mass of the tendon. Only in the last years, studies on structure and function of elastic fibres in tendons have been performed. Aim of this review is to revise data on the organization of elastic fibres in tendons, in particular fibrillin structure and function, and on the clinical manifestations associated to alterations of elastic fibres in tendons. Indeed, microfibrils may contribute to tendon mechanics; therefore, their alterations may cause joint hypermobility and contractures which have been found to be clinical features in patients with Marfan syndrome and Beals syndrome. The two diseases are caused by mutations in genes FBN1 and FBN2 encoding fibrillin 1 and fibrillin 2, respectively.

  7. The 'bridging sign', a MR finding for combined full-thickness tears of the subscapularis tendon and the supraspinatus tendon

    International Nuclear Information System (INIS)

    Jung, Jin Young; Yoon, Young Cheol; Cha, Dong Ik; Yoo, Jae-Chul; Jung, Jee Young

    2013-01-01

    Background: In daily practice, we discovered one of the secondary magnetic resonance (MR) findings of the subscapularis (SSC) tendon tear, the 'bridging sign', which has not been previously described. Purpose: To describe the 'bridging sign' on shoulder MR imaging and its radiological and clinical significance in patients with SSC tendon tear. Material and Methods: Twenty-nine patients who had undergone shoulder arthroscopy and had full-thickness tear of the subscapularis tendon were enrolled. The medical records of the 29 patients were retrospectively reviewed for the duration of shoulder pain, rotator cuff tears, and associated arthroscopic findings: biceps tendon abnormality and superior glenoid labral tear. Then, preoperative shoulder MR images were retrospectively reviewed for the presence or absence of the 'bridging sign' and associated MR findings: periarticular fluid and fatty atrophy of the supraspinatus and subscapularis muscles. The type of rotator cuff tear associated with the 'bridging sign' was assessed and the sensitivity, specificity, and accuracy of the 'bridging sign' for the diagnosis of a certain type of rotator cuff tear were calculated. Associated arthroscopic and MR findings and mean duration of the shoulder pain between the patients with and without the 'bridging sign' were compared. Results: The 'bridging sign' was seen in 17 of 29 patients and corresponded to a complex of the torn and superomedially retracted subscapularis tendon, coracohumeral ligament, and superior glenohumeral ligament, adhered to the anterior margin of the torn supraspinatus (SSP) tendon on arthroscopy. All patients with the 'bridging sign' had combined full-thickness tear (FTT) of the cranial 1/2 portion of the subscapularis tendon and anterior 1/2 portion of the SSP tendon. The sensitivity, specificity, and accuracy of the 'bridging sign' for the diagnosis of combined FTTs of the SSC tendon and anterior portion of the SSP tendon were 81.0%, 100%, and 86

  8. The MR arthrographic anatomy of the biceps labral insertion and its morphological significance with labral tears in patients with shoulder instability

    International Nuclear Information System (INIS)

    Jakanani, G.C.; Botchu, R.; Rennie, W.J.

    2012-01-01

    Introduction: Most of the fibres of the long head of biceps tendon attach on the superior labrum just posterior to the supraglenoid tubercle. Aim: Our hypothesis was that posteriorly attached biceps tendons predispose to posterior superior labral tears and SLAP lesions. Methods and materials: A prospective analysis of all MR shoulder arthrograms for shoulder instability referred from the shoulder specialist clinics, performed during a one year period were reviewed by two independent observers who were blinded to clinical history. The biceps attachment was classified into four groups according to the method described in an earlier cadaveric study into four groups; posterior-type 1, predominantly posterior-type 2, equal contributions to both anterior and posterior labrum-type 3 and predominantly anterior labral attachment-type 4. Data was analysed using Kappa statistics and Fischer's exact test. Results: 48 patients (33 males and 15 females) were included in this study with a mean age of 32 years. Majority, 22 patients (46%) had a type 1 attachment of the biceps on the superior labrum. There was moderate intra-observer and good interobserver agreement with a Kappa of 0.58 and 0.63 respectively. There was a significant association between a type 2 attachment and posterior tears (p ≤ 0.04) and also between a type 2 attachment and SLAP tears (p ≤ 0.04). Conclusion: Our results suggest that variation in anatomy of biceps origin influences the type of labral tears that occur in patients with shoulder instability. The importance of these findings could influence selection of individuals in throwing sports like cricket and baseball.

  9. The MR arthrographic anatomy of the biceps labral insertion and its morphological significance with labral tears in patients with shoulder instability

    Energy Technology Data Exchange (ETDEWEB)

    Jakanani, G.C., E-mail: gcjakanani@gmail.com [Leicester Royal Infirmary, Leicester (United Kingdom); Botchu, R., E-mail: drrajeshb@gmail.com [Leicester Royal Infirmary, Leicester (United Kingdom); Rennie, W.J., E-mail: winston.rennie@gmail.com [Leicester Royal Infirmary, Leicester (United Kingdom)

    2012-11-15

    Introduction: Most of the fibres of the long head of biceps tendon attach on the superior labrum just posterior to the supraglenoid tubercle. Aim: Our hypothesis was that posteriorly attached biceps tendons predispose to posterior superior labral tears and SLAP lesions. Methods and materials: A prospective analysis of all MR shoulder arthrograms for shoulder instability referred from the shoulder specialist clinics, performed during a one year period were reviewed by two independent observers who were blinded to clinical history. The biceps attachment was classified into four groups according to the method described in an earlier cadaveric study into four groups; posterior-type 1, predominantly posterior-type 2, equal contributions to both anterior and posterior labrum-type 3 and predominantly anterior labral attachment-type 4. Data was analysed using Kappa statistics and Fischer's exact test. Results: 48 patients (33 males and 15 females) were included in this study with a mean age of 32 years. Majority, 22 patients (46%) had a type 1 attachment of the biceps on the superior labrum. There was moderate intra-observer and good interobserver agreement with a Kappa of 0.58 and 0.63 respectively. There was a significant association between a type 2 attachment and posterior tears (p {<=} 0.04) and also between a type 2 attachment and SLAP tears (p {<=} 0.04). Conclusion: Our results suggest that variation in anatomy of biceps origin influences the type of labral tears that occur in patients with shoulder instability. The importance of these findings could influence selection of individuals in throwing sports like cricket and baseball.

  10. Achilles tendon and sports

    International Nuclear Information System (INIS)

    Ulreich, N.; Kainberger, F.; Huber, W.; Nehrer, S.

    2002-01-01

    Because of the rising popularity of recreational sports activities achillodynia is an often associated symptom with running, soccer and athletics. Therefore radiologist are frequently asked to image this tendon. The origin of the damage of the Achilles tendon is explained by numerous hypothesis, mainly a decreased perfusion and a mechanical irritation that lead to degeneration of the tendon. High-resolution technics such as sonography and magnetic resonance imaging show alterations in the structure of the tendon which can be graduated and classified. Manifestations like tendinosis, achillobursitis, rupture and Haglunds disease can summarized as the tendon overuse syndrom. A rupture of a tendon is mostly the result of a degeneration of the collagenfibres. The task of the radiologist is to acquire the intrinsic factors for a potential rupture. (orig.) [de

  11. Effect of patient age on accuracy of primary MRI signs of long head of biceps tearing and instability in the shoulder. An MRI-arthroscopy correlation study

    Energy Technology Data Exchange (ETDEWEB)

    Borrero, Camilo G.; Costello, Joanna; Vyas, Dharmesh [University of Pittsburgh Medical Center, Pittsburgh, PA (United States); Bertolet, Marnie [University of Pittsburgh School of Medicine, Pittsburgh, PA (United States)

    2018-02-15

    To determine the effect of patient age on the accuracy of primary MRI signs of long head of biceps (LHB) tendon tearing and instability in the shoulder using arthroscopy as a reference standard. Subjects with MRI studies and subsequent arthroscopy documenting LHB tendon pathology were identified and organized into three age groups (18-40, 41-60, 61-87). Normal and tendinopathic tendons were labeled grade 0, partial tears grade 1 and full tears grade 2. Two radiologists blinded to arthroscopic data graded MRI studies independently. Prevalence of disease, MRI accuracy for outcomes of interest, and inter-reader agreement were calculated. Eighty-nine subjects fulfilled inclusion criteria with 36 grade 0, 36 grade 1 and 17 grade 2 tendons found at arthroscopy. MRI sensitivity, regardless of age, ranged between 67-86% for grade 0, 72-94% for grade 1 and 82-94% for grade 2 tendons. Specificity ranged between 83-96% for grade 0, 75-85% for grade 1 and 99-100% for grade 2 tendons. MRI accuracy for detection of each LHB category was calculated for each age group. MRI was found to be least sensitive for grade 0 and 1 LHB tendons in the middle-aged group with sensitivity between 55-85% for grade 0 and 53-88% for grade 1 tendons. Agreement between MRI readers was moderate with an unweighted kappa statistic of 62%. MRI accuracy was moderate to excellent and agreement between MRI readers was moderate. MRI appears to be less accurate in characterizing lower grades of LHB tendon disease in middle-aged subjects. (orig.)

  12. Segond fracture: involvement of the iliotibial band, anterolateral ligament, and anterior arm of the biceps femoris in knee trauma

    Energy Technology Data Exchange (ETDEWEB)

    Maeseneer, Michel de; Boulet, Cedric; Willekens, Inneke; Mey, Johan de; Shahabpour, Maryam [Universitair Ziekenhuis Brussel, Department of Radiology, Brussels (Belgium); Lenchik, Leon [Wake Forest University, Department of Radiology, Winston Salem, NC (United States); Cattrysse, Erik [Vrije Universiteit Brussel, Department of Experimental Anatomy, Brussels (Belgium)

    2014-12-04

    To evaluate the involvement of the iliotibial band (ITB), the anterolateral ligament (ALL), and the anterior arm of the biceps femoris in MRI-diagnosed Segond fracture and to evaluate other associated findings of Segond fracture. We retrospectively reviewed the MRI of 13 cases of Segond fracture. The studies included proton density-weighted, T2-weighted, and proton density-weighted with fat saturation images in the three planes. We studied 2 cadaveric specimens with emphasis on the ALL. One cadaveric specimen was dissected while the other was sectioned in the sagittal plane. The mean age of the patients was 36 years (range, 17-52). There were 7 men and 6 women. The mean size of the Segond bone fragment was 8 x 10 x 2 mm. The distance from the tibia varied from 2 to 6 mm. Associated findings included anterior cruciate ligament (ACL) tear (n = 13), medial collateral ligament (MCL) tear (n = 8), meniscocapsular tear of the posterior horn of the medial meniscus (n = 5), and posterolateral corner involvement (n = 4). Bone marrow edema involved the mid-lateral femoral condyle and the posterior tibial plateau on both the medial and the lateral side. Edema at the Segond area was seen, but was limited. Fibular head edema was also seen. The ITB (11 out of 13) and ALL (10 out of 13) inserted on the Segond bone fragment. The anterior arm of the biceps tendon did not insert on the Segond fracture. Associated findings of Segond fracture include ACL tear, MCL tear, medial meniscus tear, and posterolateral corner injury. Both the ITB and the ALL may be involved in the Segond avulsion. The anterior arm of the biceps femoris tendon is not involved. (orig.)

  13. Segond fracture: involvement of the iliotibial band, anterolateral ligament, and anterior arm of the biceps femoris in knee trauma

    International Nuclear Information System (INIS)

    Maeseneer, Michel de; Boulet, Cedric; Willekens, Inneke; Mey, Johan de; Shahabpour, Maryam; Lenchik, Leon; Cattrysse, Erik

    2015-01-01

    To evaluate the involvement of the iliotibial band (ITB), the anterolateral ligament (ALL), and the anterior arm of the biceps femoris in MRI-diagnosed Segond fracture and to evaluate other associated findings of Segond fracture. We retrospectively reviewed the MRI of 13 cases of Segond fracture. The studies included proton density-weighted, T2-weighted, and proton density-weighted with fat saturation images in the three planes. We studied 2 cadaveric specimens with emphasis on the ALL. One cadaveric specimen was dissected while the other was sectioned in the sagittal plane. The mean age of the patients was 36 years (range, 17-52). There were 7 men and 6 women. The mean size of the Segond bone fragment was 8 x 10 x 2 mm. The distance from the tibia varied from 2 to 6 mm. Associated findings included anterior cruciate ligament (ACL) tear (n = 13), medial collateral ligament (MCL) tear (n = 8), meniscocapsular tear of the posterior horn of the medial meniscus (n = 5), and posterolateral corner involvement (n = 4). Bone marrow edema involved the mid-lateral femoral condyle and the posterior tibial plateau on both the medial and the lateral side. Edema at the Segond area was seen, but was limited. Fibular head edema was also seen. The ITB (11 out of 13) and ALL (10 out of 13) inserted on the Segond bone fragment. The anterior arm of the biceps tendon did not insert on the Segond fracture. Associated findings of Segond fracture include ACL tear, MCL tear, medial meniscus tear, and posterolateral corner injury. Both the ITB and the ALL may be involved in the Segond avulsion. The anterior arm of the biceps femoris tendon is not involved. (orig.)

  14. Testing hybrid natural inflation with BICEP2

    Energy Technology Data Exchange (ETDEWEB)

    Carrillo-González, Mariana [Instituto de Ciencias Físicas, Universidad Nacional Autónoma de México, Apdo. Postal 48-3, 62251 Cuernavaca, Morelos (Mexico); Germán, Gabriel, E-mail: gabriel@fis.unam.mx [Instituto de Ciencias Físicas, Universidad Nacional Autónoma de México, Apdo. Postal 48-3, 62251 Cuernavaca, Morelos (Mexico); Herrera-Aguilar, Alfredo [Departamento de Física, Universidad Autónoma Metropolitana Iztapalapa, San Rafael Atlixco 186, CP 09340, México D.F. (Mexico); Instituto de Física y Matemáticas, Universidad Michoacana de San Nicolás de Hidalgo, Edificio C-3, Ciudad Universitaria, CP 58040, Morelia, Michoacán (Mexico); Hidalgo, Juan Carlos [Instituto de Ciencias Físicas, Universidad Nacional Autónoma de México, Apdo. Postal 48-3, 62251 Cuernavaca, Morelos (Mexico); Sussman, Roberto A. [Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Apdo. Postal 70-543, 04510 México D.F. (Mexico)

    2014-06-27

    We analyse Hybrid Natural Inflation in view of the recent results for the tensor index reported by BICEP2. We find that it predicts a large running of the scalar spectrum which is potentially detectable by large scale structure through measurements of clustering of galaxies in combination with CMB data and by 21 cm forest observations. The running of the running is also relatively large becoming close to 10{sup −2}. Along the way, we find general consistency relations at which observables are subject if the slow-roll approximation is imposed. Failure to satisfy these equations by the values obtained for the observables in surveys would be a failure of the slow-roll approximation itself.

  15. [Bursitis with severe tendon and muscle necrosis on the lateral stifle area in cattle].

    Science.gov (United States)

    Nuss, K; Räber, M; Sydler, T; Muggli, E; Hässig, M; Guscetti, F

    2011-11-01

    In 21 animals, chronic swelling on the lateral aspect of the stifle also known as «perigonitis», «stable-syndrome» or «bursitis bicipitalis femoris» were evaluated. Ultrasonography showed increased fluid in the distal subtendinous bursa of the biceps femoris muscle and structural changes in the tendons, muscles, subcutis and fasciae. Soft tissue swelling and an irregular contour of the lateral tibial condyle were typical signs on radiographs. Macroscopic changes were found at the insertion of the biceps femoris muscle, the distal subtendinous bursa of the biceps femoris muscle, the lateral collateral ligament of the stifle, the origin of muscles on the lateral femoral condyle and the lateral tibial condyle. They mainly consisted of tendon and muscle tissue necrosis with granulation tissue. Histology revealed areas of coagulation necrosis in tendons and ligaments, in which occasionally Onchocerca spp. were seen. The severity of lesions correlated well with the clinical signs, which were associated with a poor prognosis in advanced cases.

  16. Containment structure tendon investigation

    International Nuclear Information System (INIS)

    Fulton, J.F.; Murray, K.H.

    1983-01-01

    The paper describes an investigation into the possible causes of lower-than-predicted tendon forces which were measured during past tendon surveillances for a concrete containment. The containment is post tensioned by vertical tendons which are anchored into a rock foundation. The tendons were originally stressed in 1969, and lift-off tests were performed on six occasions subsequent to this date over a period of 11 years. The tendon forces measured in these tests were generally lower than predicted, and by 1979 the prestress level in the containment was only marginally above the design requirement. The tendons were retensioned in 1980, and by this time an investigation into the possible causes was underway. Potential causes investigated include the rock anchors and surrounding rock, elastomeric pad creep, wire stresses, thermal effects, stressing equipment and lift-off procedures, and wire stress relaxation. The investigation activities included stress relaxation testing of wires pulled from actual tendons. The stress relaxation test program included wire specimens at several different temperature and initial stress levels and the effect of a varying temperature history on the stress relaxation property of the wires. For purpose of future force predictions of the retensioned tendons, the test program included tests to determine the effect on stress relaxation due to restressing the wires after they had relaxed for 1000 hours and 10,000 hours. (orig./GL)

  17. Extensor Tendon Injuries

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Extensor Tendon Injuries Email to a friend * required ...

  18. Sex Hormones and Tendon

    DEFF Research Database (Denmark)

    Hansen, Mette; Kjaer, Michael

    2016-01-01

    The risk of overuse and traumatic tendon and ligament injuries differ between women and men. Part of this gender difference in injury risk is probably explained by sex hormonal differences which are specifically distinct during the sexual maturation in the teenage years and during young adulthood....... The effects of the separate sex hormones are not fully elucidated. However, in women, the presence of estrogen in contrast to very low estrogen levels may be beneficial during regular loading of the tissue or during recovering after an injury, as estrogen can enhance tendon collagen synthesis rate. Yet...... has also been linked to a reduced responsiveness to relaxin. The present chapter will focus on sex difference in tendon injury risk, tendon morphology and tendon collagen turnover, but also on the specific effects of estrogen and androgens....

  19. MRI study of associated shoulder pathology in patients with full-thickness subscapularis tendon tears.

    Science.gov (United States)

    Li, Xinning; Fallon, Jonathan; Egge, Natalie; Curry, Emily J; Patel, Ketan; Owens, Brett D; Busconi, Brian D

    2013-01-01

    Subscapularis tendon tears are a well-established cause of shoulder pain. The objective of the current study was to evaluate the associated shoulder pathology in patients with full-thickness subscapularis tendon tears using magnetic resonance imaging. Forty-seven magnetic resonance imaging studies taken between 2008 and 2009 with a diagnosis of full-thickness subscapularis tendon tears were reviewed. The size of the subscapularis tendon tear, amount of muscle volume loss, Goutallier grade, biceps tendon pathology, coracohumeral distance, and associated rotator cuff tears were recorded. Statistical analysis was performed. Patients 55 years and older vs those 54 years and younger had an average subscapularis tear size of 35 vs 19 mm, an average Goutallier grade of 2.7 vs 0.8, and a total muscle volume loss of 25% vs 5%, respectively. Patients with a dislocated vs normal biceps tendons had an average subscapularis tear size of 37 vs 23 mm, an average Goutallier grade of 3 vs 0.9, and a total muscle volume loss of 28% vs 7%, respectively. Patients with vs without concomitant rotator cuff tears had an average subscapularis tear size of 32 vs 17 mm, an average Goutallier grade of 2.3 vs 0.6, and a total muscle volume loss of 21% vs 3%, respectively. Overall average coracohumeral distance measured in the axial plane was 10.8±4.6 mm. Average coracaohumeral distance was 14.8 vs 8.1 mm in patients with a Goutallier grade of 0 vs 3 or 4, resepectively, and 13.6 vs 8.5 mm in patients with no rotator cuff tear vs those with a supra- and infraspinatus tear, respectively. Increased age, dislocated biceps tendons, and concomitant rotator cuff tears in patients with full-thickness subscapularis tendon tears are associated with larger subscapularis tendon tear size, higher Goutallier grades, and increased subscapularis muscle volume loss. Decreased coracohumeral distance is associated with a higher Goutallier grade and rotator cuff tears. Copyright 2013, SLACK Incorporated.

  20. Gauged M-flation after BICEP2

    Science.gov (United States)

    Ashoorioon, A.; Sheikh-Jabbari, M. M.

    2014-12-01

    In view of the recent BICEP2 results [arxiv:arXiv:1403.3985] which may be attributed to the observation of B-modes polarization of the CMB with tensor-to-scalar ratio r =0.2-0.05+0.07, we revisit M-flation model. Gauged M-flation is a string theory motivated inflation model with Matrix valued scalar inflaton fields in the adjoint representation of a U (N) Yang-Mills theory. In continuation of our previous works, we show that for a class of M-flation models the action for these inflaton fields can be such that the "effective inflaton field" ϕ has a double-well Higgs-like potential, with minima at ϕ = 0 , μ. We focus on the ϕ > μ, symmetry-breaking region. We thoroughly examine predictions of the model for r in the 2σ region allowed for nS by the Planck experiment. As computed in [arxiv:arXiv:0903.1481], for Ne = 60 and nS = 0.96 we find r ≃ 0.2, which sits in the sweet spot of BICEP2 region for r. We find that with increasing μ arbitrarily, nS cannot go beyond ≃0.9670, the scalar spectral index for the quadratic chaotic potential. As nS varies in the 2σ range which is allowed by Planck and could be reached by the model, r varies in the range [ 0.13 , 0.26 ]. Future cosmological experiments, like the CMBPOL, that confines nS with σ (nS) = 0.0029 can constrain the model further. Also, in this region of potential, for nS = 0.9603, we find that the largest isocurvature mode, which is uncorrelated with curvature perturbations, has a power spectrum with the amplitude of order 10-11 at the end of inflation. We also discuss the range of predictions of r in the hilltop region, ϕ < μ.

  1. Gauged M-flation after BICEP2

    International Nuclear Information System (INIS)

    Ashoorioon, A.; Sheikh-Jabbari, M.M.

    2014-01-01

    In view of the recent BICEP2 results [ (arXiv:1403.3985)] which may be attributed to the observation of B-modes polarization of the CMB with tensor-to-scalar ratio r=0.2 −0.05 +0.07 , we revisit M-flation model. Gauged M-flation is a string theory motivated inflation model with Matrix valued scalar inflaton fields in the adjoint representation of a U(N) Yang–Mills theory. In continuation of our previous works, we show that for a class of M-flation models the action for these inflaton fields can be such that the “effective inflaton field” ϕ has a double-well Higgs-like potential, with minima at ϕ=0,μ. We focus on the ϕ>μ, symmetry-breaking region. We thoroughly examine predictions of the model for r in the 2σ region allowed for n S by the Planck experiment. As computed in [ (arXiv:0903.1481)], for N e =60 and n S =0.96 we find r≃0.2, which sits in the sweet spot of BICEP2 region for r. We find that with increasing μ arbitrarily, n S cannot go beyond ≃0.9670, the scalar spectral index for the quadratic chaotic potential. As n S varies in the 2σ range which is allowed by Planck and could be reached by the model, r varies in the range [0.13,0.26]. Future cosmological experiments, like the CMBPOL, that confines n S with σ(n S )=0.0029 can constrain the model further. Also, in this region of potential, for n S =0.9603, we find that the largest isocurvature mode, which is uncorrelated with curvature perturbations, has a power spectrum with the amplitude of order 10 −11 at the end of inflation. We also discuss the range of predictions of r in the hilltop region, ϕ<μ

  2. S-dual inflation: BICEP2 data without unlikeliness

    International Nuclear Information System (INIS)

    Anchordoqui, Luis A.; Barger, Vernon; Goldberg, Haim; Huang, Xing; Marfatia, Danny

    2014-01-01

    We show that S-dual inflationary potentials solve the unlikeliness problem manifested in Planck data and explain the excess B-mode power observed by the BICEP2 experiment as arising from primordial tensor fluctuations

  3. Tendon 'turnover lengthening' technique.

    Science.gov (United States)

    Cerovac, S; Miranda, B H

    2013-11-01

    Tendon defect reconstruction is amongst the most technically challenging areas in hand surgery. Tendon substance deficiency reconstruction techniques include lengthening, grafting, two-stage reconstruction and tendon transfers, however each is associated with unique challenges over and above direct repair. We describe a novel 'turnover lengthening' technique for hand tendons that has successfully been applied to the repair of several cases, including a case of attritional flexor and traumatic extensor tendon rupture in two presented patients where primary tenorrhaphy was not possible. In both cases a good post-operative outcome was achieved, as the patients were happy having returned back to normal activities of daily living such that they were discharged 12 weeks post-operatively. Our technique avoids the additional morbidity and complications associated with grafting, transfers and two stage reconstructions. It is quick, simple and reproducible for defects not exceeding 3-4 cm, provides a means of immediate one stage reconstruction, no secondary donor site morbidity and does not compromise salvage by tendon transfer and/or two-stage reconstruction in cases of failure. To our knowledge no such technique has been previously been described to reconstruct such hand tendon defects. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  4. MR imaging of delamination tears of the rotator cuff tendons

    International Nuclear Information System (INIS)

    Walz, Daniel M.; Chen, Steven; Miller, Theodore T.; Hofman, Josh

    2007-01-01

    The objective was to describe the imaging appearances and location of delamination tears of the rotator cuff tendons on non-contrast conventional MR imaging. This study was reviewed and approved by our Institutional Review Board. The reports of 548 consecutive MR examinations of the shoulder were reviewed, looking for mention or description of delamination tears of the rotator cuff. The images of the identified cases were then reviewed by two radiologists to confirm the findings. Correlation with surgical and arthroscopic information was then performed. Delamination tears were defined as horizontal retraction of either the bursal or articular surface of the tendon, manifest as thickening of the torn retracted edge, and/or interstitial splitting of the tendon, manifest as fluid-like high signal intensity on fat-suppressed T2-weighted oblique coronal images. Fourteen cases of delamination tears were identified in 13 patients. Ten of the cases involved the supraspinatus tendon, all with articular surface involvement. Nine of these supraspinatus cases were isolated tears and one occurred as part of a full thickness tear. All 10 of these supraspinatus cases showed medial retraction of the articular surface of the tendon, with thickening of the retracted edge, and 5 of the 10 had a demonstrable horizontal cleft in the interstitium. Four cases involved the subscapularis tendon, with articular surface disruption in three and pure interstitial delamination in one. Medial subluxation of the tendon of the long head of the biceps was present in all four cases. No delamination tears occurred on the bursal surface. Only three of the 14 shoulders underwent surgical repair with one confirmation of supraspinatus delamination, one confirmation of a subscapularis tear that had become a full thickness tear 10 months after initial imaging and another interstitial subscapularis delamination that was not identified arthroscopically. Delamination tears occur most often in the

  5. MR imaging of delamination tears of the rotator cuff tendons

    Energy Technology Data Exchange (ETDEWEB)

    Walz, Daniel M.; Chen, Steven [North Shore University Hospital, Department of Radiology, Manhasset, NY (United States); Miller, Theodore T. [Hospital for Special Surgery, Department of Radiology and Imaging, New York, NY (United States); Hofman, Josh [Long Island Jewish Medical Center, New Hyde Park, NY (United States)

    2007-05-15

    The objective was to describe the imaging appearances and location of delamination tears of the rotator cuff tendons on non-contrast conventional MR imaging. This study was reviewed and approved by our Institutional Review Board. The reports of 548 consecutive MR examinations of the shoulder were reviewed, looking for mention or description of delamination tears of the rotator cuff. The images of the identified cases were then reviewed by two radiologists to confirm the findings. Correlation with surgical and arthroscopic information was then performed. Delamination tears were defined as horizontal retraction of either the bursal or articular surface of the tendon, manifest as thickening of the torn retracted edge, and/or interstitial splitting of the tendon, manifest as fluid-like high signal intensity on fat-suppressed T2-weighted oblique coronal images. Fourteen cases of delamination tears were identified in 13 patients. Ten of the cases involved the supraspinatus tendon, all with articular surface involvement. Nine of these supraspinatus cases were isolated tears and one occurred as part of a full thickness tear. All 10 of these supraspinatus cases showed medial retraction of the articular surface of the tendon, with thickening of the retracted edge, and 5 of the 10 had a demonstrable horizontal cleft in the interstitium. Four cases involved the subscapularis tendon, with articular surface disruption in three and pure interstitial delamination in one. Medial subluxation of the tendon of the long head of the biceps was present in all four cases. No delamination tears occurred on the bursal surface. Only three of the 14 shoulders underwent surgical repair with one confirmation of supraspinatus delamination, one confirmation of a subscapularis tear that had become a full thickness tear 10 months after initial imaging and another interstitial subscapularis delamination that was not identified arthroscopically. Delamination tears occur most often in the

  6. Achilles tendon healing

    International Nuclear Information System (INIS)

    Dillon, E.H.; Pope, C.F.; Barber, V.; Jokl, P.; Lynch, K.

    1990-01-01

    This paper reports on symptomatic Achilles tendon abnormalities (rupture, tendinitis) evaluated with MR imaging during the healing phase after either surgical or conservative treatment. A total of 21 patients were studied. Fifteen of 21 underwent surgery (13 tendon ruptures) and six were managed conservatively (one rupture). MR studies were obtained before treatment in 11, at 3 months in eight, at 6 months in seven, and at 12 months in 12. The 1.5-T spin-echo and gradient-echo images were correlated with clinical results, planter reflex response times, and calf force measurements. Sequential T2 times were obtained from representative levels in the tendons

  7. Achilles tendon repair

    Science.gov (United States)

    ... your Achilles tendon to point your toes and push off your foot when walking. If your Achilles ... MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice . 4th ed. Philadelphia, PA: ...

  8. Achilles Tendon Rupture

    Science.gov (United States)

    ... is a strong fibrous cord that connects the muscles in the back of your calf to your heel bone. If you overstretch your Achilles tendon, it can tear (rupture) completely or just partially. If your Achilles ...

  9. Bridging Graft in Irreparable Massive Rotator Cuff Tears: Autogenic Biceps Graft versus Allogenic Dermal Patch Graft.

    Science.gov (United States)

    Rhee, Sung Min; Oh, Joo Han

    2017-12-01

    Few comparative studies have reported on the use of biologic grafts for irreparable massive rotator cuff tears. The purpose of this study was to assess the results of arthroscopic bridging graft in irreparable massive rotator cuff tears using an autogenic long head of biceps tendon (LHBT) or an allogenic dermal patch (ADP). We retrospectively reviewed 24 patients treated using the LHBT (group I) and eight patients with complete rupture of the LHBT treated using an ADP (group II) since 2011. Preoperative Goutallier's fatty degeneration, range of motion (ROM), visual analogue scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, and Quick Disabilities of the Arm, Shoulder, and Hand (DASH) score were assessed and healing failure was evaluated at 1 year after surgery by ultrasonography or magnetic resonance imaging. The mean fatty degeneration in groups I and II was 3.9 and 3.6 for the supraspinatus ( p = 0.288), 2.7 and 2.9 for the infraspinatus ( p = 0.685), 0.9 and 1.3 for the subscapularis ( p = 0.314), and 1.3 and 3.0 for the teres minor ( p = 0.005), respectively. Subscapularis tears were found in 8 patients (33.3%) in group I and in 7 patients (87.5%) in group II ( p = 0.023). Mean ROMs and functional scores improved significantly in group I (forward flexion: 121.7° to 153.3°, p = 0.010; external rotation: 32.7° to 52.7°, p = 0.001; external rotation at 90°: 63.3° to 74.5°, p = 0.031; internal rotation: T10.5 to T9.3, p = 0.045; VAS: 7.0 to 1.1, p rotator cuff tears, especially in patients with severe fatty degeneration in the teres minor or combined biceps and subscapularis tears.

  10. [Achilles tendon rupture].

    Science.gov (United States)

    Thermann, H; Hüfner, T; Tscherne, H

    2000-03-01

    The treatment of acute of Achilles tendon rupture experienced a dynamic development in the last ten years. Decisive for this development was the application of MRI and above all the ultrasonography in the diagnostics of the pathological changes and injuries of tendons. The question of rupture morphology as well as different courses of healing could be now evaluated objectively. These advances led consequently to new modalities in treatment concepts and rehabilitation protocols. The decisive input for improvements of the outcome results and particularly the shortening of the rehabilitation period came with introduction of the early functional treatment in contrast to immobilizing plaster treatment. In a prospective randomized study (1987-1989) at the Trauma Dept. of the Hannover Medical School could show no statistical differences comparing functional non-operative with functional operative therapy with a special therapy boot (Variostabil/Adidas). The crucial criteria for therapy selection results from the sonographically measured position of the tendon stumps in plantar flexion (20 degrees). With complete adaptation of the tendons' ends surgical treatment does not achieve better results than non-operative functional treatment in term of tendon healing and functional outcome. Regarding the current therapeutic standards each method has is advantages and disadvantages. Both, the operative and non-operative functional treatment enable a stable tendon healing with a low risk of re-rupture (1-2%). Meanwhile there is consensus for early functional after-treatment of the operated Achilles' tendons. There seems to be a trend towards non-operative functional treatment in cases of adequate sonographical findings, or to minimal invasive surgical techniques.

  11. The 'bridging sign', a MR finding for combined full-thickness tears of the subscapularis tendon and the supraspinatus tendon

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jin Young [Dept. of Radiology, Saint Paul' s Hospital, The Catholic Univ. of Korea, Seoul (Korea, Republic of); Yoon, Young Cheol; Cha, Dong Ik [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan Univ, School of Medicine, Seoul (Korea, Republic of)], e-mail: ycyoon@skku.edu; Yoo, Jae-Chul [Dept. of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of); Jung, Jee Young [Dept. of Radiology, School of Medicine, Chung-Ang Univ., Seoul (Korea, Republic of)

    2013-02-15

    Background: In daily practice, we discovered one of the secondary magnetic resonance (MR) findings of the subscapularis (SSC) tendon tear, the 'bridging sign', which has not been previously described. Purpose: To describe the 'bridging sign' on shoulder MR imaging and its radiological and clinical significance in patients with SSC tendon tear. Material and Methods: Twenty-nine patients who had undergone shoulder arthroscopy and had full-thickness tear of the subscapularis tendon were enrolled. The medical records of the 29 patients were retrospectively reviewed for the duration of shoulder pain, rotator cuff tears, and associated arthroscopic findings: biceps tendon abnormality and superior glenoid labral tear. Then, preoperative shoulder MR images were retrospectively reviewed for the presence or absence of the 'bridging sign' and associated MR findings: periarticular fluid and fatty atrophy of the supraspinatus and subscapularis muscles. The type of rotator cuff tear associated with the 'bridging sign' was assessed and the sensitivity, specificity, and accuracy of the 'bridging sign' for the diagnosis of a certain type of rotator cuff tear were calculated. Associated arthroscopic and MR findings and mean duration of the shoulder pain between the patients with and without the 'bridging sign' were compared. Results: The 'bridging sign' was seen in 17 of 29 patients and corresponded to a complex of the torn and superomedially retracted subscapularis tendon, coracohumeral ligament, and superior glenohumeral ligament, adhered to the anterior margin of the torn supraspinatus (SSP) tendon on arthroscopy. All patients with the 'bridging sign' had combined full-thickness tear (FTT) of the cranial 1/2 portion of the subscapularis tendon and anterior 1/2 portion of the SSP tendon. The sensitivity, specificity, and accuracy of the 'bridging sign' for the diagnosis of combined FTTs of

  12. bicep2/KECK ARRAY. IV. OPTICAL CHARACTERIZATION AND PERFORMANCE OF THE bicep2 AND KECK ARRAY EXPERIMENTS

    Energy Technology Data Exchange (ETDEWEB)

    Ade, P. A. R. [School of Physics and Astronomy, Cardiff University, Cardiff, CF24 3AA (United Kingdom); Aikin, R. W.; Bock, J. J.; Brevik, J. A.; Filippini, J. P.; Golwala, S. R.; Hildebrandt, S. R.; Hui, H. [Department of Physics, California Institute of Technology, Pasadena, CA 91125 (United States); Barkats, D. [Joint ALMA Observatory, ESO, Santiago (Chile); Benton, S. J. [Department of Physics, University of Toronto, Toronto, ON (Canada); Bischoff, C. A.; Bradford, K. J.; Buder, I. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, MA 02138 (United States); Bullock, E. [Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455 (United States); Dowell, C. D. [Jet Propulsion Laboratory, Pasadena, CA 91109 (United States); Duband, L. [Université Grenoble Alpes, CEA INAC-SBT, F-38000 Grenoble (France); Fliescher, S. [Department of Physics, University of Minnesota, Minneapolis, MN 55455 (United States); Halpern, M.; Hasselfield, M. [Department of Physics and Astronomy, University of British Columbia, Vancouver, BC (Canada); Hilton, G. C., E-mail: avieregg@kicp.uchicago.edu [National Institute of Standards and Technology, Boulder, CO 80305 (United States); Collaboration: bicep2 and Keck Array Collaborations; and others

    2015-06-20

    bicep2 and the Keck Array are polarization-sensitive microwave telescopes that observe the cosmic microwave background (CMB) from the South Pole at degree angular scales in search of a signature of inflation imprinted as B-mode polarization in the CMB. bicep2 was deployed in late 2009, observed for three years until the end of 2012 at 150 GHz with 512 antenna-coupled transition edge sensor bolometers, and has reported a detection of B-mode polarization on degree angular scales. The Keck Array was first deployed in late 2010 and will observe through 2016 with five receivers at several frequencies (95, 150, and 220 GHz). bicep2 and the Keck Array share a common optical design and employ the field-proven bicep1 strategy of using small-aperture, cold, on-axis refractive optics, providing excellent control of systematics while maintaining a large field of view. This design allows for full characterization of far-field optical performance using microwave sources on the ground. Here we describe the optical design of both instruments and report a full characterization of the optical performance and beams of bicep2 and the Keck Array at 150 GHz.

  13. Efficacy of labral repair, biceps tenodesis, and diagnostic arthroscopy for SLAP Lesions of the shoulder: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Mowinckel Petter

    2010-10-01

    Full Text Available Abstract Background Surgery for type II SLAP (superior labral anterior posterior lesions of the shoulder is a promising but unproven treatment. The procedures include labral repair or biceps tenodesis. Retrospective cohort studies have suggested that the benefits of tenodesis include pain relief and improved function, and higher patient satisfaction, which was reported in a prospective non-randomised study. There have been no completed randomised controlled trials of surgery for type II SLAP lesions. The aims of this participant and observer blinded randomised placebo-controlled trial are to compare the short-term (6 months and long-term (2 years efficacy of labral repair, biceps tenodesis, and placebo (diagnostic arthroscopy for alleviating pain and improving function for type II SLAP lesions. Methods/Design A double-blind randomised controlled trial are performed using 120 patients, aged 18 to 60 years, with a history for type II SLAP lesions and clinical signs suggesting type II SLAP lesion, which were documented by MR arthrography and arthroscopy. Exclusion criteria include patients who have previously undergone operations for SLAP lesions or recurrent shoulder dislocations, and ruptures of the rotator cuff or biceps tendon. Outcomes will be assessed at baseline, three, six, 12, and 24 months. Primary outcome measures will be the clinical Rowe Score (1988-version and the Western Ontario Instability Index (WOSI at six and 24 months. Secondary outcome measures will include the Shoulder Instability Questionnaire (SIQ, the generic EuroQol (EQ-5 D and EQ-VAS, return to work and previous sports activity, complications, and the number of reoperations. Discussion The results of this trial will be of international importance and the results will be translatable into clinical practice. Trial Registration [ClinicalTrials.gov NCT00586742

  14. BICEP2. II. Experiment and three-year data set

    Energy Technology Data Exchange (ETDEWEB)

    Ade, P. A. R. [School of Physics and Astronomy, Cardiff University, Cardiff, CF24 3AA (United Kingdom); Aikin, R. W.; Bock, J. J.; Brevik, J. A.; Filippini, J. P.; Golwala, S. R.; Hildebrandt, S. R. [Department of Physics, California Institute of Technology, Pasadena, CA 91125 (United States); Amiri, M.; Davis, G.; Halpern, M.; Hasselfield, M. [Department of Physics and Astronomy, University of British Columbia, Vancouver, BC (Canada); Barkats, D. [Joint ALMA Observatory, ESO, Santiago (Chile); Benton, S. J. [Department of Physics, University of Toronto, Toronto, ON (Canada); Bischoff, C. A.; Buder, I. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street MS 42, Cambridge, MA 02138 (United States); Bullock, E. [Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455 (United States); Day, P. K.; Dowell, C. D. [Jet Propulsion Laboratory, Pasadena, CA 91109 (United States); Duband, L. [Université Grenoble Alpes, CEA INAC-SBT, F-38000 Grenoble (France); Fliescher, S., E-mail: ogburn@stanford.edu [Department of Physics, University of Minnesota, Minneapolis, MN 55455 (United States); Collaboration: Bicep2 Collaboration; and others

    2014-09-01

    We report on the design and performance of the BICEP2 instrument and on its three-year data set. BICEP2 was designed to measure the polarization of the cosmic microwave background (CMB) on angular scales of 1°-5°(ℓ = 40-200), near the expected peak of the B-mode polarization signature of primordial gravitational waves from cosmic inflation. Measuring B-modes requires dramatic improvements in sensitivity combined with exquisite control of systematics. The BICEP2 telescope observed from the South Pole with a 26 cm aperture and cold, on-axis, refractive optics. BICEP2 also adopted a new detector design in which beam-defining slot antenna arrays couple to transition-edge sensor (TES) bolometers, all fabricated on a common substrate. The antenna-coupled TES detectors supported scalable fabrication and multiplexed readout that allowed BICEP2 to achieve a high detector count of 500 bolometers at 150 GHz, giving unprecedented sensitivity to B-modes at degree angular scales. After optimization of detector and readout parameters, BICEP2 achieved an instrument noise-equivalent temperature of 15.8 μK√s. The full data set reached Stokes Q and U map depths of 87.2 nK in square-degree pixels (5.'2 μK) over an effective area of 384 deg{sup 2} within a 1000 deg{sup 2} field. These are the deepest CMB polarization maps at degree angular scales to date. The power spectrum analysis presented in a companion paper has resulted in a significant detection of B-mode polarization at degree scales.

  15. Clinical aspects of tendon healing

    NARCIS (Netherlands)

    J.C.H.M. van der Meulen (Jacques)

    1974-01-01

    textabstractWe know that healing of a tendon wound takes place by an invasion of fibreblasts from the surrounding tissues; the tendon itself has no intrinsic healing capacity. lt was Potenza (1962) who proved that a traumatic suture of the tendons within their sheath is followed by disintegration of

  16. Extracorporeal shockwave therapy and therapeutic exercise for supraspinatus and biceps tendinopathies in 29 dogs.

    Science.gov (United States)

    Leeman, J J; Shaw, K K; Mison, M B; Perry, J A; Carr, A; Shultz, R

    2016-10-15

    Supraspinatus tendinopathy (ST) and biceps tendinopathy (BT) are common causes of forelimb lameness in large-breed dogs and have historically been treated with conservative management or surgery. Extracorporeal shockwave therapy (ESWT) and therapeutic exercise (TE) are thought to be treatment options for these conditions. The objectives of this study were to report the clinical presentations of dogs treated with ESWT for shoulder tendinopathies, to determine the association between shoulder lesion severity identified on ultrasonography or MRI and outcome, and to compare the outcomes of dogs treated with ESWT with and without TE. Medical records of 29 dogs diagnosed with shoulder tendinopathies and treated with ESWT were reviewed, and 24 dogs were diagnosed with either unilateral BT or BT and ST. None were found to have unilateral ST. Five dogs were diagnosed with bilateral disease. Eighty-five per cent of dogs had good or excellent outcomes determined by owner assessment 11-220 weeks after therapy. Outcomes were found to be better as tendon lesion severity increased (P=0.0497), regardless if ESWT was performed with or without TE (P=0.92). ESWT should be considered a safe primary therapeutic option for canine shoulder tendinopathies. Larger controlled prospective studies are needed to adequately assess these findings. British Veterinary Association.

  17. Chaotic inflation in supergravity after Planck and BICEP2

    International Nuclear Information System (INIS)

    Kallosh, Renata; Linde, Andrei

    2014-05-01

    We discuss the general structure and observational consequences of some of the simplest versions of chaotic inflation in supergravity in relation to the data by Planck 2013 and BICEP2. We show that minimal modifications to the simplest quadratic potential are sufficient to provide a controllable tensor mode signal and a suppression of CMB power at large angular scales.

  18. Inflation in the light of BICEP2 and PLANCK

    Indian Academy of Sciences (India)

    2016-01-13

    Jan 13, 2016 ... The BICEP2/Keck+PLANCK joint analysis of the -model polarization and polarization by foreground dust sets an upper bound on the tensor-to-scalar ratio of 0.05 < 0.12 at 95% CL. The popular Starorbinsky model Higgs-inflation or the conformally equivalent Higgs-inflation model allow low values ...

  19. Flexor Tendon Injuries

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is ... Hand Therapist? Media Find a Hand Surgeon Home Anatomy ... fields From * To * DESCRIPTION The muscles that bend (flex) the fingers are called flexor ...

  20. triceps tendon avulsion

    African Journals Online (AJOL)

    GB

    2014-01-01

    Jan 1, 2014 ... trauma. Systemic causes such as chronic renal failure, steriod use, diabetes mellitus, hyperparathyroidism, rheumatoid arthritis, osteogensis imperfecta and local causes like local steriod injection, olecranon bursitis and attritional changes due to degenerative arthritis are associated with tendon weakening.

  1. Changes in hip joint muscle-tendon lengths with mode of locomotion.

    Science.gov (United States)

    Riley, Patrick O; Franz, Jason; Dicharry, Jay; Kerrigan, D Casey

    2010-02-01

    We have reported that peak hip extension is nearly identical in walking and running, suggesting that anatomical constraints, such as flexor muscle tightness may limit the range of hip extension. To obtain a more mechanistic insight into mobility at the hip and pelvis we examined the lengths of the muscle-tendons units crossing the hip joint. Data defining the three-dimensional kinematics of 26 healthy runners at self-selected walking and running speeds were obtained. These data were used to scale and drive musculoskeletal models using OpenSIM. Muscle-tendon unit (MTU) lengths were calculated for the trailing limb illiacus, rectus femoris, gluteus maximus, and biceps femoris long head and the advancing limb biceps femoris and gluteus maximus. The magnitude and timing of MTU length peaks were each compared between walking and running. The peak length of the right (trailing limb) illiacus MTU, a pure hip flexor, was nearly identical between walking and running, while the maximum length of the rectus femoris MTU, a hip flexor and knee extensor, increased during running. The maximum length of the left (leading limb) biceps femoris was also unchanged between walking and running. Further, the timing of peak illiacus MTU length and peak contralateral biceps femoris MTU length occurred essentially simultaneously during running, at a time during gait when the hamstrings are most vulnerable to stretch injury. This latter finding suggests exploring the role for hip flexor stretching in combination with hamstring stretching to treat and/or prevent running related hamstring injury. Copyright 2009 Elsevier B.V. All rights reserved.

  2. Novel fiber-based pure chitosan scaffold for tendon augmentation: biomechanical and cell biological evaluation.

    Science.gov (United States)

    Nowotny, J; Aibibu, D; Farack, J; Nimtschke, U; Hild, M; Gelinsky, M; Kasten, P; Cherif, Ch

    2016-07-01

    One possibility to improve the mechanical properties after tendon ruptures is augmentation with a scaffold. Based on wet spinning technology, chitosan fibres were processed to a novel pure high-grade multifilament yarn with reproducible quality. The fibres were braided to obtain a 3D tendon scaffold. The CS fibres and scaffolds were evaluated biomechanically and compared to human supraspinatus (SSP) tendons. For the cytobiological characterization, in vitro cell culture experiments with human mesenchymal stem cells (hMSC) were performed. Three types of 3D circular braided scaffolds were fabricated. Significantly, higher ultimate stress values were measured for scaffold with larger filament yarn, compared to scaffold with smaller filament yarn. During cultivation over 28 days, the cells showed in dependence of isolation method and/or donor a doubling or tripling of the cell number or even a six-fold increase on the CS scaffold, which was comparable to the control (polystyrene) or in the case of cells obtained from human biceps tendon even higher proliferation rates. After 14 days, the scaffold surface was covered homogeneously with a cell layer. In summary, the present work demonstrates that braided chitosan scaffolds constitute a straightforward approach for designing tendon analogues, maintaining important flexibility in scaffold design and providing favourable mechanical properties of the resulting construct.

  3. Miscellaneous conditions of tendons, tendon sheaths, and ligaments.

    Science.gov (United States)

    Dyson, S J; Dik, K J

    1995-08-01

    The use of diagnostic ultrasonography has greatly enhances our ability to diagnose injuries of tendons and tendon sheaths that were previously either unrecognized or poorly understood. For may of these injuries, there is currently only a small amount of follow-up data. This article considers injuries of the deep digital flexor tendon and its accessory ligament, the carpal tunnel syndrome soft tissue swellings on the dorsal aspect of the carpus, intertubercular (bicipital) bursitis and bicipital tendinitis, injuries of the gastrocnemius tendon, common calcaneal tendinitis, rupture of peroneus (fibularis tertius) and ligaments injuries of the back.

  4. Contribution of full-thickness supraspinatus tendon tears to acquired subcoracoid impingement

    Energy Technology Data Exchange (ETDEWEB)

    MacMahon, P.J. [Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin (Ireland)]. E-mail: petermacmahon@yahoo.com; Taylor, D.H. [Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin (Ireland); Duke, D. [Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin (Ireland); Brennan, D.D. [Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin (Ireland); O' Brien, J. [Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin (Ireland); Eustace, S.J. [Department of Radiology, Cappagh National Orthopaedic Hospital, Finglas, Dublin (Ireland)

    2007-06-15

    Aim: To assess the relationship between the severity of full-thickness supraspinatus tendon tears and the development of subcoracoid impingement. Materials and methods: Fifty-one magnetic resonance imaging (MRI) shoulder examination reports with full-thickness supraspinatus tears were retrospectively identified and reviewed by two dedicated musculoskeletal radiologists. The appearances of the rotator cuff muscles, biceps tendon and the lesser tubercle were recorded. The acromio-humeral distance and the axial coraco-humeral distance were measured. The data were recorded and analysed electronically. Results: The kappa values for inter-observer agreement were: 0.91 for acromio-humeral distance and 0.85 for coraco-humeral distance measurements. Twenty-six patients had significant retraction of the supraspinatus tendon, 85% (22 cases) of this group had imaging evidence of tear or tendonopathy of the subscapularis tendon. Twenty-five patients had no significant retraction of the supraspinatus, 56% (14 cases) of this group had imaging evidence of a subscapularis tear or tendonopathy. The acromio-humeral distance was significantly less in patients with supraspinatus tears and retraction (p < 0.05). The subscapularis tendon was significantly more likely to be abnormal if the supraspinatus was retracted than if no retraction was present (p < 0.05). There were no significant differences in coraco-humeral distances between the groups. Conclusion: Subscapularis tendon signal and structural changes are frequently associated with full-thickness supraspinatus tendon tears, particularly if the supraspinatus is significantly retracted. In this static MRI series, the data do not support the occurrence of classical subcoracoid impingement as an aetiology; however, they may support the possibility of a dynamic mechanism, to which future studies could be directed.

  5. Contribution of full-thickness supraspinatus tendon tears to acquired subcoracoid impingement

    International Nuclear Information System (INIS)

    MacMahon, P.J.; Taylor, D.H.; Duke, D.; Brennan, D.D.; O'Brien, J.; Eustace, S.J.

    2007-01-01

    Aim: To assess the relationship between the severity of full-thickness supraspinatus tendon tears and the development of subcoracoid impingement. Materials and methods: Fifty-one magnetic resonance imaging (MRI) shoulder examination reports with full-thickness supraspinatus tears were retrospectively identified and reviewed by two dedicated musculoskeletal radiologists. The appearances of the rotator cuff muscles, biceps tendon and the lesser tubercle were recorded. The acromio-humeral distance and the axial coraco-humeral distance were measured. The data were recorded and analysed electronically. Results: The kappa values for inter-observer agreement were: 0.91 for acromio-humeral distance and 0.85 for coraco-humeral distance measurements. Twenty-six patients had significant retraction of the supraspinatus tendon, 85% (22 cases) of this group had imaging evidence of tear or tendonopathy of the subscapularis tendon. Twenty-five patients had no significant retraction of the supraspinatus, 56% (14 cases) of this group had imaging evidence of a subscapularis tear or tendonopathy. The acromio-humeral distance was significantly less in patients with supraspinatus tears and retraction (p < 0.05). The subscapularis tendon was significantly more likely to be abnormal if the supraspinatus was retracted than if no retraction was present (p < 0.05). There were no significant differences in coraco-humeral distances between the groups. Conclusion: Subscapularis tendon signal and structural changes are frequently associated with full-thickness supraspinatus tendon tears, particularly if the supraspinatus is significantly retracted. In this static MRI series, the data do not support the occurrence of classical subcoracoid impingement as an aetiology; however, they may support the possibility of a dynamic mechanism, to which future studies could be directed

  6. Novel methods for tendon investigations

    DEFF Research Database (Denmark)

    Kjær, Michael; Langberg, Henning; Bojsen-Møller, J.

    2008-01-01

    Purpose. Tendon structures have been studied for decades, but over the last decade, methodological development and renewed interest for metabolic, circulatory and tissue protein turnover in tendon tissue has resulted in a rising amount of investigations. Method. This paper will detail the various...... modern investigative techniques available to study tendons. Results. There are a variety of investigative methods available to study the correlations between mechanics and biology in tendons. Conclusion. The available methodologies not only allow for potential insight into physiological...... and pathophysiological mechanisms in tendon tissue, but also, to some extent, allow for more elaborate studies of the intact human tendon. Read More: http://informahealthcare.com/doi/full/10.1080/09638280701785403...

  7. Simultaneous bilateral patellar tendon rupture ?

    OpenAIRE

    Moura, Diogo Lino; Marques, Jos? Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

    2016-01-01

    Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a s...

  8. Inflation in the light of BICEP2 and PLANCK

    Indian Academy of Sciences (India)

    Abstract. The BICEP2/Keck+PLANCK joint analysis of the B-model polarization and polar- ization by foreground dust sets an upper bound on the tensor-to-scalar ratio of r0.05 < 0.12 at 95%. CL. The popular Starorbinsky model Higgs-inflation or the conformally equivalent Higgs-inflation model allow low r values (∼10−3).

  9. Long head of biceps: from anatomy to treatment

    Directory of Open Access Journals (Sweden)

    Marco Sarmento

    2015-01-01

    Full Text Available The long head of the biceps (LHB, tendinous structure of the proximal brachial biceps, has its well-known anatomy, which contrasts with its current functional characterization. Various forms of proximal anchor and intra–articular route, important for the correct interpretation of its contribution to the pathology of the shoulder as well as the treatment methodology, are described. Knowledge of its biomechanics results mainly from cadaveric studies that contradict each other. Already the few studies in vivo indicate a depressant and stabilizing action, anterior, for the humeral head. Its pathology is rarely isolated because it is almost always correlated with rotator cuff or labrum pathology. It can be divided into 3 major groups (inflammatory, instability and traumatic and subdivided according to its location. The anterior shoulder pain is the initial symptom of pathology of LHB Its perfect characterization is dependent on the associated injuries. Clinical tests are multiple and only their combination allows better sensitivity and specificity for LHB pathology. The arthro-MRI and dynamic ultrasound are able to increase proper diagnostic of the pathology of LHB. Treatment ranges from conservative and surgical. The latter includes the repair, tenotomy and tenodesis of LHB which can be performed by open or arthroscopic methodology. The author intends to review existing literature on all aspects related to the long head of the biceps from anatomy to treatment, presenting the latest results.

  10. Quality traits of pork semimembranosus and triceps brachii muscles sourced from the United States and Mexico.

    Science.gov (United States)

    Delgado-Suárez, E J; Rubio-Lozano, M S; Toledo-López, V M; Torrescano-Urrutia, G R; Ponce-Alquicira, E; Huerta-Leidenz, N

    2016-12-01

    The study included fresh pork semimembranosus (SM, n=289) and triceps brachii (TB, n=283) muscles sourced from meat packers of Mexico and the USA. Samples were analyzed for moisture, protein, and fat content, pH, shear force (WBSF), cook loss, water holding capacity (WHC), instrumental color, emulsion capacity (EC) and stability (ES), and consumer sensory ratings. SM from the USA had lower WBSF (P0.05) across countries. TB from Mexico had higher (Ppork exhibits better technological properties, while country of origin has less effect on consumer acceptability. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. MR anatomy study of the elbow, with emphasis in ligaments and tendons structure - methodology

    International Nuclear Information System (INIS)

    Vilela, Sonia de Aguiar; Fernandes, Artur da Rocha Correa; Barbieri, Antonio; Turrini, Elisabete; Juliano, Yara

    1999-01-01

    Seventeen MR exams of the elbow joints of fifteen healthy volunteers were obtained on T1 spin-echo sequences in the transversal, coronal and sagital planes. Eight anatomic structures were selected and evaluated by three independent blind readers. The aim of this study was to establish the frequency of visibility as well to determine the best plane to characterize these anatomic structures and also to analyze the interobserver variability. The readers analyzed the exams using the same criteria: degree 0 (structure not visible); degree 1 (structure visible and partially delineated); degree 2 (structure well visible and well delineated). The structure visibility showed variability close related to the degree (1 or 2) chosen by the readers to define the structure visualization and mainly in the transverse plane. The coronal plane was showed to be the ideal to evaluate the collateral ligaments, the common extensor tendon and the com,mon flexor tendon, otherwise the sagital plane was useful to define triceps and braquial tendons. The biceps tendon and annular ligament were well defined in the transverse plane. The usefulness of this study is to establish the ideal planes to evaluate these anatomic structures, and develop faster protocols. (author)

  12. Nonsingular bouncing cosmologies in light of BICEP2

    International Nuclear Information System (INIS)

    Cai, Yi-Fu; Quintin, Jerome; Saridakis, Emmanuel N.; Wilson-Ewing, Edward

    2014-01-01

    We confront various nonsingular bouncing cosmologies with the recently released BICEP2 data and investigate the observational constraints on their parameter space. In particular, within the context of the effective field approach, we analyze the constraints on the matter bounce curvaton scenario with a light scalar field, and the new matter bounce cosmology model in which the universe successively experiences a period of matter contraction and an ekpyrotic phase. Additionally, we consider three nonsingular bouncing cosmologies obtained in the framework of modified gravity theories, namely the Hořava-Lifshitz bounce model, the f(T) bounce model, and loop quantum cosmology

  13. Bioreactor Design for Tendon/Ligament Engineering

    OpenAIRE

    Wang, Tao; Gardiner, Bruce S.; Lin, Zhen; Rubenson, Jonas; Kirk, Thomas B.; Wang, Allan; Xu, Jiake; Smith, David W.; Lloyd, David G.; Zheng, Ming H.

    2012-01-01

    Tendon and ligament injury is a worldwide health problem, but the treatment options remain limited. Tendon and ligament engineering might provide an alternative tissue source for the surgical replacement of injured tendon. A bioreactor provides a controllable environment enabling the systematic study of specific biological, biochemical, and biomechanical requirements to design and manufacture engineered tendon/ligament tissue. Furthermore, the tendon/ligament bioreactor system can provide a s...

  14. Simultaneous bilateral patellar tendon rupture.

    Science.gov (United States)

    Moura, Diogo Lino; Marques, José Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

    2017-01-01

    Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

  15. Simultaneous bilateral patellar tendon rupture

    Directory of Open Access Journals (Sweden)

    Diogo Lino Moura

    Full Text Available ABSTRACT Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

  16. Muscle Fatigue in the Three Heads of the Triceps Brachii During a Controlled Forceful Hand Grip Task with Full Elbow Extension Using Surface Electromyography.

    Science.gov (United States)

    Ali, Asraf; Sundaraj, Kenneth; Badlishah Ahmad, R; Ahamed, Nizam Uddin; Islam, Anamul; Sundaraj, Sebastian

    2015-06-27

    The objective of the present study was to investigate the time to fatigue and compare the fatiguing condition among the three heads of the triceps brachii muscle using surface electromyography during an isometric contraction of a controlled forceful hand grip task with full elbow extension. Eighteen healthy subjects concurrently performed a single 90 s isometric contraction of a controlled forceful hand grip task and full elbow extension. Surface electromyographic signals from the lateral, long and medial heads of the triceps brachii muscle were recorded during the task for each subject. The changes in muscle activity among the three heads of triceps brachii were measured by the root mean square values for every 5 s period throughout the total contraction period. The root mean square values were then analysed to determine the fatiguing condition for the heads of triceps brachii muscle. Muscle fatigue in the long, lateral, and medial heads of the triceps brachii started at 40 s, 50 s, and 65 s during the prolonged contraction, respectively. The highest fatiguing rate was observed in the long head (slope = -2.863), followed by the medial head (slope = -2.412) and the lateral head (slope = -1.877) of the triceps brachii muscle. The results of the present study concurs with previous findings that the three heads of the triceps brachii muscle do not work as a single unit, and the fiber type/composition is different among the three heads.

  17. Joint Analysis of BICEP2/Keck Array and Planck Data

    DEFF Research Database (Denmark)

    Ade, P. A. R.; Aghanim, N.; Ahmed, Z.

    2015-01-01

    We report the results of a joint analysis of data from BICEP2/Keck Array and Planck. BICEP2 and Keck Array have observed the same approximately 400 deg2 patch of sky centered on RA 0 h, Dec. -57.5°. The combined maps reach a depth of 57 nK deg in Stokes Q and U in a band centered at 150 GHz. Planck...... GHz to a lensed-ΛCDM model that includes dust and a possible contribution from inflationary gravitational waves (as parametrized by the tensor-to-scalar ratio r), using a prior on the frequency spectral behavior of polarized dust emission from previous Planck analysis of other regions of the sky. We...... present an alternative analysis which is similar to a map-based cleaning of the dust contribution, and show that this gives similar constraints. The final result is expressed as a likelihood curve for r, and yields an upper limit r 0.05

  18. Recovery of pectoralis major and triceps brachii after bench press exercise.

    Science.gov (United States)

    Ferreira, Diogo V; Gentil, Paulo; Soares, Saulo Rodrigo Sampaio; Bottaro, Martim

    2017-11-01

    The present study evaluated and compared the recovery of pectoralis major (PM) and triceps brachii (TB) muscles of trained men after bench press exercise. Eighteen volunteers performed eight sets of bench press exercise to momentary muscle failure and were evaluated for TB and PM peak torque and total work on an isokinetic dynamometer. PM peak torque and total work remained lower than baseline for 72 and 96 h, respectively. TB peak torque was only different from baseline immediately post training, while total work was significantly lower than baseline immediately and 48 h after training. Normalized peak torque values were only different between TB and PM at 48 h after training. Considering the small and nonsignificant difference between the recovery of TB and PM muscles, the results suggest that bench press exercise may promote a similar stress on these muscles. Muscle Nerve 56: 963-967, 2017. © 2016 Wiley Periodicals, Inc.

  19. Tendon overuse syndrome: imaging diagnosis

    International Nuclear Information System (INIS)

    Huber, W.; Nehrer, S.; Muellner, T.; Kainberger, F.; Ulreich, N.; Bernhard, C.; Imhof, H.

    2001-01-01

    Injuries of muscles and tendons occur commonly during various sporting activities and in most cases the athletes feel such an accident to be sudden and unavoidable. The rupture of a tendon, however, has to be considered in many cases as the final stage of a long-standing progressive degeneration of collagen fibers. This process con be described as 'tendon overuse syndrome (TOS)'. Diagnostic imaging modalities, especially sonography and MRI, are suitable to detect and analyse the different stages of this syndrome and the degree of morphological abnormalities. The first stage is painful functional derangement, followed by tendovaginitis, peritendinitis, or bursitis. The third stage is tendinosis resulting from biomechanical or ischaemic injury of tendon fibers which may eventually be followed by partial or complete rupture. Regional or individual specifications of these four stages may occur at anatomically predisposing sites, so-called critical zones, or during periods of specific proneness, the vulnerable phases. (author)

  20. Proximal biceps rupture: management of an unusual injury in an arm wrestler

    OpenAIRE

    Pratt, D A; Tennent, T D

    2007-01-01

    Arm wrestling may cause unusual injuries, which may require operative repair in the sporting individual. Injury to the proximal biceps as a consequence of arm wrestling has not been reported previously. The diagnosis and treatment of a 36‐year‐old man who sustained a proximal biceps rupture while arm wrestling and his operative management are described.

  1. Radiative inflation and dark energy RIDEs again after BICEP2

    International Nuclear Information System (INIS)

    Bari, Pasquale Di; King, Stephen F.; Merle, Alexander; Luhn, Christoph; Schmidt-May, Angnis

    2014-01-01

    Following the ground-breaking measurement of the tensor-to-scalar ratio r=0.20 +0.07 -0.05 by the BICEP2 collaboration, we perform a statistical analysis of a model that combines Radiative Inflation with Dark Energy (RIDE) based on the M 2 |Φ| 2 ln(|Φ| 2 /Λ 2 ) potential and compare its predictions to those based on the traditional chaotic inflation M 2 |Φ| 2 potential. We find a best-fit value in the RIDE model of r=0.18 as compared to r=0.17 in the chaotic model, with the spectral index being n S =0.96 in both models

  2. Probing nuclear rates with Planck and BICEP2

    CERN Document Server

    Di Valentino, Eleonora; Lesgourgues, Julien; Mangano, Gianpiero; Melchiorri, Alessandro; Miele, Gennaro; Pisanti, Ofelia

    2014-01-01

    Big Bang Nucleosynthesis (BBN) relates key cosmological parameters to the primordial abundance of light elements. In this paper, we point out that the recent observations of Cosmic Microwave Background anisotropies by the Planck satellite and by the BICEP2 experiment constrain these parameters with such a high level of accuracy that the primordial deuterium abundance can be inferred with remarkable precision. For a given cosmological model, one can obtain independent information on nuclear processes in the energy range relevant for BBN, which determine the eventual ^2H/H yield. In particular, assuming the standard cosmological model, we show that a combined analysis of Planck data and of recent deuterium abundance measurements in metal-poor damped Lyman-alpha systems provides independent information on the cross section of the radiative capture reaction d(p,\\gamma)^3He converting deuterium into helium. Interestingly, the result is higher than the values suggested by a fit of present experimental data in the B...

  3. Quantifying the BICEP2-Planck tension over gravitational waves.

    Science.gov (United States)

    Smith, Kendrick M; Dvorkin, Cora; Boyle, Latham; Turok, Neil; Halpern, Mark; Hinshaw, Gary; Gold, Ben

    2014-07-18

    The recent BICEP2 measurement of B-mode polarization in the cosmic microwave background (r = 0.2(-0.05)(+0.07)), a possible indication of primordial gravity waves, appears to be in tension with the upper limit from WMAP (r < 0.13 at 95% C.L.) and Planck (r < 0.11 at 95% C.L.). We carefully quantify the level of tension and show that it is very significant (around 0.1% unlikely) when the observed deficit of large-scale temperature power is taken into account. We show that measurements of TE and EE power spectra in the near future will discriminate between the hypotheses that this tension is either a statistical fluke or a sign of new physics. We also discuss extensions of the standard cosmological model that relieve the tension and some novel ways to constrain them.

  4. bicep2/ KECK ARRAY . IV. OPTICAL CHARACTERIZATION AND PERFORMANCE OF THE bicep2 AND KECK ARRAY EXPERIMENTS

    Energy Technology Data Exchange (ETDEWEB)

    Ade, P.A.R.; Aikin, R.W.; Barkats, D.; Benton, S.J.; Bischoff, C.A.; Bock, J.J.; Bradford, K.J.; Brevik, J.A.; Buder, I.; Bullock, E.; Dowell, C.D.; Duband, L.; Filippini, J.P.; Fliescher, S.; Golwala, S.R.; Halpern, M.; Hasselfield, M.; Hildebrandt, S.R.; Hilton, G.C.; Hui, H.; Irwin, K.D.

    2015-06-18

    bicep2/KECK ARRAY. IV. OPTICAL CHARACTERIZATION AND PERFORMANCE OF THE bicep2 AND KECK ARRAY EXPERIMENTS P. A. R. Ade1, R. W. Aikin2, D. Barkats3, S. J. Benton4, C. A. Bischoff5, J. J. Bock2,6, K. J. Bradford5, J. A. Brevik2, I. Buder5, E. Bullock7Show full author list Published 2015 June 18 • © 2015. The American Astronomical Society. All rights reserved. The Astrophysical Journal, Volume 806, Number 2 Article PDF Figures Tables References Citations 273 Total downloads Cited by 6 articles Turn on MathJax Share this article Get permission to re-use this article Article information Abstract bicep2 and the Keck Array are polarization-sensitive microwave telescopes that observe the cosmic microwave background (CMB) from the South Pole at degree angular scales in search of a signature of inflation imprinted as B-mode polarization in the CMB. bicep2 was deployed in late 2009, observed for three years until the end of 2012 at 150 GHz with 512 antenna-coupled transition edge sensor bolometers, and has reported a detection of B-mode polarization on degree angular scales. The Keck Array was first deployed in late 2010 and will observe through 2016 with five receivers at several frequencies (95, 150, and 220 GHz). bicep2 and the Keck Array share a common optical design and employ the field-proven bicep1 strategy of using small-aperture, cold, on-axis refractive optics, providing excellent control of systematics while maintaining a large field of view. This design allows for full characterization of far-field optical performance using microwave sources on the ground. Here we describe the optical design of both instruments and report a full characterization of the optical performance and beams of bicep2 and the Keck Array at 150 GHz.

  5. MRI of tibialis anterior tendon rupture

    International Nuclear Information System (INIS)

    Gallo, Robert A.; DeMeo, Patrick J.; Kolman, Brett H.; Daffner, Richard H.; Sciulli, Robert L.; Roberts, Catherine C.

    2004-01-01

    Ruptures of the tibialis anterior tendon are rare. We present the clinical histories and MRI findings of three recent male patients with tibialis anterior tendon rupture aged 58-67 years, all of whom presented with pain over the dorsum of the ankle. Two of the three patients presented with complete rupture showing discontinuity of the tendon, thickening of the retracted portion of the tendon, and excess fluid in the tendon sheath. One patient demonstrated a partial tear showing an attenuated tendon with increased surrounding fluid. Although rupture of the tibialis anterior tendon is a rarely reported entity, MRI is a useful modality in the definitive detection and characterization of tibialis anterior tendon ruptures. (orig.)

  6. Achilles Tendon's Tear

    OpenAIRE

    F. Shahandeh

    2008-01-01

    Introduction: The achilles and plantaris tendons to-gether makeup the posterior grouptendons of ankle. Their seldom confusion in interpreting MR images of the achilles tendon. The achilles tendon should ap-pear informally straight and black on sagital T1 weighted images and on fluid sensitive images."nCase Presentation: After a heavy sport, a 55 year-old woman cannot walk with right foot."nDiscussion: The classic achilles tendon rupture occurs with forced dorsiflexion of planted foo...

  7. Pathophysiology of overuse tendon injury

    International Nuclear Information System (INIS)

    Kannus, P.; Paavola, M.; Paakkala, T.; Parkkari, J.; Jaervinen, T.; Jaervinen, M.

    2002-01-01

    Overuse tendon injury is one of the most common injuries in sports.The etiology as well as the pathophysilogical mechanisms leading to tendinopathy are of crucial medical importance.At the moment intrinsic and extrinsic factors are assumed as mechanisms of overuse tendon injury. Except for the acute, extrinsic trauma, the chronic overuse tendon injury is a multifactorial process. There are many other factors, such as local hypoxia, less of nutrition, impaired metabolism and local inflammatory that may also contribute to the development of tissue damage.The exact interaction of these factors cannot be explained entirely at the moment.Further studies will be necessary in order to get more information. (orig.) [de

  8. Isocurvature perturbations and tensor mode in light of Planck and BICEP2

    Energy Technology Data Exchange (ETDEWEB)

    Kawasaki, Masahiro; Yokoyama, Shuichiro [Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582 (Japan); Sekiguchi, Toyokazu [Helsinki Institute of Physics, University of Helsinki, PO Box 64, FIN-00014 (Finland); Takahashi, Tomo, E-mail: kawasaki@icrr.u-tokyo.ac.jp, E-mail: toyokazu.sekiguchi@helsinki.fi, E-mail: tomot@cc.saga-u.ac.jp, E-mail: shu@icrr.u-tokyo.ac.jp [Department of Physics, Saga University, Saga 840-8502 (Japan)

    2014-08-01

    We investigate the degeneracy of the isocurvature perturbations and the primordial gravitational waves, by using recent observations of the cosmic microwave background (CMB) reported by Planck and BICEP2 collaborations. We show that the tension in the bound on the tensor-to-scalar ratio r between Planck and BICEP2 can be resolved by introducing the anti-correlated isocurvature perturbations. Quantitatively, we find that with the anti-correlated isocurvature perturbations the constraints on r from Planck alone and BICEP2 results can be consistent at 68 % C.L.

  9. Osteocalcin expressing cells from tendon sheaths in mice contribute to tendon repair by activating Hedgehog signaling

    OpenAIRE

    Wang, Yi; Zhang, Xu; Huang, Huihui; Xia, Yin; Yao, YiFei; Mak, Arthur Fuk-Tat; Yung, Patrick Shu-Hang; Chan, Kai-Ming; Wang, Li; Zhang, Chenglin; Huang, Yu; Mak, Kingston King-Lun

    2017-01-01

    Both extrinsic and intrinsic tissues contribute to tendon repair, but the origin and molecular functions of extrinsic tissues in tendon repair are not fully understood. Here we show that tendon sheath cells harbor stem/progenitor cell properties and contribute to tendon repair by activating Hedgehog signaling. We found that Osteocalcin (Bglap) can be used as an adult tendon-sheath-specific marker in mice. Lineage tracing experiments show that Bglap-expressing cells in adult sheath tissues pos...

  10. Spontaneous Achilles tendon rupture in alkaptonuria | Mohammed ...

    African Journals Online (AJOL)

    Spontaneous Achilles tendon ruptures are uncommon. We present a 46-year-old man with spontaneous Achilles tendon rupture due to ochronosis. To our knowledge, this has not been previously reported in Sudan literature. The tendon of the reported patient healed well after debridement and primary repairs.

  11. A Six-Week Resistance Training Program Does Not Change Shear Modulus of the Triceps Brachii.

    Science.gov (United States)

    Akagi, Ryota; Shikiba, Tomofumi; Tanaka, Jun; Takahashi, Hideyuki

    2016-08-01

    We investigated the effect of a 6-week resistance training program on the shear modulus of the triceps brachii (TB). Twenty-three young men were randomly assigned to either the training (n = 13) or control group (n = 10). Before and after conducting the resistance training program, the shear modulus of the long head of the TB was measured at the point 70% along the length of the upper arm from the acromial process of the scapula to the lateral epicondyle of the humerus using shear wave ultrasound elastography. Muscle thickness of the long head of the TB was also determined at the same site by ultrasonography used during both tests. A resistance exercise was performed 3 days a week for 6 weeks using a dumbbell mass-adjusted to 80% of the 1-repetition maximum (1RM). The training effect on the muscle thickness and 1RM was significant. Nevertheless, the muscle shear modulus was not significantly changed after the training program. From the perspective of muscle mechanical properties, the present results indicate that significant adaptation must occur to make the TB more resistant to subsequent damaging bouts during the 6-week training program to target the TB.

  12. Can PRP effectively treat injured tendons?

    Science.gov (United States)

    Wang, James H-C

    2014-01-01

    PRP is widely used to treat tendon and other tissue injuries in orthopaedics and sports medicine; however, the efficacy of PRP treatment on injured tendons is highly controversial. In this commentary, I reason that there are many PRP- and patient-related factors that influence the outcomes of PRP treatment on injured tendons. Therefore, more basic science studies are needed to understand the mechanism of PRP on injured tendons. Finally, I suggest that better understanding of the PRP action mechanism will lead to better use of PRP for the effective treatment of tendon injuries in clinics.

  13. Bioreactor design for tendon/ligament engineering.

    Science.gov (United States)

    Wang, Tao; Gardiner, Bruce S; Lin, Zhen; Rubenson, Jonas; Kirk, Thomas B; Wang, Allan; Xu, Jiake; Smith, David W; Lloyd, David G; Zheng, Ming H

    2013-04-01

    Tendon and ligament injury is a worldwide health problem, but the treatment options remain limited. Tendon and ligament engineering might provide an alternative tissue source for the surgical replacement of injured tendon. A bioreactor provides a controllable environment enabling the systematic study of specific biological, biochemical, and biomechanical requirements to design and manufacture engineered tendon/ligament tissue. Furthermore, the tendon/ligament bioreactor system can provide a suitable culture environment, which mimics the dynamics of the in vivo environment for tendon/ligament maturation. For clinical settings, bioreactors also have the advantages of less-contamination risk, high reproducibility of cell propagation by minimizing manual operation, and a consistent end product. In this review, we identify the key components, design preferences, and criteria that are required for the development of an ideal bioreactor for engineering tendons and ligaments.

  14. Tendoscopy of the peroneal tendons

    NARCIS (Netherlands)

    van Dijk, C. N.; Kort, N.

    1998-01-01

    An anatomic cadaver study was performed. Subsequently, in a prospective study, diagnostic and therapeutic tendoscopy (tendon sheath endoscopy) was performed in nine consecutive patients with a history of persistent posterolateral ankle pain for at least 6 months. All patients had pain on palpation

  15. Smart Tendon Actuated Flexible Actuator

    Directory of Open Access Journals (Sweden)

    Md. Masum Billah

    2015-01-01

    Full Text Available We investigate the kinematic feasibility of a tendon-based flexible parallel platform actuator. Much of the research on tendon-driven Stewart platforms is devoted either to the completely restrained positioning mechanism (CRPM or to one particular type of the incompletely restrained positioning mechanism (IRPM where the external force is provided by the gravitational pull on the platform such as in cable-suspended Stewart platforms. An IRPM-based platform is proposed which uses the external force provided by a compliant member. The compliant central column allows the configuration to achieve n DOFs with n tendons. In particular, this investigation focuses on the angular deflection of the upper platform with respect to the lower platform. The application here is aimed at developing a linkable module that can be connected to one another so as to form a “snake robot” of sorts. Since locomotion takes precedence over positioning in this application, a 3-DOF Stewart platform is adopted. For an arbitrary angular displace of the end-effector, the corresponding length of each tendon can be determined through inverse kinematics. Mathematical singularities are investigated using the traditional analytical method of defining the Jacobian.

  16. Adaptive tracking for pneumatic muscle actuators in bicep and tricep configurations.

    Science.gov (United States)

    Lilly, John H

    2003-09-01

    Adaptive tracking techniques are applied to pneumatic muscle actuators arranged in bicep and tricep configurations. The control objective is to force the joint angle to track a specified reference path. Mathematical models are derived for the bicep and tricep configurations. The models are nonlinear and in general time-varying, making adaptive control desirable. Stability results are derived, and the results of simulation studies are presented, contrasting the nonlinear adaptive control to a nonadaptive PID control approach.

  17. Voluntary activation of biceps-to-triceps and deltoid-to-triceps transfers in quadriplegia.

    Science.gov (United States)

    Peterson, Carrie L; Bednar, Michael S; Bryden, Anne M; Keith, Michael W; Perreault, Eric J; Murray, Wendy M

    2017-01-01

    The biceps or the posterior deltoid can be transferred to improve elbow extension function for many individuals with C5 or C6 quadriplegia. Maximum strength after elbow reconstruction is variable; the patient's ability to voluntarily activate the transferred muscle to extend the elbow may contribute to the variability. We compared voluntary activation during maximum isometric elbow extension following biceps transfer (n = 5) and deltoid transfer (n = 6) in three functional postures. Voluntary activation was computed as the elbow extension moment generated during maximum voluntary effort divided by the moment generated with full activation, which was estimated via electrical stimulation. Voluntary activation was on average 96% after biceps transfer and not affected by posture. Individuals with deltoid transfer demonstrated deficits in voluntary activation, which differed by posture (80% in horizontal plane, 69% in overhead reach, and 70% in weight-relief), suggesting inadequate motor re-education after deltoid transfer. Overall, individuals with a biceps transfer better activated their transferred muscle than those with a deltoid transfer. This difference in neural control augmented the greater force-generating capacity of the biceps leading to increased elbow extension strength after biceps transfer (average 9.37 N-m across postures) relative to deltoid transfer (average 2.76 N-m across postures) in our study cohort.

  18. Tenderization effect of soy sauce on beef M. biceps femoris.

    Science.gov (United States)

    Kim, Hyun-Wook; Choi, Yun-Sang; Choi, Ji-Hun; Kim, Hack-Youn; Lee, Mi-Ai; Hwang, Ko-Eun; Song, Dong-Heon; Lim, Yun-Bin; Kim, Cheon-Jei

    2013-08-15

    This study was conducted to evaluate the tenderization effect of soy sauce on beef M. biceps femoris (BF). Five marinades were prepared with 4% (w/v) sodium chloride and 25% (w/v) soy sauce solutions (4% salt concentration) and mixed with the ratios of 100:0 (S0, pH 6.52), 75:25 (S25, 5.40) 50:50 (S50, 5.24), 25:75 (S75, 5.05), and 0:100 (S100, 4.85), respectively. The BF samples which were obtained from Hanwoo cows at 48 h postmortem (n=24) were marinated with five marinades for 72 h at 4°C (1:4 w/w), and the effects of soy sauce on tenderness were evaluated. Soy sauce marination resulted in a decrease in the pH value of the BF sample. However, there were no significant differences in the water holding capacity (Psauce may attribute various mechanisms such as increased collagen solubility or proteolysis which depend on soy sauce level in marinade. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Hyperuricemic PRP in Tendon Cells

    Directory of Open Access Journals (Sweden)

    I. Andia

    2014-01-01

    Full Text Available Platelet-rich plasma (PRP is injected within tendons to stimulate healing. Metabolic alterations such as the metabolic syndrome, diabetes, or hyperuricemia could hinder the therapeutic effect of PRP. We hypothesise that tendon cells sense high levels of uric acid and this could modify their response to PRP. Tendon cells were treated with allogeneic PRPs for 96 hours. Hyperuricemic PRP did not hinder the proliferative actions of PRP. The gene expression pattern of inflammatory molecules in response to PRP showed absence of IL-1b and COX1 and modest expression of IL6, IL8, COX2, and TGF-b1. IL8 and IL6 proteins were secreted by tendon cells treated with PRP. The synthesis of IL6 and IL8 proteins induced by PRP is decreased significantly in the presence of hyperuricemia (P = 0.017 and P = 0.012, resp.. Concerning extracellular matrix, PRP-treated tendon cells displayed high type-1 collagen, moderate type-3 collagen, decorin, and hyaluronan synthase-2 expression and modest expression of scleraxis. Hyperuricemia modified the expression pattern of extracellular matrix proteins, upregulating COL1 (P = 0.036 and COMP (P = 0.012 and downregulating HAS2 (P = 0.012. Positive correlations between TGF-b1 and type-1 collagen (R = 0.905, P = 0.002 and aggrecan (R = 0.833, P = 0.010 and negative correlations between TGF-b1 and IL6 synthesis (R = −0.857, P = 0.007 and COX2 (R = −0.810, P = 0.015 were found.

  20. Results of treatment of the calcific tendinitis of the shoulder supraspinatus muscle tendon

    Directory of Open Access Journals (Sweden)

    S. S. Strafun

    2017-12-01

    Full Text Available The aim of the study was to identify and compare the results of conservative and surgical treatment of the calcific tendinitis of the shoulder supraspinatus muscle tendon. Materials and methods. The clinical group consisted of 120 patients with calcific tendinitis of supraspinatus tendon. All patients were divided into two groups, according to the operative or conservative treatment, each of these groups have been subdivided into two (with calcific deposits less or more than 1.5 cm in length according to Bosworth radiological classification. Conservative treatment ("needling" included: evacuation of calcific deposits with saline under ultrasound control with subsequent injection of prolonged corticosteroid into the subacromial space, use of nonsteroid anti-inflammatory drugs, physiotherapy. Surgical treatment included: evacuation of calcium deposits from the tendon followed by rotator cuff repair and biceps tendon tenodesis at the proximal third of the intertubercular groove. Results. In the majority of patients, after the "needling" of little - 1.5 cm calcific deposits (55 patients - 45.8% clinical and radiographic healing occurred in 2 weeks after procedure. The level of pain in average was 2,39 ± 0,39 points according to VAS scale and function of the shoulder joint has increased in average to 40,26 ± 4,39 points on Oxford Shoulder Score. In 3 months after treatment begining, the best average results were obtained in patients with calcific deposits less than 1.5 cm - 43 ± 3,8 points on Oxford Shoulder Score, the worst 26 ± 4,8 points - in patients with calcific deposits bigger than 1.5 cm who underwent conservative treatment (р≤0,05. Conclusions. In group of patients after surgical treatment, size of calcific deposits did not significantly affect the treatment result (р≤0,01. Slightly better results were obtained in patients with calcific deposits size less than1.5 cm - 39 ± 3,8 points on Oxford Shoulder Score.

  1. Toward an understanding of foreground emission in the BICEP2 region

    International Nuclear Information System (INIS)

    Flauger, Raphael; Hill, J. Colin; Spergel, David N.

    2014-01-01

    BICEP2 has reported the detection of a degree-scale B-mode polarization pattern in the Cosmic Microwave Background (CMB) and has interpreted the measurement as evidence for primordial gravitational waves. Motivated by the profound importance of the discovery of gravitational waves from the early Universe, we examine to what extent a combination of Galactic foregrounds and lensed E-modes could be responsible for the signal. We reanalyze the BICEP2 results and show that the 100 ×150 GHz and 150 ×150 GHz data are consistent with a cosmology with r=0.2 and negligible foregrounds, but also with a cosmology with r=0 and a significant dust polarization signal. We give independent estimates of the dust polarization signal in the BICEP2 region using a number of different approaches: (1) data-driven models based on Planck 353 GHz intensity, polarization fractions inferred from the same Planck data used by the BICEP2 team but corrected for CMB and CIB contributions, and polarization angles from starlight polarization data or the Planck sky model; (2) the same set of pre-Planck models used by the BICEP2 team but taking into account the higher polarization fractions observed in the CMB- and CIB-corrected map; (3) a measurement of neutral hydrogen gas column density N HI in the BICEP2 region combined with an extrapolation of a relation between HI column density and dust polarization derived by Planck; and (4) a dust polarization map based on digitized Planck data, which we only use as a final cross-check. While these approaches are consistent with each other, the expected amplitude of the dust polarization power spectrum remains uncertain by about a factor of three. The lower end of the prediction leaves room for a primordial contribution, but at the higher end the dust in combination with the standard CMB lensing signal could account for the BICEP2 observations, without requiring the existence of primordial gravitational waves. By measuring the cross-correlations between the

  2. Magnetotherapy: The quest for tendon regeneration.

    Science.gov (United States)

    Pesqueira, Tamagno; Costa-Almeida, Raquel; Gomes, Manuela E

    2018-05-09

    Tendons are mechanosensitive tissues that connect and transmit the forces generated by muscles to bones by allowing the conversion of mechanical input into biochemical signals. These physical forces perform the fundamental work of preserving tendon homeostasis assuring body movements. However, overloading causes tissue injuries, which leads us to the field of tendon regeneration. Recently published reviews have broadly shown the use of biomaterials and different strategies to attain tendon regeneration. In this review, our focus is the use of magnetic fields as an alternative therapy, which has demonstrated clinical relevance in tendon medicine because of their ability to modulate cell fate. Yet the underlying cellular and molecular mechanisms still need to be elucidated. While providing a brief outlook about specific signalling pathways and intracellular messengers as framework in play by tendon cells, application of magnetic fields as a subcategory of physical forces is explored, opening up a compelling avenue to enhance tendon regeneration. We outline here useful insights on the effects of magnetic fields both at in vitro and in vivo levels, particularly on the expression of tendon genes and inflammatory cytokines, ultimately involved in tendon regeneration. Subsequently, the potential of using magnetically responsive biomaterials in tendon tissue engineering is highlighted and future directions in magnetotherapy are discussed. © 2018 Wiley Periodicals, Inc.

  3. Ipsilateral free semitendinosus tendon graft transfer for reconstruction of chronic tears of the Achilles tendon

    Directory of Open Access Journals (Sweden)

    Gougoulias Nikolaos

    2008-07-01

    Full Text Available Abstract Background Many techniques have been developed for the reconstruction of the Achilles tendon in chronic tears. In presence of a large gap (greater than 6 centimetres, tendon augmentation is required. Methods We present our method of minimally invasive semitendinosus reconstruction for the Achilles tendon using one para-midline and one midline incision. Results The first incision is a 5 cm longitudinal incision, made 2 cm proximal and just medial to the palpable end of the residual tendon. The second incision is 3 cm long and is also longitudinal but is 2 cm distal and in the midline to the distal end of the tendon rupture. The distal and proximal Achilles tendon stumps are mobilised. After trying to reduce the gap of the ruptured Achilles tendon, if the gap produced is greater than 6 cm despite maximal plantar flexion of the ankle and traction on the Achilles tendon stumps, the ipsilateral semitendinosus tendon is harvested. The semitendinosus tendon is passed through small incisions in the substance of the proximal stump of the Achilles tendon, and it is sutured to the Achilles tendon. It is then passed beneath the intact skin bridge into the distal incision, and passed from medial to lateral through a transverse tenotomy in the distal stump. With the ankle in maximal plantar flexion, the semitendinosus tendon is sutured to the Achilles tendon at each entry and exit point Conclusion This minimally invasive technique allows reconstruction of the Achilles tendon using the tendon of semitendinosus preserving skin integrity over the site most prone to wound breakdown, and can be especially used to reconstruct the Achilles tendon in the presence of large gap (greater than 6 centimetres.

  4. Active Achilles tendon kinesitherapy accelerates Achilles tendon repair by promoting neurite regeneration.

    Science.gov (United States)

    Jielile, Jiasharete; Aibai, Minawa; Sabirhazi, Gulnur; Shawutali, Nuerai; Tangkejie, Wulanbai; Badelhan, Aynaz; Nuerduola, Yeermike; Satewalede, Turde; Buranbai, Darehan; Hunapia, Beicen; Jialihasi, Ayidaer; Bai, Jingping; Kizaibek, Murat

    2012-12-15

    Active Achilles tendon kinesitherapy facilitates the functional recovery of a ruptured Achilles tendon. However, protein expression during the healing process remains a controversial issue. New Zealand rabbits, aged 14 weeks, underwent tenotomy followed immediately by Achilles tendon microsurgery to repair the Achilles tendon rupture. The tendon was then immobilized or subjected to postoperative early motion treatment (kinesitherapy). Mass spectrography results showed that after 14 days of motion treatment, 18 protein spots were differentially expressed, among which, 12 were up-regulated, consisting of gelsolin isoform b and neurite growth-related protein collapsing response mediator protein 2. Western blot analysis showed that gelsolin isoform b was up-regulated at days 7-21 of motion treatment. These findings suggest that active Achilles tendon kinesitherapy promotes the neurite regeneration of a ruptured Achilles tendon and gelsolin isoform b can be used as a biomarker for Achilles tendon healing after kinesitherapy.

  5. Active Achilles tendon kinesitherapy accelerates Achilles tendon repair by promoting neurite regeneration☆

    Science.gov (United States)

    Jielile, Jiasharete; Aibai, Minawa; Sabirhazi, Gulnur; Shawutali, Nuerai; Tangkejie, Wulanbai; Badelhan, Aynaz; Nuerduola, Yeermike; Satewalede, Turde; Buranbai, Darehan; Hunapia, Beicen; Jialihasi, Ayidaer; Bai, Jingping; Kizaibek, Murat

    2012-01-01

    Active Achilles tendon kinesitherapy facilitates the functional recovery of a ruptured Achilles tendon. However, protein expression during the healing process remains a controversial issue. New Zealand rabbits, aged 14 weeks, underwent tenotomy followed immediately by Achilles tendon microsurgery to repair the Achilles tendon rupture. The tendon was then immobilized or subjected to postoperative early motion treatment (kinesitherapy). Mass spectrography results showed that after 14 days of motion treatment, 18 protein spots were differentially expressed, among which, 12 were up-regulated, consisting of gelsolin isoform b and neurite growth-related protein collapsing response mediator protein 2. Western blot analysis showed that gelsolin isoform b was up-regulated at days 7–21 of motion treatment. These findings suggest that active Achilles tendon kinesitherapy promotes the neurite regeneration of a ruptured Achilles tendon and gelsolin isoform b can be used as a biomarker for Achilles tendon healing after kinesitherapy. PMID:25317130

  6. Effect of estrogen on tendon collagen synthesis, tendon structural characteristics, and biomechanical properties in postmenopausal women

    DEFF Research Database (Denmark)

    Hansen, Mette; Kongsgaard, Mads; Holm, Lars

    2009-01-01

    and fibril characteristics were determined by MRI and transmission electron microscopy, whereas tendon biomechanical properties were measured during isometric maximal voluntary contraction by ultrasound recording. Tendon FSR was markedly higher in ERT-users (P

  7. Tendon Force Transmission at the Nanoscale

    DEFF Research Database (Denmark)

    Svensson, René

    2013-01-01

    of connective tissue function that are poorly understood. One such aspect is the microscopic mechanisms of force transmission through tendons over macroscopic distances. Force transmission is at the heart of tendon function, but the large range of scales in the hierarchical structure of tendons has made...... it difficult to tackle. The tendon hierarchy ranges from molecules (2 nm) over fibrils (200 nm), fibers (2 μm) and fascicles (200 μm) to tendons (10 mm), and to derive the mechanisms of force transmission it is necessary to know the mechanical behavior at each hierarchical level. The aim of the present work...... was to elucidate the mechanisms of force transmission in tendons primarily by investigating the mechanical behavior at the hierarchical level of collagen fibrils. To do so we have developed an atomic force microscopy (AFM) method for tensile testing of native collagen fibrils. The thesis contains five papers...

  8. Achilles tendon rupture in badminton.

    Science.gov (United States)

    Kaalund, S; Lass, P; Høgsaa, B; Nøhr, M

    1989-01-01

    The typical badminton player with an Achilles tendon rupture is 36 years old and, despite limbering up, is injured at the rear line in a sudden forward movement. He resumes work within three months and has a slight lack of dorsiflexion in the ankle as the main complication. Most patients resume badminton within one year, but some finish their sports career, mainly due to fear of a new injury. The investigation discusses predisposing factors and prophylactic measures. PMID:2605439

  9. The roentgenographic findings of achilles tendon rupture

    Energy Technology Data Exchange (ETDEWEB)

    Seouk, Kang Hyo; Keun, Rho Yong [Shilla General Hospital, Seoul (Korea, Republic of)

    1999-03-01

    To evaluate the diagnostic value of a lateral view of the ankles in Achilles tendon rupture. We performed a retrospective analysis of the roentgenographic findings of 15 patients with surgically proven Achilles tendon rupture. Four groups of 15 patients(normal, ankle sprain, medial lateral malleolar fracture, and calcaneal fracture) were analysed as reference groups. Plain radiographs were reviewed with regard to Kager's triangle, Arner's sign, Toygar's angle, ill defined radiolucent shadow through the Achilles tendon, sharpness of the anterior margin of Achilles tendon, and meniscoid smooth margin of the posterior skin surface of the ankle. Kager's triangle was deformed and disappeared after rupture of the Achilles tendon in nine patients(60%) with operative verification of the rupture, six patients(40%) had a positive Arner's sign, while none had a diminished Toygars angle. In 13 patients(87%) with a ruptured Achilles tendon, the thickness of this was nonuniform compared with the reference group. The anterior margin of the Achilles tendon became serrated and indistinct in 14 patients(93%) in whom this was ruptured. An abnormal ill defined radiolucent shadow through the Achilles tendon was noted in nine patient(60%), and nonparallelism between the anterior margin of the Achilles tendon and posterior skin surface of the ankle was detected in 11 patients(73%). The posterior skin surface of the ankle had a nodular surface margin in 13 patients(87%). A deformed Kager's triangle and Achilles tendon, and an abnormal ill defined radiolucent shadow through the Achilles tendon in a lateral view of the ankles are important findings for the diagnesis of in diagnosing achilles tendon rupture.

  10. The roentgenographic findings of achilles tendon rupture

    International Nuclear Information System (INIS)

    Seouk, Kang Hyo; Keun, Rho Yong

    1999-01-01

    To evaluate the diagnostic value of a lateral view of the ankles in Achilles tendon rupture. We performed a retrospective analysis of the roentgenographic findings of 15 patients with surgically proven Achilles tendon rupture. Four groups of 15 patients(normal, ankle sprain, medial lateral malleolar fracture, and calcaneal fracture) were analysed as reference groups. Plain radiographs were reviewed with regard to Kager's triangle, Arner's sign, Toygar's angle, ill defined radiolucent shadow through the Achilles tendon, sharpness of the anterior margin of Achilles tendon, and meniscoid smooth margin of the posterior skin surface of the ankle. Kager's triangle was deformed and disappeared after rupture of the Achilles tendon in nine patients(60%) with operative verification of the rupture, six patients(40%) had a positive Arner's sign, while none had a diminished Toygars angle. In 13 patients(87%) with a ruptured Achilles tendon, the thickness of this was nonuniform compared with the reference group. The anterior margin of the Achilles tendon became serrated and indistinct in 14 patients(93%) in whom this was ruptured. An abnormal ill defined radiolucent shadow through the Achilles tendon was noted in nine patient(60%), and nonparallelism between the anterior margin of the Achilles tendon and posterior skin surface of the ankle was detected in 11 patients(73%). The posterior skin surface of the ankle had a nodular surface margin in 13 patients(87%). A deformed Kager's triangle and Achilles tendon, and an abnormal ill defined radiolucent shadow through the Achilles tendon in a lateral view of the ankles are important findings for the diagnesis of in diagnosing achilles tendon rupture

  11. Tendon sheath fibroma in the thigh.

    Science.gov (United States)

    Moretti, Vincent M; Ashana, Adedayo O; de la Cruz, Michael; Lackman, Richard D

    2012-04-01

    Tendon sheath fibromas are rare, benign soft tissue tumors that are predominantly found in the fingers, hands, and wrists of young adult men. This article describes a tendon sheath fibroma that developed in the thigh of a 70-year-old man, the only known tendon sheath fibroma to form in this location. Similar to tendon sheath fibromas that develop elsewhere, our patient's lesion presented as a painless, slow-growing soft tissue nodule. Physical examination revealed a firm, nontender mass with no other associated signs or symptoms. Although the imaging appearance of tendon sheath fibromas varies, our patient's lesion appeared dark on T1- and bright on T2-weighted magnetic resonance imaging. It was well marginated and enhanced with contrast.Histologically, tendon sheath fibromas are composed of dense fibrocollagenous stromas with scattered spindle-shaped fibroblasts and narrow slit-like vascular spaces. Most tendon sheath fibromas can be successfully removed by marginal excision, although 24% of lesions recur. No lesions have metastasized. Our patient's tendon sheath fibroma was removed by marginal excision, and the patient remained disease free 35 months postoperatively. Despite its rarity, tendon sheath fibroma should be included in the differential diagnosis of a thigh mass on physical examination or imaging, especially if it is painless, nontender, benign appearing, and present in men. Copyright 2012, SLACK Incorporated.

  12. Biology and augmentation of tendon-bone insertion repair

    OpenAIRE

    Lui, PPY; Zhang, P; Chan, KM; Qin, L

    2010-01-01

    Abstract Surgical reattachment of tendon and bone such as in rotator cuff repair, patellar-patella tendon repair and anterior cruciate ligament (ACL) reconstruction often fails due to the failure of regeneration of the specialized tissue ("enthesis") which connects tendon to bone. Tendon-to-bone healing taking place between inhomogenous tissues is a slow process compared to healing within homogenous tissue, such as tendon to tendon or bone to bone healing. Therefore special attention must be ...

  13. Redundancy or heterogeneity in the electric activity of the biceps brachii muscle? Added value of PCA-processed multi-channel EMG muscle activation estimates in a parallel-fibered muscle

    NARCIS (Netherlands)

    Staudenmann, D.; Stegeman, D.F.; van Dieen, J.H.

    2013-01-01

    Conventional bipolar EMG provides imprecise muscle activation estimates due to possibly heterogeneous activity within muscles and due to improper alignment of the electrodes with the muscle fibers. Principal component analysis (PCA), applied on multi-channel monopolar EMG yielded substantial

  14. High-intensity high-volume swimming induces more robust signaling through PGC-1α and AMPK activation than sprint interval swimming in m. triceps brachii

    DEFF Research Database (Denmark)

    Casuso, Rafael A; Plaza-Díaz, Julio; Ruiz-Ojeda, Francisco J

    2017-01-01

    We aimed to test whether high-intensity high-volume training (HIHVT) swimming would induce more robust signaling than sprint interval training (SIT) swimming within the m. triceps brachii due to lower metabolic and oxidation. Nine well-trained swimmers performed the two training procedures...... on separate randomized days. Muscle biopsies from m. triceps brachii and blood samples were collected at three different time points: a) before the intervention (pre), b) immediately after the swimming procedures (post) and c) after 3 h of rest (3 h). Hydroperoxides, creatine kinase (CK), and lactate...

  15. MRI findings of achilles tendon rupture

    International Nuclear Information System (INIS)

    Zhang Xuezhe

    2009-01-01

    Objective: To evaluate the MRI findings of achilles tendon rupture. Methods: The MRI data of 7 patients with achilles tendon rupture were retrospectively analysed. All 7 patients were male with the age ranging from 34 to 71 years. Routine MR scanning was performed in axial and sagittal planes, including T 1 WI, T 2 WI and a fat suppression MRI (SPIR). Results: Among 7 patients, complete achilles tendon rupture was seen in 6 cases, partial achilles tendon rupture 1 case. The site of tendon disruption were 2.6-11.0 cm( mean 5.4 cm) proximal to the insertion in the calcaneus. The MRI findings of a partial or complete rupture of the achilles tendon included enlarged and thickened achilles tendon (7 cases), wavy lax achilles tendon (2 cases), discontinuity of some or all of its fibers and intratendinous regions of increased signal intensity (7 cases). In the cases of complete tendon rupture, the size of the tendinous gap varied from 3.0-8.0 mm, which was filled with blood and appeared as edema of increase signal intensity on T 2 WI and SPIR. In all 7 patients, MR scanning showed medium signal intensity (7 cases) on T 1 WI, or medium signal intensity (1 cases), medium-high signal intensity (3 cases ), high signal intensity (3 cases) on T 2 WI, and medium-high signal intensity (2 cases), high signal intensity (5 cases) on fat suppression MRI. The preachilles fat pad showed obscure in 6 cases of complete achilles tendon rupture. Conclusion: MRI is an excellent method for revealing achilles tendon rupture and confirming the diagnosis. (authors)

  16. The Effect of Sodium Hyaluronate on Ligamentation and Biomechanical Property of Tendon in Repair of Achilles Tendon Defect with Polyethylene Terephthalate Artificial Ligament: A Rabbit Tendon Repair Model

    OpenAIRE

    Li, Shengkun; Ma, Kui; Li, Hong; Jiang, Jia; Chen, Shiyi

    2016-01-01

    The Achilles tendon is the most common ruptured tendon of human body. Reconstruction with polyethylene terephthalate (PET) artificial ligament is recommended in some serious cases. Sodium hyaluronate (HA) is beneficial for the healing of tendon injuries. We aimed to determine the effect of sodium hyaluronate in repair of Achilles tendon defect with PET artificial ligament in an animal tendon repair model. Sixteen New Zealand White rabbits were divided into two groups. Eight rabbits repaired w...

  17. Mechanical Properties of Human Patellar Tendon at the Hierarchical levels of Tendon and Fibril

    DEFF Research Database (Denmark)

    Svensson, Rene Brüggebusch; Hansen, Philip; Hassenkam, Tue

    2012-01-01

    Tendons are strong hierarchical structures, but how tensile forces are transmitted between different levels remains incompletely understood. Collagen fibrils are thought to be primary determinants of whole tendon properties, and therefore we hypothesized that the whole human patellar tendon and its...... distinct collagen fibrils would display similar mechanical properties. Human patellar tendons (n=5) were mechanically tested in vivo by ultrasonography. Biopsies were obtained from each tendon and individual collagen fibrils were dissected and tested mechanically by atomic force microscopy. The Young...... that of tendon supports that fibrillar rather than interfibrillar properties govern sub-failure tendon response, making the fibrillar level a meaningful target of intervention. The lower modulus found in vitro suggests a possible adverse effect of removing the tissue from its natural environment. In addition...

  18. Simulation of tendon energy storage in pedaling

    DEFF Research Database (Denmark)

    Rasmussen, John; Damsgaard, Michael; Christensen, Søren Tørholm

    2001-01-01

    The role of elastic energy stored in tendons during pedaling is investigated by means of numerical simulation using the AnyBody body modeling system. The loss of metabolic energy due to tendon elasticity is computed and compared to the mechanical work involved in the process. The AnyBody simulati...

  19. Rupture of Achilles Tendon : Usefulness of Ultrasonography

    International Nuclear Information System (INIS)

    Kim, Nam Hyeon; Ki, Won Woo; Yoon, Kwon Ha; Kim, Song Mun; Shin, Myeong Jin; Kwon, Soon Tae

    1996-01-01

    To differentiate a complete rupture of Achilles tendon from an incomplete one which is important because its treatment is quite different. And it is necessary to know the exact site of the rupture preoperatively. Fifteen cases of fourteen patients which were diagnosed as Achilles tendon rupture by ultrasonography and surgery were reviewed. We compared sonographic rupture site with surgical findings. Ultrasonographic criteria for differentiation of complete and incomplete rupture was defined as follows : the discreteness, which means the proximal intervening hypoechogenicity to the interface echogenicity of distal margin of ruptured tendon : the slant sign, which represents the interface of ruptured distal margin which was seen over the 3/4 of the thickness of the tendon without intervening low echogeneicity : the invagination sign, which means the echogenic invagination from Kager triangle into posterior aspect of Achilles tendon over the half thickness of the tendon. The sites of complete tendon rupture were exactly corresponded to surgical finding in four cases of ten complete ruptures. And the discrepancy between sonographic and surgical findings in the site of complete rupture was 1.2 ± 0.4 cm in six cases. Three of ten complete ruptures showed the discreteness sign, all of ten showed the slant sign and two of ten showed the invagination sign. It is helpful to differentiate a complete from incomplete rupture of the Achilles tendon and to localize the site of the complete rupture with the ultrasonographic evaluation

  20. Measuring Regional Changes in Damaged Tendon

    Science.gov (United States)

    Frisch, Catherine Kayt Vincent

    Mechanical properties of tendon predict tendon health and function, but measuring these properties in vivo is difficult. An ultrasound-based (US) analysis technique called acoustoelastography (AE) uses load-dependent changes in the reflected US signal to estimate tissue stiffness non-invasively. This thesis explores whether AE can provide information about stiffness alteration resulting from tendon tears both ex vivo and in vivo. An ex vivo ovine infraspinatus tendon model suggests that the relative load transmitted by the different tendon layers transmit different fractions of the load and that ultrasound echo intensity change during cyclic loading decreases, becoming less consistent once the tendon is torn. An in vivo human tibialis anterior tendon model using electrically stimulated twitch contractions investigated the feasibility of measuring the effect in vivo. Four of the five subjects showed the expected change and that the muscle contraction times calculated using the average grayscale echo intensity change compared favorably with the times calculated based on the force data. Finally an AE pilot study with patients who had rotator cuff tendon tears found that controlling the applied load and the US view of the system will be crucial to a successful in vivo study.

  1. Bilateral synchronous rupture of the quadriceps tendon.

    LENUS (Irish Health Repository)

    Ellanti, P

    2012-09-01

    Bilateral simultaneous rupture of the quadriceps tendon is a rare entity. They are often associated with degenerative changes of the tendons and predisposing conditions such as diabetes or excessive steroid use. They most commonly tend to occur in patients of 40 years of age or older.

  2. Thompson Test in Achilles Tendon Rupture

    Directory of Open Access Journals (Sweden)

    Spencer Albertson

    2016-07-01

    Full Text Available HPI: A 26-year old male presented to the emergency department after experiencing the acute onset of left ankle pain while playing basketball. Upon jumping, he felt a “pop” in his left posterior ankle, followed by pain and difficulty ambulating. His exam was notable for a defect at the left Achilles tendon on palpation. The practitioner performed a Thompson test, which was positive (abnormal on the left. Significant Findings: The left Achilles tendon had a defect on palpation, while the right Achilles tendon was intact. When squeezing the right (unaffected calf, the ankle spontaneously plantar flexed, indicating a negative (normal Thompson test. Upon squeeze of the left (affected calf, the ankle did not plantar flex, signifying a positive (abnormal Thompson test. The diagnosis of left Achilles tendon rupture was confirmed intraoperatively one week later. Discussion: The Achilles tendon (also: calcaneal tendon or heel cord is derived from the medial and lateral heads of the gastrocnemius muscle, as well as the soleus muscle. Rupture of the Achilles tendon most commonly occurs in the distal tendon, approximately 2-6 cm from its attachment to the calcaneal tuberosity, in an area of hypovascularity known as the “watershed” or “critical” zone.1-3 The Thompson test (also: Simmonds-Thompson test, described by Simmonds in 1957 and Thompson in 1962, is done while the patient is in the prone position, with feet hanging over the end of a table/gurney, or with the patient kneeling on a stool or chair.4-5 Squeezing the calf of an unaffected limb will cause the ankle to plantar flex, but squeezing the calf of a limb with an Achilles tendon rupture will cause no motion. The sensitivity of the Thompson’s test for the diagnosis of a complete Achilles tendon rupture is 96-100% and the specificity is 93-100%, but data is limited.6-8

  3. THE ROLE OF DETRAINING IN TENDON MECHANOBIOLOGY

    Directory of Open Access Journals (Sweden)

    Antonio eFrizziero

    2016-02-01

    Full Text Available Introduction: Several conditions such as training, aging, estrogen deficiency and drugs could affect the biological and anatomo-physiological characteristics of the tendon. Additionally, recent preclinical and clinical studies examined the effect of detraining on tendon, showing alterations in its structure and morphology and in tenocyte mechanobiology. However, there is a paucity of data examining the impact that cessation of training may have on tendon. In practice, we do not fully understand how tendons respond to a period of training followed by sudden detraining. Therefore, within this review, we summarize the studies where tendon detraining was examined.Materials and methods: A descriptive systematic literature review was conducted by searching three databases (PubMed, Scopus and Web of Knowledge on tendon detraining. Original articles in English from 2000 to 2015 were included. In addition, the search was extended to the reference lists of the selected articles. A public reference manager (www.mendeley.com was used to delete duplicate articles.Results: An initial literature search yielded 134 references (www.pubmed.org: 53; www.scopus.com: 11; www.webofknowledge.com: 70. 15 publications were extracted based on the title for further analysis by two independent reviewers. Abstracts and whole articles were then reviewed to detect if they met inclusion criteria.Conclusions: The revised literature comprised 4 clinical studies and an in vitro and three in vivo reports. Overall, the results showed that tendon structure and properties after detraining are compromised, with an alteration in the tissue structural organization and mechanical properties. Clinical studies usually showed a lesser extent of tendon alterations, probably because preclinical studies permit an in-depth evaluation of tendon modifications, which is hard to perform in human subjects. In conclusion, after a period of sudden detraining (e.g. after an injury, physical activity

  4. Serial superficial digital flexor tendon biopsies for diagnosing and monitoring collagenase-induced tendonitis in horses

    Directory of Open Access Journals (Sweden)

    José C. de Lacerda Neto

    2013-06-01

    Full Text Available The purpose of this investigation was to demonstrate the feasibility of a biopsy technique by performing serial evaluations of tissue samples of the forelimb superficial digital flexor tendon (SDFT in healthy horses and in horses subjected to superficial digital flexor tendonitis induction. Eight adult horses were evaluated in two different phases (P, control (P1 and tendonitis-induced (P2. At P1, the horses were subjected to five SDFT biopsies of the left forelimb, with 24 hours (h of interval. Clinical and ultrasonographic (US examinations were performed immediately before the tendonitis induction, 24 and 48 h after the procedure. The biopsied tendon tissues were analyzed through histology. P2 evaluations were carried out three months later, when the same horses were subjected to tendonitis induction by injection of bacterial collagenase into the right forelimb SDFT. P2 clinical and US evaluations, and SDFT biopsies were performed before, and after injury induction at the following time intervals: after 24, 48, 72 and 96 h, and after 15, 30, 60, 90, 120 and 150 days. The biopsy technique has proven to be easy and quick to perform and yielded good tendon samples for histological evaluation. At P1 the horses did not show signs of localised inflammation, pain or lameness, neither SDFT US alterations after biopsies, showing that the biopsy procedure per se did not risk tendon integrity. Therefore, this procedure is feasible for routine tendon histological evaluations. The P2 findings demonstrate a relation between the US and histology evaluations concerning induced tendonitis evolution. However, the clinical signs of tendonitis poorly reflected the microscopic tissue condition, indicating that clinical presentation is not a reliable parameter for monitoring injury development. The presented method of biopsying SDFT tissue in horses enables the serial collection of material for histological analysis causing no clinical signs and tendon damage seen

  5. Achilles tendon: US diagnosis of pathologic conditions. Work in progress

    International Nuclear Information System (INIS)

    Blei, C.L.; Nirschl, R.P.; Grant, E.G.

    1986-01-01

    Twenty-three patients were prospectively examined with ultra-sound (US) for acute or recurrent Achilles tendon symptoms. Three types of pathologic conditions of the Achilles tendon were found: tendinitis/tenosynovitis, acute tendon trauma, and postoperative changes. US appears to enable differentiation of these conditions and to contribute to the diagnosis of a broad range of Achilles tendon disorders

  6. Achilles tendon: US diagnosis of pathologic conditions. Work in progress

    Energy Technology Data Exchange (ETDEWEB)

    Blei, C.L.; Nirschl, R.P.; Grant, E.G.

    1986-06-01

    Twenty-three patients were prospectively examined with ultra-sound (US) for acute or recurrent Achilles tendon symptoms. Three types of pathologic conditions of the Achilles tendon were found: tendinitis/tenosynovitis, acute tendon trauma, and postoperative changes. US appears to enable differentiation of these conditions and to contribute to the diagnosis of a broad range of Achilles tendon disorders.

  7. Micromechanical properties and collagen composition of ruptured human achilles tendon

    DEFF Research Database (Denmark)

    Hansen, Philip; Kovanen, Vuokko; Hölmich, Per

    2013-01-01

    The Achilles tendon is one of the strongest tendons in the human body, and yet it frequently ruptures, which is a substantial clinical problem. However, the cause of ruptures remains elusive.......The Achilles tendon is one of the strongest tendons in the human body, and yet it frequently ruptures, which is a substantial clinical problem. However, the cause of ruptures remains elusive....

  8. Region-specific mechanical properties of the human patella tendon

    DEFF Research Database (Denmark)

    Haraldsson, B T; Aagaard, P; Krogsgaard, M

    2004-01-01

    The present study investigated the mechanical properties of tendon fascicles from the anterior and posterior human patellar tendon. Collagen fascicles from the anterior and posterior human patellar tendon in healthy young men (mean +/- SD, 29.0 +/- 4.6 yr, n = 6) were tested in a mechanical rig...... portion of the tendon, indicating region-specific material properties....

  9. High-field MR imaging of the tendons

    International Nuclear Information System (INIS)

    Beltran, J.; Burk, J.M.; Herman, L.J.; Mosure, J.C.

    1987-01-01

    MR imaging was used to investigate normal anatomy and pathologic conditions of the tendons. Tendons of experimental animals, cadaver joints, normal volunteers, and patients with suspected tendon pathology were studied. Tendon anatomy is easily identified because of the hypointensity of the tendons contrasting with the hyperintendensity of the surrounding fat. Pathologic conditions including posttraumatic and postsurgical tendon rupture, peritendinous scarring, tendinitis, and tenosynovitis are well seen with MR imaging. A detailed study of normal and abnormal tendon anatomy of the finger, wrist, shoulder, knee, and ankle is displayed, including MR images, gross specimens, and line drawings

  10. Effect of cooling on thixotropic position-sense error in human biceps muscle.

    Science.gov (United States)

    Sekihara, Chikara; Izumizaki, Masahiko; Yasuda, Tomohiro; Nakajima, Takayuki; Atsumi, Takashi; Homma, Ikuo

    2007-06-01

    Muscle temperature affects muscle thixotropy. However, it is unclear whether changes in muscle temperature affect thixotropic position-sense errors. We studied the effect of cooling on thixotropic position-sense errors induced by short-length muscle contraction (hold-short conditioning) in the biceps of 12 healthy men. After hold-short conditioning of the right biceps muscle in a cooled (5.0 degrees C) or control (36.5 degrees C) environment, subjects perceived greater extension of the conditioned forearm at 5.0 degrees C. The angle differences between the two forearms following hold-short conditioning of the right biceps muscle in normal or cooled conditions were significantly different (-3.335 +/- 1.680 degrees at 36.5 degrees C vs. -5.317 +/- 1.096 degrees at 5.0 degrees C; P=0.043). Induction of a tonic vibration reflex in the biceps muscle elicited involuntary forearm elevation, and the angular velocities of the elevation differed significantly between arms conditioned in normal and cooled environments (1.583 +/- 0.326 degrees /s at 36.5 degrees C vs. 3.100 +/- 0.555 degrees /s at 5.0 degrees C, P=0.0039). Thus, a cooled environment impairs a muscle's ability to provide positional information, potentially leading to poor muscle performance.

  11. Changes in recruitment order of motor units in the human biceps muscle

    NARCIS (Netherlands)

    Haar Romenij, ter B.M.; Denier van der Gon, J.J.; Gielen, C.C.A.M.

    1982-01-01

    Changes in recruitment threshold of individual motor units of the human biceps (caput longum), a multifunctional muscle, were investigated during different tasks, i.e., isometric flexion of the elbow, isometric supination of the forearm, and isometric exorotation of the humerus of the 110° flexed

  12. Toward an Understanding of Foreground Emission in the BICEP2 Region

    CERN Multimedia

    CERN. Geneva

    2014-01-01

    BICEP2 has reported the detection of a degree-scale B-mode polarization pattern in the Cosmic Microwave Background (CMB) and has interpreted the measurement as evidence for primordial gravitational waves. Motivated by the profound importance of the discovery of gravitational waves from the early Universe, I will discuss to what extent a combination of Galactic foregrounds and lensed E-modes could be responsible for the signal. I will present independent estimates of the dust polarization signal in the BICEP2 region using several different approaches. These estimates of the dust polarization signal in the BICEP2 region are consistent with each other, but the expected amplitude of the dust polarization power spectrum is uncertain by about a factor of three. The lower end of the prediction leaves room for a primordial contribution, but at the higher end the dust in combination with the standard CMB lensing signal could account for the BICEP2 observations, without requiring the existence of primordial gravitatio...

  13. Content Analysis Schedule for Bilingual Education Programs: BICEP Intercambio de la Cultura.

    Science.gov (United States)

    Shore, Marietta Saravia; Nafus, Charles

    This content analysis schedule for BICEP Intercambio de la Cultura (San Bernardino, California), presents information on the history, funding, and scope of the project. Included are sociolinguistic process variables such as the native and dominant languages of students and their interaction. Information is provided on staff selection and the…

  14. SUSY see-saw and NMSO(10)GUT inflation after BICEP2

    Indian Academy of Sciences (India)

    2016-01-13

    Jan 13, 2016 ... Recently, BICEP2, a telescope mounted at the south pole for background imaging of cosmic extragalatic polarization claimed the detection of the signal of primordial gravitational waves. The gravitational waves active during the inflationary epoch produce polarization in cosmic microwave background.

  15. Strain sonoelastographic evaluation of biceps muscle intrinsic stiffness after botulinum toxin-A injection.

    Science.gov (United States)

    Aşkın, Ayhan; Kalaycı, Özlem Tuğçe; Bayram, Korhan Barış; Tosun, Aliye; Demirdal, Ümit Seçil; Atar, Emel; İnci, Mehmet Fatih

    2017-01-01

    The most commonly used clinical tools for measuring spasticity are modified Ashworth scale (MAS) and Tardieu scale but both yield subjective rather than objective results. Ultrasound elastography (EUS) provides information on tissue stiffness and allows the qualitative or quantitative measurements of the mechanical properties of tissues. To assess the stiffness of biceps brachialis muscles in stroke patients by strain EUS and to investigate the sonoelastographic changes and its correlations with clinical evaluation parameters after botulinum toxin-A (BTA) injections. This is a prospective study. A total of 48 chronic stroke patients requiring BTA injections to biceps brachialis muscles were included in the study. All patients received injections with BTA to biceps brachialis muscles under ultrasound guidance. MAS, goniometric measurements, and strain EUS assessments were performed at preintervention and at 4-week postintervention. Strain index values of biceps muscle on the affected side were significantly increased compared with those on the unaffected side (p < 0.01). At 4 weeks after BTA injection, significant improvements were observed in MAS grades and goniometric measurements (p < 0.05). Statistically significant differences were also found between the MAS grades and strain index values in both pre-/postintervention period (p < 0.01). No significant correlations were observed between clinical parameters and strain EUS findings. Strain EUS is a promising diagnostic tool for assessing stiffness in spastic muscles, in establishing the treatment plan and monitoring the effectiveness of the therapeutic modality.

  16. Shortened stapedius tendon: a rare cause of conductive hearing loss.

    Science.gov (United States)

    Zawawi, F; Varshney, R; Schloss, M D

    2014-01-01

    Anomalies of the stapedius tendon have been reported to cause conductive hearing loss; in theory, such anomalies limit the movement of the stapes. To demonstrate a rare cause of conductive hearing loss resulting from anomaly of the stapedius tendon and to compare the clinical findings of this patient to other stapedius tendon anomalies reported in the literature. Case report of a single case of shortened stapedius tendon and a review of the English literature on stapedius tendon anomalies. This is a case report of a 15-year-old boy with shortened stapedius tendon causing unilateral hearing loss, accompanied by a review of the literature. Contrary to other reported cases, this patient did not have an ossified tendon, but rather an extremely short tendon. The boy regained normal hearing following excision of the stapedius tendon. A shortened stapedius tendon is a very rare diagnosis, yet it should be considered as a possible cause of conductive hearing loss.

  17. Reliability of biceps femoris and semitendinosus muscle architecture measurements obtained with ultrasonography

    Directory of Open Access Journals (Sweden)

    Viviane Bastos de Oliveira

    Full Text Available Introduction Currently, little attention is given to the muscle architecture reliability studies of the hamstring using a robust statistical. Our purpose was to determine the reliability of ultrasound measurements of muscle thickness, fascicle length and pennation angle of the biceps femoris and semitendinosus muscles, including heteroskedasticity and internal consistency analyses. Methods Two images of biceps femoris and semitendinosus at 50% of the thigh length were acquired from 21 volunteers, in two visits. The parameters were measured three times in each image, and for each muscle. The reliability was analyzed by the intraclass correlation coefficient (ICC and Cronbach’s alpha (αCronbach. The relative standard error of the measurements (%SEM were calculated and Bland-Altman plots were generated. Results All parameters presented excellent ICC for the three repeated measurements (ICC from 0.93 ‒ 0.99 and moderate to excellent reliability intraday (ICC from 0.70 ‒ 0.95 for both muscles. The present study indicates that ultrasound is a reliable tool to estimate the biceps femoris fascicle length (ICC = 0.97, αCronbach = 0.98, %SEM = 7.86 and semitendinosus (ICC = 0.90, αCronbach = 0.95, %SEM = 7.55, as well as the biceps femoris muscle thickness (ICC = 0.89, αCronbach = 0.94, %SEM = 10.23 and semitendinosus muscle thickness (ICC = 0.87, αCronbach = 0.93, %SEM = 1.35. At last, biceps femoris pennation angle (ICC = 0.93, αCronbach = 0.96 and %SEM = 4.36 and semitendinosus (ICC = 0.96, αCronbach = 0.98 and %SEM = 4.25 also had good repeatability. Conclusion Ultrasonography show good repeatability in estimating of muscle architecture parameters.

  18. Association of hypovitaminosis D with triceps brachii muscle fatigability among older women: Findings from the EPIDOS cohort.

    Science.gov (United States)

    Duval, G; Rolland, Y; Schott, A M; Blain, H; Dargent-Molina, P; Walrand, S; Duque, G; Annweiler, C

    2018-05-01

    Vitamin D affects physical performance in older adults. Its effects on muscles, notably on muscle strength, remain unclear. The objective of this cross-sectional study was to determine whether hypovitaminosis D is associated with triceps brachii muscle fatigability in community-dwelling older women. A randomized subset of 744 women aged ≥75years from the EPIDOS cohort was categorized into two groups according to triceps brachii muscle fatigability, defined as loss of strength >5% between two consecutive maximal isometric voluntary contractions. Hypovitaminosis D was defined using consensual threshold values (i.e., serum 25-hydroxyvitamin D concentration [25OHD] ≤10 ng/mL, ≤20 ng/mL, and ≤30 ng/mL). Age, body mass index, comorbidities, use psychoactive drugs, physical activity, first triceps strength measure, hyperparathyroidism, serum concentrations of calcium, albumin and creatinine, season and study centers were used as potential confounders. The prevalence of hypovitaminosis D ≤ 30 ng/mL was greater among women with muscle fatigability compared with the others (P = .009). There was no between-group difference using the other definitions of hypovitaminosis D. The serum 25OHD concentration was inversely associated with the between-test change in triceps strength (adjusted β = -0.09 N, P = .04). Hypovitaminosis D ≤ 30 ng/mL was positively associated with triceps fatigability (adjusted OR = 3.15, P = .02). Vitamin D concentration was inversely associated with the ability to maintain strength over time in this cohort of community-dwelling older women. This is a relevant new orientation of research toward understanding the involvement of vitamin D in muscle function. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. IFSSH Flexor Tendon Committee report 2014: from the IFSSH Flexor Tendon Committee (Chairman: Jin Bo Tang).

    Science.gov (United States)

    Tang, Jin Bo; Chang, James; Elliot, David; Lalonde, Donald H; Sandow, Michael; Vögelin, Esther

    2014-01-01

    Hand surgeons continue to search for the best surgical flexor tendon repair and treatment of the tendon sheaths and pulleys, and they are attempting to establish postoperative regimens that fit diverse clinical needs. It is the purpose of this report to present the current views, methods, and suggestions of six senior hand surgeons from six different countries - all experienced in tendon repair and reconstruction. Although certainly there is common ground, the report presents provocative views and approaches. The report reflects an update in the views of the committee. We hope that it is helpful to surgeons and therapists in treating flexor tendon injuries.

  20. [Flexor tendon repair: a short story].

    Science.gov (United States)

    Moutet, F; Corcella, D; Forli, A; Mesquida, V

    2014-12-01

    This short story of flexor tendon repair aims to illustrate hesitations and wanderings of this surgery. Obviously tendon repair was very early considered, but it developed and diffused rather lately. It became a routine practice only in 20th century. This was due on the one hand, in Occident, to the Galen's dogmatic interdiction, on the other hand, to the repair difficulties of this paradoxical structure. Actually tendon is made of fibroblasts and collagen (sticky substances), and then its only goal is to move. According to this necessity, whatever the used techniques are, gliding is the final purpose. Technical evolutions are illustrated by historical contributions to flexor tendon surgery of several "giants" of hand surgery. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  1. Terminology for Achilles tendon related disorders

    NARCIS (Netherlands)

    van Dijk, C. N.; van Sterkenburg, M. N.; Wiegerinck, J. I.; Karlsson, J.; Maffulli, N.

    2011-01-01

    The terminology of Achilles tendon pathology has become inconsistent and confusing throughout the years. For proper research, assessment and treatment, a uniform and clear terminology is necessary. A new terminology is proposed; the definitions hereof encompass the anatomic location, symptoms,

  2. Endoscopic Treatment of Intrasheath Peroneal Tendon Subluxation

    Directory of Open Access Journals (Sweden)

    Frederick Michels

    2013-01-01

    Full Text Available Intrasheath subluxation of the peroneal tendons within the peroneal groove is an uncommon problem. Open exploration combined with a peroneal groove-deepening procedure and retinacular reefing is the recommended treatment. This extensive lateral approach needs incision of the intact superior peroneal retinaculum and repair afterwards. We treated three patients with a painful intrasheath subluxation using an endoscopic approach. During this tendoscopy both tendons were inspected. The distal muscle fibers of the peroneus brevis tendon were resected in two patients. A partial tear was debrided in the third patient. All patients had a good result. No wound-healing problems or other complications occurred. Early return to work and sports was possible. An endoscopic approach was successful in treatment of an intrasheath subluxation of the peroneal tendons.

  3. Quadriceps Tendon Autograft Medial Patellofemoral Ligament Reconstruction.

    Science.gov (United States)

    Fink, Christian; Steensen, Robert; Gföller, Peter; Lawton, Robert

    2018-06-01

    Critically evaluate the published literature related to quadriceps tendon (QT) medial patellofemoral ligament (MPFL) reconstruction. Hamstring tendon (HT) MPFL reconstruction techniques have been shown to successfully restore patella stability, but complications including patella fracture are reported. Quadriceps tendon (QT) reconstruction techniques with an intact graft pedicle on the patella side have the advantage that patella bone tunnel drilling and fixation are no longer needed, reducing risk of patella fracture. Several QT MPFL reconstruction techniques, including minimally invasive surgical (MIS) approaches, have been published with promising clinical results and fewer complications than with HT techniques. Parallel laboratory studies have shown macroscopic anatomy and biomechanical properties of QT are more similar to native MPFL than hamstring (HS) HT, suggesting QT may more accurately restore native joint kinematics. Quadriceps tendon MPFL reconstruction, via both open and MIS techniques, have promising clinical results and offer valuable alternatives to HS grafts for primary and revision MPFL reconstruction in both children and adults.

  4. Jumper's Knee (Patellar Tendonitis) (For Parents)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Jumper's Knee (Patellar Tendonitis) KidsHealth / For Parents / Jumper's Knee (Patellar ... prevent continued damage to the knee. How the Knee Works To understand how jumper's knee happens, it ...

  5. Experimental tests of pretensioned high strength tendons

    International Nuclear Information System (INIS)

    Hajutin, J.G.; Kriczewskij, A.Z.

    1977-01-01

    The tests carried out to estimate the losses of the prestressing force and the real bearing capacity of the parallel wire tendons and seven-wire strands are described. The practical experiences in tenden anchoring etc. are also received. (author)

  6. Investigations related to failure of prestressing tendons

    International Nuclear Information System (INIS)

    Boyadjiev, Z.

    1995-01-01

    Kozloduy NPP units 5 and 6 containment cladding shells are prestressed by the use of tendons 450 φ 5, made of high strength wires, class B-II. The prestressing force for each tendon is 10000 kN and the calculated breakdown force - 14000 kN. There are 96 tendons in the cylindrical part of the shell and 36 ones located in the containment dome. They are located in channel forming tubes of inner diameter of 200 mm, made of dense polyethylene. In order to assure biaxial prestressed condition, the prestressing tendons are located on screw shaped lines, both left and right, with declination to the horizon 35 degrees and 15 minutes. Each prestressing tendon initially forms a knee and following the bending at elevation + 10.80 m forms the other knee, in such a way, that its two ends are anchored in one and the same area-in a common or adjacent upper anchor boxes. The prestressing tendons in the containment dome are located in two perpendicular rows. Both ends of each tendon are anchored in a common fixing, the tendon being bent to the opposite side of the dome. During construction and operation of units 5 and 6, it was found, that the design prestressing force of 10000 kN can not be reached with some tendons, due to separate wires ruptures or due to the anchoring screw spent thread. The 1992 preliminary wires tests on a failed tendon found out deformation properties, different from the systematically obtained ones for the initial steel. Taking into consideration this fact, together with the IAEA regional project, concerning WWER-1000 seismic safety and items 4 and 6 of Kozloduy NPP Technical Council decisions of 10 June 1993, brought to delegation to the Research Construction Institute the performance of the technical analysis of the applied system for shell prestressing of containments of of units 5 and 6. The analysis comprises physical-mechanical and rheological properties of the high strength wires, used for containment shell prestressing and the over all technological

  7. Dynamic ultrasound of peroneal tendon instability.

    Science.gov (United States)

    Pesquer, Lionel; Guillo, Stéphane; Poussange, Nicolas; Pele, Eric; Meyer, Philippe; Dallaudière, Benjamin

    2016-07-01

    Ankle snapping may be caused by peroneal tendon instability. Anterior instability occurs after traumatic superior peroneal retinaculum injury, whereas peroneal tendon intrasheath subluxation is atraumatic. Whereas subluxation is mainly dynamic, ultrasound allows for the diagnosis and classification of peroneal instability because it allows for real-time exploration. The purpose of this review is to describe the anatomic and physiologic bases for peroneal instability and to heighten the role of dynamic ultrasound in the diagnosis of snapping.

  8. Optimization of human tendon tissue engineering: peracetic acid oxidation for enhanced reseeding of acellularized intrasynovial tendon.

    Science.gov (United States)

    Woon, Colin Y L; Pridgen, Brian C; Kraus, Armin; Bari, Sina; Pham, Hung; Chang, James

    2011-03-01

    Tissue engineering of human flexor tendons combines tendon scaffolds with recipient cells to create complete cell-tendon constructs. Allogenic acellularized human flexor tendon has been shown to be a useful natural scaffold. However, there is difficulty repopulating acellularized tendon with recipient cells, as cell penetration is restricted by a tightly woven tendon matrix. The authors evaluated peracetic acid treatment in optimizing intratendinous cell penetration. Cadaveric human flexor tendons were harvested, acellularized, and divided into experimental groups. These groups were treated with peracetic acid in varying concentrations (2%, 5%, and 10%) and for varying time periods (4 and 20 hours) to determine the optimal treatment protocol. Experimental tendons were analyzed for differences in tendon microarchitecture. Additional specimens were reseeded by incubation in a fibroblast cell suspension at 1 × 10(6) cells/ml. This group was then analyzed for reseeding efficacy. A final group underwent biomechanical studies for strength. The optimal treatment protocol comprising peracetic acid at 5% concentration for 4 hours produced increased scaffold porosity, improving cell penetration and migration. Treated scaffolds did not show reduced collagen or glycosaminoglycan content compared with controls (p = 0.37 and p = 0.65, respectively). Treated scaffolds were cytotoxic to neither attached cells nor the surrounding cell suspension. Treated scaffolds also did not show inferior ultimate tensile stress or elastic modulus compared with controls (p = 0.26 and p = 0.28, respectively). Peracetic acid treatment of acellularized tendon scaffolds increases matrix porosity, leading to greater reseeding. It may prove to be an important step in tissue engineering of human flexor tendon using natural scaffolds.

  9. Grasp Assist Device with Shared Tendon Actuator Assembly

    Science.gov (United States)

    Ihrke, Chris A. (Inventor); Bergelin, Bryan J. (Inventor); Bridgwater, Lyndon (Inventor)

    2015-01-01

    A grasp assist device includes a glove with first and second tendon-driven fingers, a tendon, and a sleeve with a shared tendon actuator assembly. Tendon ends are connected to the respective first and second fingers. The actuator assembly includes a drive assembly having a drive axis and a tendon hook. The tendon hook, which defines an arcuate surface slot, is linearly translatable along the drive axis via the drive assembly, e.g., a servo motor thereof. The flexible tendon is routed through the surface slot such that the surface slot divides the flexible tendon into two portions each terminating in a respective one of the first and second ends. The drive assembly may include a ball screw and nut. An end cap of the actuator assembly may define two channels through which the respective tendon portions pass. The servo motor may be positioned off-axis with respect to the drive axis.

  10. Natural inflation: consistency with cosmic microwave background observations of Planck and BICEP2

    International Nuclear Information System (INIS)

    Freese, Katherine; Kinney, William H.

    2015-01-01

    Natural inflation is a good fit to all cosmic microwave background (CMB) data and may be the correct description of an early inflationary expansion of the Universe. The large angular scale CMB polarization experiment BICEP2 has announced a major discovery, which can be explained as the gravitational wave signature of inflation, at a level that matches predictions by natural inflation models. The natural inflation (NI) potential is theoretically exceptionally well motivated in that it is naturally flat due to shift symmetries, and in the simplest version takes the form V(φ) = Λ 4  [1 ± cos(Nφ/f)]. A tensor-to-scalar ratio r > 0.1 as seen by BICEP2 requires the height of any inflationary potential to be comparable to the scale of grand unification and the width to be comparable to the Planck scale. The Cosine Natural Inflation model agrees with all cosmic microwave background measurements as long as f ≥ m Pl (where m Pl  = 1.22 × 10 19  GeV) and Λ ∼ m GUT  ∼ 10 16  GeV. This paper also discusses other variants of the natural inflation scenario: we show that axion monodromy with potential V∝ φ 2/3 is inconsistent with the BICEP2 limits at the 95% confidence level, and low-scale inflation is strongly ruled out. Linear potentials V ∝ φ are inconsistent with the BICEP2 limit at the 95% confidence level, but are marginally consistent with a joint Planck/BICEP2 limit at 95%. We discuss the pseudo-Nambu Goldstone model proposed by Kinney and Mahanthappa as a concrete realization of low-scale inflation. While the low-scale limit of the model is inconsistent with the data, the large-field limit of the model is marginally consistent with BICEP2. All of the models considered predict negligible running of the scalar spectral index, and would be ruled out by a detection of running

  11. Microstructural stress relaxation mechanics in functionally different tendons.

    Science.gov (United States)

    Screen, H R C; Toorani, S; Shelton, J C

    2013-01-01

    Tendons experience widely varying loading conditions in vivo. They may be categorised by their function as either positional tendons, which are used for intricate movements and experience lower stress, or as energy storage tendons which act as highly stressed springs during locomotion. Structural and compositional differences between tendons are thought to enable an optimisation of their properties to suit their functional environment. However, little is known about structure-function relationships in tendon. This study adopts porcine flexor and extensor tendon fascicles as examples of high stress and low stress tendons, comparing their mechanical behaviour at the micro-level in order to understand their stress relaxation response. Stress-relaxation was shown to occur predominantly through sliding between collagen fibres. However, in the more highly stressed flexor tendon fascicles, more fibre reorganisation was evident when the tissue was exposed to low strains. By contrast, the low load extensor tendon fascicles appears to have less capacity for fibre reorganisation or shearing than the energy storage tendon, relying more heavily on fibril level relaxation. The extensor fascicles were also unable to sustain loads without rapid and complete stress relaxation. These findings highlight the need to optimise tendon repair solutions for specific tendons, and match tendon properties when using grafts in tendon repairs. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

  12. Local trauma in human patellar tendon leads to widespread changes in the tendon gene expression

    DEFF Research Database (Denmark)

    Heinemeier, Katja Maria; Lorentzen, Marc P; Kildevang Jensen, Jacob

    2016-01-01

    Low cellular activity and slow tissue turnover in human tendon may prolong resolution of tendinopathy. This may be stimulated by moderate localized traumas such as needle penetrations, but whether this results in a widespread cellular response in tendons is unknown. In an initial hypothesis-gener...

  13. Structural tendon changes in patients with acromegaly: assessment of Achilles tendon with sonoelastography.

    Science.gov (United States)

    Onal, Eda Demil; Ipek, Ali; Evranos, Berna; Idilman, Ilkay Sedakat; Cakir, Bekir; Ersoy, Reyhan

    2016-03-01

    To describe the sonoelastographic appearance of the Achilles tendon in acromegalic patients and to determine whether the blood concentrations of growth hormone (GH) and insulin-like growth factor (IGF-1) are associated with the various sonographic elasticity types of Achilles tendons. Eighty-four Achilles tendons of 42 acromegaly patients and 84 Achilles tendons of 42 healthy volunteers were assessed with sonoelastography. The tendons were classified into two main types according to the elasticity features: type 1 blue/green (hard tissue) and type 2 yellow/red within green (intermediate-soft tissue). Two subtypes of these types were also defined. According to the definition, the elasticity of the tissue was in a spectrum ranging from hard to soft as the type progressed from 1a to 2b. The mean thickness of Achilles tendons in patients with acromegaly was significantly higher compared with healthy Achilles tendons (5.1+/-0.7 mm vs. 4.4+/-0.5, pacromegaly patients had type 2 sonoelastographic appearance of the Achilles tendon (124/252 third; 49.2% vs. 81/252 third; 32.1%, p=0.0001). Activity status of acromegaly and GH/IGF-I levels were similar in patients with different types of elasticity (p>0.05). Sonoelastography revealed structural changes in the tendinous tissue of patients with acromegaly, but it was not sensitive enough to reflect changes in the serum levels of GH/IGF-1.

  14. Histological Changes in the Proximal and Distal Tendon Stumps Following Transection of Achilles Tendon in the Rabbits.

    Science.gov (United States)

    Al-Qattan, Mohammad M; Mawlana, Ola Helmi; Mohammed Ahmed, Raeesa Abdel-Twab; Hawary, Khalid

    2016-05-01

    To determine tendon stump changes following unrepaired Achilles tendon lacerations in an animal model. An experimental study. King Saud University, Riyadh, Saudi Arabia, from October 2013 to January 2014. Arabbit model was developed and studied tendon retraction and histological changes in the proximal and distal stumps following transection of the Achilles tendon. Over a period of 12 weeks, retraction of the distal tendon stump was minimal (2 - 3 mm). In contrast, retraction of the proximal tendon stump peaked to reach 6 mm at 4 weeks post-injury and plateaued to reach 7 - 8 mm at the 12-week interval. Following complete transection of the Achilles tendon, tendon retraction correlated with the density of myofibroblast expression within the tendon stump. Further research is needed to investigate the pathophysiology of these findings.

  15. Histological Changes in the Proximal and Distal Tendon Stumps Following Transection of Achilles Tendon in the Rabbits

    International Nuclear Information System (INIS)

    Al-Qattan, M. M.; Hawary, K.; Mawlana, O. H.; Ahmed, R. A. M.

    2016-01-01

    Objective: To determine tendon stump changes following unrepaired Achilles tendon lacerations in an animal model. Study Design: An experimental study. Place and Duration of Study: King Saud University, Riyadh, Saudi Arabia, from October 2013 to January 2014. Methodology: Arabbit model was developed and studied tendon retraction and histological changes in the proximal and distal stumps following transection of the Achilles tendon. Result: Over a period of 12 weeks, retraction of the distal tendon stump was minimal (2 - 3 mm). In contrast, retraction of the proximal tendon stump peaked to reach 6 mm at 4 weeks post-injury and plateaued to reach 7 - 8 mm at the 12-week interval. Conclusion: Following complete transection of the Achilles tendon, tendon retraction correlated with the density of myofibroblast expression within the tendon stump. Further research is needed to investigate the pathophysiology of these findings. (author)

  16. Magnetic resonance imaging appearance of the flexor carpi radialis tendon after harvest in ligamentous reconstruction tendon interposition arthroplasty

    International Nuclear Information System (INIS)

    Beall, Douglas P.; Fish, Jon R.; Ritchie, Eric R.; Tran, Hoang N.; Ingari, John V.; Campbell, Scot E.; Grayson, David E.; Sanders, Timothy G.; Mundis, Gregory; Lehman, Thomas P.

    2006-01-01

    To determine whether the post-harvest magnetic resonance (MR) imaging appearance of flexor carpi radialis (FCR) tendons, harvested during ligamentous reconstruction tendon interposition (LRTI) of the thumb carpometacarpal (CMC) joint arthroplasty, is consistent with tendon regeneration. Operative reports and patient medical records for all patients undergoing LRTI arthroplasty between 1995 and 2003 at our institution were reviewed. MR images of the patients' forearms and wrists were obtained and interpreted by two musculoskeletal radiologists. Using the flexor carpi ulnaris (FCU) tendon as an internal standard, the extent of FCR tendon regeneration was expressed as a percentage by dividing the volume of regenerated FCR tendon by the volume of the FCU tendon. Fourteen patients who had the full thickness of the FCR tendon harvested and who were available for MR imaging were identified and included in the study. At least partial regeneration of the FCR tendon occurred in 11 of the 14 patients (79%). Of these, 2 patients (14%), demonstrated complete, or nearly complete regeneration. Partial regeneration of the FCR tendon was seen in 9 of the 14 patients (64%). In 3 patients (21%), there was no appreciable regeneration of the FCR tendon. Among patients who underwent full-thickness harvest of the FCR tendon for LRTI arthroplasty of the first CMC joint, the follow-up MR imaging appearance of the flexor carpi radialis tendon was consistent with tendon regeneration in 79% of those examined. (orig.)

  17. MR Imaging and US of the Wrist Tendons.

    Science.gov (United States)

    Plotkin, Benjamin; Sampath, Srihari C; Sampath, Srinath C; Motamedi, Kambiz

    2016-10-01

    The tendons of the wrist are commonly symptomatic. They can be injured, infected, or inflamed. Magnetic resonance imaging and ultrasonography are useful tools for evaluating the wrist. Pathologic conditions of the wrist tendons include de Quervain tenosynovitis, extensor carpi ulnaris tendinopathy, rheumatoid tenosynovitis, infectious synovitis, tendon tears, hydroxyapatite deposition disease, intersection syndrome, tenosynovial giant cell tumor, and fibroma of the tendon sheath. In this article, we review the normal appearance of the wrist tendons, discuss relevant anatomy, and give an overview of common pathologic conditions affecting the wrist tendons. Online supplemental material is available for this article. © RSNA, 2016.

  18. FRP tendon anchorage in post-tensioned concrete structures

    DEFF Research Database (Denmark)

    Schmidt, Jacob Wittrup; Täljsten, Björn; Bennitz, Anders

    2008-01-01

    effective Young´s modulus and the high stress capacity in the linear elastic range of the material. The use of external tendons increases the requirements on the anchorage systems. This is in particular important when using un-bonded tendon systems, where the anchorage and deviators are the only force...... transfer points. The demand for high capacity anchorage tendons is fulfilled for steel tendons, but no competitive mechanical anchor has yet been developed for FRP tendon. A new small, reliable and more user friendly anchor has to be developed, before FRP tendons can be utilized with all of its capacity...

  19. Mechanical properties of the human Achilles tendon, in vivo

    DEFF Research Database (Denmark)

    Kongsgaard, M; Nielsen, C H; Hegnsvad, S

    2011-01-01

    Ultrasonography has been widely applied for in vivo measurements of tendon mechanical properties. Assessments of human Achilles tendon mechanical properties have received great interest. Achilles tendon injuries predominantly occur in the tendon region between the Achilles-soleus myotendinous...... junction and Achilles-calcaneus osteotendinous junction i.e. in the free Achilles tendon. However, there has been no adequate ultrasound based method for quantifying the mechanical properties of the free human Achilles tendon. This study aimed to: 1) examine the mechanical properties of the free human...

  20. Optimal arm posture control and tendon traction forces of a coupled tendon-driven manipulator

    International Nuclear Information System (INIS)

    Ma, Shugen

    1997-01-01

    In this study, the optimum arm posture of a coupled tendon-driven multijoint manipulator arm (or CT Arm) at maximum payload output was derived and the corresponding tendon traction forces were also analyzed, during management of a heavy payload by the manipulator in a gravity environment. The CT Arm is special tendon traction transmission mechanism in which a pair of tendons used to drive a joint is pulled from base actuators via pulleys mounted on the base-side joints. This mechanism enables optimal utilization of the coupled drive function of tendon traction forces and thus enables the lightweight manipulator to exhibit large payload capability. The properties of the CT Arm mechanism are elucidated by the proposed optimal posture control scheme. Computer simulation was also executed to verify the validity of the proposed control scheme. (author)

  1. Highly Unusual Tendon Abnormality: Spontaneous Rupture of the Distal Iliopsoas Tendon

    Directory of Open Access Journals (Sweden)

    Gokcen Coban

    2014-06-01

    Full Text Available Iliopsoas tendon injuries are not common and usually occur due to avulsion of the iliopsoas tendon with detachment of the lesser trochanter, secondary to an athletic injury or trauma. In the absence of a trauma, avulsion of the lesser trochanter in an adult is regarded as a sign of metastatic disease until proven otherwise. Complete iliopsoas tendon tears have thus far only been described in elderly women, and without trauma or an underlying systemic disease, a hormonal basis may be a reason for the gender differences. In this article, we present an 87-year-old woman with spontaneous rupture of the left distal iliopsoas tendon unassociated with fracture of the lesser trochanter and in the absence of a recent trauma history. This elderly patient presented with acute groin pain and normal plain radiographs. Magnetic resonance imaging must be kept in mind as a modality of choice for identifying iliopsoas tendon abnormalities.

  2. Reconstruction of scalar field theories realizing inflation consistent with the Planck and BICEP2 results

    Directory of Open Access Journals (Sweden)

    Kazuharu Bamba

    2014-10-01

    Full Text Available We reconstruct scalar field theories to realize inflation compatible with the BICEP2 result as well as the Planck. In particular, we examine the chaotic inflation model, natural (or axion inflation model, and an inflationary model with a hyperbolic inflaton potential. We perform an explicit approach to find out a scalar field model of inflation in which any observations can be explained in principle.

  3. Biceps tenodesis is a viable option for salvage of failed SLAP repair.

    Science.gov (United States)

    Werner, Brian C; Pehlivan, Hakan C; Hart, Joseph M; Lyons, Matthew L; Gilmore, C Jan; Garrett, Cara B; Carson, Eric W; Diduch, David R; Miller, Mark D; Brockmeier, Stephen F

    2014-08-01

    Outcomes of arthroscopic superior labral anterior-posterior (SLAP) repairs have been well reported with generally favorable outcomes. Unfortunately, a percentage of patients remain dissatisfied or suffer further injury after SLAP repair and may seek additional treatment. The purpose of this study was to evaluate the surgical outcomes of biceps tenodesis for failed SLAP repairs. A retrospective review of all patients undergoing biceps tenodesis was completed. Inclusion criteria were previous SLAP repair and subsequent revision biceps tenodesis. Exclusion criteria were additional shoulder procedures including rotator cuff repair, instability procedures, and preoperative frozen shoulder. Objective outcomes were postoperative assessments with Constant score, American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation, Simple Shoulder Test, and Veterans RAND 36-Item Health Survey. Physical examination was conducted to determine postoperative range of motion and strength compared with the nonoperative shoulder. A cohort of 24 patients was identified, and of these, 17 patients (71%) completed the study at 2 years' follow-up. The average postoperative Constant score was 84.4; American Shoulder and Elbow Surgeons score, 75.5; Single Assessment Numeric Evaluation score, 73.1%; Simple Shoulder Test score, 9.2; and Veterans RAND 36-Item Health Survey score, 76.1. Postoperative range of motion of the operative shoulder returned to near that of the asymptomatic nonoperative shoulder. Workers' compensation status led to inferior results. Options for patients with a failed prior SLAP repair are limited. As a salvage operation for failed SLAP repair, biceps tenodesis serves the majority of patients well, with favorable outcomes by validated measures and excellent shoulder range of motion and elbow strength at 2 years' follow-up. Workers' compensation status may predispose patients to poorer outcomes. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board

  4. Killing the straw man: Does BICEP prove inflation at the GUT scale?

    Energy Technology Data Exchange (ETDEWEB)

    Dent, James B. [Department of Physics, University of Louisiana at Lafayette, Lafayette, LA 70504 (United States); Krauss, Lawrence M. [Department of Physics and School of Earth and Space Exploration, Arizona State University, Tempe, AZ 85287 (United States); Mount Stromlo Observatory, Research School of Astronomy and Astrophysics, Australian National University, Weston, ACT, 2611 (Australia); Mathur, Harsh [Department of Physics, Case Western Reserve University, Cleveland, OH 44106-7079 (United States)

    2014-09-07

    The surprisingly large value of r, the ratio of power in tensor to scalar density perturbations in the CMB reported by the BICEP2 Collaboration, if confirmed, provides strong evidence for Inflation at the GUT scale. While the Inflationary signal remains the best motivated source, a large value of r alone would still allow for the possibility that a comparable gravitational wave background might result from a self ordering scalar field (SOSF) transition that takes place later at somewhat lower energy. We find that even without detailed considerations of the predicted BICEP signature of such a transition, simple existing limits on the isocurvature contribution to CMB anisotropies would definitively rule out a contribution of more than 5% to r≈0.2. We also present a general relation for the allowed fractional SOSF contribution to r as a function of the ultimate measured value of r. These results point strongly not only to an inflationary origin of the BICEP2 signal, if confirmed, but also to the fact that if the GUT scale is of order 10{sup 16} GeV then either the GUT transition happens before Inflation or the Inflationary transition and the GUT transition must be one and the same.

  5. Killing the straw man: Does BICEP prove inflation at the GUT scale?

    International Nuclear Information System (INIS)

    Dent, James B.; Krauss, Lawrence M.; Mathur, Harsh

    2014-01-01

    The surprisingly large value of r, the ratio of power in tensor to scalar density perturbations in the CMB reported by the BICEP2 Collaboration, if confirmed, provides strong evidence for Inflation at the GUT scale. While the Inflationary signal remains the best motivated source, a large value of r alone would still allow for the possibility that a comparable gravitational wave background might result from a self ordering scalar field (SOSF) transition that takes place later at somewhat lower energy. We find that even without detailed considerations of the predicted BICEP signature of such a transition, simple existing limits on the isocurvature contribution to CMB anisotropies would definitively rule out a contribution of more than 5% to r≈0.2. We also present a general relation for the allowed fractional SOSF contribution to r as a function of the ultimate measured value of r. These results point strongly not only to an inflationary origin of the BICEP2 signal, if confirmed, but also to the fact that if the GUT scale is of order 10 16 GeV then either the GUT transition happens before Inflation or the Inflationary transition and the GUT transition must be one and the same.

  6. Postoperative US of leg tendon reconstruction

    International Nuclear Information System (INIS)

    Draghi, F.; Calliada, F.; Fulle, I.; Madonia, L.; Bottinelli, O.; Campani, R.

    1999-01-01

    The role of ultrasound (US) in the postoperative assessment of tendon reconstruction is not clearly defined and there is non systematic arrangement of US patterns. The authors examined 34 patients submitted to surgery or conservative treatment for total/partial tear or musculotendinous detachment of patellar or Achilles tendon in the last 5 years. All patients underwent physical and US examinations. The surgical tendon exhibited the same US patterns in 23/28 patients: it was markedly enlarged (three-/fourfold the normal diameter) and more rounded, with inhomogeneous and hypoechoic appearance not only at the tear/surgical site but also above and below it, for some cm. Small hyperechoic images, mainly dots, were seen in 19 cases, which were referable to small calcifications and stitches. More and larger calcifications were found in 8 patients, where they were associated with anechoic degeneration areas. Color Doppler US showed moderate or strong hypervascularization around the tear in the first months post injury. US patterns did not correlate with physical findings, but color Doppler patterns did. In 6 cases of musculotendinous detachment submitted to conservative treatment, US showed enlargement and hypoechogenicity in the injury site only, with no involvement of the remaining tendon. US was also used to time and guide drainage of perilesional hematomas, which were often quite large. US is the method of choice in the postoperative follow-up of tendon tears and musculotendinous detachments because it shows abnormal signs which are missed at clinics and provides additional information needed for treatment planning [it

  7. management of open achilles tendon injury: primary repair and early ...

    African Journals Online (AJOL)

    is attributable to increase in both competitive and recreational sports. In most of the literature written on Achilles tendon injuries there were rarely any information about open Achilles tendon ... The most common aetiology was motorbike spoke.

  8. Robot Arm with Tendon Connector Plate and Linear Actuator

    Science.gov (United States)

    Ihrke, Chris A. (Inventor); Diftler, Myron A. (Inventor); Bridgwater, Lyndon (Inventor); Nguyen, Vienny (Inventor); Millerman, Alexander (Inventor)

    2014-01-01

    A robotic system includes a tendon-driven end effector, a linear actuator, a flexible tendon, and a plate assembly. The linear actuator assembly has a servo motor and a drive mechanism, the latter of which translates linearly with respect to a drive axis of the servo motor in response to output torque from the servo motor. The tendon connects to the end effector and drive mechanism. The plate assembly is disposed between the linear actuator assembly and the tendon-driven end effector and includes first and second plates. The first plate has a first side that defines a boss with a center opening. The second plate defines an accurate through-slot having tendon guide channels. The first plate defines a through passage for the tendon between the center opening and a second side of the first plate. A looped end of the flexible tendon is received within the tendon guide channels.

  9. BICEP2, Planck, spinorial space-time, pre-Big Bang.

    Directory of Open Access Journals (Sweden)

    Gonzalez-Mestres Luis

    2015-01-01

    Full Text Available The field of Cosmology is currently undergoing a positive and constructive crisis. Controversies concerning inflation are not really new. But after the 2013-2014 Planck and BICEP2 announcements, and the more recent joint analysis by Planck, BICEP2 and the Keck Array (PBKA, the basic issues can involve more direct links between the Mathematical Physics aspects of cosmological patterns and the interpretation of experimental results. Open questions and new ideas on the foundations of Cosmology can emerge, while future experimental and observational programs look very promising. The BICEP2 result reporting an excess of B-mode polarization signal of the cosmic microwave background (CMB radiation was initially presented as a signature of primordial gravitational waves from cosmic inflation. But polarized dust emission can be at the origin of such a signal, and the evidence claimed by BICEP2 is no longer secure after the PBKA analysis. Furthermore, even assuming that significant CMB B-mode polarization has indeed been generated by the early Universe, its theoretical and cosmological interpretation would be far from obvious. Inflationary gravitational waves are not the only possible source of primordial CMB B-modes. Alternative cosmologies such as pre-Big Bang patterns and the spinorial space-time (SST we introduced in 1996-97 can naturally produce this polarization. Furthermore, the SST automatically generates for each comoving observer a local privileged space direction (PSD whose existence may have been confirmed by Planck data. If such a PSD exists, vector perturbations have most likely been strong in the early Universe and may have produced CMB B-modes. Pre-Big Bang cosmologies can also generate gravitational waves in the early Universe without inflation. After briefly describing detectors devoted to the study of the CMB polarization, we discuss the situation emerging from BICEP2 results, Planck results and the PBKA analysis. In particular, we

  10. Partial tear of the quadriceps tendon in a child

    International Nuclear Information System (INIS)

    Khanna, Geetika; El-Khoury, George

    2008-01-01

    We present a case of partial rupture of the quadriceps tendon in an 8-year-old girl. This is one of the youngest patients reported with a quadriceps tendon rupture, an entity seen predominantly in middle-aged people. The strength of the muscle tendon unit in a child makes tendon injuries extremely unusual as compared to apophyseal avulsions. The MR imaging findings of this unusual pediatric injury are illustrated. (orig.)

  11. Calcaneal tendon: imaging findings; Tendao calcaneo: avaliacao por imagem

    Energy Technology Data Exchange (ETDEWEB)

    Montandon, Cristiano; Fonseca, Cristiano Rezio; Montandon Junior, Marcelo Eustaquio [Colegio Brasileiro de Radiologia e Diagnostico por Imagem, Sao Paulo, SP (Brazil)]. E-mail: crismontandon@hotmail.com; Lobo, Leonardo Valadares; Ribeiro, Flavia Aparecida de Souza; Teixeira, Kim-Ir-Sen Santos [Goias Univ., Goiania, GO (Brazil). Hospital de Clinicas. Dept. de Diagnostico por Imagem e Anatomia Patologica

    2003-12-01

    We reviewed the radiological and clinical features of 23 patients with calcaneal tendon diseases, who were submitted to ultrasound or magnetic resonance imaging. The objective of this study was to characterize the lesions for a precise diagnosis of calcaneal tendon injuries. A wide range of calcaneal tendon diseases include degenerative lesions, inflammation of the peritendinous tissue such as peritendinitis and bursitis, and rupture. Imaging methods are essential in the diagnosis, treatment and follow-up of calcaneal tendon diseases. (author)

  12. MRI in flexor tendon rupture after collagenase injection

    International Nuclear Information System (INIS)

    Khurana, Shruti; Wadhwa, Vibhor; Chhabra, Avneesh; Amirlak, Bardia

    2017-01-01

    Flexor tendon rupture is an unusual complication following collagenase injection to relieve contractures. These patients require a close follow-up and in the event of tendon rupture, a decision has to be made whether to repair the tendon or manage the complication conservatively. The authors report the utility of MRI in the prognostication and management of a patient with Dupuytren's contracture, who underwent collagenase injection and subsequently developed flexor digitorum profundus tendon rupture. (orig.)

  13. p38 MAPK signaling in postnatal tendon growth and remodeling.

    Directory of Open Access Journals (Sweden)

    Andrew J Schwartz

    Full Text Available Tendon is a dynamic tissue whose structure and function is influenced by mechanical loading, but little is known about the fundamental mechanisms that regulate tendon growth and remodeling in vivo. Data from cultured tendon fibroblasts indicated that the p38 MAPK pathway plays an important role in tendon fibroblast proliferation and collagen synthesis in vitro. To gain greater insight into the mechanisms of tendon growth, and explore the role of p38 MAPK signaling in this process, we tested the hypotheses that inducing plantaris tendon growth through the ablation of the synergist Achilles tendon would result in rapid expansion of a neotendon matrix surrounding the original tendon, and that treatment with the p38 MAPK inhibitor SB203580 would prevent this growth. Rats were treated with vehicle or SB203580, and subjected to synergist ablation by bilateral tenectomy of the Achilles tendon. Changes in histological and biochemical properties of plantaris tendons were analyzed 3, 7, or 28 days after overload, and comparisons were made to non-overloaded animals. By 28 days after overload, tendon mass had increased by 30% compared to non-overloaded samples, and cross-sectional area (CSA increased by around 50%, with most of the change occurring in the neotendon. The expansion in CSA initially occurred through the synthesis of a hyaluronic acid rich matrix that was progressively replaced with mature collagen. Pericytes were present in areas of active tendon growth, but never in the original tendon ECM. Inhibition of p38 MAPK resulted in a profound decrease in IL6 expression, and had a modest effect on the expression of other ECM and cell proliferation genes, but had a negligible impact on overall tendon growth. The combined results from this study provided novel insights into tendon mechanobiology, and suggest that p38 MAPK signaling does not appear to be necessary for tendon growth in vivo.

  14. MRI in flexor tendon rupture after collagenase injection

    Energy Technology Data Exchange (ETDEWEB)

    Khurana, Shruti [Lady Hardinge Medical College, New Delhi (India); Wadhwa, Vibhor [University of Arkansas for Medical Sciences, Little Rock, AR (United States); Chhabra, Avneesh [UT Southwestern Medical Center, Dallas, TX (United States); Johns Hopkins University, Baltimore, MD (United States); Amirlak, Bardia [UT Southwestern Medical Center, Dallas, TX (United States)

    2017-02-15

    Flexor tendon rupture is an unusual complication following collagenase injection to relieve contractures. These patients require a close follow-up and in the event of tendon rupture, a decision has to be made whether to repair the tendon or manage the complication conservatively. The authors report the utility of MRI in the prognostication and management of a patient with Dupuytren's contracture, who underwent collagenase injection and subsequently developed flexor digitorum profundus tendon rupture. (orig.)

  15. PERONEAL TENDON LESIONS IN ATHLETES (REVIEW

    Directory of Open Access Journals (Sweden)

    E. E. Achkasov

    2016-01-01

    Full Text Available The authors analyzed scientific literature in respect of various issues in treatment of athletes with peroneal muscles lesions starting from 1987 till 2016. Key search and publications selection was made in PubMed and russian national electronic scientific library eLIBRARY. Peroneal tendons pathology is not the major but the underestimated cause of pain in lateral and hindfoot as well as of foot dysfunction which is difficult to distinguish from lesions of lateral ligaments of the ankle joint. Untreated lesions of peroneal tendons can result in chronic ankle pain and significant functional disorders. The purpose of the present paper is to improve the current comprehension of anatomy, to identify factors contributing to pathology, to perform diagnostic evaluation of peroneal tendons and to review current treatment options of such lesions.

  16. Triple Achilles Tendon Rupture: Case Report.

    Science.gov (United States)

    Saxena, Amol; Hofer, Deann

    We present a case report with 1-year follow-up data of a 57-year-old male soccer referee who had sustained an acute triple Achilles tendon rupture injury during a game. His triple Achilles tendon rupture consisted of a rupture of the proximal watershed region, a rupture of the main body (mid-watershed area), and an avulsion-type rupture of insertional calcific tendinosis. The patient was treated surgically with primary repair of the tendon, including tenodesis with anchors. Postoperative treatment included non-weightbearing for 4 weeks and protected weightbearing until 10 weeks postoperative, followed by formal physical therapy, which incorporated an "antigravity" treadmill. The patient was able to return to full activity after 26 weeks, including running and refereeing, without limitations. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Lateral force transmission between human tendon fascicles

    DEFF Research Database (Denmark)

    Haraldsson, Bjarki T; Aagaard, Per; Qvortrup, Klaus

    2008-01-01

    Whether adjacent collagen fascicles transmit force in parallel is unknown. The purpose of the present study was to examine the magnitude of lateral force transmission between adjacent collagen fascicles from the human patellar and Achilles tendon. From each sample two adjacent strands of fascicles...... was transversally cut while the other fascicle and the fascicular membrane were kept intact. Cycle 3: both fascicles were cut in opposite ends while the fascicular membrane was left intact. A decline in peak force of 45% and 55% from cycle 1 to cycle 2, and 93% and 92% from cycle 2 to cycle 3 was observed...... in the patellar and Achilles tendon fascicles, respectively. A decline in stiffness of 39% and 60% from cycle 1 to cycle 2, and of 93% and 100% from cycle 2 to cycle 3 was observed in the patellar and Achilles tendon fascicles, respectively. The present data demonstrate that lateral force transmission between...

  18. Flexor digitorum profundus tendon anatomy in the forearm

    Directory of Open Access Journals (Sweden)

    Teoman Dogan

    2012-04-01

    Methods: We used 11 forearms belonging to cadavers and fixed with formaldehyde. The forearms numbered 1, 2, 8, 9, 10, 11 were the left and right arms of the same cadavers. Those numbered 3, 4, 5, 6, 7 belonged to different cadavers. Dissections were made by using the atraumatic surgical technique. The tendons were studied to identify the structure and number of the fibers forming them. Results: The presence of a large common tendon was found in 10 of the 11 forearms. In 4 of these, the common tendon included the tendons of all four fingers. While the common tendon included 3 fingers in four forearms, it only included tendons belonging to 2 fingers in two forearms. It was not possible in one forearm to separate the common tendon into its fibers. In another forearm, tendons belonging to each digit were separate and independent starting at the muscle-tendon junction to the attachment points. Conclusion: The majority of the cadaver forearms used in the study displayed a single large FDP tendon in the zone between the muscle-tendon joint to the carpal tunnel entry prior to being distributed into each index. This anatomical feature should be considered in choosing materials and surgical technique for Zone V FDP tendon injuries, as well as in planning the rehabilitation process. [Hand Microsurg 2012; 1(1.000: 25-29

  19. Bilateral spontaneous rupture of flexor digitorum profundus tendons.

    LENUS (Irish Health Repository)

    O'Sullivan, S T

    2012-02-03

    Spontaneous tendon rupture is an unusual condition usually associated with underlying disease processes such as rheumatoid arthritis, chronic renal failure or bony abnormalities of the hand. We report a case of spontaneous, non-concurrent bilateral rupture of flexor profundus tendons in an otherwise healthy individual. Treatment was successful and consisted of a two-stage reconstruction of the ruptured tendon.

  20. Ultrasound diagnostics of muscle and tendon injuries

    Directory of Open Access Journals (Sweden)

    Stević Ruža

    2009-01-01

    Full Text Available Introduction. Sonography is a useful technique for the investigation of a number of musculoskeletal disorders. The most common indication for ultrasonography of muscles and tendons is the diagnosis of traumatic lesions, distinguishing them from other disorders and follow-up of healing process. Objective. The purpose of this paper is to show the importance of ultrasound in the diagnosis of muscle and tendon injuries. Methods. The study included 170 patients (148 male and 22 female, mean age 29.6 years (range 14-60 years. All examinations were performed by linear transducer of 7.5-10 MHz, with longitudinal and transverse scanning. Ultrasound examination followed physical examination. Results. Traumatic lesions of muscles were diagnosed in 113 patients (66.7% and tendon injuries in 57 cases (33.2%. The muscle changes detected by ultrasonography were the following: 70 (61.9% partial and two (1.76% complete ruptures, 22 (19.46% haematoma, 9 (7.96% strains grade I, 4 fibroses and 4 ossifying myositis 4 (3.5%, respectively. Complications of muscle injuries were diagnosed in two cases, a muscular hernia and an arteriovenous fistula. Among tendon injuries, 21 (33.8% ruptures and 36 (66.1% tendinitis were diagnosed. Accompanying effusion in the bursa of patients with tendon injuries was found in 9 cases. Conclusion. Ultrasonography allowed visualization and objective assessment of the type and the extent of traumatic pathomorphological changes of muscles and tendons. Such diagnostic possibilities of ultrasonography are especially important in the choice of appropriate therapy.

  1. Spontaneous Achilles tendon rupture in alkaptonuria

    Directory of Open Access Journals (Sweden)

    Omar A. Alajoulin

    2015-12-01

    Full Text Available Alkaptonuria (AKU is a rare inborn metabolic disease characterized by accumulation of homogentisic acid (HGA. Excretion of HGA in urine causes darkening of urine and its deposition in connective tissues causes dark pigmentation (ochronosis, early degeneration of articular cartilage, weakening of the tendons, and subsequent rupture. In this case report, we present a rare case of a patient presented with unilateral spontaneous rupture of Achilles tendon due to AKU. The patient developed most of the orthopedic manifestations of the disease earlier than typical presentations. Alkaptonuria patients should avoid strenuous exercises and foot straining especially in patients developing early orthopedic manifestations.

  2. Spontaneous Achilles tendon rupture in alkaptonuria.

    Science.gov (United States)

    Alajoulin, Omar A; Alsbou, Mohammed S; Ja'afreh, Somayya O; Kalbouneh, Heba M

    2015-12-01

    Alkaptonuria (AKU) is a rare inborn metabolic disease characterized by accumulation of homogentisic acid (HGA). Excretion of HGA in urine causes darkening of urine and its deposition in connective tissues causes dark pigmentation (ochronosis), early degeneration of articular cartilage, weakening of the tendons, and subsequent rupture. In this case report, we present a rare case of a patient presented with unilateral spontaneous rupture of Achilles tendon due to AKU. The patient developed most of the orthopedic manifestations of the disease earlier than typical presentations. Alkaptonuria patients should avoid strenuous exercises and foot straining especially in patients developing early orthopedic manifestations.

  3. [Development of Achilles tendon rupture in skiing].

    Science.gov (United States)

    Suckert, K; Benedetto, K P; Vogel, A

    1983-06-01

    This is an analysis of decline of rupture of the Achilles tendon in skiing while there is a steady increase of skiing injuries. Three groups, equipped with three different types of ski boots were observed once on a plane slope on the other hand on a bump track. The simultaneous size of angle of knee and ankle was measured by telemetry. The high plastic ski boot, which obstructs the ankle forward and lateral is apart from the rise of heel in the boot, the safety binding and the new skiing style the main reason for decline of rupture of the Achilles tendon in skiing.

  4. The Effect of Sodium Hyaluronate on Ligamentation and Biomechanical Property of Tendon in Repair of Achilles Tendon Defect with Polyethylene Terephthalate Artificial Ligament: A Rabbit Tendon Repair Model.

    Science.gov (United States)

    Li, Shengkun; Ma, Kui; Li, Hong; Jiang, Jia; Chen, Shiyi

    2016-01-01

    The Achilles tendon is the most common ruptured tendon of human body. Reconstruction with polyethylene terephthalate (PET) artificial ligament is recommended in some serious cases. Sodium hyaluronate (HA) is beneficial for the healing of tendon injuries. We aimed to determine the effect of sodium hyaluronate in repair of Achilles tendon defect with PET artificial ligament in an animal tendon repair model. Sixteen New Zealand White rabbits were divided into two groups. Eight rabbits repaired with PET were assigned to PET group; the other eight rabbits repaired with PET along with injection of HE were assigned to HA-PET group. All rabbits were sacrificed at 4 and 8 weeks postoperatively for biomechanical and histological examination. The HA-PET group revealed higher biomechanical property compared with the PET group. Histologically, more collagen tissues grew into the HA-PET group compared with PET group. In conclusion, application of sodium hyaluronate can improve the healing of Achilles tendon reconstruction with polyethylene terephthalate artificial ligament.

  5. Peroneal tendon displacement accompanying intra-articular calcaneal fractures.

    Science.gov (United States)

    Toussaint, Rull James; Lin, Darius; Ehrlichman, Lauren K; Ellington, J Kent; Strasser, Nicholas; Kwon, John Y

    2014-02-19

    Peroneal tendon displacement (subluxation or dislocation) accompanying an intra-articular calcaneal fracture is often undetected and under-treated. The goals of this study were to determine (1) the prevalence of peroneal tendon displacement accompanying intra-articular calcaneal fractures, (2) the association of tendon displacement with fracture classifications, (3) the association of tendon displacement with heel width, and (4) the rate of missed diagnosis of the tendon displacement on radiographs and computed tomography (CT) scans and the resulting treatment rate. A retrospective radiographic review of all calcaneal fractures presenting at three institutions from June 30, 2006, to June 30, 2011, was performed. CT imaging of 421 intra-articular calcaneal fractures involving the posterior facet was available for review. The prevalence of peroneal tendon displacement was noted and its associations with fracture classification and heel width were evaluated. Peroneal tendon displacement was identified in 118 (28.0%) of the 421 calcaneal fracture cases. The presence of tendon displacement was significantly associated with joint-depression fractures compared with tongue-type fractures (p displacement had been identified in the radiology reports. Although sixty-five (55.1%) of the fractures with tendon displacement had been treated with internal fixation, the tendon displacement was treated surgically in only seven (10.8%) of these cases. Analysis of CT images showed a 28% prevalence of peroneal tendon displacement accompanying intra-articular calcaneal fractures. Surgeons and radiologists are encouraged to consider this association.

  6. Plantar tendons of the foot: MR imaging and US.

    Science.gov (United States)

    Donovan, Andrea; Rosenberg, Zehava Sadka; Bencardino, Jenny T; Velez, Zoraida Restrepo; Blonder, David B; Ciavarra, Gina A; Adler, Ronald Steven

    2013-01-01

    Tendon disorders along the plantar aspect of the foot may lead to significant symptoms but are often clinically misdiagnosed. Familiarity with the normal anatomy of the plantar tendons and its appearance at magnetic resonance (MR) imaging and ultrasonography (US) is essential for recognizing plantar tendon disorders. At MR imaging, the course of the plantar tendons is optimally visualized with dedicated imaging of the midfoot and forefoot. This imaging should include short-axis images obtained perpendicular to the long axis of the metatarsal shafts, which allows true cross-sectional evaluation of the plantar tendons. Normal plantar tendons appear as low-signal-intensity structures with all MR sequences. At US, accurate evaluation of the tendons requires that the ultrasound beam be perpendicular to the tendon. The normal tendon appears as a compact linear band of echogenic tissue that contains a fine, mixed hypoechoic and hyperechoic internal fibrillar pattern. Tendon injuries can be grouped into six major categories: tendinosis, peritendinosis, tenosynovitis, entrapment, rupture, and instability (subluxation or dislocation) and can be well assessed with both MR imaging and US. The radiologist plays an important role in the diagnosis of plantar tendon disorders, and recognizing their imaging appearances at MR imaging and US is essential.

  7. Biceps-Related Physical Findings Are Useful to Prevent Misdiagnosis of Cervical Spondylotic Amyotrophy as a Rotator Cuff Tear.

    Science.gov (United States)

    Iwata, Eiichiro; Shigematsu, Hideki; Inoue, Kazuya; Egawa, Takuya; Tanaka, Masato; Okuda, Akinori; Morimoto, Yasuhiko; Masuda, Keisuke; Yamamoto, Yusuke; Sakamoto, Yoshihiro; Koizumi, Munehisa; Tanaka, Yasuhito

    2018-02-01

    Case-control study. The aim of the present study was to identify physical findings useful for differentiating between cervical spondylotic amyotrophy (CSA) and rotator cuff tears to prevent the misdiagnosis of CSA as a rotator cuff tear. CSA and rotator cuff tears are often confused among patients presenting with difficulty in shoulder elevation. Twenty-five patients with CSA and 27 with rotator cuff tears were enrolled. We included five physical findings specific to CSA that were observed in both CSA and rotator cuff tear patients. The findings were as follows: (1) weakness of the deltoid muscle, (2) weakness of the biceps muscle, (3) atrophy of the deltoid muscle, (4) atrophy of the biceps muscle, and (5) swallow-tail sign (assessment of the posterior fibers of the deltoid). Among 25 CSA patients, 10 (40.0%) were misdiagnosed with a rotator cuff tear on initial diagnosis. The sensitivity and specificity of each physical finding were as follows: (1) deltoid weakness (sensitivity, 92.0%; specificity, 55.6%), (2) biceps weakness (sensitivity, 80.0%; specificity, 100%), (3) deltoid atrophy (sensitivity, 96.0%; specificity, 77.8%), (4) biceps atrophy (sensitivity, 88.8%; specificity, 92.6%), and (5) swallow-tail sign (sensitivity, 56.0%; specificity, 74.1%). There were statistically significant differences in each physical finding. CSA is likely to be misdiagnosed as a rotator cuff tear; however, weakness and atrophy of the biceps are useful findings for differentiating between CSA and rotator cuff tears to prevent misdiagnosis.

  8. Variation in the insertion of the palmaris longus tendon

    Science.gov (United States)

    Sunil, Vinutha; Rajanna, Shubha; Gitanjali; Kadaba, Jayanthi

    2015-01-01

    The palmaris longus is harvested as a tendon graft in various surgical procedures. We herein report the variations in the insertion of the palmaris longus tendon. During a routine dissection, a rare variation in the insertion of the palmaris longus tendon was observed. In the left forearm, the palmaris longus tendon bifurcated, while in the right forearm, the palmaris longus tendon trifurcated, giving rise to an accessory muscle, which passed superficial to the ulnar artery and ulnar nerve. The accessory muscle was supplied by a deep branch of the ulnar nerve, and the ulnar artery was observed to be tortuous. During reconstructive surgeries, surgeons should bear in mind the accessory muscle. Also, since the palmaris longus muscle provides a very useful graft in tendon surgery, every surgeon should be aware of the variations in the insertion of the palmaris longus tendon. PMID:25640108

  9. A Rare Case of Simultaneous Acute Bilateral Quadriceps Tendon Rupture and Unilateral Achilles Tendon Rupture

    Directory of Open Access Journals (Sweden)

    Wei Yee Leong

    2013-07-01

    Full Text Available Introduction: There have been multiple reported cases of bilateral quadriceps tendon ruptures (QTR in the literature. These injuries frequently associated with delayed diagnosis, which results in delayed surgical treatment. In very unusual cases, bilateral QTRs can be associated with other simultaneous tendon ruptures. Case Report: We present a rare case of bilateral QTR with a simultaneous Achilles Tendon Rupture involving a 31 years old Caucasian man who is a semi-professional body builder taking anabolic steroids. To date bilateral QTR with additional TA rupture has only been reported once in the literature and to our knowledge this is the first reported case of bilateral QTR and simultaneous TA rupture in a young, fit and healthy individual. Conclusion: The diagnosis of bilateral QTR alone can sometimes be challenging and the possibility of even further tendon injuries should be carefully assessed. A delay in diagnosis could result in delay in treatment and potentially worse outcome for the patient. Keywords: Quadriceps tendon rupture; Achilles tendon rupture; Bilateral.

  10. Tendoscopy of the posterior tibial tendon

    NARCIS (Netherlands)

    van Dijk, C. N.; Kort, N.; Scholten, P. E.

    1997-01-01

    An anatomic cadaver study was performed and subsequently, in a prospective study, diagnostic and therapeutic tendoscopy (tendon sheath endoscopy) was performed in 16 consecutive patients with a history of persistent posteromedial ankle pain for at least 6 months. All patients had pain on palpation

  11. A posterior tibial tendon skipping rope

    NARCIS (Netherlands)

    van Sterkenburg, M. N.; Haverkamp, D.; van Dijk, C. N.; Kerkhoffs, G. M. M. J.

    2010-01-01

    This report presents an athletic patient with swelling and progressive pain on the posteromedial side of his right ankle on weight bearing. MRI demonstrated tenosynovitis and suspicion of a length rupture. On posterior tibial tendoscopy, there was no rupture, but medial from the tendon a tissue cord

  12. Radiographic Features of Acute Patellar Tendon Rupture.

    Science.gov (United States)

    Fazal, Muhammad Ali; Moonot, Pradeep; Haddad, Fares

    2015-11-01

    The purpose of our study was to assess soft tissue features of acute patellar tendon rupture on lateral knee radiograph that would facilitate early diagnosis. The participants were divided into two groups of 35 patients each. There were 28 men and seven women with a mean age of 46 years in the control group and 26 men and nine women with a mean age of 47 years in the rupture group. The lateral knee radiograph of each patient was evaluated for Insall-Salvati ratio for patella alta, increased density of the infrapatellar fat pad, appearance of the soft tissue margin of the patellar tendon and bony avulsions. In the rupture group there were three consistent soft tissue radiographic features in addition to patellar alta. These were increased density of infrapatellar fat pad; loss of sharp, well-defined linear margins of the patellar tendon and angulated wavy margin of the patellar tendon while in the control group these features were not observed. The soft tissue radiographic features described in the rupture group are consistent and reliable. When coupled with careful clinical assessment, these will aid in early diagnosis and further imaging will be seldom required. © 2015 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

  13. Engaging Stem Cells for Customized Tendon Regeneration

    Directory of Open Access Journals (Sweden)

    Hatim Thaker

    2012-01-01

    Full Text Available The need for a consistent therapeutic approach to tendon injury repair is long overdue. Patients with tendon microtears or full ruptures are eligible for a wide range of invasive and non invasive interventions, often subjectively decided by the physician. Surgery produces the best outcomes, and while studies have been conducted to optimize graft constructs and to track outcomes, the data from these studies have been inconclusive on the whole. What has been established is a clear understanding of healthy tendon architecture and the inherent process of healing. With this knowledge, tissue regeneration efforts have achieved immense progress in scaffold design, cell line selection, and, more recently, the appropriate use of cytokines and growth factors. This paper evaluates the plasticity of bone-marrow-derived stem cells and the elasticity of recently developed biomaterials towards tendon regeneration efforts. Mesenchymal stem cells (MSCs, hematopoietic progenitor cells, and poly(1,8-octanediol co-citrate scaffolds (POC are discussed in the context of established grafting strategies. With POC scaffolds to cradle the growth of MSCs and hematopoietic progenitor cells, developing a fibroelastic network guided by cytokines and growth factors may contribute towards consistent graft constructs, enhanced functionality, and better patient outcomes.

  14. [The history of flexor tendon surgery].

    Science.gov (United States)

    Chamay, A

    1997-01-01

    Flexor tendon injuries were already treated in antiquity by Hippocrates, Galien and Avicenne. Since the Renaissance, other surgeons have attempted to repair flexor tendon injuries, but without success due to problems related to unsuitable materials and ignorance of the basic rules of asepsis and the absence of antiseptics until the second half of the 19th century. The first successful flexor tendon grafts in man were performed by K. Biesalski in 1910, E. Lexer in 1912 and L. Mayer in 1916. These three authors published their series of grafts and described in detail the anatomical, physiological and technical principles to be respected. St. Bunnell, in 1918, developed various pull-out direct suture procedures, but faced with the problems of adhesions, he abandoned this technique and proposed not to repair flexors in the digital tunnels but to graft them. He defined the famous zone which he called No man's land, which subsequently became Claude Verdan's zone II, in 1959. In 1960, C. Verdan published his first series of sutures maintained by 2 pins in zone II with comparable results to those obtained after grafting. In 1967, H. Kleinert, with his mobile suture, became the leader of direct tendon repair in zone II. 2-stage grafts were introduced in 1965 under the impetus of J. Hunter, who revised and popularized the studies conducted by A. Bassett and R.E. Caroll in 1950.

  15. Scalar perturbation in warm tachyon inflation in LQC in light of Plank and BICEP2

    Energy Technology Data Exchange (ETDEWEB)

    Setare, M.R., E-mail: rezakord@ipm.ir [Department of Science, Campus of Bijar, University of Kurdistan, Bijar (Iran, Islamic Republic of); Kamali, V., E-mail: vkamali1362@gmail.com [Department of Physics, Faculty of Science, Bu-Ali Sina University, Hamedan, 65178 (Iran, Islamic Republic of)

    2014-12-12

    We study warm-tachyon inflationary universe model in the context of the effective field theory of loop quantum cosmology. In slow-roll approximation the primordial perturbation spectrums for this model are calculated. We also obtain the general expressions of the tensor-to-scalar ratio and scalar spectral index. We develop this model by using exponential potential, the characteristics of this model are presented in great details. The parameters of the model are restricted by recent observational data from Planck, WMAP9 and BICEP2.

  16. Higgs inflation is still alive after the results from BICEP2.

    Science.gov (United States)

    Hamada, Yuta; Kawai, Hikaru; Oda, Kin-Ya; Park, Seong Chan

    2014-06-20

    The observed value of the Higgs boson mass indicates that the Higgs potential becomes small and flat at the scale around 10(17)  GeV. Having this fact in mind, we reconsider the Higgs inflation scenario proposed by Bezrukov and Shaposhnikov. It turns out that the nonminimal coupling ξ of the Higgs squared to the Ricci scalar can be smaller than 10. For example, ξ=7 corresponds to the tensor-to-scalar ratio r≃0.2, which is consistent with the recent observation by BICEP2.

  17. Mineral distributions at the developing tendon enthesis.

    Science.gov (United States)

    Schwartz, Andrea G; Pasteris, Jill D; Genin, Guy M; Daulton, Tyrone L; Thomopoulos, Stavros

    2012-01-01

    Tendon attaches to bone across a functionally graded interface, "the enthesis". A gradient of mineral content is believed to play an important role for dissipation of stress concentrations at mature fibrocartilaginous interfaces. Surgical repair of injured tendon to bone often fails, suggesting that the enthesis does not regenerate in a healing setting. Understanding the development and the micro/nano-meter structure of this unique interface may provide novel insights for the improvement of repair strategies. This study monitored the development of transitional tissue at the murine supraspinatus tendon enthesis, which begins postnatally and is completed by postnatal day 28. The micrometer-scale distribution of mineral across the developing enthesis was studied by X-ray micro-computed tomography and Raman microprobe spectroscopy. Analyzed regions were identified and further studied by histomorphometry. The nanometer-scale distribution of mineral and collagen fibrils at the developing interface was studied using transmission electron microscopy (TEM). A zone (∼20 µm) exhibiting a gradient in mineral relative to collagen was detected at the leading edge of the hard-soft tissue interface as early as postnatal day 7. Nanocharacterization by TEM suggested that this mineral gradient arose from intrinsic surface roughness on the scale of tens of nanometers at the mineralized front. Microcomputed tomography measurements indicated increases in bone mineral density with time. Raman spectroscopy measurements revealed that the mineral-to-collagen ratio on the mineralized side of the interface was constant throughout postnatal development. An increase in the carbonate concentration of the apatite mineral phase over time suggested possible matrix remodeling during postnatal development. Comparison of Raman-based observations of localized mineral content with histomorphological features indicated that development of the graded mineralized interface is linked to endochondral

  18. Changes in Achilles tendon mechanical properties following eccentric heel drop exercise are specific to the free tendon.

    Science.gov (United States)

    Obst, S J; Newsham-West, R; Barrett, R S

    2016-04-01

    Mechanical loading of the Achilles tendon during isolated eccentric contractions could induce immediate and region-dependent changes in mechanical properties. Three-dimensional ultrasound was used to examine the immediate effect of isolated eccentric exercise on the mechanical properties of the distal (free tendon) and proximal (gastrocnemii) regions of the Achilles tendon. Participants (n = 14) underwent two testing sessions in which tendon measurements were made at rest and during a 30% and 70% isometric plantar flexion contractions immediately before and after either: (a) 3 × 15 eccentric heel drops or (b) 10-min rest. There was a significant time-by-session interaction for free tendon length and strain for all loading conditions (P tendon length and strain at all contraction intensities after eccentric exercise (P tendon for any of the measured parameters. Immediate changes in Achilles tendon mechanical properties were specific to the free tendon and consistent with changes due to mechanical creep. These findings suggest that the mechanical properties of the free tendon may be more vulnerable to change with exercise compared with the gastrocnemii aponeurosis or tendon. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. [Reconstruction of the extensor pollicis longus tendon by transposition of the extensor indicis tendon].

    Science.gov (United States)

    Loos, A; Kalb, K; Van Schoonhoven, J; Landsleitner Dagger, B

    2003-12-01

    Rupture of the extensor pollicis longus-tendon (EPL) is a frequent complication after distal radius fractures. Other traumatic and non-traumatic reasons for this tendon lesion are known, including a theory about a disorder in the blood supply to the tendon itself. We examined 40 patients after reconstruction of the EPL-tendon in a mean follow-up time of 30 months. All patients were clinically examined and a DASH questionnaire was answered by all patients. The method to reconstruct the EPL-tendon was the transposition of the extensor indicis-tendon. After the operations the thumb was put in a splint for four weeks in a "hitch-hiker's-position". 31 ruptures of the tendon (77.5 %) were a result of trauma. In 20 of them (50 %) a distal radius fracture had occurred. Clinical examination included measurements of the movement of the thumb- and index-finger joints, the grip strength and the maximal span of the hand. Significant differences were not found. The isolated extension of the index finger was possible in all patients. But it was reduced in ten cases which represent 25 %. Our results were evaluated by the Geldmacher score to evaluate the reconstruction of the EPL-tendon. 20 % excellent, 65 % good, 12.5 % fair and 2.5 % poor results were reached. The Geldmacher score was used critically. We suggest its modification for the evaluation of thumb abduction. The DASH score reached a functional value of ten points which represents a very good result. In conclusion the extensor indicis-transposition is a safe method to reconstruct the EPL-tendon. Its substantial advantage is taking a healthy muscle as the motor, thereby avoiding the risk of using a degenerated muscle in late tendon reconstruction. A powerful extension of the index finger will be maintained by physical education. Generally, the loss of the extension of the index finger is negligible. It does not disturb the patients. But it has to be discussed with the patient before the operation.

  20. Use of Ultrasound to Monitor Biceps Femoris Mechanical Adaptations after Injury in a Professional Soccer Player

    Directory of Open Access Journals (Sweden)

    Eleftherios Kellis, Nikiforos Galanis, Chrysanthos Chrysanthou, Nikolaos Kofotolis

    2016-03-01

    Full Text Available This study examined the use of ultrasound to monitor changes in the long head of the biceps femoris (BF architecture of aprofessional soccer player with acute first-time hamstring strain. The player followed a 14 session physiotherapy treatment until return to sport. The pennation angle and aponeurosis strain of the long head of the biceps femoris (BF were monitored at 6 occasions (up until 1 year after injury. The size of the scar / hematoma was reduced by 63.56% (length and 67.9% (width after the intervention and it was almost non-traceable one year after injury. The pennation angle of the fascicles underneath the scar showed a decline of 51.4% at the end of the intervention while an increase of 109.2% of the fascicles which were closer to deep aponeurosis was observed. In contrast, pennation angle of fascicles located away from the injury site were relatively unaffected. The treatment intervention resulted in a 57.9% to 77.3% decline of maximum strain per unit of MVC moment and remained similar one year after the intervention. This study provided an example of the potential use of ultrasound-based parameters to link the mechanical adaptations of the injured muscle to specific therapeutic intervention.

  1. Self-unitarization of New Higgs Inflation and compatibility with Planck and BICEP2 data

    International Nuclear Information System (INIS)

    Germani, Cristiano; Wintergerst, Nico; Watanabe, Yuki

    2014-01-01

    In this paper we show that the Germani-Kehagias model of Higgs inflation (or New Higgs Inflation), where the Higgs boson is kinetically non-minimally coupled to the Einstein tensor is in perfect compatibility with the latest Planck and BICEP2 data. Moreover, we show that the tension between the Planck and BICEP2 data can be relieved within the New Higgs inflation scenario by a negative running of the spectral index. Regarding the unitarity of the model, we argue that it is unitary throughout the evolution of the Universe. Weak couplings in the Higgs-Higgs and Higgs-graviton sectors are provided by a large background dependent cut-off scale during inflation. In the same regime, the W and Z gauge bosons acquire a very large mass, thus decouple. On the other hand, if they are also non-minimally coupled to the Higgs boson, their effective masses can be enormously reduced. In this case, the W and Z bosons are no longer decoupled. After inflation, the New Higgs model is well approximated by a quartic Galileon with a renormalizable potential. We argue that this can unitarily create the right conditions for inflation to eventually start

  2. Self-unitarization of New Higgs Inflation and compatibility with Planck and BICEP2 data

    Energy Technology Data Exchange (ETDEWEB)

    Germani, Cristiano; Wintergerst, Nico [Arnold Sommerfeld Center, Ludwig-Maximilians-Universität, Theresienstr. 37, 80333 München (Germany); Watanabe, Yuki, E-mail: cristiano.germani@lmu.de, E-mail: watanabe@resceu.s.u-tokyo.ac.jp, E-mail: nico.wintergerst@physik.lmu.de [Research Center for the Early Universe, University of Tokyo, Tokyo 113-0033 (Japan)

    2014-12-01

    In this paper we show that the Germani-Kehagias model of Higgs inflation (or New Higgs Inflation), where the Higgs boson is kinetically non-minimally coupled to the Einstein tensor is in perfect compatibility with the latest Planck and BICEP2 data. Moreover, we show that the tension between the Planck and BICEP2 data can be relieved within the New Higgs inflation scenario by a negative running of the spectral index. Regarding the unitarity of the model, we argue that it is unitary throughout the evolution of the Universe. Weak couplings in the Higgs-Higgs and Higgs-graviton sectors are provided by a large background dependent cut-off scale during inflation. In the same regime, the W and Z gauge bosons acquire a very large mass, thus decouple. On the other hand, if they are also non-minimally coupled to the Higgs boson, their effective masses can be enormously reduced. In this case, the W and Z bosons are no longer decoupled. After inflation, the New Higgs model is well approximated by a quartic Galileon with a renormalizable potential. We argue that this can unitarily create the right conditions for inflation to eventually start.

  3. SUSY see-saw and NMSO(10)GUT inflation after BICEP2

    International Nuclear Information System (INIS)

    Garg, Ila

    2016-01-01

    Supersymmetric see-saw slow roll inflection point inflation occurs along a MSSM D-flat direction associated with gauge invariant combination of Higgs, s lepton and right-handed s neutrino at a scale set by the right-handed neutrino mass M vc ∼ 10 6 -10 13 GeV. The tensor to scalar perturbation ratio r ∼ 10 -3 can be achieved in this scenario. However, this scenario faced difficulty in being embedded in the realistic new minimal supersymmetric SO(10) grand unified theory (NMSO(10)GUT). The recent discovery of B-mode polarization by BICEP2, changes the prospects of NMSO(10) GUT inflation. Inflection point models become strongly disfavoured, as the trilinear coupling of SUSY see-saw inflation potential gets suppressed relative to the mass parameter favoured by BICEP2. Large values of r ≈ 0.2 can be achieved with super-Planck scale inflaton values and mass scales of inflaton ≥10 13 GeV. In NMSO(10)GUT, this can be made possible with an admixture of heavy Higgs doublet fields, i.e., other than MSSM Higgs field, which are present and have masses of order GUT scale. (author)

  4. The influence of sodium bicarbonate on maximal force and rates of force development in the triceps surae and brachii during fatiguing exercise.

    Science.gov (United States)

    Siegler, Jason C; Mudie, Kurt; Marshall, Paul

    2016-11-01

    What is the central question of this study? Does metabolic alkalosis in humans, induced by sodium bicarbonate, affect rates of skeletal muscle fatigue differentially in muscle groups composed predominately of slow- and fast-twitch fibres? What is the main finding and its importance? Sodium bicarbonate exhibited no effect on the fatigue profile observed between triceps surae and brachii muscle groups during and after 2 min of tetanic stimulation. For the first time in exercising humans, we have profiled the effect of sodium bicarbonate on the voluntary and involuntary contractile characteristics of muscle groups representative of predominately slow- and fast-twitch fibres. The effect of metabolic alkalosis on fibre-specific maximal force production and rates of force development (RFD) has been investigated previously in animal models, with evidence suggesting an improved capacity to develop force rapidly in fast- compared with slow-twitch muscle. We have attempted to model in vivo the fatigue profile of voluntary and involuntary maximal force and RFD in the triceps surae and brachii after sodium bicarbonate (NaHCO 3 ) ingestion. In a double-blind, three-way repeated-measures design, participants (n = 10) ingested either 0.3 g kg -1 NaHCO 3 (ALK) or equivalent calcium carbonate (PLA) prior to 2 min of continuous (1 Hz) supramaximal stimulation (300 ms at 40 Hz) of the triceps surae or brachii, with maximal voluntary efforts (maximal voluntary torque) coupled with direct muscle stimulation also measured at baseline, 1 and 2 min. Metabolic alkalosis was achieved in both ALK trials but was not different between muscle groups. Regardless of the conditions, involuntary torque declined nearly 60% in the triceps brachii (P < 0.001) and ∼30% in the triceps surae (P < 0.001). In all trials, there was a significant decline in normalized involuntary RFD (P < 0.05). Maximal voluntary torque declined nearly 28% but was not different between conditions (P < 0

  5. The relationship between shear force, compression, collagen characteristics, desmin degradation and sarcomere length in lamb biceps femoris.

    Science.gov (United States)

    Starkey, Colin P; Geesink, Geert H; van de Ven, Remy; Hopkins, David L

    2017-04-01

    This study aimed to identity the relationships between known variants of tenderness (collagen content (total and soluble), desmin degradation and sarcomere length) and shear force and compression in the biceps femoris aged for 14days from 112 mixed sex lambs. Desmin degradation was related to compression (Pcompression decreased. Sarcomere length (SL) was related to shear force (Pcompression (Pcompression, sarcomere length and soluble collagen. The findings from this experiment indicate that the known variants (soluble collagen, sarcomere length and desmin degradation) are related to shear force and compression in ovine biceps femoris. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  6. A Tendon Cell Specific RNAi Screen Reveals Novel Candidates Essential for Muscle Tendon Interaction.

    Directory of Open Access Journals (Sweden)

    Prabhat Tiwari

    Full Text Available Tendons are fibrous connective tissue which connect muscles to the skeletal elements thus acting as passive transmitters of force during locomotion and provide appropriate body posture. Tendon-derived cues, albeit poorly understood, are necessary for proper muscle guidance and attachment during development. In the present study, we used dorsal longitudinal muscles of Drosophila and their tendon attachment sites to unravel the molecular nature of interactions between muscles and tendons. We performed a genetic screen using RNAi-mediated knockdown in tendon cells to find out molecular players involved in the formation and maintenance of myotendinous junction and found 21 candidates out of 2507 RNAi lines screened. Of these, 19 were novel molecules in context of myotendinous system. Integrin-βPS and Talin, picked as candidates in this screen, are known to play important role in the cell-cell interaction and myotendinous junction formation validating our screen. We have found candidates with enzymatic function, transcription activity, cell adhesion, protein folding and intracellular transport function. Tango1, an ER exit protein involved in collagen secretion was identified as a candidate molecule involved in the formation of myotendinous junction. Tango1 knockdown was found to affect development of muscle attachment sites and formation of myotendinous junction. Tango1 was also found to be involved in secretion of Viking (Collagen type IV and BM-40 from hemocytes and fat cells.

  7. Motor responses to experimental Achilles tendon pain

    DEFF Research Database (Denmark)

    Henriksen, Marius; Aaboe, Jens; Graven-Nielsen, Thomas

    2011-01-01

    of the exercise are affected by Achilles tendon pain. Objective The authors aimed to determine the effects of experimental Achilles tendon pain on motor function during one-legged weight bearing ankle plantar and dorsal flexion exercises. Methods In a crossover study, with 16 healthy subjects tested on two......Background Achilles tendinopathies are characterised by pain and reduced function, and heavy-load exercises have been shown to be effective in the treatment of painful chronic Achilles tendinopathies. However, basic information is needed on how the biomechanics and neuromuscular control...... different days separated by 1 week, three-dimensional ground reaction forces, ankle joint kinematics and surface electromyography (EMG) of the lower leg muscles were recorded during one-legged full weight-bearing ankle plantar (concentric) and dorsal (eccentric) flexion exercises. Measurements were done...

  8. A passive exoskeleton with artificial tendons: design and experimental evaluation.

    Science.gov (United States)

    van Dijk, Wietse; van der Kooij, Herman; Hekman, Edsko

    2011-01-01

    We developed a passive exoskeleton that was designed to minimize joint work during walking. The exoskeleton makes use of passive structures, called artificial tendons, acting in parallel with the leg. Artificial tendons are elastic elements that are able to store and redistribute energy over the human leg joints. The elastic characteristics of the tendons have been optimized to minimize the mechanical work of the human leg joints. In simulation the maximal reduction was 40 percent. The performance of the exoskeleton was evaluated in an experiment in which nine subjects participated. Energy expenditure and muscle activation were measured during three conditions: Normal walking, walking with the exoskeleton without artificial tendons, and walking with the exoskeleton with the artificial tendons. Normal walking was the most energy efficient. While walking with the exoskeleton, the artificial tendons only resulted in a negligibly small decrease in energy expenditure. © 2011 IEEE

  9. Imaging the infrapatellar tendon in the elite athlete

    International Nuclear Information System (INIS)

    Peace, K.A.L.; Lee, J.C.; Healy, J.

    2006-01-01

    Extensor mechanism injuries constitute a major cause of anterior knee pain in the elite athlete. Sonography and magnetic resonance imaging (MRI) are the imaging methods of choice when assessing the infrapatellar tendon. A comprehensive imaging review of infrapatellar tendon normal anatomy, tendinopathy, and partial/full-thickness tendon tears is provided. The value of imaging the infrapatellar tendon in clinical practice, including whether sonography can predict symptoms in asymptomatic athletes, is discussed. Acute avulsion fractures, including periosteal sleeve avulsion, and chronic avulsion injuries, including Sinding-Larsen-Johansson and Osgood-Schlatter syndromes, are shown. Mimics of infrapatellar tendon pathology, including infrapatellar plica injury, patellar tendon-lateral femoral condyle friction syndrome, and Hoffa's syndrome, are illustrated

  10. About tendon tissue regeneration in experimental radiation disease

    Energy Technology Data Exchange (ETDEWEB)

    Popov, D; Trichkova, P

    1976-01-01

    Under the conditions of experimental acute radiation disease the authors study the tendon tissue regeneration after suture of the lateral part of the gastrocnemius muscle tendon. Tendon auto and alloplasty were applied. In four postoperative periods the histological features are described in details as well as the characteristic phenomena observed during the regeneration influenced to a considerable degree by the irradiation. Round cell infiltration, large necrotic zones, erythrocyte infiltrations as well as predominance of non-specific tendon regeneration long after the surgery characterize the recovery period of the traumatically damaged tendon, nevertheless that at the end there is real tendon regeneration even though in a longer period in comparison with the controls (non-irradiated animals).

  11. Calcaneal Tendon Collagen Fiber Morphometry and Aging

    Czech Academy of Sciences Publication Activity Database

    Hadraba, Daniel; Janáček, Jiří; Filová, Eva; Lopot, F.; Paesen, R.; Fanta, O.; Jarman, A.; Nečas, A.; Ameloot, M.; Jelen, K.

    2017-01-01

    Roč. 23, č. 5 (2017), s. 1040-1047 ISSN 1431-9276 R&D Projects: GA ČR(CZ) GA16-14758S; GA MŠk(CZ) LO1309; GA MŠk(CZ) LM2015062 Institutional support: RVO:67985823 ; RVO:68378041 Keywords : collagen * aging * crimp * fiber orientation * tendon Subject RIV: EB - Genetics ; Molecular Biology; BO - Biophysics (UEM-P) OBOR OECD: Developmental biology; Biophysics (UEM-P) Impact factor: 1.891, year: 2016

  12. An artificial tendon with durable muscle interface.

    Science.gov (United States)

    Melvin, Alan; Litsky, Alan; Mayerson, Joel; Witte, David; Melvin, David; Juncosa-Melvin, Natalia

    2010-02-01

    A coupling mechanism that can permanently fix a forcefully contracting muscle to a bone anchor or any totally inert prosthesis would meet a serious need in orthopaedics. Our group developed the OrthoCoupler device to satisfy these demands. The objective of this study was to test OrthoCoupler's performance in vitro and in vivo in the goat semitendinosus tendon model. For in vitro evaluation, 40 samples were fatigue-tested, cycling at 10 load levels, n = 4 each. For in vivo evaluation, the semitendinosus tendon was removed bilaterally in eight goats. Left sides were reattached with an OrthoCoupler, and right sides were reattached using the Krackow stitch with #5 braided polyester sutures. Specimens were harvested 60 days postsurgery and assigned for biomechanics and histology. Fatigue strength of the devices in vitro was several times the contractile force of the semitendinosus muscle. The in vivo devices were built equivalent to two of the in vitro devices, providing an additional safety factor. In strength testing at necropsy, suture controls pulled out at 120.5 +/- 68.3 N, whereas each OrthoCoupler was still holding after the muscle tore, remotely, at 298 +/- 111.3 N (mean +/- SD) (p < 0.0003). Muscle tear strength was reached with the fiber-muscle composite produced in healing still soundly intact. This technology may be of value for orthopaedic challenges in oncology, revision arthroplasty, tendon transfer, and sports-injury reconstruction. (c) 2009 Orthopaedic Research Society.

  13. Arthroscopically-Asissted Achilles Tendon Repair; Long-Term Results

    OpenAIRE

    Turgut, Ak?n; Asfuro?lu, Mert Zeynel

    2014-01-01

    Objectives: The ruptures of the Achilles tendon (AT) are relatively common. Since there is no consensus on the best method of the repair of the AT; the treatment is determined on the preference of the surgeon and the patient. The study evaluating the cadaveric and short term clinical results done by our clinic in 2002, has shown us that arthroscopically Achilles tendon repair can be good choise in achilles tendon ruptures. Methods: Fortyfour patients who underwent arthroscopically assisted ac...

  14. Reconstruction of Ligament and Tendon Defects Using Cell Technologies.

    Science.gov (United States)

    Chailakhyan, R K; Shekhter, A B; Ivannikov, S V; Tel'pukhov, V I; Suslin, D S; Gerasimov, Yu V; Tonenkov, A M; Grosheva, A G; Panyushkin, P V; Moskvina, I L; Vorob'eva, N N; Bagratashvili, V N

    2017-02-01

    We studied the possibility of restoring the integrity of the Achilles tendon in rabbits using autologous multipotent stromal cells. Collagen or gelatin sponges populated with cells were placed in a resorbable Vicryl mesh tube and this tissue-engineered construct was introduced into a defect of the middle part of the Achilles tendon. In 4 months, histological analysis showed complete regeneration of the tendon with the formation of parallel collagen fibers, spindle-shaped tenocytes, and newly formed vessels.

  15. Contrast material filling of the peroneal tendon sheath

    International Nuclear Information System (INIS)

    Zadravecz, Gy.; Grexa, E.

    1981-01-01

    In case of complaints after fracture of the calcaneus the common sheath of the peroneus tendons was filled up with contrast material. The tendon sheath was punctured Oehind the external ankle. The three-directional radiograms clearly showed the dislocation and compression of the tendons, caused by the exostosis of the calcaneus. The concomitant tendovaginitis caused the complaints. This alteration was observed in 11% of all the calcaneus fractures. (L.E.)

  16. 77 FR 69508 - Inservice Inspection of Prestressed Concrete Containment Structures With Grouted Tendons

    Science.gov (United States)

    2012-11-19

    ... Containment Structures With Grouted Tendons AGENCY: Nuclear Regulatory Commission. ACTION: Regulatory guide... (RG) 1.90, ``Inservice Inspection of Prestressed Concrete Containment Structures with Grouted Tendons... appropriate surveillance program for prestressed concrete containment structures with grouted tendons...

  17. Nanoparticles for tendon healing and regeneration: literature review.

    Directory of Open Access Journals (Sweden)

    Paolo Domenico Parchi

    2016-08-01

    Full Text Available Tendon injuries are commonly met in the emergency department. Unfortunately, tendon tissue has limited regeneration potential and usually the consequent formation of scar tissue causes inferior mechanical properties Nanoparticles could be used in different way to improve tendon healing and regeneration, ranging from scaffolds manufacturing (increasing the strength and endurance or anti-adhesions, anti-microbial and anti-inflammatory properties to gene therapy. This paper aims to summarize the most relevant studies showing the potential application of nanoparticles for tendon tissue regeneration

  18. Tendon synovial cells secrete fibronectin in vivo and in vitro

    International Nuclear Information System (INIS)

    Banes, A.J.; Link, G.W.; Bevin, A.G.; Peterson, H.D.; Gillespie, Y.; Bynum, D.; Watts, S.; Dahners, L.

    1988-01-01

    The chemistry and cell biology of the tendon have been largely overlooked due to the emphasis on collagen, the principle structural component of the tendon. The tendon must not only transmit the force of muscle contraction to bone to effect movement, but it must also glide simultaneously over extratendonous tissues. Fibronectin is classified as a cell attachment molecule that induces cell spreading and adhesion to substratum. The external surface of intact avian flexor tendon stained positively with antibody to cellular fibronectin. However, if the surface synovial cells were first removed with collagenase, no positive reaction with antifibronectin antibody was detected. Analysis of immunologically stained frozen sections of tendon also revealed fibronectin at the tendon synovium, but little was associated with cells internal in tendon. The staining pattern with isolated, cultured synovial cells and fibroblasts from the tendon interior substantiated the histological observations. Analysis of polyacrylamide gel profiles of 35 S-methionine-labeled proteins synthesized by synovial cells and internal fibroblasts indicated that fibronectin was synthesized principally by synovial cells. Fibronectin at the tendon surface may play a role in cell attachment to prevent cell removal by the friction of gliding. Alternatively, fibronectin, with its binding sites for hyaluronic acid and collagen, may act as a complex for boundary lubrication

  19. Magnetic resonance imaging and computed radiography in Achilles tendon rupture

    International Nuclear Information System (INIS)

    Korenaga, Tateo; Hachiya, Junichi; Miyasaka, Yasuo

    1988-01-01

    Magnetic Resonance Imaging (MRI) and Computed Radiography (CR) were performed in 15 patients with complete Achilles tendon rupture who were treated conservatively without surgery. MRI was obtained using Toshiba MRT 50 A superconductive machine, operaing at 0.5 Tesla. CR was performed by CR-101, Fuji Medical System. In fresh cases, ruptured tendons showed intermediate signal intensity on T1-weighted images and high intensity on T2-weighted images. Thickening of the tendon was observed in all cases except in very acute stage. Configuration of thickend tendons tends to be dumbbell shape in subacute stage and fusiform in chronic stage of more than six months after the initial trauma. In cases which showed high signal intensity at the ruptured area both on T1 and T2 weighted images, migration of fat into the sapces between the ruptured tendons was considered to be the major source of increased signal intensity. Computed radiography showed thickening of the tendon, blurring of anterior margin of the tendon, and decreased translucency of pre-Achilles fat pad. However, MRI better demonstrated the details of ruptured tendons when compared to CR, and thought to be an usefull way of following up the healing process of the ruptured tendon to facilitate more reasonable judgement of the time of removing plaster casts and stating exercise. (author)

  20. Ossification of the bilateral Achilles tendon: a rare entity

    International Nuclear Information System (INIS)

    Arora, Abhishek J; Arora, Richa

    2015-01-01

    Ossification of the Achilles tendon is a rare clinical entity comprising of one or more segments of variable sized ossified masses in the fibrocartilaginous substance of the tendon. The etiology of ossification of the Achilles tendon is multifactorial with recurrent trauma and surgery comprising major predisposing factors, with others being metabolic, systemic, and infectious diseases. The possibility of a genetic predisposition towards this entity has also been raised, but has not yet been proven. We present a rare case of ossification of the bilateral Achilles tendons without any history of trauma or surgery in a 48-year-old female patient

  1. Biology and augmentation of tendon-bone insertion repair

    Directory of Open Access Journals (Sweden)

    Lui PPY

    2010-08-01

    Full Text Available Abstract Surgical reattachment of tendon and bone such as in rotator cuff repair, patellar-patella tendon repair and anterior cruciate ligament (ACL reconstruction often fails due to the failure of regeneration of the specialized tissue ("enthesis" which connects tendon to bone. Tendon-to-bone healing taking place between inhomogenous tissues is a slow process compared to healing within homogenous tissue, such as tendon to tendon or bone to bone healing. Therefore special attention must be paid to augment tendon to bone insertion (TBI healing. Apart from surgical fixation, biological and biophysical interventions have been studied aiming at regeneration of TBI healing complex, especially the regeneration of interpositioned fibrocartilage and new bone at the healing junction. This paper described the biology and the factors influencing TBI healing using patella-patellar tendon (PPT healing and tendon graft to bone tunnel healing in ACL reconstruction as examples. Recent development in the improvement of TBI healing and directions for future studies were also reviewed and discussed.

  2. Numerical models for prestressing tendons in containment structures

    International Nuclear Information System (INIS)

    Kwak, Hyo-Gyoung; Kim, Jae Hong

    2006-01-01

    Two modified stress-strain relations for bonded and unbonded internal tendons are proposed. The proposed relations can simulate the post-cracking behavior and tension stiffening effect in prestressed concrete containment structures. In the case of the bonded tendon, tensile forces between adjacent cracks are transmitted from a bonded tendon to concrete by bond forces. Therefore, the constitutive law of a bonded tendon stiffened by grout needs to be determined from the bond-slip relationship. On the other hand, a stress increase beyond the effective prestress in an unbonded tendon is not section-dependent but member-dependent. It means that the tendon stress unequivocally represents a uniform distribution along the length when the friction loss is excluded. Thus, using a strain reduction factor, the modified stress-strain curve of an unbonded tendon is derived by successive iterations. In advance, the prediction of cracking behavior and ultimate resisting capacity of prestressed concrete containment structures using the introduced numerical models are succeeded, and the need for the consideration of many influencing factors such as the tension stiffening effect, plastic hinge length and modification of stress-strain relation of tendon is emphasized. Finally, the developed numerical models are applied to prestressed concrete containment structures to verify the efficiency and applicability in simulating the structural behavior with bonded and/or unbonded tendons

  3. Injection of marinade with actinidin increases tenderness of porcine M. biceps femoris and affects myofibrils and connective tissue

    DEFF Research Database (Denmark)

    Christensen, M.; Torngren, M. A.; Gunvig, A.

    2009-01-01

    BACKGROUND: Marination of beef muscles with brine solutions containing proteolytic enzymes from fruit extracts has been shown to tenderize meat. However, the effect of marination with actinidin on tenderness of pork muscles has not been investigated. Tenderness and eating quality of porcine M. bi...... indicate that actinidin tenderizes pork M. biceps femoris by affecting both the myofibrils and connective tissue....

  4. Variable effect of steam injection level on beef muscles: semitendinosus and biceps femoris cooked in convection-steam oven.

    Science.gov (United States)

    Zając, Marzena; Kącik, Sławomir; Palka, Krystyna; Widurek, Paweł

    2015-01-01

    Combi ovens are used very often in restaurants to heat up food. According to the producers the equipment allows to cook meat portions which are more tender and flavoursome comparing to conventional cooking techniques. Beef steaks from muscles semitendinosus and biceps femoris were cooked in convection-steam oven at three humidity levels: 10, 60 and 100%. Chemical composition, including total and insoluble collagen content and cook losses were analysed along with the texture and colour parameters. M. biceps femoris was the hardest and the most chewy at 100% steam saturation level and hardness measured for m. semitendinosus was the lowest at 10% of vapour injection. Changing the steam conditions in the oven chamber did not affect the detectable colour differences of m. biceps femoris, but it was significant for m. semitendinosus. Applying 100% steam saturation caused higher cook losses and the increase of insoluble collagen fractions in both analysed muscles. The results are beneficial for caterers using steam-convection ovens in terms of providing evidence that the heating conditions should be applied individually depending on the muscle used. The tenderness of m. semitendinosus muscle cooked at 10% steam saturation level was comparable to the tenderness obtained for the same muscle aged for 10 days and cooked with 100% steam saturation. Steaks from m. biceps femoris muscle should be cooked with maximum 60% saturation level to obtain higher tenderness.

  5. Increased supraspinatus tendon thickness following fatigue loading in rotator cuff tendinopathy: potential implications for exercise therapy

    OpenAIRE

    McCreesh, Karen M; Purtill, Helen; Donnelly, Alan E; Lewis, Jeremy S

    2017-01-01

    Background/aim Exercise imparts a load on tendon tissue that leads to changes in tendon properties. Studies suggest that loading immediately reduces tendon thickness, with a loss of this response in symptomatic tendinopathy. No studies investigating the response of tendon dimensions to load for the rotator cuff tendons exist. This study aimed to examine the short-term effect of loading on the thickness of the supraspinatus tendon and acromiohumeral distance those with and without rotator cuff...

  6. Repair of Achilles tendon defect with autologous ASCs engineered tendon in a rabbit model.

    Science.gov (United States)

    Deng, Dan; Wang, Wenbo; Wang, Bin; Zhang, Peihua; Zhou, Guangdong; Zhang, Wen Jie; Cao, Yilin; Liu, Wei

    2014-10-01

    Adipose derived stem cells (ASCs) are an important cell source for tissue regeneration and have been demonstrated the potential of tenogenic differentiation in vitro. This study explored the feasibility of using ASCs for engineered tendon repair in vivo in a rabbit Achilles tendon model. Total 30 rabbits were involved in this study. A composite tendon scaffold composed of an inner part of polyglycolic acid (PGA) unwoven fibers and an outer part of a net knitted with PGA/PLA (polylactic acid) fibers was used to provide mechanical strength. Autologous ASCs were harvested from nuchal subcutaneous adipose tissues and in vitro expanded. The expanded ASCs were harvested and resuspended in culture medium and evenly seeded onto the scaffold in the experimental group, whereas cell-free scaffolds served as the control group. The constructs of both groups were cultured inside a bioreactor under dynamic stretch for 5 weeks. In each of 30 rabbits, a 2 cm defect was created on right side of Achilles tendon followed by the transplantation of a 3 cm cell-seeded scaffold in the experimental group of 15 rabbits, or by the transplantation of a 3 cm cell-free scaffold in the control group of 15 rabbits. Animals were sacrificed at 12, 21 and 45 weeks post-surgery for gross view, histology, and mechanical analysis. The results showed that short term in vitro culture enabled ASCs to produce matrix on the PGA fibers and the constructs showed tensile strength around 50 MPa in both groups (p > 0.05). With the increase of implantation time, cell-seeded constructs gradually form neo-tendon and became more mature at 45 weeks with histological structure similar to that of native tendon and with the presence of bipolar pattern and D-periodic structure of formed collagen fibrils. Additionally, both collagen fibril diameters and tensile strength increased continuously with significant difference among different time points (p tendon tissue with fibril structure observable only at 45 weeks

  7. Role of tissue-engineered artificial tendon in healing of a large Achilles tendon defect model in rabbits.

    Science.gov (United States)

    Moshiri, Ali; Oryan, Ahmad; Meimandi-Parizi, Abdolhamid

    2013-09-01

    Treatment of large Achilles tendon defects is technically demanding. Tissue engineering is an option. We constructed a collagen-based artificial tendon, covered it with a polydioxanon (PDS) sheath, and studied the role of this bioimplant on experimental tendon healing in vivo. A 2-cm tendon gap was created in the left Achilles tendon of rabbits (n = 120). The animals were randomly divided into 3 groups: control (no implant), treated with tridimensional-collagen, and treated with tridimensional-collagen-bidimensional-PDS implants. Each group was divided into 2 subgroups of 60 and 120 days postinjury (DPI). Another 50 pilot animals were used to study the host-implant interaction. Physical activity of the animals was scored and ultrasonographic and bioelectrical characteristics of the injured tendons were investigated weekly. After euthanasia, macro, micro, and nano morphologies and biophysical and biomechanical characteristics of the healing tendons were studied. Treatment improved function of the animals, time dependently. At 60 and 120 DPI, the treated tendons showed significantly higher maximum load, yield, stiffness, stress, and modulus of elasticity compared with controls. The collagen implant induced inflammation and absorbed the migrating fibroblasts in the defect area. By its unique architecture, it aligned the fibroblasts and guided their proliferation and collagen deposition along the stress line of the tendon and resulted in improved collagen density, micro-amp, micro-ohm, water uptake, and delivery of the regenerated tissue. The PDS-sheath covering amplified these characteristics. The implants were gradually absorbed and replaced by a new tendon. Minimum amounts of peritendinous adhesion, muscle atrophy, and fibrosis were observed in the treated groups. Some remnants of the implants were preserved and accepted as a part of the new tendon. The implants were cytocompatible, biocompatible, biodegradable, and effective in tendon healing and regeneration. This

  8. Short-latency crossed responses in the human biceps femoris muscle

    DEFF Research Database (Denmark)

    Stevenson, Andrew J T; Kamavuako, Ernest N; Geertsen, Svend Sparre

    2015-01-01

    Interlimb reflexes contribute to the central neural coordination between different limbs in both humans and animals. Although commissural interneurons have only been directly identified in animals, spinally mediated interlimb reflexes have been discovered in a number of human lower limb muscles......, indicating their existence in humans. The aim of the present study was to investigate whether short-latency crossed-spinal reflexes are present in the contralateral biceps femoris (cBF) muscle following ipsilateral knee (iKnee) joint rotations during a sitting task, where participants maintained a slight pre...... pathways (likely involving commissural interneurons) from ipsilateral afferents to common motoneurons in the contralateral leg can likely explain the perturbation direction-dependent reversal in the sign of the short-latency cBF reflex. This article is protected by copyright. All rights reserved....

  9. Proteome profiles of longissimus and biceps femoris porcine muscles related to exercise and resting

    DEFF Research Database (Denmark)

    F.W.Te Pas, Marinus; Keuning, Els; Van der Wiel, Dick J.M.

    2011-01-01

    Exercise affects muscle metabolism and composition in the untrained muscles. The proteome of muscle tissue will be affected by exercise and resting. This is of economic importance for pork quality where transportation relates to exercise of untrained muscles. Rest reverses exercise effects....... The objective of this research was to develop potential protein biomarkers that predict the optimal resting time after exercise related to optimal pork quality. Ten litters of four female pigs were within litter allocated to the four treatment groups: exercise by running on a treadmill for 27 minutes followed...... by rest for 0, 1, or 3 h; control pigs without exercise. Proteome profiles and biochemical traits measuring energy metabolism and meat quality traits expected to be related to exercise were determined in the Longissimus and the Biceps femoris of the pigs. The results indicated associations between protein...

  10. The Effect of Phospholipids (Surfactant on Adhesion and Biomechanical Properties of Tendon: A Rat Achilles Tendon Repair Model

    Directory of Open Access Journals (Sweden)

    T. Kursat Dabak

    2015-01-01

    Full Text Available Adhesion of the tendon is a major challenge for the orthopedic surgeon during tendon repair. Manipulation of biological environment is one of the concepts to prevent adhesion. Lots of biochemicals have been studied for this purpose. We aimed to determine the effect of phospholipids on adhesion and biomechanical properties of tendon in an animal tendon repair model. Seventy-two Wistar rats were divided into 4 groups. Achilles tendons of rats were cut and repaired. Phospholipids were applied at two different dosages. Tendon adhesion was determined histopathologically and biomechanical test was performed. At macroscopic evaluation of adhesion, there are statistically significant differences between multiple-dose phospholipid injection group and Control group and also hyaluronic acid group and Control group (p0.008. Ultimate strength was highest at hyaluronic acid injection group and lowest at multiple-dose phospholipid injection group. Single-dose phospholipids (surfactant application may have a beneficial effect on the tendon adhesion. Although multiple applications of phospholipids seem the most effective regime to reduce the tendon adhesion among groups, it deteriorated the biomechanical properties of tendon.

  11. Science to Practice: Quantitative US Elastography Can Be Used to Quantify Mechanical and Histologic Tendon Healing in a Rabbit Model of Achilles Tendon Transection.

    Science.gov (United States)

    Lee, Kenneth S; Martin, Jack; Thelen, Darryl

    2017-05-01

    Compression-based ultrasonographic (US) elastography is associated with time-dependent mechanical and histologic changes of the healing tendon in a transected rabbit model of the Achilles tendon. This finding will lead to continued development of quantitative US, which can be used to objectively assess a diseased or healing tendon. With advances in the method used, clinical translation of tendon elastography may enable clinicians to diagnose tendon damage and track healing, which should improve both treatment and outcome.

  12. Measurement of stress strain and vibrational properties of tendons

    Science.gov (United States)

    Revel, Gian Marco; Scalise, Alessandro; Scalise, Lorenzo

    2003-08-01

    The authors present a new non-intrusive experimental procedure based on laser techniques for the measurement of mechanical properties of tendons. The procedure is based on the measurement of the first resonance frequency of the tendon by laser Doppler vibrometry during in vitro tensile experiments, with the final aim of establishing a measurement procedure to perform the mechanical characterization of tendons by extracting parameters such as the resonance frequency, also achievable during in vivo investigation. The experimental procedure is reported, taking into account the need to simulate the physiological conditions of the Achilles tendon, and the measurement technique used for the non-invasive determination of tendon cross-sectional area during tensile vibration tests at different load levels is described. The test procedure is based on a tensile machine, which measures longitudinal tendons undergoing controlled load conditions. Cross-sectional area is measured using a new non-contact procedure for the measurement of tendon perimeter (repeatability of 99% and accuracy of 2%). For each loading condition, vibration resonance frequency and damping, cross-sectional area and tensile force are measured, allowing thus a mechanical characterization of the tendon. Tendon stress-strain curves are reported. Stress-strain curves have been correlated to the first vibration resonance frequency and damping of the tendon measured using a single-point laser Doppler vibrometer. Moreover, experimental results have been compared with a theoretical model of a vibrating cord showing discrepancies. In vitro tests are reported, demonstrating the validity of the method for the comparison of different aged rabbit tendons.

  13. The Relation between Calcium Supplement Consumption and Calcific Shoulder Tendonitis

    Directory of Open Access Journals (Sweden)

    Alireza Rouhani

    2015-10-01

    Full Text Available Background: Calcific tendonitis is a common cause of non-traumatic shoulder pain. Previous studies have suggested a relation between minerals and endocrine and calcium deposition. Thus, hypercalcemia is probably related to calcific tendonitis. This study aims at evaluating the relation found between calcium supplement consumption and calcific shoulder tendonitis. Methods: This analytical-descriptive study was conducted on 250 patients with shoulder pain referring to clinics and emergency department of Shohada Orthopedics Hospital during one year for considering calcific shoulder tendonitis and calcium supplement consumption. Patients with calcific tendonitis were treated and their functional ability was evaluated using DASH questionnaire, pain severity and range of motion (ROM before and after treatment and their correlation with calcium supplement consumption. Results: Calcific tendonitis and calcium consumption were generally seen in 30 (12% and 73 (29.2% cases, respectively. Calcium consumption frequency in patients with calcific tendonitis was significantly higher than the patients who did not consume calcium supplements (76.7% vs. 22.7%. Patients with calcific tendonitis who did not consume calcium supplements suffered from significantly longer periods of shoulder pain. All patients having consumed calcium supplement were female. The group who consumed calcium supplement had significantly severe pain and higher DASH score before and after treatment, while there was no significant difference in number of impaired ROM before and after treatment. Also, there was a negative correlation between calcium supplement consumption, pain severity and DASH score before and after treatment. Conclusion: Calcium supplement consumption is related to calcific tendonitis and is also accompanied with more pain and lower functional ability in patients with calcific tendonitis.    Keywords: Calcific tendonitis; Shoulder; Calcium supplement; Pain

  14. Sensitivity of subject-specific models to Hill muscle-tendon model parameters in simulations of gait.

    Science.gov (United States)

    Carbone, V; van der Krogt, M M; Koopman, H F J M; Verdonschot, N

    2016-06-14

    Subject-specific musculoskeletal (MS) models of the lower extremity are essential for applications such as predicting the effects of orthopedic surgery. We performed an extensive sensitivity analysis to assess the effects of potential errors in Hill muscle-tendon (MT) model parameters for each of the 56 MT parts contained in a state-of-the-art MS model. We used two metrics, namely a Local Sensitivity Index (LSI) and an Overall Sensitivity Index (OSI), to distinguish the effect of the perturbation on the predicted force produced by the perturbed MT parts and by all the remaining MT parts, respectively, during a simulated gait cycle. Results indicated that sensitivity of the model depended on the specific role of each MT part during gait, and not merely on its size and length. Tendon slack length was the most sensitive parameter, followed by maximal isometric muscle force and optimal muscle fiber length, while nominal pennation angle showed very low sensitivity. The highest sensitivity values were found for the MT parts that act as prime movers of gait (Soleus: average OSI=5.27%, Rectus Femoris: average OSI=4.47%, Gastrocnemius: average OSI=3.77%, Vastus Lateralis: average OSI=1.36%, Biceps Femoris Caput Longum: average OSI=1.06%) and hip stabilizers (Gluteus Medius: average OSI=3.10%, Obturator Internus: average OSI=1.96%, Gluteus Minimus: average OSI=1.40%, Piriformis: average OSI=0.98%), followed by the Peroneal muscles (average OSI=2.20%) and Tibialis Anterior (average OSI=1.78%) some of which were not included in previous sensitivity studies. Finally, the proposed priority list provides quantitative information to indicate which MT parts and which MT parameters should be estimated most accurately to create detailed and reliable subject-specific MS models. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Step Cut Lengthening: A Technique for Treatment of Flexor Pollicis Longus Tendon Rupture.

    Science.gov (United States)

    Chong, Chew-Wei; Chen, Shih-Heng

    2018-04-01

    Reconstruction of a tendon defect is a challenging task in hand surgery. Delayed repair of a ruptured flexor pollicis longus (FPL) tendon is often associated with tendon defect. Primary repair of the tendon is often not possible, particularly after debridement of the unhealthy segment of the tendon. As such, various surgical treatments have been described in the literature, including single-stage tendon grafting, 2-stage tendon grafting, flexor digitorum superficialis tendon transfer from ring finger, and interphalangeal joint arthrodesis. We describe step cut lengthening of FPL tendon for the reconstruction of FPL rupture. This is a single-stage reconstruction without the need for tendon grafting or tendon transfer. To our knowledge, no such technique has been previously described.

  16. Bradykinin type 2 receptor -9/-9 genotype is associated with triceps brachii muscle hypertrophy following strength training in young healthy men

    Directory of Open Access Journals (Sweden)

    Popadic Gacesa Jelena Z

    2012-11-01

    Full Text Available Abstract Background Bradykinin type 2 receptor (B2BRK genotype was reported to be associated with changes in the left-ventricular mass as a response to aerobic training, as well as in the regulation of the skeletal muscle performance in both athletes and non-athletes. However, there are no reports on the effect of B2BRK 9-bp polymorphism on the response of the skeletal muscle to strength training, and our aim was to determine the relationship between the B2BRK SNP and triceps brachii functional and morphological adaptation to programmed physical activity in young adults. Methods In this 6-week pretest-posttest exercise intervention study, twenty nine healthy young men (21.5 ± 2.7 y, BMI 24.2 ± 3.5 kg/m2 were put on a 6-week exercise protocol using an isoacceleration dynamometer (5 times a week, 5 daily sets with 10 maximal elbow extensions, 1 minute rest between sets. Triceps brachii muscle volumes were assessed by using magnetic resonance imaging before and after the strength training. Bradykinin type 2 receptor 9 base pair polymorphism was determined for all participants. Results Following the elbow extensors training, an average increase in the volume of both triceps brachii was 5.4 ± 3.4% (from 929.5 ± 146.8 cm3 pre-training to 977.6 ± 140.9 cm3 after training, p9 allele compared to individuals with one or two +9 alleles (−9/-9, 8.5 ± 3.8%; vs. -9/+9 and +9/+9 combined, 4.7 ± 4.5%, p B2BRK genotype (−9/-9, 50.2 ± 19.2%; vs. -9/+9 and +9/+9 combined, 46.8 ± 20.7%, p > 0.05. Conclusions We found that muscle morphological response to targeted training – hypertrophy – is related to polymorphisms of B2BRK. However, no significant influence of different B2BRK genotypes on functional muscle properties after strength training in young healthy non athletes was found. This finding could be relevant, not only in predicting individual muscle adaptation capacity to training or sarcopenia related to aging and inactivity, but also in

  17. Mechanical Coupling between Muscle-Tendon Units Reduces Peak Stresses

    NARCIS (Netherlands)

    Maas, Huub; Finni, Taija

    2018-01-01

    The presence of mechanical linkages between synergistic muscles and their common tendons may distribute forces among the involved structures. We review studies, using humans and other animals, examining muscle and tendon interactions and discuss the hypothesis that connections between muscle bellies

  18. Semitendinosus Tendon for Solitary Use in Anterior Cruciate ...

    African Journals Online (AJOL)

    The ANNALS of AFRICAN SURGERY | www.annalsofafricansurgery.com. The ANNALS of ... knee instability. Tendon allografts and autografts have been used successfully to reconstruct a torn. ACL. However, allografts have been associated with a higher rate of failure .... Semitendinosus Tendon to Prevent a. Postoperative ...

  19. Tendinography for diagnosing injuries to tendons and ligaments

    International Nuclear Information System (INIS)

    Grevsten, S.; Eriksson, K.

    1979-01-01

    A radiographic method of tendinography is described. In rabbits no inflammatory reaction in the Achilles tendon was observed 12 to 15 days after injection of contrast medium. Effects of examination of two healthy subjects and a patient with a traumatic condition are described. Suitable amounts and concentrations of contrast medium for examinations of Achilies tendon and cruciate ligaments are discussed. (Auth.)

  20. Rehabilitation of tendon problems in patients with diabetes mellitus

    NARCIS (Netherlands)

    Rees, Jonathan; Gaida, Jamie E.; Silbernagel, Karin Grävare; Zwerver, Johannes; Anthony, Joseph S.; Scott, Alex; Ackermann, PW; Hart, DA

    2016-01-01

    Exercise is crucial in the management of diabetes mellitus and its associated complications. However, individuals with diabetes have a heightened risk of musculoskeletal problems, including tendon pathologies. Diabetes has a significant impact on the function of tendons due to the accumulation of

  1. Stem Cell Applications in Tendon Disorders: A Clinical Perspective

    Directory of Open Access Journals (Sweden)

    Mark Young

    2012-01-01

    Full Text Available Tendon injuries are a common cause of morbidity and a significant health burden on society. Tendons are structural tissues connecting muscle to bone and are prone to tearing and tendinopathy, an overuse or degenerative condition that is characterized by failed healing and cellular depletion. Current treatments, for tendon tear are conservative, surgical repair or surgical scaffold reconstruction. Tendinopathy is treated by exercises, injection therapies, shock wave treatments or surgical tendon debridement. However, tendons usually heal with fibrosis and scar tissue, which has suboptimal tensile strength and is prone to reinjury, resulting in lifestyle changes with activity restriction. Preclinical studies show that cell therapies have the potential to regenerate rather than repair tendon tissue, a process termed tenogenesis. A number of different cell lines, with varying degrees of differentiation, have being evaluated including stem cells, tendon derived cells and dermal fibroblasts. Even though cellular therapies offer some potential in treating tendon disorders, there have been few published clinical trials to determine the ideal cell source, the number of cells to administer, or the optimal bioscaffold for clinical use.

  2. Neurotization of the biceps muscle by end-to-side neurorraphy between ulnar and musculocutaneous nerves. A series of five cases.

    Science.gov (United States)

    Franciosi, L F; Modestti, C; Mueller, S F

    1998-01-01

    Three patients with avulsed C5, C6, and C7 roots and two patients with avulsed C5 and C6 roots after trauma of the brachial plexus, were treated by neurotization of the biceps using nerve fibers derived from the ulnar nerve and obtained by end-to-side neurorraphy between the ulnar and musculocutaneous nerves. The age of patients ranged from 19 to 45. The interval between the accident and surgery was 2 to 13 months. Return of biceps contraction was observed 4 to 6 months after surgery. Four patients recovered grade 4 elbow flexion. One 45-year-old patient did not obtain any biceps contraction after 9 months.

  3. Open extensor tendon injuries: an epidemiologic study.

    Science.gov (United States)

    Patillo, Dominic; Rayan, Ghazi M

    2012-01-01

    To report the epidemiology, mechanism, anatomical location, distribution, and severity of open extensor tendon injuries in the digits, hand, and forearm as well as the frequency of associated injuries to surrounding bone and soft tissue. Retrospective chart review was conducted for patients who had operative repair of open digital extensor tendon injuries in all zones within an 11-year period. Data was grouped according to patient characteristics, zone of injury, mechanism of injury, and presence of associated injury. Statistical analysis was used to determine the presence of relevant associations. Eighty-six patients with 125 severed tendons and 105 injured digits were available for chart reviews. Patients were predominantly males (83%) with a mean age of 34.2 years and the dominant extremity was most often injured (60%). The thumb was the most commonly injured (25.7%), followed by middle finger (24.8), whereas small finger was least affected (10.5%). Sharp laceration was the most common mechanism of injury (60%), and most of these occurred at or proximal to the metacarpophalangeal joints. Most saw injuries occurred distal to the metacarpophalangeal joint. Zone V was the most commonly affected in the fingers (27%) while zone VT was the most commonly affected in the thumb (69%). Associated injuries to bone and soft tissue occurred in 46.7% of all injuries with saw and crush/avulsions being predictive of fractures and damage to the underlying joint capsule. The extensor mechanism is anatomically complex, and open injuries to the dorsum of the hand, wrist, and forearm, especially of crushing nature and those inflicted by saws, must be thoroughly evaluated. Associated injuries should be ruled out in order to customize surgical treatment and optimize outcome.

  4. Pain level after ACL reconstruction: A comparative study between free quadriceps tendon and hamstring tendons autografts.

    Science.gov (United States)

    Buescu, Cristian Tudor; Onutu, Adela Hilda; Lucaciu, Dan Osvald; Todor, Adrian

    2017-03-01

    The objective of this study was to compare the pain levels and analgesic consumption after single bundle ACL reconstruction with free quadriceps tendon autograft versus hamstring tendon autograft. A total of 48 patients scheduled for anatomic single-bundle ACL reconstruction were randomized into two groups: the free quadriceps tendon autograft group (24 patients) and the hamstring tendons autograft group (24 patients). A basic multimodal analgesic postoperative program was used for all patients and rescue analgesia was provided with tramadol, at pain scores over 30 on the Visual Analog Scale. The time to the first rescue analgesic, the number of doses of tramadol and pain scores were recorded. The results within the same group were compared with the Wilcoxon signed test. Supplementary analgesic drug administration proved significantly higher in the group of subjects with hamstring grafts, with a median (interquartile range) of 1 (1.3) dose, compared to the group of subjects treated with a quadriceps graft, median = 0.5 (0.1.25) (p = 0.009). A significantly higher number of subjects with a quadriceps graft did not require any supplementary analgesic drug (50%) as compared with subjects with hamstring graft (13%; Z-statistics = 3.01, p = 0.002). The percentage of subjects who required a supplementary analgesic drug was 38% higher in the HT group compared with the FQT group. The use of the free quadriceps tendon autograft for ACL reconstruction leads to less pain and analgesic consumption in the immediate postoperative period compared with the use of hamstrings autograft. Level I Therapeutic study. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

  5. An Artificial Tendon with Durable Muscle Interface

    OpenAIRE

    Melvin, Alan; Litsky, Alan; Mayerson, Joel; Witte, David; Melvin, David; Juncosa-Melvin, Natalia

    2010-01-01

    A coupling mechanism that can permanently fix a forcefully contracting muscle to a bone anchor or any totally inert prosthesis would meet a serious need in orthopaedics. Our group developed the OrthoCoupler™ device to satisfy these demands. The objective of this study was to test OrthoCoupler’s performance in vitro and in vivo in the goat semitendinosus tendon model. For in vitro evaluation, 40 samples were fatigue-tested, cycling at 10 load levels, n=4 each. For in vivo evaluation, the semit...

  6. Specialisation of extracellular matrix for function in tendons and ligaments

    Science.gov (United States)

    Birch, Helen L.; Thorpe, Chavaunne T.; Rumian, Adam P.

    2013-01-01

    Summary Tendons and ligaments are similar structures in terms of their composition, organisation and mechanical properties. The distinction between them stems from their anatomical location; tendons form a link between muscle and bone while ligaments link bones to bones. A range of overlapping functions can be assigned to tendon and ligaments and each structure has specific mechanical properties which appear to be suited for particular in vivo function. The extracellular matrix in tendon and ligament varies in accordance with function, providing appropriate mechanical properties. The most useful framework in which to consider extracellular matrix differences therefore is that of function rather than anatomical location. In this review we discuss what is known about the relationship between functional requirements, structural properties from molecular to gross level, cellular gene expression and matrix turnover. The relevance of this information is considered by reviewing clinical aspects of tendon and ligament repair and reconstructive procedures. PMID:23885341

  7. Torque Control of Underactuated Tendon-driven Robotic Fingers

    Science.gov (United States)

    Abdallah, Muhammad E. (Inventor); Ihrke, Chris A. (Inventor); Reiland, Matthew J. (Inventor); Wampler, Charles W. (Inventor); Diftler, Myron A. (Inventor); Platt, Robert (Inventor); Bridgwater, Lyndon (Inventor)

    2013-01-01

    A robotic system includes a robot having a total number of degrees of freedom (DOF) equal to at least n, an underactuated tendon-driven finger driven by n tendons and n DOF, the finger having at least two joints, being characterized by an asymmetrical joint radius in one embodiment. A controller is in communication with the robot, and controls actuation of the tendon-driven finger using force control. Operating the finger with force control on the tendons, rather than position control, eliminates the unconstrained slack-space that would have otherwise existed. The controller may utilize the asymmetrical joint radii to independently command joint torques. A method of controlling the finger includes commanding either independent or parameterized joint torques to the controller to actuate the fingers via force control on the tendons.

  8. Final report on PCRV thermal cylinder axial tendon failures

    International Nuclear Information System (INIS)

    Canonico, D.A.; Griess, J.C.; Robinson, G.C.

    1976-01-01

    The post-test examination of the failed tendons from the PCRV thermal cylinder experiment has been concluded. Failures in the wires are attributed to stress-corrosion cracking. The cause of tendon failures has not been unequivocably established, but they may have been due to nitrates in the duct. The wires employed in the manufacture of the tendons will crack in less than 72 hr in a 0.2 M solution of ammonium nitrate at 70 0 C. The quality of the wires is poor, and surface cracks were detected. These could have acted as concentrating sites for both stress and the deleterious contaminants. It is believed that the factors that led to the failures in the thermal cylinder experiment were unique. An improper formulation of the epoxy resin did not provide the tendon anchor plate seal that was desired; indeed, the improper formulation is responsible for the high level of nitrogen in the ducts of the failed tendons

  9. Nonoperative, dynamic treatment of acute achilles tendon rupture

    DEFF Research Database (Denmark)

    Barfod, Kristoffer Weisskirchner; Bencke, Jesper; Lauridsen, Hanne Bloch

    2015-01-01

    Acute Achilles tendon rupture alters the biomechanical properties of the plantar flexor muscle-tendon complex that can affect functional performance and the risk of repeat injury. The purpose of the present study was to compare the biomechanical properties of the plantar flexor muscle-tendon comp......Acute Achilles tendon rupture alters the biomechanical properties of the plantar flexor muscle-tendon complex that can affect functional performance and the risk of repeat injury. The purpose of the present study was to compare the biomechanical properties of the plantar flexor muscle...... in the terminal part of dorsiflexion was found in the non-weightbearing group. The altered stiffness and strength in the affected limb could affect the coordination of gait and running....

  10. Different Achilles Tendon Pathologies Show Distinct Histological and Molecular Characteristics

    Directory of Open Access Journals (Sweden)

    Franka Klatte-Schulz

    2018-01-01

    Full Text Available Reasons for the development of chronic tendon pathologies are still under debate and more basic knowledge is needed about the different diseases. The aim of the present study was therefore to characterize different acute and chronic Achilles tendon disorders. Achilles tendon samples from patients with chronic tendinopathy (n = 7, chronic ruptures (n = 6, acute ruptures (n = 13, and intact tendons (n = 4 were analyzed. The histological score investigating pathological changes was significantly increased in tendinopathy and chronic ruptures compared to acute ruptures. Inflammatory infiltration was detected by immunohistochemistry in all tendon pathology groups, but was significantly lower in tendinopathy compared to chronic ruptures. Quantitative real-time PCR (qRT-PCR analysis revealed significantly altered expression of genes related to collagens and matrix modeling/remodeling (matrix metalloproteinases, tissue inhibitors of metalloproteinases in tendinopathy and chronic ruptures compared to intact tendons and/or acute ruptures. In all three tendon pathology groups markers of inflammation (interleukin (IL 1β, tumor necrosis factor α, IL6, IL10, IL33, soluble ST2, transforming growth factor β1, cyclooxygenase 2, inflammatory cells (cluster of differentaition (CD 3, CD68, CD80, CD206, fat metabolism (fatty acid binding protein 4, peroxisome proliferator-activated receptor γ, CCAAT/enhancer-binding protein α, adiponectin, and innervation (protein gene product 9.5, growth associated protein 43, macrophage migration inhibitory factor were detectable, but only in acute ruptures significantly regulated compared to intact tendons. The study gives an insight into structural and molecular changes of pathological processes in tendons and might be used to identify targets for future therapy of tendon pathologies.

  11. Rotator cuff tendon connections with the rotator cable.

    Science.gov (United States)

    Rahu, Madis; Kolts, Ivo; Põldoja, Elle; Kask, Kristo

    2017-07-01

    The literature currently contains no descriptions of the rotator cuff tendons, which also describes in relation to the presence and characteristics of the rotator cable (anatomically known as the ligamentum semicirculare humeri). The aim of the current study was to elucidate the detailed anatomy of the rotator cuff tendons in association with the rotator cable. Anatomic dissection was performed on 21 fresh-frozen shoulder specimens with an average age of 68 years. The rotator cuff tendons were dissected from each other and from the glenohumeral joint capsule, and the superior glenohumeral, coracohumeral, coracoglenoidal and semicircular (rotator cable) ligaments were dissected. Dissection was performed layer by layer and from the bursal side to the joint. All ligaments and tendons were dissected in fine detail. The rotator cable was found in all specimens. It was tightly connected to the supraspinatus (SSP) tendon, which was partly covered by the infraspinatus (ISP) tendon. The posterior insertion area of the rotator cable was located in the region between the middle and inferior facets of the greater tubercle of the humerus insertion areas for the teres minor (TM), and ISP tendons were also present and fibres from the SSP extended through the rotator cable to those areas. The connection between the rotator cable and rotator cuff tendons is tight and confirms the suspension bridge theory for rotator cuff tears in most areas between the SSP tendons and rotator cable. In its posterior insertion area, the rotator cable is a connecting structure between the TM, ISP and SSP tendons. These findings might explain why some patients with relatively large rotator cuff tears can maintain seamless shoulder function.

  12. MRI and gross anatomy of the iliopsoas tendon complex

    International Nuclear Information System (INIS)

    Polster, Joshua M.; Lee, Ho; Klika, Alison; Barsoum, Wael; Drake, Richard; Elgabaly, Mohamed

    2008-01-01

    The objective was to explain the anatomic basis of a longitudinal cleft of increased signal in the iliopsoas tendon seen on hip MR arthrograms. A prospective review of 20 MR hip arthrograms was performed using standard and fat-suppressed T1-weighted images to establish whether or not the cleft was composed of fatty tissue and to define the anatomy of the iliopsoas tendon complex. Three cadaver dissections of the hip region were then performed for anatomic correlation. Fourteen out of 20 MR hip arthrograms demonstrated a longitudinal cleft of increased T1 signal adjacent to the iliopsoas tendon, which suppressed on frequency selective fat-suppressed images, indicating fatty composition. Gross anatomic correlation demonstrated this fatty cleft to represent a fascial plane adjacent to the iliopsoas tendon, in one case separating the iliopsoas tendon medially from a thin intramuscular tendon within the lateral portion of the iliacus muscle. Also noted was a direct muscular insertion of the lateral portion of the iliacus muscle onto the anterior portion of the proximal femoral diaphysis in all 3 cadavers. The anatomy of the iliopsoas tendon complex is more complicated than typically illustrated and includes the iliopsoas tendon itself attaching to the lesser trochanter, the lateral portion of the iliacus muscle attaching directly upon the anterior portion of the proximal femoral diaphysis, and a thin intramuscular tendon within this lateral iliacus muscle that is separated from the iliopsoas tendon by a cleft of fatty fascia that accounts for the MRI findings of a cleft of increased T1 signal. (orig.)

  13. Tendon injury and repair - A perspective on the basic mechanisms of tendon disease and future clinical therapy

    NARCIS (Netherlands)

    Snedeker, J.G.; Foolen, J.

    2017-01-01

    Tendon is an intricately organized connective tissue that efficiently transfers muscle force to the bony skeleton. Its structure, function, and physiology reflect the extreme, repetitive mechanical stresses that tendon tissues bear. These mechanical demands also lie beneath high clinical rates of

  14. Quadriceps Tendon Rupture and Contralateral Patella Tendon Avulsion Post Primary Bilateral Total Knee Arthroplasty: A Case Report

    Directory of Open Access Journals (Sweden)

    Gaurav Sharma

    2016-07-01

    Full Text Available Background: Extensor mechanism failure secondary to knee replacement could be due to tibial tubercle avulsion, Patellar tendon rupture, patellar fracture or quadriceps tendon rupture. An incidence of Patella tendon rupture of 0.17% and Quadriceps tendon rupture of around 0.1% has been reported after Total knee arthroplasty. These are considered a devastating complication that substantially affects the clinical results and are challenging situations to treat with surgery being the mainstay of the treatment. Case Description: We report here an interesting case of a patellar tendon rupture of one knee and Quadriceps tendon rupture of the contralateral knee following simultaneous bilateral knee replacement in a case of inflammatory arthritis patient. End to end repair for Quadriceps tear and augmentation with Autologous Hamstring tendon graft was done for Patella tendon rupture. OUTCOME: Patient was followed up for a period of 1 year and there was no Extension lag with a flexion of 100 degrees in both the knees. DISCUSSION: The key learning points and important aspects of diagnosing these injuries early and the management techniques are described in this unique case of bilateral extensor mechanism disruption following knee replacements.

  15. Flexor tendon lacerations in zone V.

    Science.gov (United States)

    Stefanich, R J; Putnam, M D; Peimer, C A; Sherwin, F S

    1992-03-01

    Twenty-three patients with zone V flexor tendon lacerations rehabilitated by the Kleinert protocol were studied at an average of 46 months after trauma. Hand function was subjectively normal in only eight. Of fourteen patients who were employed at the time of injury, eight returned to their original occupations. Eight others were working at other jobs, and we considered six more capable of employment. Only one had a poor functional result that precluded occupational use of the hand. Pinch/grip strengths recovered to 85%/79% of the uninvolved side. Independent flexor digitorum superficialis/flexor digitorum profundus action was present in only seven patients. Sixteen regained full digital flexion. Extension loss averaged 25% at the wrist and 10% in each digit. As assessed by static two-point discrimination, sensibility was poor after associated median and ulnar nerve transections; this did not preclude good objective functional results. Complications included two tendon ruptures, proximal interphalangeal hyperextension in the presence of an unrepaired flexor digitorum superficialis, and limited motion in two patients after poor compliance in therapy. Tenolysis was needed in 4 of the 23. We now use a modified Duran technique for noncompliant patients and in those who are unable to extend their PIP joints because of weak intrinsic muscles.

  16. The Effect of Sodium Hyaluronate on Ligamentation and Biomechanical Property of Tendon in Repair of Achilles Tendon Defect with Polyethylene Terephthalate Artificial Ligament: A Rabbit Tendon Repair Model

    Directory of Open Access Journals (Sweden)

    Shengkun Li

    2016-01-01

    Full Text Available The Achilles tendon is the most common ruptured tendon of human body. Reconstruction with polyethylene terephthalate (PET artificial ligament is recommended in some serious cases. Sodium hyaluronate (HA is beneficial for the healing of tendon injuries. We aimed to determine the effect of sodium hyaluronate in repair of Achilles tendon defect with PET artificial ligament in an animal tendon repair model. Sixteen New Zealand White rabbits were divided into two groups. Eight rabbits repaired with PET were assigned to PET group; the other eight rabbits repaired with PET along with injection of HE were assigned to HA-PET group. All rabbits were sacrificed at 4 and 8 weeks postoperatively for biomechanical and histological examination. The HA-PET group revealed higher biomechanical property compared with the PET group. Histologically, more collagen tissues grew into the HA-PET group compared with PET group. In conclusion, application of sodium hyaluronate can improve the healing of Achilles tendon reconstruction with polyethylene terephthalate artificial ligament.

  17. Fetal development of the pulley for muscle insertion tendons: A review and new findings related to the tensor tympani tendon.

    Science.gov (United States)

    Rodríguez-Vázquez, Jose Francisco; Honkura, Yohei; Katori, Yukio; Murakami, Gen; Abe, Hiroshi

    2017-01-01

    The existence of hard tissue pulleys that act to change the direction of a muscle insertion tendon is well known in the human body. These include (1) the trochlea for the extraocular obliquus superior muscle, (2) the pterygoid hamulus for the tensor veli palatini muscle, (3) the deep sulcus on the plantar aspect of the cuboid bone for the peroneus longus tendon, (4) the lesser sciatic notch for the obturator internus muscle, and (5) the bony trochleariformis process for the tensor tympani muscle tendon. In addition, (6) the stapedius muscle tendon shows a lesser or greater angulation at the pyramidal eminence of the temporal bone. Our recent studies have shown that the development of pulleys Nos. 1 and 2 can be explained by a change in the topographical relationship between the pulley and the tendon, that of pulley No. 3 by the rapidly growing calcaneus pushing the tendon, and that of pulley No. 4 by migration of the insertion along the sciatic nerve and gluteus medius tendon. Therefore, in Nos. 1-4, an initially direct tendon curves secondarily and obtains an attachment to the pulley. In case No. 6, the terminal part of the stapedius tendon originates secondarily from the interzone mesenchymal tissue of the incudostapedial joint. In the case of pulley No. 5, we newly demonstrated that its initial phase of development was similar to No. 6, but the tensor tympani tendon achieved a right-angled turn under guidance by a specific fibrous tissue and it migrated along the growing malleus manubrium. Copyright © 2016 Elsevier GmbH. All rights reserved.

  18. Bevacizumab Improves Achilles Tendon Repair in a Rat Model

    Directory of Open Access Journals (Sweden)

    Herbert Tempfer

    2018-04-01

    Full Text Available Background/Aims: Effective wound-healing generally requires efficient re-vascularization after injury, ensuring sufficient supply with oxygen, nutrients, and various cell populations. While this applies to most tissues, tendons are mostly avascular in nature and harbor relatively few cells, probably contributing to their poor regenerative capacity. Considering the minimal vascularization of healthy tendons, we hypothesize that controlling angiogenesis in early tendon healing is beneficial for repair tissue quality and function. Methods: To address this hypothesis, Bevacizumab, a monoclonal antibody blocking VEGF-A signaling, was locally injected into the defect area of a complete tenotomy in rat Achilles tendon. At 28 days post-surgery, the defect region was investigated using immunohistochemistry against vascular and lymphatic epitopes. Polarization microscopy and biomechanical testing was used to determine tendon integrity and gait analysis for functional testing in treated vs non-treated animals. Results: Angiogenesis was found to be significantly reduced in the Bevacizumab treated repair tissue, accompanied by significantly reduced cross sectional area, improved matrix organization, increased stiffness and Young’s modulus, maximum load and stress. Further, we observed an improved gait pattern when compared to the vehicle injected control group. Conclusion: Based on the results of this study we propose that reducing angiogenesis after tendon injury can improve tendon repair, potentially representing a novel treatment-option.

  19. Tendon shift in hallux valgus: observations at MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Eustace, S. [Department of Radiology, Boston University Medical Center Hospital, 88 East Newton Street, Atrium - 2, Boston, MA 02118 (United States); Williamson, D. [Department of Radiology, Brigham and Womens Hospital, Boston, Massachusetts (United States); Wilson, M. [Department of Orthopedics, Brigham and Womens Hospital, Boston, Massachusetts (United States); O`Byrne, J. [Department of Radiology, Boston University Medical Center Hospital, 88 East Newton Street, Atrium - 2, Boston, MA 02118 (United States); Bussolari, L. [Department of Radiology, Brigham and Womens Hospital, Boston, Massachusetts (United States); Thomas, M. [Department of Radiology, Brigham and Womens Hospital, Boston, Massachusetts (United States); Stephens, M. [Department of Radiology, Boston University Medical Center Hospital, 88 East Newton Street, Atrium - 2, Boston, MA 02118 (United States); Stack, J. [Department of Radiology, Boston University Medical Center Hospital, 88 East Newton Street, Atrium - 2, Boston, MA 02118 (United States); Weissman, B. [Department of Radiology, Brigham and Womens Hospital, Boston, Massachusetts (United States)

    1996-08-01

    Objective. This study was undertaken to demonstrate a shift in tendon alignment at the first metatarsophalangeal joint in patients with hallux valgus by means of magnetic resonance imaging. Design. Ten normal feet and 20 feet with the hallux valgus deformity conforming to conventional clinical and radiographic criteria were prospectively studied using magnetic resonance imaging. Correlation was made between tendon position at the first metatarsophalangeal joint and the severity of the hallux valgus deformity. Results. There is a significant shift in tendon position at the first metatarsophalangeal joint of patients with hallux valgus. The insertion of the abductor hallucis tendon is markedly plantarward and the flexor and extensor tendons bowstring at the first metatarsophalangeal joint compared with patients without the deformity. The severity of the tendon shift correlates with the hallux valgus angle and clinical severity of the hallux valgus deformity in each case. Conclusion. Patients with hallux valgus have a significant tendon shift at the first metatarsophalangeal joint which appears to contribute to development of the deformity. (orig.). With 4 figs., 1 tab.

  20. Tendon shift in hallux valgus: observations at MR imaging

    International Nuclear Information System (INIS)

    Eustace, S.; Williamson, D.; Wilson, M.; O'Byrne, J.; Bussolari, L.; Thomas, M.; Stephens, M.; Stack, J.; Weissman, B.

    1996-01-01

    Objective. This study was undertaken to demonstrate a shift in tendon alignment at the first metatarsophalangeal joint in patients with hallux valgus by means of magnetic resonance imaging. Design. Ten normal feet and 20 feet with the hallux valgus deformity conforming to conventional clinical and radiographic criteria were prospectively studied using magnetic resonance imaging. Correlation was made between tendon position at the first metatarsophalangeal joint and the severity of the hallux valgus deformity. Results. There is a significant shift in tendon position at the first metatarsophalangeal joint of patients with hallux valgus. The insertion of the abductor hallucis tendon is markedly plantarward and the flexor and extensor tendons bowstring at the first metatarsophalangeal joint compared with patients without the deformity. The severity of the tendon shift correlates with the hallux valgus angle and clinical severity of the hallux valgus deformity in each case. Conclusion. Patients with hallux valgus have a significant tendon shift at the first metatarsophalangeal joint which appears to contribute to development of the deformity. (orig.). With 4 figs., 1 tab

  1. The effectiveness of two novel techniques in establishing the mechanical and contractile responses of biceps femoris

    International Nuclear Information System (INIS)

    Ditroilo, Massimiliano; De Vito, Giuseppe; Hunter, Angus M; Haslam, Samuel

    2011-01-01

    Portable tensiomyography (TMG) and myotonometry (MMT) devices have been developed to measure mechanical and contractile properties of skeletal muscle. The aim of this study was to explore the sensitivity of the aforementioned techniques in detecting a change in passive mechanical properties of the biceps femoris (BF) muscle as a result of change in knee joint angle (i.e. muscle length). BF responses were assessed in 16 young participants (23.4 ± 4.9 years), at three knee joint angles (0°, 45° and 90°), for maximal isometric torque (MIT) along with myo-electrical activity. Contractile and mechanical properties were measured in a relaxed state. Inter-day reliability of the TMG and MMT was also assessed. MIT changed significantly (p < 0.01) across the three angles, so did stiffness and other parameters measured with MMT (p < 0.01). Conversely, TMG could detect changes only at two knee angles (0° and 45°, p < 0.01), when there is enough tension in the muscle. Reliability was overall insufficient for TMG whilst absolute reliability was excellent (coefficient of variation < 5%) for MMT. The ability of MMT more than TMG to detect an inherent change in stiffness can be conceivably exploited in a number of clinical/therapeutic applications that have to do with unnatural changes in passive muscle stiffness

  2. Rheological behavior of pork Biceps femoris muscle influenced by injection-tumbling process and brine type

    Directory of Open Access Journals (Sweden)

    Livia PĂTRAŞCU

    2014-12-01

    Full Text Available The effect of tumbling time (1-9 h, injection rate (20, 30, 40, and 50 % and k-carrageenan addition (0, 0.25, and 0.5 % on the rheological characteristics of pork Biceps femoris muscle were assessed. The results of the creep-recovery tests were analyzed using Burger’s equation. Increasing tumbling time up to 9 h along with injection rate also increased compliance values and decreased viscosity. K-carrageenan addition showed the occurrence of a more gel-like structure of the brine-meat system, causing further increase of the compliance and strain values. Samples injected with brine were more elastic compared to those containing k-carrageenan. A longer mechanical treatment provided a softer like matrix. Mathematical modeling of creep-compliance data showed a decreasing tendency for viscosity values with k-carrageenan addition. Discrete retarded elastic compliance values increased when adding k-carrageenan to meat-brine system. Addition of k-carrageenan did not affect the equilibrium compliance values.

  3. Natural Braneworld Inflation in Light of Recent Results from Planck and BICEP2

    CERN Document Server

    Neupane, Ishwaree P.

    2014-01-01

    In this paper we report on a major theoretical observation in cosmology. We present a concrete cosmological model for which inflation has natural beginning and natural ending. Inflation is driven by a cosine-form potential, $V(\\phi)= \\Lambda^4 (1-\\cos(\\phi/f))$, which begins at $\\phi \\lesssim \\pi f$ and ends at $\\phi =\\phi_{\\text{end}} \\lesssim 5 f/3$. The distance traversed by the inflaton field $\\phi$ is sub-Planckian. The Gauss-Bonnet term ${\\cal R}^2$ arising as leading curvature corrections in the action $S = \\int d^5{x} \\sqrt{-g_{5}} M^3 (- 6\\lambda M^2 + R + \\alpha M^{-2} {\\cal R}^2)+ \\int d^{4}x \\sqrt{-g_{4}} (\\dot{\\phi}^2/2 - V(\\phi)- \\sigma +{\\cal L}_{\\text{matter}})$ (where $\\alpha$ and $\\lambda$ are constants and $M$ is the five-dimensional Planck mass) plays a key role to terminate inflation. The model generates appropriate tensor-to-scalar ratio $r$ and inflationary perturbations that are consistent with results from Planck and BICEP2. For example, for $N_*= 50-60$ and $n_s\\sim 0.960\\pm 0.005$, ...

  4. Higgs vacuum stability and inflationary dynamics after BICEP2 and PLANCK dust polarisation data

    International Nuclear Information System (INIS)

    Bhattacharya, Kaushik; Chakrabortty, Joydeep; Das, Suratna; Mondal, Tanmoy

    2014-01-01

    If the recent detection of B-mode polarization of the Cosmic Microwave Background by BICEP2 observations, withstand the test of time after the release of recent PLANCK dust polarisation data, then it would surprisingly put the inflationary scale near Grand Unification scale if one considers single-field inflationary models. On the other hand, Large Hadron Collider has observed the elusive Higgs particle whose presently observed mass can lead to electroweak vacuum instability at high scale (∼ O(10 10 ) GeV). In this article, we seek for a simple particle physics model which can simultaneously keep the vacuum of the theory stable and yield high-scale inflation successfully. To serve our purpose, we extend the Standard Model of particle physics with a U(1) B-L gauged symmetry which spontaneously breaks down just above the inflationary scale. Such a scenario provides a constrained parameter space where both the issues of vacuum stability and high-scale inflation can be successfully accommodated. The threshold effect on the Higgs quartic coupling due to the presence of the heavy inflaton field plays an important role in keeping the electroweak vacuum stable. Furthermore, this scenario is also capable of reheating the universe at the end of inflation. Though the issues of Dark Matter and Dark Energy, which dominate the late-time evolution of our universe, cannot be addressed within this framework, this model successfully describes the early universe dynamics according to the Big Bang model

  5. Constraints on cosmological birefringence from PLANCK and Bicep2/Keck data

    Energy Technology Data Exchange (ETDEWEB)

    Gruppuso, A. [INAF-IASF Bologna, Istituto di Astrofisica Spaziale e Fisica Cosmica di Bologna, Istituto Nazionale di Astrofisica, via Gobetti 101, I-40129 Bologna (Italy); Gerbino, M.; Pagano, L.; Melchiorri, A. [Dipartimento di Fisica and INFN, Università di Roma ' ' La Sapienza' ' , P.le Aldo Moro 2, 00185, Rome (Italy); Natoli, P.; Mandolesi, N.; Molinari, D., E-mail: gruppuso@iasbo.inaf.it, E-mail: martina.gerbino@roma1.infn.it, E-mail: ntlpla@unife.it, E-mail: luca.pagano@roma1.infn.it, E-mail: mandolesi@iasfbo.inaf.it, E-mail: alessandro.melchiorri@roma1.infn.it, E-mail: molinari@iasfbo.inaf.it [Dipartimento di Fisica e Scienze della Terra and INFN, Università degli Studi di Ferrara, Via Saragat 1, I-44100 Ferrara (Italy)

    2016-06-01

    The polarization of cosmic microwave background (CMB) can be used to constrain cosmological birefringence, the rotation of the linear polarization of CMB photons potentially induced by parity violating physics beyond the standard model. This effect produces non-null CMB cross correlations between temperature and B mode-polarization, and between E- and B-mode polarization. Both cross-correlations are otherwise null in the standard cosmological model. We use the recently released 2015 PLANCK likelihood in combination with the Bicep2/Keck/Planck (BKP) likelihood to constrain the birefringence angle α. Our findings, that are compatible with no detection, read α = 0.0° ± 1.3° (stat) ± 1° (sys) for PLANCK data and α = 0.30° ± 0.27° (stat) ± 1° (sys) for BKP data. We finally forecast the expected improvements over present constraints when the PLANCK BB, TB and EB spectra at high ℓ will be included in the analysis.

  6. Stimulation of tendon repair by platelet concentrate, CDMP-2 and mechanical loading in animal models

    OpenAIRE

    Virchenko, Olena

    2007-01-01

    Growth factor delivery may be useful to accelerate the rate of tendon healing. We studied Platelet Concentrate, which in effect can be regarded as a cocktail of growth factors relevant for tendon healing. In a rat Achilles tendon transection model, one postoperative injection of Platelet Concentrate resulted in increased strength even 3 weeks later. Mechanical stimulation improves the repair of ruptured tendons. We studied the effects of platelets upon Achilles tendon regenerates in rats 3, 5...

  7. Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review

    OpenAIRE

    Rio, Ebonie; Kidgell, Dawson; Moseley, G Lorimer; Gaida, Jamie; Docking, Sean; Purdam, Craig; Cook, Jill

    2015-01-01

    Tendinopathy can be resistant to treatment and often recurs, implying that current treatment approaches are suboptimal. Rehabilitation programmes that have been successful in terms of pain reduction and return to sport outcomes usually include strength training. Muscle activation can induce analgesia, improving self-efficacy associated with reducing one's own pain. Furthermore, strength training is beneficial for tendon matrix structure, muscle properties and limb biomechanics. However, curre...

  8. Tendon collagen synthesis declines with immobilization in elderly humans

    DEFF Research Database (Denmark)

    Dideriksen, Kasper; Boesen, Anders P; Reitelseder, Søren

    2017-01-01

    -80 yr) were randomly assigned to NSAIDs (ibuprofen 1,200 mg/day; Ibu) or placebo (Plc). One lower limb was immobilized in a cast for 2 wk and retrained for 6 wk. Tendon collagen protein synthesis, mechanical properties, size, expression of genes related to collagen turnover and remodeling, and signal...... intensity (from magnetic resonance imaging) were investigated. Tendon collagen synthesis decreased (P ... immobilization in both groups, whereas scleraxis mRNA decreased with inactivity in the Plc group only (P collagen protein synthesis decreased after 2 wk of immobilization, whereas tendon stiffness and modulus were only marginally reduced, and NSAIDs had no influence upon this...

  9. Ultrasound-based testing of tendon mechanical properties

    DEFF Research Database (Denmark)

    Seynnes, O R; Bojsen-Møller, J.; Albracht, K

    2015-01-01

    In the past 20 years, the use of ultrasound-based methods has become a standard approach to measure tendon mechanical properties in vivo. Yet the multitude of methodological approaches adopted by various research groups probably contribute to the large variability of reported values. The technique......, or signal synchronization; and 2) in physiological considerations related to the viscoelastic behavior or length measurements of tendons. Hence, the purpose of the present review is to assess and discuss the physiological and technical aspects connected to in vivo testing of tendon mechanical properties...

  10. Ultrasonography of the equine shoulder: technique and normal appearance.

    Science.gov (United States)

    Tnibar, M A; Auer, J A; Bakkali, S

    1999-01-01

    This study was intended to document normal ultrasonographic appearance of the equine shoulder and anatomic landmarks useful in clinical imaging. Both forelimbs of five equine cadavers and both forelimbs of six live adult horses were used. To facilitate understanding of the images, a zoning system assigned to the biceps brachii and to the infraspinatus tendon was developed. Ultrasonography was performed with a real-time B-mode semiportable sector scanner using 7.5- and 5-MHz transducers. On one cadaver limb, magnetic resonance imaging (MRI) was performed using a system at 1.5 Tesla, T1-weighted spin-echo sequence. Ultrasonography images were compared to frozen specimens and MRI images to correlate the ultrasonographic findings to the gross anatomy of the shoulder. Ultrasonography allowed easy evaluation of the biceps brachii and the infraspinatus tendon and their bursae, the supraspinatus muscle and tendons, the superficial muscles of the shoulder, and the underlying humerus and scapula. Only the lateral and, partially, the caudal aspects of the humeral head could be visualized with ultrasound. Ultrasonographic appearance, orientation, and anatomic relationships of these structures are described. Ultrasonographic findings correlated well with MRI images and with gross anatomy in the cadavers' limbs.

  11. Bone marrow-derived mesenchymal stem cells influence early tendon-healing in a rabbit achilles tendon model.

    Science.gov (United States)

    Chong, Alphonsus K S; Ang, Abel D; Goh, James C H; Hui, James H P; Lim, Aymeric Y T; Lee, Eng Hin; Lim, Beng Hai

    2007-01-01

    A repaired tendon needs to be protected for weeks until it has accrued enough strength to handle physiological loads. Tissue-engineering techniques have shown promise in the treatment of tendon and ligament defects. The present study tested the hypothesis that bone marrow-derived mesenchymal stem cells can accelerate tendon-healing after primary repair of a tendon injury in a rabbit model. Fifty-seven New Zealand White rabbits were used as the experimental animals, and seven others were used as the source of bone marrow-derived mesenchymal stem cells. The injury model was a sharp complete transection through the midsubstance of the Achilles tendon. The transected tendon was immediately repaired with use of a modified Kessler suture and a running epitendinous suture. Both limbs were used, and each side was randomized to receive either bone marrow-derived mesenchymal stem cells in a fibrin carrier or fibrin carrier alone (control). Postoperatively, the rabbits were not immobilized. Specimens were harvested at one, three, six, and twelve weeks for analysis, which included evaluation of gross morphology (sixty-two specimens), cell tracing (twelve specimens), histological assessment (forty specimens), immunohistochemistry studies (thirty specimens), morphometric analysis (forty specimens), and mechanical testing (sixty-two specimens). There were no differences between the two groups with regard to the gross morphology of the tendons. The fibrin had degraded by three weeks. Cell tracing showed that labeled bone marrow-derived mesenchymal stem cells remained viable and present in the intratendinous region for at least six weeks, becoming more diffuse at later time-periods. At three weeks, collagen fibers appeared more organized and there were better morphometric nuclear parameters in the treatment group (p tendon repair can improve histological and biomechanical parameters in the early stages of tendon-healing.

  12. TGIF1 Gene Silencing in Tendon-Derived Stem Cells Improves the Tendon-to-Bone Insertion Site Regeneration

    Directory of Open Access Journals (Sweden)

    Liyang Chen

    2015-11-01

    Full Text Available Background/Aims: The slow healing process of tendon-to-bone junctions can be accelerated via implanted tendon-derived stem cells (TDSCs with silenced transforming growth interacting factor 1 (TGIF1 gene. Tendon-to-bone insertion site is the special form of connective tissues derivatives of common connective progenitors, where TGF-β plays bidirectional effects (chondrogenic or fibrogenic through different signaling pathways at different stages. A recent study revealed that TGF-β directly induces the chondrogenic gene Sox9. However, TGIF1 represses the expression of the cartilage master Sox9 gene and changes its expression rate against the fibrogenesis gene Scleraxis (Scx. Methods: TGIF1 siRNA was transduced or TGIF1 was over-expressed in tendon-derived stem cells. Following suprapinatus tendon repair, rats were either treated with transduced TDSCs or nontransduced TDSCs. Histologic examination and Western blot were performed in both groups. Results: In this study, the silencing of TGIF1 significantly upregulated the chondrogenic genes and markers. Similarly, TGIF1 inhibited TDSC differentiation into cartilage via interactions with TGF-β-activated Smad2 and suppressed the phosphorylation of Smad2. The area of fibrocartilage at the tendon-bone interface was significantly increased in the TGIF1 (- group compared with the control and TGIF1-overexpressing groups in the early stages of the animal model. The interface between the tendon and bone showed a increase of new bone and fibrocartilage in the TGIF1 (- group at 4 weeks. Fibrovascular scar tissue was observed in the TGIF1-overexpressing group and the fibrin glue only group. Low levels of fibrocartilage and fibrovascular scar tissue were found in the TDSCs group. Conclusion: Collectively, this study shows that the tendon-derived stem cell modified with TGIF1 gene silencing has promising effects on tendon-to-bone healing which can be further explored as a therapeutic tool in regenerative medicine.

  13. The interfascicular matrix enables fascicle sliding and recovery in tendon, and behaves more elastically in energy storing tendons.

    Science.gov (United States)

    Thorpe, Chavaunne T; Godinho, Marta S C; Riley, Graham P; Birch, Helen L; Clegg, Peter D; Screen, Hazel R C

    2015-12-01

    While the predominant function of all tendons is to transfer force from muscle to bone and position the limbs, some tendons additionally function as energy stores, reducing the cost of locomotion. Energy storing tendons experience extremely high strains and need to be able to recoil efficiently for maximum energy storage and return. In the equine forelimb, the energy storing superficial digital flexor tendon (SDFT) has much higher failure strains than the positional common digital extensor tendon (CDET). However, we have previously shown that this is not due to differences in the properties of the SDFT and CDET fascicles (the largest tendon subunits). Instead, there is a greater capacity for interfascicular sliding in the SDFT which facilitates the greater extensions in this particular tendon (Thorpe et al., 2012). In the current study, we exposed fascicles and interfascicular matrix (IFM) from the SDFT and CDET to cyclic loading followed by a test to failure. The results show that IFM mechanical behaviour is not a result of irreversible deformation, but the IFM is able to withstand cyclic loading, and is more elastic in the SDFT than in the CDET. We also assessed the effect of ageing on IFM properties, demonstrating that the IFM is less able to resist repetitive loading as it ages, becoming stiffer with increasing age in the SDFT. These results provide further indications that the IFM is important for efficient function in energy storing tendons, and age-related alterations to the IFM may compromise function and predispose older tendons to injury. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Powered AFO for Achilles tendon rupture.

    Science.gov (United States)

    Yoshizawa, Nobuyuki

    2008-01-01

    This paper proposes a powered ankle foot orthosis (AFO) for the treatment of a ruptured Achilles tendon. Usually, conservative orthosis treatment requires about two months, and a motionless ankle degrades activities of daily living (ADL). It is difficult to go to school or work on foot, and a pair of crutches is needed to go up and down stairs. In order to improve the ADL, an electric powered AFO has been designed to improve the ability to walk with a fixed ankle joint. The sole of the proposed AFO is equipped with an electric actuator. The prototype actuator consists of Nd magnets and electromagnets and is lightweight and battery driven. The actuator can switch the upright posture and the stepped forward posture of the patient. In an experiment, the use of this electric AFO made it possible to walk and to ascend and descend stairs with a fixed ankle joint.

  15. Tension Stiffened and Tendon Actuated Manipulator

    Science.gov (United States)

    Doggett, William R. (Inventor); Dorsey, John T. (Inventor); Ganoe, George G. (Inventor); King, Bruce D. (Inventor); Jones, Thomas C. (Inventor); Mercer, Charles D. (Inventor); Corbin, Cole K. (Inventor)

    2015-01-01

    A tension stiffened and tendon actuated manipulator is provided performing robotic-like movements when acquiring a payload. The manipulator design can be adapted for use in-space, lunar or other planetary installations as it is readily configurable for acquiring and precisely manipulating a payload in both a zero-g environment and in an environment with a gravity field. The manipulator includes a plurality of link arms, a hinge connecting adjacent link arms together to allow the adjacent link arms to rotate relative to each other and a cable actuation and tensioning system provided between adjacent link arms. The cable actuation and tensioning system includes a spreader arm and a plurality of driven and non-driven elements attached to the link arms and the spreader arm. At least one cable is routed around the driven and non-driven elements for actuating the hinge.

  16. Region specific patella tendon hypertrophy in humans following resistance training

    DEFF Research Database (Denmark)

    Kongsgaard, M.; Reitelseder, S; Pedersen, T.G.

    2007-01-01

    AIM: To examine if cross-sectional area (CSA) differs along the length of the human patellar tendon (PT), and if there is PT hypertrophy in response to resistance training. METHODS: Twelve healthy young men underwent baseline and post-training assessments. Maximal isometric knee extension strength...... (MVC) was determined unilaterally in both legs. PT CSA was measured at the proximal-, mid- and distal PT level and quadriceps muscle CSA was measured at mid-thigh level using magnetic resonance imaging. Mechanical properties of the patellar tendons were determined using ultrasonography. Subsequently....... CONCLUSIONS: To our knowledge, this study is the first to report tendon hypertrophy following resistance training. Further, the data show that the human PT CSA varies along the length of the tendon....

  17. Magnetic resonance imaging of Achilles tendon xanthomas in familial hypercholesterolemia

    International Nuclear Information System (INIS)

    Liem, M.S.L.; Bloem, J.L.; Schipper, J.

    1992-01-01

    The demonstration of tendon xanthomas is helpful in diagnosing heterozygous familial hypercholesterolemia. We investigated the possibility the lipid element with magnetic resonance (MR) imaging in seven patients with familial hypercholesterolemia and six controls. Although the mean relative signal intensities measured on long TR/TE spin echo sequences of the tendon were significantly higher in patients than in controls, the lack of such elevation does not rule out the presence of such lesions. MR imaging and US provide equal information on the anatomy of the Achilles tendon; as an abnormally increased signal intensity within the xanthoma on MRI was found in only a minority of our patients, the value of MRI in the demonstration of Achilles tendon xanthomas is limited when using conventional T1 and T2 spin echo sequences. (orig./DG)

  18. Bilateral giant cell tumor of tendon sheath of tendoachilles

    Directory of Open Access Journals (Sweden)

    Soma Datta

    2014-01-01

    Full Text Available Giant cell tumor of tendon sheath arises from the synovium of tendon sheaths, joints, or bursae, mostly affects adults between 30 and 50 years of age, and is slightly more common in females. We report the case of a 32-years-old male presenting with pain in both ankles without any history of trauma. On clinical examination, tenderness on both tendoachilles and local thickening were observed. Ultrasonography showed thickening of local tendinous area with increase in anteroposterior diameter, and Doppler demonstrated increased flow in peritendinous area. MRI findings showed that most of the tumor had intermediate signal intensity and portions of the tumor had low signal intensity. Fine needle aspiration cytology confirmed the diagnosis of giant cell tumor of tendon sheath. Excision biopsy was done with no recurrence on five month follow-up. Review of literature did not reveal any similar result; so, bilateral giant cell tumor of tendon sheath of tendoachilles is a rare presentation.

  19. CT of peroneal tendon injury in patients with calcaneal fractures

    International Nuclear Information System (INIS)

    Rosenberg, Z.S.; Feldman, F.; Singson, R.D.

    1986-01-01

    Injury to the peroneal tendons is a major complication of intraarticular calcaneal fractures. Heretofore, the injury has been difficult to diagnose by routine imaging modalities. However, CT studies of 24 intraarticular calcaneal fractures revealed evidence of peroneal tendon injury in 22 cases. The pathologic conditions included lateral displacement, subluxation, dislocation, and impingement on the tendons by bony fragments, hematomas, and scar tissue. Patients studied 6-12 months after injury had CT evidence consistent with clinical symptoms of peroneal tenosynovitis. Since peroneal tendon injury is surgically correctable, it should be differentiated from other known and more obvious complications, of calcaneal fractures. CT therefore serves as a valuable, noninvasive tool in evaluating these otherwise nonvisualized soft tissue structures in the immediate posttraumatic period as well as during long-term follow up

  20. Corticospinal excitability changes following prolonged muscle tendon vibration

    NARCIS (Netherlands)

    Steyvers, M.; Levin, O.; Baelen, M.G.M. van; Swinnen, S.P.

    2003-01-01

    The present experiment addressed the time course of corticospinal excitability changes following interventional muscle tendon vibration. Using transcranial magnetic stimulation, motor evoked potentials of the flexor carpi radialis and extensor carpi radialis brevis muscle were recorded for a period

  1. Extracellular matrix adaptation of tendon and skeletal muscle to exercise

    DEFF Research Database (Denmark)

    Kjaer, Michael; Magnusson, Peter; Krogsgaard, Michael

    2006-01-01

    The extracellular matrix (ECM) of connective tissues enables linking to other tissues, and plays a key role in force transmission and tissue structure maintenance in tendons, ligaments, bone and muscle. ECM turnover is influenced by physical activity, and both collagen synthesis and metalloprotease......-beta and IL-6 is enhanced following exercise. For tendons, metabolic activity (e.g. detected by positron emission tomography scanning), circulatory responses (e.g. as measured by near-infrared spectroscopy and dye dilution) and collagen turnover are markedly increased after exercise. Tendon blood flow...... is regulated by cyclooxygenase-2 (COX-2)-mediated pathways, and glucose uptake is regulated by specific pathways in tendons that differ from those in skeletal muscle. Chronic loading in the form of physical training leads both to increased collagen turnover as well as to some degree of net collagen synthesis...

  2. A rare knee extensor mechanism injury: Vastus intermedius tendon rupture

    Directory of Open Access Journals (Sweden)

    Engin Cetinkaya

    2015-01-01

    Conclusion: We report the first case of isolated rupture of the vastus intermedius tendon in the literature and we claim that disorder may be succesfully treated with conservative treatment and adequate physiotheraphy.

  3. [Achilles tendon xanthoma imaging on ultrasound and magnetic resonance imaging].

    Science.gov (United States)

    Fernandes, Eloy de Ávila; Santos, Eduardo Henrique Sena; Tucunduva, Tatiana Cardoso de Mello; Ferrari, Antonio J L; Fernandes, Artur da Rocha Correa

    2015-01-01

    The Achilles tendon xanthoma is a rare disease and has a high association with primary hyperlipidemia. An early diagnosis is essential to start treatment and change the disease course. Imaging exams can enhance diagnosis. This study reports the case of a 60-year-old man having painless nodules on his elbows and Achilles tendons without typical gout crisis, followed in the microcrystalline disease clinic of Unifesp for diagnostic workup. Laboratory tests obtained showed dyslipidemia. The ultrasound (US) showed a diffuse Achilles tendon thickening with hypoechoic areas. Magnetic resonance imaging (MRI) showed a diffuse tendon thickening with intermediate signal areas, and a reticulate pattern within. Imaging studies showed relevant aspects to diagnose a xanthoma, thus helping in the differential diagnosis. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  4. Dextrose prolotherapy and corticosteroid injection into rat Achilles tendon.

    Science.gov (United States)

    Martins, C A Q; Bertuzzi, R T; Tisot, R A; Michelin, A F; do Prado, J M; Stroher, A; Burigo, M

    2012-10-01

    To assess the mechanical behavior and the histology of collagen fibers after prolotherapy with 12.5% dextrose into rat Achilles tendons and to compare with those of corticosteroid treatment. Out of 60 adult female Wistar rats (70 tendons), 15 received 12.5% dextrose (group I); 15 were treated with corticosteroid injection (group II); and 15 were given 0.9% saline injection (group III), all into the right Achilles tendon, whereas 13 animals received no injections (group IV). Three doses of each substance (groups I, II, and III) were given at a 5-day interval. Collagen fiber color was quantitatively assessed in three samples from each group and in five samples from the control group using picrosirius red staining under polarized and nonpolarized light. Twelve tendons from each group treated with the test substance and 20 tendons from the control group were submitted to the tensile strength test. There was no statistical difference across the groups with respect to maximum load at failure (n.s.) and absorbed energy (n.s.). With respect to tendon rupture, there was no difference between the myotendinous and the tendinous regions (n.s.). However, hematoxylin-eosin staining revealed statistical significance in lymphocytic inflammatory infiltrate (P = 0.008) and in parallel fiber orientation (P = 0.003) when comparing groups to the control group, without significance for either neovascularization (n.s.) or the presence of fibroblasts (n.s.). Likewise, there was no significant difference between the percentage of mature (n.s.) and immature (n.s.) fibers. Dextrose was not deleterious to the tendinous tissue, as it did not change the mechanical and histological properties of Achilles tendons in rats. The data obtained in this study may help clinicians in their daily work as they suggest that injections of 12.5% dextrose caused no harm to the tendons, although the clinical importance in humans still needs to be defined.

  5. Ultrasound Diagnosis of Bilateral Quadriceps Tendon Rupture After Statin Use

    Directory of Open Access Journals (Sweden)

    Nesselroade, Ryan D

    2010-09-01

    Full Text Available Simultaneous bilateral quadriceps tendon rupture is a rare injury. We report the case of bilateral quadriceps tendon rupture sustained with minimal force while refereeing a football game. The injury was suspected to be associated with statin use as the patient had no other identifiable risk factors.The diagnosis was confirmed using bedside ultrasound. [West J Emerg Med. 2010; 11(4:306-309.

  6. Sex Variation in Patellar Tendon Kinetics During Running

    Directory of Open Access Journals (Sweden)

    Sinclair Jonathan

    2015-06-01

    Full Text Available Purpose. The aim of the current investigation was to determine whether female recreational runners exhibit distinct patellar tendon loading patterns in relation to their male counterparts. Methods. Twelve male (age 26.55 ± 4.11 years, height 1.78 ± 0.11 m, mass 77.11 ± 5.06 kg and twelve female (age 26.67 ± 5.34 years, height 1.67 ± 0.12 m, mass 63.28 ± 9.75 kg runners ran over a force platform at 4.0 m · s-1. Lower limb kinematics were collected using an eight-camera optoelectric motion capture system which operated at 250 Hz. Patellar tendon loads were examined using a predictive algorithm. Sex differences in limb, knee and ankle joint stiffness were examined statistically using independent samples t tests. Results. The results indicate that patellar tendon force (male = 6.49 ± 2.28, female = 7.03 ± 1.35 and patelllar tendon loading rate (male = 92.41 ± 32.51, female = 111.05 ± 48.58 were significantly higher in female runners. Conclusions. Excessive tendon loading in female runners indicates that female runners may be at increased risk of patellar tendon pathologies.

  7. Association of gastrocnemius tendon calcification with chondrocalcinosis of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Foldes, K. [Department of Radiology, Veterans Administration Medical Center (VAMC), San Diego, CA (United States)]|[University of California San Diego Medical Center (UCSD), San Diego, CA (United States)]|[National Institute of Rheumatology and Physiotherapy, Budapest (Hungary); Lenchik, L. [Department of Radiology, Veterans Administration Medical Center (VAMC), San Diego, CA (United States)]|[University of California San Diego Medical Center (UCSD), San Diego, CA (United States); Jaovisidha, S. [Department of Radiology, Veterans Administration Medical Center (VAMC), San Diego, CA (United States)]|[University of California San Diego Medical Center (UCSD), San Diego, CA (United States); Clopton, P. [Department of Radiology, Veterans Administration Medical Center (VAMC), San Diego, CA (United States); Sartoris, D.J. [Department of Radiology, Veterans Administration Medical Center (VAMC), San Diego, CA (United States)]|[University of California San Diego Medical Center (UCSD), San Diego, CA (United States); Resnick, D. [Department of Radiology, Veterans Administration Medical Center (VAMC), San Diego, CA (United States)]|[University of California San Diego Medical Center (UCSD), San Diego, CA (United States)

    1996-10-01

    Objective. Chondrocalcinosis of the knee is a common radiological finding in the elderly. However, visualization of chondrocalcinosis may be difficult in patients with advanced cartilage loss.The purpose of this study was to determine sensitivity, specificity, and accuracy of gastrocnemius tendon calcification that might serve as a radiographic marker of chondrocalcinosis in patients with painful knees. Design and patients. We prospectively evaluated 37 knee radiographs in 30 consecutive patients (29 men, 8 women; mean age 67 years, age range 37-90 years) with painful knees who had radiographic evidence of chondrocalcinosis. The frequency of fibrocartilage, hyaline cartilage, and gastrocnemius tendon calcification was determined. For a control group, we evaluated knee radiographs in 65 consecutive patients with knee pain (54 men, 11 women; mean age 59 years, age range 40-93 years) who had no radiological signs of chondrocalcinosis. The frequency of gastrocnemius tendon calcification in the control group was determined. Results. Gastrocnemius tendon calcification was 41% sensitive, 100% specific, and 78% accurate in predicting chondrocalcinosis. The gastrocnemius tendon was calcified on 15 of 37 (41%) radiographs in the experimental group and on 0 of 67 radiographs in the control group. In the chondrocalcinosis group, 23 (62%) had posterior hyaline cartilage calcification, 14 (38%) had anterior hyaline cartilage calcification, 31 (84%) had medial meniscus calcification, and 36 (97%) had lateral meniscus calcification. Conclusions. Our results show that gastrocnemius tendon calcification is an accurate radiographic marker of chondrocalcinosis in patients with knee pain. (orig.). With 2 figs., 2 tabs.

  8. Association of gastrocnemius tendon calcification with chondrocalcinosis of the knee

    International Nuclear Information System (INIS)

    Foldes, K.; Lenchik, L.; Jaovisidha, S.; Clopton, P.; Sartoris, D.J.; Resnick, D.

    1996-01-01

    Objective. Chondrocalcinosis of the knee is a common radiological finding in the elderly. However, visualization of chondrocalcinosis may be difficult in patients with advanced cartilage loss.The purpose of this study was to determine sensitivity, specificity, and accuracy of gastrocnemius tendon calcification that might serve as a radiographic marker of chondrocalcinosis in patients with painful knees. Design and patients. We prospectively evaluated 37 knee radiographs in 30 consecutive patients (29 men, 8 women; mean age 67 years, age range 37-90 years) with painful knees who had radiographic evidence of chondrocalcinosis. The frequency of fibrocartilage, hyaline cartilage, and gastrocnemius tendon calcification was determined. For a control group, we evaluated knee radiographs in 65 consecutive patients with knee pain (54 men, 11 women; mean age 59 years, age range 40-93 years) who had no radiological signs of chondrocalcinosis. The frequency of gastrocnemius tendon calcification in the control group was determined. Results. Gastrocnemius tendon calcification was 41% sensitive, 100% specific, and 78% accurate in predicting chondrocalcinosis. The gastrocnemius tendon was calcified on 15 of 37 (41%) radiographs in the experimental group and on 0 of 67 radiographs in the control group. In the chondrocalcinosis group, 23 (62%) had posterior hyaline cartilage calcification, 14 (38%) had anterior hyaline cartilage calcification, 31 (84%) had medial meniscus calcification, and 36 (97%) had lateral meniscus calcification. Conclusions. Our results show that gastrocnemius tendon calcification is an accurate radiographic marker of chondrocalcinosis in patients with knee pain. (orig.). With 2 figs., 2 tabs

  9. Suture anchor tenodesis in repair of distal Achilles tendon injuries.

    Science.gov (United States)

    Kiliçoğlu, Onder; Türker, Mehmet; Yildız, Fatih; Akalan, Ekin; Temelli, Yener

    2014-01-01

    Distal Achilles tendon avulsions are in the form of either bony and nonbony avulsion of Achilles tendon from its calcaneal insertion. Four patients with distal Achilles tendon avulsions or ruptures which were treated with tendon to bone repair using suture anchors are presented here. Operated leg was immobilized in above-knee cast for 4 weeks while the patient walked non-weight-bearing. Then, cast was changed to below knee, and full weight-bearing was allowed. Patients underwent gait analysis minimum at first postoperative year. Mean American Orthopedics Foot Ankle Society ankle/hindfoot score of patients at last visit was 88.75 (range 85-100), and Achilles tendon total rupture score was 77.75 (range 58-87). Mean passive dorsiflexion of injured ankles (14° ± 5°) was lower than uninjured ankles (23° ± 9°). All the kinematic parameters of gait analysis were comparable to the uninjured side. Maximum plantar flexion power of injured ankle was 1.40 W/kg, and this was significantly lower than the contralateral side value 2.38 W/kg; (P = 0.0143). There were no visually altered gait or problems in daily life. Suture anchor tenodesis technique of distal Achilles tendon avulsions was successful in achieving durable osteotendinous repairs.

  10. The anatomical footprint of the Achilles tendon: a cadaveric study.

    Science.gov (United States)

    Ballal, M S; Walker, C R; Molloy, A P

    2014-10-01

    We dissected 12 fresh-frozen leg specimens to identify the insertional footprint of each fascicle of the Achilles tendon on the calcaneum in relation to their corresponding muscles. A further ten embalmed specimens were examined to confirm an observation on the retrocalcaneal bursa. The superficial part of the insertion of the Achilles tendon is represented by fascicles from the medial head of the gastrocnemius muscle, which is inserted over the entire width of the inferior facet of the calcaneal tuberosity. In three specimens this insertion was in continuity with the plantar fascia in the form of periosteum. The deep part of the insertion of the Achilles tendon is made of fascicles from the soleus tendon, which insert on the medial aspect of the middle facet of the calcaneal tuberosity, while the fascicles of the lateral head of the gastrocnemius tendon insert on the lateral aspect of the middle facet of the calcaneal tuberosity. A bicameral retrocalcaneal bursa was present in 15 of the 22 examined specimens. This new observation and description of the insertional footprint of the Achilles tendon and the retrocalcaneal bursa may allow a better understanding of the function of each muscular part of the gastrosoleus complex. This may have clinical relevance in the treatment of Achilles tendinopathies. ©2014 The British Editorial Society of Bone & Joint Surgery.

  11. Modified rerouting procedure for failed peroneal tendon dislocation surgery.

    Science.gov (United States)

    Gaulke, R; Hildebrand, F; Panzica, M; Hüfner, T; Krettek, C

    2010-04-01

    Recurrent dislocation of the peroneal tendons following operative treatment is relatively uncommon, but can be difficult to treat. We asked whether subligamental transposition of the peroneus brevis tendon, fibular grooving, and reattachment of the superior peroneal retinaculum for failed peroneal tendon dislocation surgery would achieve a stable fixation of the peroneal tendons and whether there would be restrictions of ROM or instability of the hindfoot. We reviewed six female patients (mean age, 24.5 years) with general laxity of joints preoperatively and at 6 weeks and 3, 6, and 12 months postoperatively. Within 1 year postoperatively no recurrence was found. In two ankles the extension was restricted 5 degrees to 10 degrees . In another pronation and supination was restricted 5 degrees each. Stability of the ankle increased in four patients and stayed unchanged in two. AOFAS score increased from a mean value of 36 +/- 20.6 preoperatively to 90 +/- 7 postoperatively at 1 year. We conclude transposition of the peroneus brevis tendon is a reasonable treatment for failed peroneal tendon dislocation surgery. Level IV, therapeutic study (prospective case series). See Guidelines for Authors for a complete description of levels of evidence.

  12. Initial experience with visualizing hand and foot tendons by dual-energy computed tomography.

    Science.gov (United States)

    Deng, Kai; Sun, Cong; Liu, Cheng; Ma, Rui

    2009-01-01

    To assess the feasibility of visualizing hand and foot tendons by dual-energy computed tomography (CT). Twenty patients who suffered from hand or feet pains were scanned on dual-source CT (Definition, Forchheim, Germany) with dual-energy mode at tube voltages of 140 and 80 kV and a corresponding ratio of 1:4 between tube currents. The reconstructed images were postprocessed by volume rendering techniques (VRT) and multiplanar reconstruction (MPR). All of the suspected lesions were confirmed by surgery or follow-up studies. Twelve patients (total of 24 hands and feet, respectively) were found to be normal and the other eight patients (total of nine hands and feet, respectively) were found abnormal. Dual-energy techniques are very useful in visualizing tendons of the hands and feet, such as flexor pollicis longus tendon, flexor digitorum superficialis/profundus tendon, Achilles tendon, extensor hallucis longus tendon, and extensor digitorum longus tendon, etc. It can depict the whole shape of the tendons and their fixation points clearly. Peroneus longus tendon in the sole of the foot was not displayed very well. The distal ends of metacarpophalangeal joints with extensor digitoium tendon and extensor pollicis longus tendon were poorly shown. The lesions of tendons such as the circuitry, thickening, and adherence were also shown clearly. Dual-energy CT offers a new method to visualize tendons of the hand and foot. It could clearly display both anatomical structures and pathologic changes of hand and foot tendons.

  13. Glutaraldehyde cross-linking of tendon mechanical effects at the level of the tendon fascicle and fibril

    DEFF Research Database (Denmark)

    Hansen, Philip; Hassenkam, Tue; Svensson, Rene Bruggebusch

    2009-01-01

    at the tendon fibril level were examined by atomic force microscopy. Peak forces increased from approximately 1379 to approximately 2622 pN while an extended Hertz fit of force-indentation data showed a approximately 24 fold increase in Young's modulus on indentation. The effect of glutaraldehyde cross......Conclusive insight into the microscopic principles that govern the strength of tendon and related connective tissues is lacking and the importance of collagen cross-linking has not been firmly established. The combined application of whole-tissue mechanical testing and atomic force spectroscopy...... allowed for a detailed characterization of the effect of cross-linking in rat-tail tendon. The cross-link inducing agent glutaraldehyde augmented the tensile strength of tendon fascicles. Stress at failure increased from approximately 8 MPa to approximately 39 MPa. The mechanical effects of glutaraldehyde...

  14. Glutaraldehyde Cross-Linking of TendonMechanical Effects at the Level of the Tendon Fascicle and Fibril

    DEFF Research Database (Denmark)

    Hansen, P.; Svensson, R.B.; Aagaard, P.

    2009-01-01

    were examined by atomic force microscopy. Peak forces increased from 1379 to 2622 pN while an extended Hertz fit of force-indentation data showed a 24 fold increase in Young's modulus on indentation. The effect of glutaraldehyde cross-linking on the tensile properties of a single collagen fibril......Conclusive insight into the microscopic principles that govern the strength of tendon and related connective tissues is lacking and the importance of collagen cross-linking has not been firmly established. The combined application of whole-tissue mechanical testing and atomic force spectroscopy...... allowed for a detailed characterization of the effect of cross-linking in rat-tail tendon. The cross-link inducing agent glutaraldehyde augmented the tensile strength of tendon fascicles. Stress at failure increased from 8 MPa to 39 MPa. The mechanical effects of glutaraldehyde at the tendon fibril level...

  15. [Reconstruction of chronic Achilles tendon rupture with flexor hallucis longus tendon harvested using a minimally invasive technique].

    Science.gov (United States)

    Miao, Xudong; Wu, Yongping; Tao, Huimin; Yang, Disheng

    2011-07-01

    To evaluate the effectiveness of flexor hallucis longus tendon harvested using a minimally invasive technique in reconstruction of chronic Achilles tendon rupture. Between July 2006 and December 2009, 22 patients (22 feet) with chronic Achilles tendon rupture were treated, including 16 males and 6 females with a median age of 48 years (range, 28-65 years). The disease duration was 27-1,025 days (median, 51 days). Twenty-one patients had hooflike movement's history and 1 patient had no obvious inducement. The result of Thompson test was positive in 22 cases. The score was 53.04 +/- 6.75 according to American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot score system. MRI indicated that the gap of the chronic Achilles tendon rupture was 4.2-8.0 cm. A 3 cm-long incision was made vertically in the plantar aspect of the midfoot and a 1 cm-long transverse incision was made in a plantar flexor crease at the base of the great toe to harvest flexor hallucis longus tendon. The flexor hallucis longus tendon was 10.5-13.5 cm longer from tuber calcanei to the end of the Achilles tendon, and then the tendon was fixed to the tuber calcanei using interface screws or anchor nail after they were woven to form reflexed 3-bundle and sutured. Wound healed by first intention in all patients and no early complication occurred. Twenty-two patients were followed up 12-42 months (mean, 16.7 months). At 12 months after operation, The AOFAS ankle and hindfoot score was 92.98 +/- 5.72, showing significant difference when compared with that before operation (t= -40.903, P=0.000). The results were excellent in 18 cases, good in 2 cases, and fair in 2 cases with an excellent and good rate of 90.9%. No sural nerve injury, posterior tibial nerve injury, plantar painful scar, medial plantar nerve injury, and lateral plantar nerve injury occurred. Chronic Achilles tendon rupture reconstruction with flexor hallucis longus tendon harvested using a minimally invasive technique offers a

  16. The blood-tendon barrier: identification and characterisation of a novel tissue barrier in tendon blood vessels

    Directory of Open Access Journals (Sweden)

    C Lehner

    2016-05-01

    Full Text Available Tissue barriers function as “gate keepers” between different compartments (usually blood and tissue and are formed by specialised membrane-associated proteins, localising to the apicolateral plasma membrane domain of epithelial and endothelial cells. By sealing the paracellular space, the free diffusion of solutes and molecules across epithelia and endothelia is impeded. Thereby, tissue barriers contribute to the establishment and maintenance of a distinct internal and external environment, which is crucial during organ development and allows maintenance of an organ-specific homeostatic milieu. So far, various epithelial and endothelial tissue barriers have been described, including the blood-brain barrier, the blood-retina barrier, the blood-testis barrier, the blood-placenta barrier, and the cerebrospinal fluid (CSF-brain barrier, which are vital for physiological function and any disturbance of these barriers can result in severe organ damage or even death. Here, we describe the identification of a novel barrier, located in the vascular bed of tendons, which we term the blood-tendon barrier (BTB. By using immunohistochemistry, transmission electron microscopy, and tracer studies we demonstrate the presence of a functional endothelial barrier within tendons restricting the passage of large blood-borne molecules into the surrounding tendon tissue. We further provide in vitro evidence that the BTB potentially contributes to the creation of a distinct internal tissue environment impacting upon the proliferation and differentiation of tendon-resident cells, effects which might be fundamental for the onset of tendon pathologies.

  17. Regional strain variations in the human patellar tendon.

    Science.gov (United States)

    Pearson, Stephen J; Ritchings, Tim; Mohamed, Azlan S A

    2014-07-01

    Characteristics of localized tendon strain in vivo are largely unknown. The present study examines local tendon strain between the deep, middle, and surface structures at the proximal and distal aspects of the patellar tendon during ramped isometric contractions. Male subjects (age 28.0 ± 6.3 yr) were examined for patellar tendon excursion (anterior, midsection, and posterior) during ramped isometric voluntary contractions using real-time B-mode ultrasonography and dynamometry. Regional tendon excursion measurements were compared using an automated pixel tracking method. Strain was determined from the tendon delta length normalized to initial/resting segment length. Strain increased from 10% to 100% of force for all regions. Significantly greater mean strain was seen for the anterior proximal region compared to the posterior and mid layer of the tendon (7.5% ± 1.1% vs 3.7% ± 0.5% vs 5.5% ± 1.0%; P < 0.05). Similarly, the distal posterior region showed greater mean strain compared to the mid and anterior regions (7.9% ± 0.6% vs 5.0% ± 0.6% vs 5.4% ± 0.6%; P < 0.05). Relative changes in strain differences from 50% to 100% of force for the proximal region were greatest for the anterior to midline regions (4.6% ± 0.6% and 5.6% ± 0.6%, respectively) and those for the distal region were also greatest for the anterior to midline regions (4.4% ± 0.2% and 5.3% ± 0.2%, respectively). The largest mean strain for the proximal region was at the anterior layer (7.5% ± 1.1%) and that for the distal tendon region was at the posterior layer (7.9% ± 0.9%). This study shows significant regional differences in strain during ramped isometric contractions for the patellar tendon. Lower proximal strains in the posterior tendon compared to the anterior region may be associated with the suggestion of "stress shielding" as an etiological factor in insertional tendinopathy.

  18. Methods of Assessing Human Tendon Metabolism and Tissue Properties in Response to Changes in Mechanical Loading

    DEFF Research Database (Denmark)

    Heinemeier, Katja M; Kjaer, Michael; Magnusson, S Peter

    2016-01-01

    expression as well as protein synthesis rate. Further the (14)C bomb-pulse method has provided data on long-term tissue turnover in human tendon. Non-invasive techniques allow measurement of tendon metabolism (positron emission tomography (PET)), tendon morphology (magnetic resonance imaging (MRI......In recent years a number of methodological developments have improved the opportunities to study human tendon. Microdialysis enables sampling of interstitial fluid in the peritendon tissue, while sampling of human tendon biopsies allows direct analysis of tendon tissue for gene- and protein...

  19. Effect of ageing time in vacuum package on veal longissimus dorsi and biceps femoris physical and sensory traits

    Directory of Open Access Journals (Sweden)

    G. Baldi

    2015-09-01

    Full Text Available Study evaluated the effects of vacuum ageing (2, 4, 6, 8, 10, 12, 16 days on veal loin (longissimus dorsi; LD and silverside (biceps femoris; BF physical and sensory characteristics. Ageing did not affect cooking loss, increased LD pH and L*, a* and b* in both muscles. Shear force (SF decreased until day 6 in LD and day 10 in BF. Aroma, flavor and taste were not affected, while texturetraits were improved. SF was negative correlated with tenderness and juiciness and positive correlated with BF fibrousness and stringy sensation. Ageing improved texture properties withoutaltering other sensory traits.

  20. Presence of Bacteria in Spontaneous Achilles Tendon Ruptures.

    Science.gov (United States)

    Rolf, Christer G; Fu, Sai-Chuen; Hopkins, Chelsea; Luan, Ju; Ip, Margaret; Yung, Shu-Hang; Friman, Göran; Qin, Ling; Chan, Kai-Ming

    2017-07-01

    The structural pathology of Achilles tendon (AT) ruptures resembles tendinopathy, but the causes remain unknown. Recently, a number of diseases were found to be attributed to bacterial infections, resulting in low-grade inflammation and progressive matrix disturbance. The authors speculate that spontaneous AT ruptures may also be influenced by the presence of bacteria. Bacteria are present in ruptured ATs but not in healthy tendons. Cross-sectional study; Level of evidence, 3. Patients with spontaneous AT ruptures and patients undergoing anterior cruciate ligament (ACL) reconstruction were recruited for this study. During AT surgical repair, excised tendinopathic tissue was collected, and healthy tendon samples were obtained as controls from hamstring tendon grafts used in ACL reconstruction. Half of every sample was reserved for DNA extraction and the other half for histology. Polymerase chain reaction (PCR) was conducted using 16S rRNA gene universal primers, and the PCR products were sequenced for the identification of bacterial species. A histological examination was performed to compare tendinopathic changes in the case and control samples. Five of 20 AT rupture samples were positive for the presence of bacterial DNA, while none of the 23 hamstring tendon samples were positive. Sterile operating and experimental conditions and tests on samples, controlling for harvesting and processing procedures, ruled out the chance of postoperative bacterial contamination. The species identified predominantly belonged to the Staphylococcus genus. AT rupture samples exhibited histopathological features characteristic of tendinopathy, and most healthy hamstring tendon samples displayed normal tendon features. There were no apparent differences in histopathology between the bacterial DNA-positive and bacterial DNA-negative AT rupture samples. The authors have demonstrated the presence of bacterial DNA in ruptured AT samples. It may suggest the potential involvement of bacteria

  1. A photoactivated nanofiber graft material for augmented Achilles tendon repair.

    Science.gov (United States)

    Ni, Tao; Senthil-Kumar, Prabhu; Dubbin, Karen; Aznar-Cervantes, Salvador D; Datta, Néha; Randolph, Mark A; Cenis, José L; Rutledge, Gregory C; Kochevar, Irene E; Redmond, Robert W

    2012-10-01

    Suture repair of Achilles tendon rupture can cause infection, inflammation and scarring, while prolonged immobilization promotes adhesions to surrounding tissues and joint stiffness. Early mobilization can reduce complications provided the repair is strong enough to resist re-rupture. We have developed a biocompatible, photoactivated tendon wrap from electrospun silk (ES) to provide additional strength to the repair that could permit early mobilization, and act as a barrier to adhesion formation. ES nanofiber mats were prepared by electrospinning. New Zealand white rabbits underwent surgical transection of the Achilles tendon and repair by: (a) SR: standard Kessler suture + epitendinous suture (5-0 vicryl). (b) ES/PTB: a single stay suture and a section of ES mat, stained with 0.1% Rose Bengal (RB), wrapped around the tendon and bonded with 532 nm light (0.3 W/cm(2) , 125 J/cm(2) ). (c) SR + ES/PTB: a combination of (a) and (b). Gross appearance, extent of adhesion formation and biomechanical properties of the repaired tendon were evaluated at Days 7, 14, or 28 post-operatively (n = 8 per group at each time point). Ultimate stress (US) and Young's modulus (E) in the SR group were not significantly different from the ES/PTB group at Days 7 (US, P = 0.85; E, P = 1), 14 (US, P = 0.054; E, P = 1), and 28 (US, P = 0.198; E, P = 0.12) post-operatively. Adhesions were considerably greater in the SR group compared to the ES/PTB group at Days 7 (P = 0.002), 14 (P tendon repair site provides considerable benefit in Achilles tendon repair. Lasers Surg. Med. 44: 645-652, 2012. © 2012 Wiley Periodicals, Inc. Copyright © 2012 Wiley Periodicals, Inc.

  2. Fixation of the Achilles tendon insertion using suture button technology.

    Science.gov (United States)

    Fanter, Nathan J; Davis, Edward W; Baker, Champ L

    2012-09-01

    In the operative treatment of Achilles insertional tendinopathy, no guidelines exist concerning which form of fixation of the Achilles tendon insertion is superior. Transcalcaneal drill pin passage does not place any major plantar structures at risk, and the addition of a Krackow stitch and suture button to the fixation technique provides a significant increase in ultimate load to failure in Achilles tendon insertional repairs. Controlled laboratory study. The Achilles tendon insertions in 6 fresh-frozen cadaveric ankles were detached, and transcalcaneal drill pins were passed. Plantar dissection took place to evaluate the drill pin relationship to the plantar fascia, lateral plantar nerve and artery, flexor digitorum longus tendon, and master knot of Henry. The Achilles tendons were then repaired with a double-row suture anchor construct alone or with a suture button and Krackow stitch added to the double-row suture anchor construct. The repairs were then tested to maximum load to failure at 20 mm/min. The mode of failure was recorded, and the mean maximum load to failure was assessed using the Student t test for distributions with equal variance. Transcalcaneal drill pin passage did not place any selected anatomic structures at risk. The mean maximum load to failure for the suture bridge group was 239.2 N; it was 391.4 N for the group with the suture button (P = .014). The lateral plantar artery was the structure placed at greatest risk from drill pin placement, with a mean distance of 22.7 mm (range, 16.5-29.2 mm) between the pin and artery. In this laboratory study, transcalcaneal drill pin passage appeared to be anatomically safe, and the use of suture button technology with a Krackow stitch for Achilles tendon insertional repair significantly increased repair strength. Achilles tendon insertional repair with suture button fixation and a Krackow stitch may facilitate the earlier institution of postoperative rehabilitation and improve clinical outcomes.

  3. Achilles tendon and sports; Die Achillessehne im Sport

    Energy Technology Data Exchange (ETDEWEB)

    Ulreich, N.; Kainberger, F. [Univ.-Klinik fuer Radiodiagnostik Wien (Austria); Huber, W.; Nehrer, S. [Univ.-Klinik fuer Orthopaedie Wien (Austria)

    2002-10-01

    Because of the rising popularity of recreational sports activities achillodynia is an often associated symptom with running, soccer and athletics. Therefore radiologist are frequently asked to image this tendon. The origin of the damage of the Achilles tendon is explained by numerous hypothesis, mainly a decreased perfusion and a mechanical irritation that lead to degeneration of the tendon. High-resolution technics such as sonography and magnetic resonance imaging show alterations in the structure of the tendon which can be graduated and classified. Manifestations like tendinosis, achillobursitis, rupture and Haglunds disease can summarized as the tendon overuse syndrom. A rupture of a tendon is mostly the result of a degeneration of the collagenfibres. The task of the radiologist is to acquire the intrinsic factors for a potential rupture. (orig.) [German] Aufgrund des starken Anstiegs des Freizeitsportes sind Achillodynien ein besonders mit Laufsport, Fussball und Leichtathletik assoziiertes Symptom und die Indikation zur radiologischen Abklaerung wird oft gestellt. Die Entstehung von Sehnenschaeden wird durch eine Reihe von Hypothesen erklaert, wobei eine gestoerte Gewebeperfusion und eine mechanische Irritation als Hauptursachen angesehen werden, die zur Degeneration des Sehnengewebes und des umgebenden Gleitlagers fuehren. Sie koennen aufgrund sonographischer und MR-tomographischer Zeichen meist klar klassifiziert und graduiert werden, wobei hochaufloesende Techniken eine wesentliche Voraussetzung fuer die subtile Analyse der Sehnenstruktur darstellen. Die einzelnen klinischen Erscheinungsformen wie Tendinose, Achillobursitis, Haglund-Ferse und Sehnenruptur koennen unter dem Begriff des ''Sehnenueberlastungssyndroms'' (Tendon overuse syndrome) subsummiert werden. Rupturen der Achillessehne treten so gut wie immer bei bereits vorgeschaedigtem Kollagenfasergewebe auf, und der radiologischen Diagnostik kommt wesentliche Bedeutung dabei zu

  4. Relationship between the Ulnar Nerve and the Branches of the Radial Nerve to the Medial Head of the Triceps Brachii Muscle.

    Science.gov (United States)

    Sh, Cho; Ih, Chung; Uy, Lee

    2018-05-17

    One branch of the radial nerve to the medial head of the triceps brachii muscle (MHN) has been described as accompanying or joining the ulnar nerve. Mostly two MHN branches have been reported, with some reports of one; however, the topographical anatomy is not well documented. We dissected 52 upper limbs from adult cadavers and found one, two, and three MHN branches in 9.6%, 80.8%, and 9.6% of cases, respectively. The MHN accompanying the ulnar nerve was always the superior MHN. The relationship between the ulnar nerve and the MHN was classified into four types according to whether the MHN was enveloped along with the ulnar nerve in the connective tissue sheath and whether it was in contact with the ulnar nerve. It contacted the ulnar nerve in 75.0% of cases and accompanied it over a mean distance of 73.6 mm (range 36-116 mm). In all cases in which the connective tissue sheath enveloped the branch of the MHN and the ulnar nerve, removing the sheath confirmed that the MHN branch originated from the radial nerve. The detailed findings and anatomical measurements of the MHN in this study will help in identifying its branches during surgical procedures. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

  5. Assessment of the meat quality of lamb M. longissimus thoracis et lumborum and M. triceps brachii following three different Halal slaughter procedures.

    Science.gov (United States)

    Danso, A S; Richardson, R I; Khalid, R

    2017-05-01

    A total of fifteen male and fifteen female lambs were allocated to three groups of ten animals and subjected to: traditional Halal slaughter without stunning (TNS); slaughter following electric head-only stunning (EHOS) or; post-cut electric head-only stun (PCEHOS) and their meat quality was determined. Instrumental and sensory analyses were carried out on two muscles; M. longissimus thoracis et lumborum (LTL) and M. triceps brachii (TB). Additionally, the effects of sex and muscle type were also assessed. No differences were found among slaughter methods for pH, drip loss and shear force. TB had a higher pHu and was more tender than LTL. Muscles from EHOS and PCEHOS lambs discoloured more quickly than TNS muscles. There were no differences in the measured sensory attributes, with the exception of EHOS meat being tougher than PCEHOS and TNS meat. This study showed that the three slaughter methods had no substantial effect on lamb meat quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Effects of celecoxib on proliferation and tenocytic differentiation of tendon-derived stem cells

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Kairui; Zhang, Sheng [Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515 (China); Li, Qianqian [Cancer Research Institute, Southern Medical University, Guangzhou 510515 (China); Yang, Jun [Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515 (China); Department of Orthopaedics, 421 Hospital of PLA, Guangzhou 510318 (China); Dong, Weiqiang [Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515 (China); Department of Orthopaedics, The First Affiliated Hospital to Guangzhou Medical University, Guangzhou 510120 (China); Wang, Shengnan; Cheng, Yirong; Al-Qwbani, Mohammed [Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515 (China); Wang, Qiang, E-mail: 1780468505@qq.com [Department of Orthopaedics, Subei People’s Hospital of Jiangsu Province (Clinical Medical College of Yangzhou University), Yangzhou, Jiangsu Province 225001 (China); Yu, Bin, E-mail: carryzhang1985@live.com [Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515 (China)

    2014-07-18

    Highlights: • Celecoxib has no effects on TDSCs cell proliferation in various concentrations. • Celecoxib reduced mRNAs levels of tendon associated transcription factor. • Celecoxib reduced mRNAs levels of main tendon associated collagen. • Celecoxib reduced mRNAs levels of tendon associated molecules. - Abstract: NSAIDs are often ingested to reduce the pain and improve regeneration of tendon after tendon injury. Although the effects of NSAIDs in tendon healing have been reported, the data and conclusions are not consistent. Recently, tendon-derived stem cells (TDSCs) have been isolated from tendon tissues and has been suggested involved in tendon repair. Our study aims to determine the effects of COX-2 inhibitor (celecoxib) on the proliferation and tenocytic differentiation of TDSCs. TDSCs were isolated from mice Achilles tendon and exposed to celecoxib. Cell proliferation rate was investigated at various concentrations (0.1, 1, 10 and 100 μg/ml) of celecoxib by using hemocytometer. The mRNA expression of tendon associated transcription factors, tendon associated collagens and tendon associated molecules were determined by reverse transcription-polymerase chain reaction. The protein expression of Collagen I, Collagen III, Scleraxis and Tenomodulin were determined by Western blotting. The results showed that celecoxib has no effects on TDSCs cell proliferation in various concentrations (p > 0.05). The levels of most tendon associated transcription factors, tendon associated collagens and tendon associated molecules genes expression were significantly decreased in celecoxib (10 μg/ml) treated group (p < 0.05). Collagen I, Collagen III, Scleraxis and Tenomodulin protein expression were also significantly decreased in celecoxib (10 μg/ml) treated group (p < 0.05). In conclusion, celecoxib inhibits tenocytic differentiation of tendon-derived stem cells but has no effects on cell proliferation.

  7. Effects of celecoxib on proliferation and tenocytic differentiation of tendon-derived stem cells

    International Nuclear Information System (INIS)

    Zhang, Kairui; Zhang, Sheng; Li, Qianqian; Yang, Jun; Dong, Weiqiang; Wang, Shengnan; Cheng, Yirong; Al-Qwbani, Mohammed; Wang, Qiang; Yu, Bin

    2014-01-01

    Highlights: • Celecoxib has no effects on TDSCs cell proliferation in various concentrations. • Celecoxib reduced mRNAs levels of tendon associated transcription factor. • Celecoxib reduced mRNAs levels of main tendon associated collagen. • Celecoxib reduced mRNAs levels of tendon associated molecules. - Abstract: NSAIDs are often ingested to reduce the pain and improve regeneration of tendon after tendon injury. Although the effects of NSAIDs in tendon healing have been reported, the data and conclusions are not consistent. Recently, tendon-derived stem cells (TDSCs) have been isolated from tendon tissues and has been suggested involved in tendon repair. Our study aims to determine the effects of COX-2 inhibitor (celecoxib) on the proliferation and tenocytic differentiation of TDSCs. TDSCs were isolated from mice Achilles tendon and exposed to celecoxib. Cell proliferation rate was investigated at various concentrations (0.1, 1, 10 and 100 μg/ml) of celecoxib by using hemocytometer. The mRNA expression of tendon associated transcription factors, tendon associated collagens and tendon associated molecules were determined by reverse transcription-polymerase chain reaction. The protein expression of Collagen I, Collagen III, Scleraxis and Tenomodulin were determined by Western blotting. The results showed that celecoxib has no effects on TDSCs cell proliferation in various concentrations (p > 0.05). The levels of most tendon associated transcription factors, tendon associated collagens and tendon associated molecules genes expression were significantly decreased in celecoxib (10 μg/ml) treated group (p < 0.05). Collagen I, Collagen III, Scleraxis and Tenomodulin protein expression were also significantly decreased in celecoxib (10 μg/ml) treated group (p < 0.05). In conclusion, celecoxib inhibits tenocytic differentiation of tendon-derived stem cells but has no effects on cell proliferation

  8. Comparative anatomy of rabbit and human achilles tendons with magnetic resonance and ultrasound imaging.

    Science.gov (United States)

    Doherty, Geoffrey P; Koike, Yoichi; Uhthoff, Hans K; Lecompte, Martin; Trudel, Guy

    2006-02-01

    We sought to describe the comparative anatomy of the Achilles tendon in rabbits and humans by using macroscopic observation, magnetic resonance imaging, and ultrasonography. The calcaneus-Achilles tendon-gastrocnemius-soleus complexes from 18 New Zealand white rabbits underwent ultrasound (US) and magnetic resonance (MR) imaging and gross anatomic sectioning; these results were compared with those from a cadaveric gastrocnemius-soleus-Achilles tendon-calcaneus specimen from a 68-y-old human male. The medial and lateral gastrocnemius muscle tendons merged 5.2 +/- 0.6 mm proximal to the calcaneal insertion macroscopically, at 93% of their course, different from the gastrocnemius human tendons, which merged at 23% of their overall course. The rabbit flexor digitorum superficialis tendon, corresponding to the flexor digitorum longus tendon in human and comparable in size with the gastrocnemius tendons, was located medial and anterior to the medial gastrocnemius tendon proximally and rotated dorsally and laterally to run posterior to the Achilles tendon-calcaneus insertion. In humans, the flexor digitorum longus tendon tracks posteriorly to the medial malleolus. The soleus muscle and tendon are negligible in the rabbit; these particular comparative anatomic features in the rabbit were confirmed on the MR images. Therefore the rabbit Achilles tendon shows distinctive gross anatomical and MR imaging features that must be considered when using the rabbit as a research model, especially for mechanical testing, or when generalizing results from rabbits to humans.

  9. Biomechanical and histologic comparison of Achilles tendon ruptures reinforced with intratendinous and peritendinous plantaris tendon grafts in rabbits: an experimental study.

    Science.gov (United States)

    Ilhami, Kuru; Gokhan, Maralcan; Ulukan, Inan; Eray, Bozan M; Levent, Altinel; Ciğdem, Tokyol

    2004-11-01

    We hypothesized that the closer the reinforcing graft was to the repair zone, the more strength the healed tendon would achieved. Therefore, we compared the ruptured rabbit Achilles tendons reinforced with intratendinous and peritendinous plantaris grafts. The experimental study was performed on Achilles tendons of 20 rabbits. First, they were divided into two groups: group I (n=10) underwent intratendinous graft and end-to-end tenorraphy, and group P (n=10) were repaired end-to-end and then reinforced with a peritendinous plantaris graft. An above-knee cast was applied during 6 weeks postoperatively. The two groups were compared to each other biomechanically and histologically. Seven randomly selected rabbits from each group were used for biomechanical evaluation. The remaining six rabbits (three from each group) were used for histologic comparison. Non-operated sides (n=20) served as the control group. The mean maximum load at rupture of the repaired and control groups was 159.9+/-31 N, 83+/-7.5 N, and 207.5+/-35 N for group I, group P, and the control group, respectively. Values between groups were significantly different considering maximum load and absorbed energy to rupture. There was no significant difference between groups I and P in respect to strain. Control group tendons (groups I-C and P-C) had significantly more lengthening capability than operated tendons. Macroscopically, group I tendons were thicker and stiffer than group P tendons. Histologically, differences between the group I and group P specimens revealed that the healing process was faster in tendons augmented intratendinously. In reinforcing Achilles tendon repair, the site of the tendon graft affected the result. When the graft was used intratendinously, the healed tendon was more similar biomechanically to normal tendon and had more graft-tendon orientation histologically than the tendon augmented peritendinously.

  10. MADURACIÓN DEL SOLOMO (Biceps femoris EN VACAS DE DESCARTE Bos indicus Y Bos taurus

    Directory of Open Access Journals (Sweden)

    Roger Alonso Cubero-Rojas

    2013-01-01

    Full Text Available El objetivo de este trabajo fue evaluar el efecto de la maduración sobre la terneza del músculo Biceps femoris en vacas de descarte Bos indicus y Bos taurus. En la planta procesadora de Montecillos R.L., ubicada en Alajuela, se realizó la escogencia y sacrificio de los animales, la maduración y empaque al vacío de la carne. La cocción, determinación de la terneza y evaluación sensorial se llevó a cabo a los 0, 14 y 28 días de maduración, en el Laboratorio de Análisis Sensorial del Centro de Investigaciones en Tecnología de Alimentos de la Universidad de Costa Rica, ubicado en San Pedro de Montes de Oca, San José, en julio del año 2011. De acuerdo con la evaluación instrumental, la especie y la cronometría dental no fueron factores significativos en la determinación de la terneza de la carne, mientras que el tiempo de maduración sí mostró cambios altamente significativos (p>0,001 sobre el mismo parámetro. Los mejores resultados se obtuvieron a los 28 días, donde B. indicus mostró 3,78 kg de fuerza al corte, mientras que para B. taurus se obtuvo 3,88 kg. En la evaluación sensorial, los animales B. indicus se calificaron como más jugosos (p=0,016 y con mejor sabor (p<0,001. Se determinó una relación inversa entre sabor y tiempo de maduración, lo cual indicó que a mayor tiempo de maduración el sabor de la carne se volvió menos agradable al paladar.

  11. Uncovering the cellular and molecular changes in tendon stem/progenitor cells attributed to tendon aging and degeneration.

    Science.gov (United States)

    Kohler, Julia; Popov, Cvetan; Klotz, Barbara; Alberton, Paolo; Prall, Wolf Christian; Haasters, Florian; Müller-Deubert, Sigrid; Ebert, Regina; Klein-Hitpass, Ludger; Jakob, Franz; Schieker, Matthias; Docheva, Denitsa

    2013-12-01

    Although the link between altered stem cell properties and tissue aging has been recognized, the molecular and cellular processes of tendon aging have not been elucidated. As tendons contain stem/progenitor cells (TSPC), we investigated whether the molecular and cellular attributes of TSPC alter during tendon aging and degeneration. Comparing TSPC derived from young/healthy (Y-TSPC) and aged/degenerated human Achilles tendon biopsies (A-TSPC), we observed that A-TSPC exhibit a profound self-renewal and clonogenic deficits, while their multipotency was still retained. Senescence analysis showed a premature entry into senescence of the A-TSPC, a finding accompanied by an upregulation of p16(INK4A). To identify age-related molecular factors, we performed microarray and gene ontology analyses. These analyses revealed an intriguing transcriptomal shift in A-TSPC, where the most differentially expressed probesets encode for genes regulating cell adhesion, migration, and actin cytoskeleton. Time-lapse analysis showed that A-TSPC exhibit decelerated motion and delayed wound closure concomitant to a higher actin stress fiber content and a slower turnover of actin filaments. Lastly, based on the expression analyses of microarray candidates, we suggest that dysregulated cell-matrix interactions and the ROCK kinase pathway might be key players in TSPC aging. Taken together, we propose that during tendon aging and degeneration, the TSPC pool is becoming exhausted in terms of size and functional fitness. Thus, our study provides the first fundamental basis for further exploration into the molecular mechanisms behind tendon aging and degeneration as well as for the selection of novel tendon-specific therapeutical targets. © 2013 The Authors. Aging Cell published by the Anatomical Society and John Wiley & Sons Ltd.

  12. A new barbed device for repair of flexor tendons.

    LENUS (Irish Health Repository)

    Hirpara, K M

    2012-02-01

    We split 100 porcine flexor tendons into five groups of 20 tendons for repair. Three groups were repaired using the Pennington modified Kessler technique, the cruciate or the Savage technique, one using one new device per tendon and the other with two new devices per tendon. Half of the tendons received supplemental circumferential Silfverskiold type B cross-stitch. The repairs were loaded to failure and a record made of their bulk, the force required to produce a 3 mm gap, the maximum force applied before failure and the stiffness. When only one device was used repairs were equivalent to the Pennington modified Kessler for all parameters except the force to produce a 3 mm gap when supplemented with a circumferential repair, which was equivalent to the cruciate. When two devices were used the repair strength was equivalent to the cruciate repair, and when the two-device repair was supplemented with a circumferential suture the force to produce a 3 mm gap was equivalent to that of the Savage six-strand technique.

  13. Anti-inflammatory management for tendon injuries - friends or foes?

    Directory of Open Access Journals (Sweden)

    Chan Kai-Ming

    2009-10-01

    Full Text Available Abstract Acute and chronic tendon injuries are very common among athletes and in sedentary population. Most physicians prescribe anti-inflammatory managements to relieve the worst symptoms of swelling and pain, including non-steroidal anti-inflammatory drugs, corticosteroids and physical therapies. However, experimental research shows that pro-inflammatory mediators such as prostaglandins may play important regulatory roles in tendon healing. Noticeably nearly all cases of chronic tendon injuries we treat as specialists have received non-steroidal anti-inflammatory drugs by their physician, suggesting that there might be a potential interaction in some of these cases turning a mild inflammatory tendon injury into chronic tendinopathy in predisposed individuals. We are aware of the fact that non-steroidal anti-inflammatory drugs and corticosteroids may well have a positive effect on the pain control in the clinical situation whilst negatively affect the structural healing. It follows that a comprehensive evaluation of anti-inflammatory management for tendon injuries is needed and any such data would have profound clinical and health economic importance.

  14. Changes in tendon spatial frequency parameters with loading.

    Science.gov (United States)

    Pearson, Stephen J; Engel, Aaron J; Bashford, Gregory R

    2017-05-24

    To examine and compare the loading related changes in micro-morphology of the patellar tendon. Fifteen healthy young males (age 19±3yrs, body mass 83±5kg) were utilised in a within subjects matched pairs design. B mode ultrasound images were taken in the sagittal plane of the patellar tendon at rest with the knee at 90° flexion. Repeat images were taken whilst the subjects were carrying out maximal voluntary isometric contractions. Spatial frequency parameters related to the tendon morphology were determined within regions of interest (ROI) from the B mode images at rest and during isometric contractions. A number of spatial parameters were observed to be significantly different between resting and contracted images (Peak spatial frequency radius (PSFR), axis ratio, spatial Q-factor, PSFR amplitude ratio, and the sum). These spatial frequency parameters were indicative of acute alterations in the tendon micro-morphology with loading. Acute loading modifies the micro-morphology of the tendon, as observed via spatial frequency analysis. Further research is warranted to explore its utility with regard to different loading induced micro-morphological alterations, as these could give valuable insight not only to aid strengthening of this tissue but also optimization of recovery from injury and treatment of conditions such as tendinopathies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Nonlinear model for viscoelastic behavior of Achilles tendon.

    Science.gov (United States)

    Kahn, Cyril J F; Wang, Xiong; Rahouadj, Rachid

    2010-11-01

    Although the mechanical properties of ligament and tendon are well documented in research literature, very few unified mechanical formulations can describe a wide range of different loadings. The aim of this study was to propose a new model, which can describe tendon responses to various solicitations such as cycles of loading, unloading, and reloading or successive relaxations at different strain levels. In this work, experiments with cycles of loading and reloading at increasing strain level and sequences of relaxation were performed on white New Zealand rabbit Achilles tendons. We presented a local formulation of thermodynamic evolution outside equilibrium at a representative element volume scale to describe the tendon's macroscopic behavior based on the notion of relaxed stress. It was shown that the model corresponds quite well to the experimental data. This work concludes with the complexity of tendons' mechanical properties due to various microphysical mechanisms of deformation involved in loading such as the recruitment of collagen fibers, the rearrangement of the microstructure (i.e., collagens type I and III, proteoglycans, and water), and the evolution of relaxed stress linked to these mechanisms.

  16. Button fixation technique for Achilles tendon reinsertion: a biomechanical study.

    Science.gov (United States)

    Awogni, David; Chauvette, Guillaume; Lemieux, Marie-Line; Balg, Frédéric; Langelier, Ève; Allard, Jean-Pascal

    2014-01-01

    Chronic insertional tendinopathy of the Achilles tendon is a frequent and disabling pathologic entity. Operative treatment is indicated for patients for whom nonoperative management has failed. The treatment can consist of the complete detachment of the tendon insertion and extensive debridement. We biomechanically tested a new operative technique that uses buttons for fixation of the Achilles tendon insertion on the posterior calcaneal tuberosity and compared it with 2 standard bone anchor techniques. A total of 40 fresh-frozen cadaver specimens were used to compare 3 fixation techniques for reinserting the Achilles tendon: single row anchors, double row anchors, and buttons. The ultimate loads and failure mechanisms were recorded. The button assembly (median load 764 N, range 713 to 888) yielded a median fixation strength equal to 202% (range 137% to 251%) of that obtained with the double row anchors (median load 412 N, range 301 to 571) and 255% (range 213% to 317%) of that obtained with the single row anchors (median load 338 N, range 241 to 433N). The most common failure mechanisms were suture breakage with the buttons (55%) and pull out of the implant with the double row (70%) and single row (85%) anchors. The results of the present biomechanical cadaver study have shown that Achilles tendon reinsertion fixation using the button technique provides superior pull out strength than the bone anchors tested. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  17. An investigation of tendon sheathing filler migration into concrete

    International Nuclear Information System (INIS)

    Naus, D.J.; Oland, C.B.

    1998-03-01

    During some of the inspections at nuclear power plants with prestressed concrete containments, it was observed that the containments has experienced leakage of the tendon sheathing filler (i.e., streaks). The objective of this activity was to provide an indication of the extent of tendon sheathing filler leakage into the concrete and its affects on concrete properties. Literature was reviewed and concrete core samples were obtained from the Trojan Nuclear Plant and tested. The literature primarily addressed effects of crude or lubricating oils that are known to cause concrete damage. However, these materials have significantly different characteristics relative to the materials used as tendon sheathing fillers. Examination and testing of the concrete cores indicated that the appearance of tendon sheathing filler on the concrete surface was due to leakage from the conduits and its subsequent migration through cracks that were present. Migration of the tendon sheathing filler was confined to the cracks and there was no perceptible movement into the concrete. Results of compressive strength testing indicated that the concrete quality was consistent in the containment and that the strength had increased over 40% in 25.4 years relative to the average compressive strength at 28-days age

  18. Effect of aging and exercise on the tendon

    DEFF Research Database (Denmark)

    Svensson, Rene B; Heinemeier, Katja Maria; Couppé, Christian

    2016-01-01

    Here, we review the literature on how tendons respond and adapt to ageing and exercise. With respect to aging, there are considerable changes early in life, but this seems to be maturation rather than aging per se. In vitro data indicate that aging is associated with a decreased potential for cel...... and modulus of the tendon and may reduce the amount of glycation. Exercise thereby tends to counteract the effects of aging.......Here, we review the literature on how tendons respond and adapt to ageing and exercise. With respect to aging, there are considerable changes early in life, but this seems to be maturation rather than aging per se. In vitro data indicate that aging is associated with a decreased potential for cell...... glycation-derived cross-links increase substantially. Mechanically, aging appears to be associated with a reduction in modulus and strength. With respect to exercise, tendon cells respond by producing growth factors, and there is some support for a loading-induced increase in tendon collagen synthesis...

  19. Mechanoactive scaffold induces tendon remodeling and expression of fibrocartilage markers.

    Science.gov (United States)

    Spalazzi, Jeffrey P; Vyner, Moira C; Jacobs, Matthew T; Moffat, Kristen L; Lu, Helen H

    2008-08-01

    Biological fixation of soft tissue-based grafts for anterior cruciate ligament (ACL) reconstruction poses a major clinical challenge. The ACL integrates with subchondral bone through a fibrocartilage enthesis, which serves to minimize stress concentrations and enables load transfer between two distinct tissue types. Functional integration thus requires the reestablishment of this fibrocartilage interface on reconstructed ACL grafts. We designed and characterized a novel mechanoactive scaffold based on a composite of poly-alpha-hydroxyester nanofibers and sintered microspheres; we then used the scaffold to test the hypothesis that scaffold-induced compression of tendon grafts would result in matrix remodeling and the expression of fibrocartilage interface-related markers. Histology coupled with confocal microscopy and biochemical assays were used to evaluate the effects of scaffold-induced compression on tendon matrix collagen distribution, cellularity, proteoglycan content, and gene expression over a 2-week period. Scaffold contraction resulted in over 15% compression of the patellar tendon graft and upregulated the expression of fibrocartilage-related markers such as Type II collagen, aggrecan, and transforming growth factor-beta3 (TGF-beta3). Additionally, proteoglycan content was higher in the compressed tendon group after 1 day. The data suggest the potential of a mechanoactive scaffold to promote the formation of an anatomic fibrocartilage enthesis on tendon-based ACL reconstruction grafts.

  20. Effects of aging and resistance training in rat tendon remodeling.

    Science.gov (United States)

    Marqueti, Rita C; Durigan, João L Q; Oliveira, Anderson José S; Mekaro, Marcelo Shinyu; Guzzoni, Vinicius; Aro, Andrea A; Pimentel, Edson Rosa; Selistre-de-Araujo, Heloisa S

    2018-01-01

    In elderly persons, weak tendons contribute to functional limitations, injuries, and disability, but resistance training can attenuate this age-related decline. We evaluated the effects of resistance training on the extracellular matrix (ECM) of the calcaneal tendon (CT) in young and old rats and its effect on tendon remodeling. Wistar rats aged 3 mo (young, n = 30) and 20 mo (old, n = 30) were divided into 4 groups: young sedentary, young trained, old sedentary (OS), and old trained (OT). The training sessions were conducted over a 12-wk period. Aging in sedentary rats showed down-regulation in key genes that regulated ECM remodeling. Moreover, the OS group showed a calcification focus in the distal region of the CT, with reduced blood vessel volume density. In contrast, resistance training was effective in up-regulating connective tissue growth factor, VEGF, and decorin gene expression in old rats. Resistance training also increased proteoglycan content in young and old rats in special small leucine-rich proteoglycans and blood vessels and prevented calcification in OT rats. These findings confirm that resistance training is a potential mechanism in the prevention of aging-related loss in ECM and that it attenuates the detrimental effects of aging in tendons, such as ruptures and tendinopathies.-Marqueti, R. C., Durigan, J. L. Q., Oliveira, A. J. S., Mekaro, M. S., Guzzoni, V., Aro, A. A., Pimentel, E. R., Selistre-de-Araujo, H. S. Effects of aging and resistance training in rat tendon remodeling. © FASEB.

  1. Genetics Home Reference: hereditary fibrosing poikiloderma with tendon contractures, myopathy, and pulmonary fibrosis

    Science.gov (United States)

    ... Hereditary fibrosing poikiloderma with tendon contractures, myopathy, and pulmonary fibrosis Printable PDF Open All Close All Enable Javascript ... Fibrosing Poikiloderma with Tendon Contractures, Myopathy, and Pulmonary ... Lung, and Blood Institute (NHLBI): Pulmonary Function Tests National ...

  2. The adaptability of tendon to loading differs in men and women

    DEFF Research Database (Denmark)

    Magnusson, Peter S; Hansen, Philip; Langberg, Henning

    2007-01-01

    The reason why women sustain more soft tissue injury than men during physical activity is unknown. Connective tissue properties and extracellular matrix adaptability in human tendon were investigated in models that addressed biochemical, physiological and biomechanical aspects of tendon connectiv...

  3. Diclofenac Patch for Treatment of Mild to Moderate Tendonitis or Bursitis

    Science.gov (United States)

    2008-08-05

    Rotator Cuff Tendonitis; Bicipital Tendonitis; Subdeltoid Bursitis of the Shoulder; Subacromial Bursitis of the Shoulder; Medial Epicondylitis of the Elbow; Lateral Epicondylitis of the Elbow; DeQuervain's Tenosynovitis of the Wrist

  4. MOLECULAR PATHOBIOLOGICAL AND SCANNING ELECTRON MICROSCOPIC CHANGES IN HORSE TENDON CELLS TREA TED WITH ENROFLOXACIN

    Directory of Open Access Journals (Sweden)

    A. Khan1 and J. Halper

    2003-12-01

    Full Text Available Fluoroquinolone (FQNL antibiotics have been used widely in horses because of their broad-spectrum bactericidal activity and relative safety, however, their use is not without risk. Tendonitis and spontaneous tendon rupture have been reported in people during or following therapy with FQNLs. To evaluate the potential damage of enrofloxacin (ENRO on the equine superficial digital flexor tendon (SOFT, an equine cell culture system as an in vitro model of equine tendon injury and repair was developed. The effects of ENRO on tendon cell cultures established from equine SOFT were studied. The data thus collected demonstrated that ENRO inhibited cell proliferation, induced morphological changes and altered proteoglycan synthesis in equine tendon cell cultures. Interestingly, these effects were more pronounced in juvenile tendon cells as compared to adult horses, It. is hypothesized that morphological changes and inhibition of cell proliferation is a result of impaired production of proteoglycans and other glycoproteins in the extracellular matrix of ENRO-treated tendon cells.

  5. Tendon allograft sterilized by peracetic acid/ethanol combined with gamma irradiation.

    Science.gov (United States)

    Zhou, Mo; Zhang, Naili; Liu, Xiaoming; Li, Youchen; Zhang, Yumin; Wang, Xusheng; Li, Baoming; Li, Baoxing

    2014-07-01

    Research and clinical applications have demonstrated that the effects of tendon allografts are comparable to those of autografts when reconstructing injured tendons or ligaments, but allograft safety remains problematic. Sterilisation could eliminate or decrease the possibility of disease transmission, but current methods seldom achieve satisfactory sterilisation without affecting the mechanical properties of the tendon. Peracetic acid-ethanol in combination with low-dose gamma irradiation (PE-R) would inactivate potential deleterious microorganisms without affecting mechanical and biocompatible properties of tendon allograft. Controlled laboratory design. HIV, PPV, PRV and BVDV inactivation was evaluated. After verifying viral inactivation, the treated tendon allografts were characterised by optical microscopy, scanning electron microscopy and tensile testing, and the cytocompatibility was assessed with an MTT assay and by subcutaneous implantation. Effective and efficient inactivation of HIV, PPV, PRV and BVDV was observed. Histological structure and ultrastructure were unchanged in the treated tendon allograft, which also exhibited comparable biomechanical properties and good biocompatibility. The preliminary results confirmed our hypothesis and demonstrated that the PE-R tendon allograft has significant potential as an alternative to ligament/tendon reconstruction. Tendon allografts have been extensively used in ligament reconstruction and tendon repair. However, current sterilisation methods have various shortcomings, so PE-R has been proposed. This study suggests that PE-R tendon allograft has great potential as an alternative for ligament/tendon reconstruction. Sterilisation has been a great concern for tendon allografts. However, most sterilisation methods cannot inactivate viruses and bacteria without impairing the mechanical properties of the tendon allograft. Peracetic acid/ethanol with gamma irradiation can effectively inactivate viruses and bacteria

  6. MRI of the Achilles tendon: A comprehensive review of the anatomy, biomechanics, and imaging of overuse tendinopathies

    Energy Technology Data Exchange (ETDEWEB)

    Pierre-Jerome, Claude; Moncayo, Valeria; Terk, Michael R. (Dept. of Radiology, Emory Univ. Orthopedics and Spine Center, Atlanta, GA (United States)), e-mail: cpierr3@emory.edu

    2010-05-15

    The Achilles tendon is the largest tendon in the body; it plays an important role in the biomechanics of the lower extremity. It can withstand great forces, especially during sporting exercises and pivoting. The pathologies related to the Achilles tendon are diverse and many carry undesirable consequences. We retrospectively analyzed the images of patients who underwent examinations of the ankle/foot region to review the anatomy of the Achilles tendon and its surroundings and to search for pathologies consistent with overuse injuries. The anatomy of the tendon is described from origin to insertion. The imaging characteristics of the Achilles tendon including pitfalls are reviewed. We also describe the Achilles overuse injuries: paratenonitis, tendinosis, tendon tear, atypical tear, tendon re-tear, retrocalcaneal bursitis, retro-Achilles bursitis, Haglund's deformity, and tendon calcification. We present other entities like tendon ossification and failed transplanted Achilles tendon, with emphasis on MRI

  7. MRI of the Achilles tendon: A comprehensive review of the anatomy, biomechanics, and imaging of overuse tendinopathies

    International Nuclear Information System (INIS)

    Pierre-Jerome, Claude; Moncayo, Valeria; Terk, Michael R.

    2010-01-01

    The Achilles tendon is the largest tendon in the body; it plays an important role in the biomechanics of the lower extremity. It can withstand great forces, especially during sporting exercises and pivoting. The pathologies related to the Achilles tendon are diverse and many carry undesirable consequences. We retrospectively analyzed the images of patients who underwent examinations of the ankle/foot region to review the anatomy of the Achilles tendon and its surroundings and to search for pathologies consistent with overuse injuries. The anatomy of the tendon is described from origin to insertion. The imaging characteristics of the Achilles tendon including pitfalls are reviewed. We also describe the Achilles overuse injuries: paratenonitis, tendinosis, tendon tear, atypical tear, tendon re-tear, retrocalcaneal bursitis, retro-Achilles bursitis, Haglund's deformity, and tendon calcification. We present other entities like tendon ossification and failed transplanted Achilles tendon, with emphasis on MRI

  8. Ultrasound elasticity imaging of human posterior tibial tendon

    Science.gov (United States)

    Gao, Liang

    Posterior tibial tendon dysfunction (PTTD) is a common degenerative condition leading to a severe impairment of gait. There is currently no effective method to determine whether a patient with advanced PTTD would benefit from several months of bracing and physical therapy or ultimately require surgery. Tendon degeneration is closely associated with irreversible degradation of its collagen structure, leading to changes to its mechanical properties. If these properties could be monitored in vivo, it could be used to quantify the severity of tendonosis and help determine the appropriate treatment. Ultrasound elasticity imaging (UEI) is a real-time, noninvasive technique to objectively measure mechanical properties in soft tissue. It consists of acquiring a sequence of ultrasound frames and applying speckle tracking to estimate displacement and strain at each pixel. The goals of my dissertation were to 1) use acoustic simulations to investigate the performance of UEI during tendon deformation with different geometries; 2) develop and validate UEI as a potentially noninvasive technique for quantifying tendon mechanical properties in human cadaver experiments; 3) design a platform for UEI to measure mechanical properties of the PTT in vivo and determine whether there are detectable and quantifiable differences between healthy and diseased tendons. First, ultrasound simulations of tendon deformation were performed using an acoustic modeling program. The effects of different tendon geometries (cylinder and curved cylinder) on the performance of UEI were investigated. Modeling results indicated that UEI accurately estimated the strain in the cylinder geometry, but underestimated in the curved cylinder. The simulation also predicted that the out-of-the-plane motion of the PTT would cause a non-uniform strain pattern within incompressible homogeneous isotropic material. However, to average within a small region of interest determined by principal component analysis (PCA

  9. Mechanical anchorage of FRP tendons – A literature review

    DEFF Research Database (Denmark)

    Schmidt, Jacob W.; Bennitz, Anders; Täljsten, Björn

    2012-01-01

    High tensile strength, good resistance to degradation and creep, low weight and, to some extent, the ability to change the modulus of elasticity are some of the advantages of using prestressed, unidirectional FRP (Fibre Reinforced Polymer) tendon systems. Bonded and non-bonded versions of these s......High tensile strength, good resistance to degradation and creep, low weight and, to some extent, the ability to change the modulus of elasticity are some of the advantages of using prestressed, unidirectional FRP (Fibre Reinforced Polymer) tendon systems. Bonded and non-bonded versions...... with such systems. This is especially important in external post-tensioned tendon systems, where the anchorage points are exposed to the full load throughout the life span of the structure. Consequently, there are large requirements related to the long-term capacity and fatigue resistance of such systems. Several...

  10. Validity and Reliability of the Achilles Tendon Total Rupture Score

    DEFF Research Database (Denmark)

    Ganestam, Ann; Barfod, Kristoffer; Klit, Jakob

    2013-01-01

    study was to validate a Danish translation of the ATRS. The ATRS was translated into Danish according to internationally adopted standards. Of 142 patients, 90 with previous rupture of the Achilles tendon participated in the validity study and 52 in the reliability study. The ATRS showed moderately......The best treatment of acute Achilles tendon rupture remains debated. Patient-reported outcome measures have become cornerstones in treatment evaluations. The Achilles tendon total rupture score (ATRS) has been developed for this purpose but requires additional validation. The purpose of the present...... = .07). The limits of agreement were ±18.53. A strong correlation was found between test and retest (intercorrelation coefficient .908); the standard error of measurement was 6.7, and the minimal detectable change was 18.5. The Danish version of the ATRS showed moderately strong criterion validity...

  11. Could Ossification of the Achilles Tendon Have a Hereditary Component?

    Directory of Open Access Journals (Sweden)

    Chawki Cortbaoui

    2013-01-01

    Full Text Available Ossification of the Achilles tendon (OTA is an unusual clinical condition. It is characterized by the presence of an ossified mass within the fibrocartilaginous substance of the Achilles tendon. The etiology of the ossification of the Achilles tendon is unknown. Review of the literature suggests that its etiology is multifactorial. The major contributing factors are trauma and surgery with other minor causes such as systemic diseases, metabolic conditions, and infections. To our knowledge, no previous reports suggest any genetic/hereditary predisposition in OAT. We report 3 siblings who have OAT with no history of any of the aforementioned predisposing factors. Could OAT have a hereditary component as one of its etiologies?

  12. PRP as an Adjunct to Rotator Cuff Tendon Repair.

    Science.gov (United States)

    Barber, F Alan

    2018-06-01

    Arthroscopic rotator cuff repair is a commonly performed repair. Technical developments provide surgeons the tools to create biomechanically robust repairs. How can the biological response mirror the strong and stable surgery? Platelet-rich plasma (PRP) is a supraphysiological platelet concentration which may positively augment rotator cuff healing. Not all PRPs are the same. High leukocyte levels and thrombin activation may be detrimental to tendon healing. Thrombin activation triggers an immediate release of growth factors and may actually inhibit some parts of the healing response. Clear differences exist between liquid PRP (products released within hours after activation) and solid fibrin PRP which slowly releases factors over days. The heterogenicity data and grouping liquid and solid PRP together make systematic reviews confusing. Solid PRP fibrin constructs are often associated with increased tendon healing. PRP fibrin matrix offers the greatest promise for improving clinical success after rotator cuff tendon repair.

  13. Biomechanical characteristics of the eccentric Achilles tendon exercise

    DEFF Research Database (Denmark)

    Henriksen, Marius; Aaboe, Jens; Bliddal, Henning

    2009-01-01

    that although the tendon loads are similar, the tendon is vibrated at higher frequencies during the eccentric phase than during the concentric phases. This study provides data that may explain the mechanisms behind the effectiveness of eccentric exercises used in the treatment of Achilles tendinopathies........ No differences in Achilles tendon loads were found. INTERPRETATION: This descriptive study demonstrates differences in the movement biomechanics between the eccentric and concentric phases of one-legged full weight bearing ankle dorsal and plantar flexion exercises. In particular, the findings imply......BACKGROUND: Eccentric exercise has been shown to provide good short-term clinical results in the treatment of painful mid-portion chronic Achilles tendinopathies. However, the mechanisms behind the positive effects of eccentric rehabilitation regimes are not known, and research...

  14. Multiple Tophaceous Gout of Hand with Extensor Tendon Rupture

    Directory of Open Access Journals (Sweden)

    Haruki Tobimatsu

    2017-01-01

    Full Text Available A 45-year-old man presented with painless subcutaneous masses bilaterally on his hands and loss of motion or contracture of the fingers. Initially, drug therapy to reduce the serum uric acid was administered and was expected to reduce the tophi. However, during observation at the clinic, spontaneous rupture of an extensor tendon occurred, and surgical repair of the tendon and resection of the masses were performed. Surgical exploration of the right hand showed hypertrophic white-colored crystal deposits that both surrounded and invaded the extensor digitorum communis of the index finger, which was ruptured. Histopathologic examination of the specimen demonstrated findings consistent with gouty tophi. Tophaceous gout can induce a rupture of tendons during clinical observation, and surgical resection of the tophi might be needed to prevent ruptures.

  15. Morpho-functional changes in human tendon tissue

    Directory of Open Access Journals (Sweden)

    I Galliani

    2009-12-01

    Full Text Available Insertion tissue biopsies of right arm common extensor tendons from 11 patients with chronic lateral epicondylitis were processed for light and electron microscopy. The subjects were aged between 38 and 54 years (only one was 25. The specimens showed a variety of structural changes such as biochemical and spatial alteration of collagen, hyaline degeneration, loss of tenocytes, fibrocartilage metaplasia, calcifying processes, neovascularization and vessel wall modifications. Tissue alterations were evident in limited zones of the tendon fibrocartilage in which the surgical resection was generally visible. The areas where the degenerative processes were localized, were restricted and in spatial contiguity with morphologically normal ones. The observed cases presented histological and electron microscopic findings that characterize lateral epicondylitis as a degenerative phenomenon involving all tendon components.

  16. Metabolic activity and collagen turnover in human tendon in response to physical activity

    DEFF Research Database (Denmark)

    Kjaer, M; Langberg, H; Miller, B F

    2005-01-01

    Connective tissue of the human tendon plays an important role in force transmission. The extracellular matrix turnover of tendon is influenced by physical activity. Blood flow, oxygen demand, and the level of collagen synthesis and matrix metalloproteinases increase with mechanical loading. Gene...... of overuse tendon injuries occurring during sport, work or leisure-related activities....

  17. Structured white light scanning of rabbit Achilles tendon.

    Science.gov (United States)

    Hayes, Alex; Easton, Katrina; Devanaboyina, Pavan Teja; Wu, Jian-Ping; Kirk, Thomas Brett; Lloyd, David

    2016-11-07

    The cross-sectional area (CSA) of a material is used to calculate stress under load. The mechanical behaviour of soft tissue is of clinical interest in the management of injury; however, measuring CSA of soft tissue is challenging as samples are geometrically irregular and may deform during measurement. This study presents a simple method, using structured light scanning (SLS), to acquire a 3D model of rabbit Achilles tendon in vitro for measuring CSA of a tendon. The Artec Spider™ 3D scanner uses structured light and stereophotogrammetry technologies to acquire shape data and reconstruct a 3D model of an object. In this study, the 3D scanner was integrated with a custom mechanical rig, permitting 360-degree acquisition of the morphology of six New Zealand White rabbit Achilles tendons. The reconstructed 3D model was then used to measure CSA of the tendon. SLS, together with callipers and micro-CT, was used to measure CSA of objects with a regular or complex shape, such as a drill flute and human cervical vertebra, for validating the accuracy and repeatability of the technique. CSA of six tendons was measured with a coefficient of variation of less than 2%. The mean CSA was 9.9±1.0mm 2 , comparable with those reported by other researchers. Scanning of phantoms demonstrated similar results to μCT. The technique developed in this study offers a simple and accurate method for effectively measuring CSA of soft tissue such as tendons. This allows for localised calculation of stress along the length, assisting in the understanding of the function, injury mechanisms and rehabilitation of tissue. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Increased mast cell numbers in a calcaneal tendon overuse model.

    Science.gov (United States)

    Pingel, J; Wienecke, J; Kongsgaard, M; Behzad, H; Abraham, T; Langberg, H; Scott, A

    2013-12-01

    Tendinopathy is often discovered late because the initial development of tendon pathology is asymptomatic. The aim of this study was to examine the potential role of mast cell involvement in early tendinopathy using a high-intensity uphill running (HIUR) exercise model. Twenty-four male Wistar rats were divided in two groups: running group (n = 12); sedentary control group (n = 12). The running-group was exposed to the HIUR exercise protocol for 7 weeks. The calcaneal tendons of both hind limbs were dissected. The right tendon was used for histologic analysis using Bonar score, immunohistochemistry, and second harmonic generation microscopy (SHGM). The left tendon was used for quantitative polymerase chain reaction (qPCR) analysis. An increased tendon cell density in the runners were observed compared to the controls (P = 0.05). Further, the intensity of immunostaining of protein kinase B, P = 0.03; 2.75 ± 0.54 vs 1.17 ± 0.53, was increased in the runners. The Bonar score (P = 0.05), and the number of mast cells (P = 0.02) were significantly higher in the runners compared to the controls. Furthermore, SHGM showed focal collagen disorganization in the runners, and reduced collagen density (P = 0.03). IL-3 mRNA levels were correlated with mast cell number in sedentary animals. The qPCR analysis showed no significant differences between the groups in the other analyzed targets. The current study demonstrates that 7-week HIUR causes structural changes in the calcaneal tendon, and further that these changes are associated with an increased mast cell density. © 2013 The Authors. Scand J Med Sci Sports published by John Wiley & Sons Ltd.

  19. The Role of Bioreactors in Ligament and Tendon Tissue Engineering.

    Science.gov (United States)

    Mace, James; Wheelton, Andy; Khan, Wasim S; Anand, Sanj

    2016-01-01

    Bioreactors are pivotal to the emerging field of tissue engineering. The formation of neotissue from pluripotent cell lineages potentially offers a source of tissue for clinical use without the significant donor site morbidity associated with many contemporary surgical reconstructive procedures. Modern bioreactor design is becoming increasingly complex to provide a both an expandable source of readily available pluripotent cells and to facilitate their controlled differentiation into a clinically applicable ligament or tendon like neotissue. This review presents the need for such a method, challenges in the processes to engineer neotissue and the current designs and results of modern bioreactors in the pursuit of engineered tendon and ligament.

  20. Supraspinatus Intramuscular Calcified Hematoma or Necrosis Associated with Tendon Tear

    Directory of Open Access Journals (Sweden)

    Alexandre Lädermann

    2015-01-01

    Full Text Available Introduction. Rotator cuff intramuscular calcification is a rare condition usually caused by heterotopic ossification and myositis ossificans. Case Presentation. We describe a patient with voluminous calcified mass entrapped in supraspinatus muscle associated with corresponding tendon tear. Histological examination corresponded to a calcified hematoma or necrosis. Patient was surgically managed with open excision of the calcified hematoma and rotator cuff arthroscopic repair. At 6 months, supraspinatus muscle was healed, and functional outcome was good. Discussion and Conclusion. We hypothesized that supraspinatus intramuscular calcified hematoma was responsible for mechanical stress on the tendon. This association has never been described.

  1. Tensile tests of 2500-kip prestressing tendons for the PCRV

    International Nuclear Information System (INIS)

    Nicolayeff, V.

    1978-05-01

    A 2500-kip (11-MN) capacity prestressing tendon consisting of sixty 0.5-in. (12.7-mm) strands was designed and tested for General Atomic Company by VSL Corporation of Los Gatos, California. Results of the static tensile test described in this report, and of dynamic tensile tests conducted by VSL in 1968 and 1969, indicate that the tendon system satisfies the requirements of the ASME Boiler and Pressure Vessel Code, Section III, Division 2, and so can be used for prestressing concrete reactor vessels

  2. Human Achilles tendon glycation and function in diabetes

    DEFF Research Database (Denmark)

    Couppe, Christian; Svensson, Rene Brüggebusch; Kongsgaard, Mads

    2016-01-01

    Diabetic patients have an increased risk of foot ulcers, and glycation of collagen may increase tissue stiffness. We hypothesized that the level of glycemic control (glycation) may affect Achilles tendon stiffness, which can influence gait pattern. We therefore investigated the relationship between...... tissue cross-linking were greater in diabetic patients compared to controls. The higher foot pressure indicates that material stiffness of tendon and other tissue (e.g skin and joint capsule) may influence on foot gait. The difference in foot pressure distribution may contribute to the development...... of foot ulcers in diabetic patients....

  3. Testing of large prestressing tendon end anchorage regions

    International Nuclear Information System (INIS)

    Johnson, T.E.

    1976-01-01

    Tests were performed on concrete end anchorage regions for prestressing tendons with ultimate strengths of approximately 8,900 kN. One test structure simulated a full scale concrete containment buttress and the other two test specimens were concrete blocks. The behavior of the test structure and specimens, when subjected to loading, was monitored by strain gages and dial gages. The testing illustrated that all of the amounts of reinforcing tested should be acceptable for the end anchor zones of large tendons presently used in prestressed concrete containment structures. (author)

  4. Consumer sensory evaluation and chemical composition of beef gluteus medius and triceps brachii steaks from cattle finished on forage or concentrate diets.

    Science.gov (United States)

    Chail, A; Legako, J F; Pitcher, L R; Ward, R E; Martini, S; MacAdam, J W

    2017-04-01

    The objective of this study was to assess the impact of cattle finishing diet and muscle type on meat quality. Consumer sensory response, proximate composition, Warner-Bratzler shear force (WBSF), fatty acid composition, and volatile compounds were assessed from the gluteus medius (GM) and triceps brachii (TB) muscles of cattle ( = 6 per diet) which were grain-finished (USUGrain) on conventional feedlot or 2 forage diets, a perennial legume, birdsfoot trefoil-finished (USUBFT; ), and grass-finished (USUGrass; ). Diet had an interacting effect with muscle for all sensory attributes ( ≤ 0.002), except aroma and flavor ( ≥ 0.078). In forage-finished beef, tenderness, fattiness, overall liking, and WBSF tenderness of GM was greater ( 0.05) but the juiciness of TB was more liked than USUGrain GM ( 0.05) between GM and TB. Lower ( 0.05) to both USUGrass and USUGrain beef. However, IMF percent was not impacted by muscle type ( = 0.092). The ratio of -6:-3 fatty acids was affected by muscle dependent on diet ( = 0.016). The ratio of -6:-3 fatty acids was affected by the interaction of muscle × diet ( = 0.016). Between forage diets (USUGrass and USUBFT), -6:-3 ratios were similar ( > 0.05) between GM and TB, whereas within USUGrain, the GM was greater ( 0.05). Strecker aldehydes, ketones, pyrazines, and methional were affected ( ≤ 0.036) by muscle and found to have a greater concentration in GM compared with TB. Overall, consumers determined that USUGrain GM and TB had similar ( > 0.05) quality ratings. However, within forage-finished beef, the GM was perceived more frequently ( consumer group grilled GM and TB steaks, grain-finished beef provided more uniform quality and eating experience compared with forage-finished beef.

  5. Synergistic and Antagonistic Interplay between Myostatin Gene Expression and Physical Activity Levels on Gene Expression Patterns in Triceps Brachii Muscles of C57/BL6 Mice

    Science.gov (United States)

    Caetano-Anollés, Kelsey; Mishra, Sanjibita; Rodriguez-Zas, Sandra L.

    2015-01-01

    Levels of myostatin expression and physical activity have both been associated with transcriptome dysregulation and skeletal muscle hypertrophy. The transcriptome of triceps brachii muscles from male C57/BL6 mice corresponding to two genotypes (wild-type and myostatin-reduced) under two conditions (high and low physical activity) was characterized using RNA-Seq. Synergistic and antagonistic interaction and ortholog modes of action of myostatin genotype and activity level on genes and gene pathways in this skeletal muscle were uncovered; 1,836, 238, and 399 genes exhibited significant (FDR-adjusted P-value myostatin-reduced relative to active and inactive wild-type, (ii) inactive myostatin-reduced and active wild-type, and (iii) inactive myostatin-reduced and inactive wild-type. Several remarkable genes and gene pathways were identified. The expression profile of nascent polypeptide-associated complex alpha subunit (Naca) supports a synergistic interaction between activity level and myostatin genotype, while Gremlin 2 (Grem2) displayed an antagonistic interaction. Comparison between activity levels revealed expression changes in genes encoding for structural proteins important for muscle function (including troponin, tropomyosin and myoglobin) and for fatty acid metabolism (some linked to diabetes and obesity, DNA-repair, stem cell renewal, and various forms of cancer). Conversely, comparison between genotype groups revealed changes in genes associated with G1-to-S-phase transition of the cell cycle of myoblasts and the expression of Grem2 proteins that modulate the cleavage of the myostatin propeptide. A number of myostatin-feedback regulated gene products that are primarily regulatory were uncovered, including microRNA impacting central functions and Piezo proteins that make cationic current-controlling mechanosensitive ion channels. These important findings extend hypotheses of myostatin and physical activity master regulation of genes and gene pathways

  6. Influence of repetitive mechanical loading on MMP2 activity in tendon fibroblasts.

    Science.gov (United States)

    Huisman, Elise; Lu, Alex; Jamil, Sarwat; Mousavizadeh, Rouhollah; McCormack, Robert; Roberts, Clive; Scott, Alex

    2016-11-01

    Matrix metalloproteinase2 has been implicated in tendon pathology caused by repetitive movements. However, its activity in the early stages of the tendon's response to overuse, and its presence in the circulation as a possible indicator of tendon degradation, remain unknown. Human tendon cells were repetitively stretched for 5 days, and the rabbit Achilles tendon complex underwent repetitive motion 3× per week for 2 weeks. Quantitative polymer chain reaction analysis was performed to detect matrix metalloproteinase2/14 and tissue inhibitor of matrix metalloproteinase2 messenger ribonucleic acid of cells and rabbit tissue, and matrix metalloproteinase2 protein levels were determined with an enzyme linked immunoassay. Matrix metalloproteinase2 activity was examined using zymography of the conditioned media, tendon and serum. Immunohistochemistry was used to localize matrix metalloproteinase2 in tendon tissue, and the density of fibrillar collagen in tendons was examined using second harmonic generation microscopy. Tendon cells stretched with high strain or high frequency demonstrated increased matrix metalloproteinase2 messenger ribonucleic acid and protein levels. Matrix metalloproteinase2 activity was increased in the rabbit Achilles tendon tissue at weeks 1 and 2; however, serum activity was only increased at week 1. After 2 weeks of exercise, the collagen density was lower in specific regions of the exercised rabbit Achilles tendon complex. Matrix metalloproteinase2 expression in exercised rabbit Achilles tendons was detected surrounding tendon fibroblasts. Repetitive mechanical stimulation of tendon cells results in a small increase in matrix metalloproteinase2 levels, but it appears unlikely that serum matrix metalloproteinase2 will be a useful indicator of tendon overuse injury. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1991-2000, 2016. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  7. Tendon material properties vary and are interdependent among turkey hindlimb muscles.

    Science.gov (United States)

    Matson, Andrew; Konow, Nicolai; Miller, Samuel; Konow, Pernille P; Roberts, Thomas J

    2012-10-15

    The material properties of a tendon affect its ability to store and return elastic energy, resist damage, provide mechanical feedback and amplify or attenuate muscle power. While the structural properties of a tendon are known to respond to a variety of stimuli, the extent to which material properties vary among individual muscles remains unclear. We studied the tendons of six different muscles in the hindlimb of Eastern wild turkeys to determine whether there was variation in elastic modulus, ultimate tensile strength and resilience. A hydraulic testing machine was used to measure tendon force during quasi-static lengthening, and a stress-strain curve was constructed. There was substantial variation in tendon material properties among different muscles. Average elastic modulus differed significantly between some tendons, and values for the six different tendons varied nearly twofold, from 829±140 to 1479±106 MPa. Tendons were stretched to failure, and the stress at failure, or ultimate tensile stress, was taken as a lower-limit estimate of tendon strength. Breaking tests for four of the tendons revealed significant variation in ultimate tensile stress, ranging from 66.83±14.34 to 112.37±9.39 MPa. Resilience, or the fraction of energy returned in cyclic length changes was generally high, and one of the four tendons tested was significantly different in resilience from the other tendons (range: 90.65±0.83 to 94.02±0.71%). An analysis of correlation between material properties revealed a positive relationship between ultimate tensile strength and elastic modulus (r(2)=0.79). Specifically, stiffer tendons were stronger, and we suggest that this correlation results from a constrained value of breaking strain, which did not vary significantly among tendons. This finding suggests an interdependence of material properties that may have a structural basis and may explain some adaptive responses observed in studies of tendon plasticity.

  8. Fascicles and the interfascicular matrix show decreased fatigue life with ageing in energy storing tendons.

    Science.gov (United States)

    Thorpe, Chavaunne T; Riley, Graham P; Birch, Helen L; Clegg, Peter D; Screen, Hazel R C

    2017-07-01

    Tendon is composed of rope-like fascicles bound together by interfascicular matrix (IFM). The IFM is critical for the function of energy storing tendons, facilitating sliding between fascicles to allow these tendons to cyclically stretch and recoil. This capacity is required to a lesser degree in positional tendons. We have previously demonstrated that both fascicles and IFM in energy storing tendons have superior fatigue resistance compared with positional tendons, but the effect of ageing on the fatigue properties of these different tendon subunits has not been determined. Energy storing tendons become more injury-prone with ageing, indicating reduced fatigue resistance, hence we tested the hypothesis that the decline in fatigue life with ageing in energy storing tendons would be more pronounced in the IFM than in fascicles. We further hypothesised that tendon subunit fatigue resistance would not alter with ageing in positional tendons. Fascicles and IFM from young and old energy storing and positional tendons were subjected to cyclic fatigue testing until failure, and mechanical properties were calculated. The results show that both IFM and fascicles from the SDFT exhibit a similar magnitude of reduced fatigue life with ageing. By contrast, the fatigue life of positional tendon subunits was unaffected by ageing. The age-related decline in fatigue life of tendon subunits in energy storing tendons is likely to contribute to the increased risk of injury in aged tendons. Full understanding of the mechanisms resulting in this reduced fatigue life will aid in the development of treatments and interventions to prevent age-related tendinopathy. Understanding the effect of ageing on tendon-structure function relationships is crucial for the development of effective preventative measures and treatments for age-related tendon injury. In this study, we demonstrate for the first time that the fatigue resistance of the interfascicular matrix decreases with ageing in energy

  9. Generalization of proposed tendon friction correlation and its application to PCCV structural analysis

    International Nuclear Information System (INIS)

    Kashiwase, Takako; Nagasaka, Hideo

    2000-01-01

    The present paper dealt with the extension of tendon friction coefficient correlation as a function of loading end load and circumferential angle, proposed in the former paper. The extended correlation further included the effects of the number of strands contacted with sheath, tendon diameter, politicization of tendon and tendon local curvature. The validity of the correlation was confirmed by several published measured data. The structural analysis of middle cylinder part of 1/4 PCCV (Prestressed Concrete Containment Vessel) model was conducted using the present friction coefficient correlation. The results were compared with the analysis using constant friction coefficient, focused on the tendon tension force distribution. (author)

  10. Tendon Reattachment to Bone in an Ovine Tendon Defect Model of Retraction Using Allogenic and Xenogenic Demineralised Bone Matrix Incorporated with Mesenchymal Stem Cells.

    Directory of Open Access Journals (Sweden)

    Tanujan Thangarajah

    Full Text Available Tendon-bone healing following rotator cuff repairs is mainly impaired by poor tissue quality. Demineralised bone matrix promotes healing of the tendon-bone interface but its role in the treatment of tendon tears with retraction has not been investigated. We hypothesized that cortical demineralised bone matrix used with minimally manipulated mesenchymal stem cells will result in improved function and restoration of the tendon-bone interface with no difference between xenogenic and allogenic scaffolds.In an ovine model, the patellar tendon was detached from the tibial tuberosity and a complete distal tendon transverse defect measuring 1 cm was created. Suture anchors were used to reattach the tendon and xenogenic demineralised bone matrix + minimally manipulated mesenchymal stem cells (n = 5, or allogenic demineralised bone matrix + minimally manipulated mesenchymal stem cells (n = 5 were used to bridge the defect. Graft incorporation into the tendon and its effect on regeneration of the enthesis was assessed using histomorphometry. Force plate analysis was used to assess functional recovery.Compared to the xenograft, the allograft was associated with significantly higher functional weight bearing at 6 (P = 0.047, 9 (P = 0.028, and 12 weeks (P = 0.009. In the allogenic group this was accompanied by greater remodeling of the demineralised bone matrix into tendon-like tissue in the region of the defect (p = 0.015, and a more direct type of enthesis characterized by significantly more fibrocartilage (p = 0.039. No failures of tendon-bone healing were noted in either group.Demineralised bone matrix used with minimally manipulated mesenchymal stem cells promotes healing of the tendon-bone interface in an ovine model of acute tendon retraction, with superior mechanical and histological results associated with use of an allograft.

  11. The Prevalence and Role of Low Lying Peroneus Brevis Muscle Belly in Patients with Peroneal Tendon Pathologies: A Potential Source for Tendon Subluxation

    OpenAIRE

    Mirmiran, Roya; Squire, Chad; Wassell, Daniel

    2015-01-01

    A low lying peroneus brevis muscle belly is a rare anomaly. There are few published studies that support presence of this anomaly as an etiology for peroneal tendon tear. However, the association between a low lying peroneus muscle belly (LLMB) and tendon subluxation is not well explored. In this retrospective study, the magnetic resonance imaging (MRI) and intraoperative findings of 50 consecutive patients undergoing a primary peroneal tendon surgery, in a five year period, were assessed. Th...

  12. Physical principles demonstrate that the biceps femoris muscle relative to the other hamstring muscles exerts the most force: implications for hamstring muscle strain injuries.

    Science.gov (United States)

    Dolman, Bronwyn; Verrall, Geoffrey; Reid, Iain

    2014-07-01

    Of the hamstring muscle group the biceps femoris muscle is the most commonly injured muscle in sports requiring interval sprinting. The reason for this observation is unknown. The objective of this study was to calculate the forces of all three hamstring muscles, relative to each other, during a lengthening contraction to assess for any differences that may help explain the biceps femoris predilection for injury during interval sprinting. To calculate the displacement of each individual hamstring muscle previously performed studies on cadaveric anatomical data and hamstring kinematics during sprinting were used. From these displacement calculations for each individual hamstring muscle physical principles were then used to deduce the proportion of force exerted by each individual hamstring muscle during a lengthening muscle contraction. These deductions demonstrate that the biceps femoris muscle is required to exert proportionally more force in a lengthening muscle contraction relative to the semimembranosus and semitendinosus muscles primarily as a consequence of having to lengthen over a greater distance within the same time frame. It is hypothesized that this property maybe a factor in the known observation of the increased susceptibility of the biceps femoris muscle to injury during repeated sprints where recurrent higher force is required.

  13. Analysis of factors that influence the maximum number of repetitions in two upper-body resistance exercises: curl biceps and bench press.

    Science.gov (United States)

    Iglesias, Eliseo; Boullosa, Daniel A; Dopico, Xurxo; Carballeira, Eduardo

    2010-06-01

    The purpose of this study was to analyze the influence of exercise type, set configuration, and relative intensity load on relationship between 1 repetition maximum (1RM) and maximum number of repetitions (MNR). Thirteen male subjects, experienced in resistance training, were tested in bench press and biceps curl for 1RM, MNR at 90% of 1RM with cluster set configuration (rest of 30s between repetitions) and MNR at 70% of 1RM with traditional set configuration (no rest between repetitions). A lineal encoder was used for measuring displacement of load. Analysis of variance analysis revealed a significant effect of load (pbench press and biceps curl, respectively; pbench press and biceps curl, respectively; p>0.05). Correlation between 1RM and MNR was significant for medium-intensity in biceps curl (r=-0.574; pvelocity along set, so velocity seems to be similar at a same relative intensity for subjects with differences in maximum strength levels. From our results, we suggest the employment of MNR rather than % of 1RM for training monitoring. Furthermore, we suggest the introduction of cluster set configuration for upper-body assessment of MNR and for upper-body muscular endurance training at high-intensity loads, as it seems an efficient approach in looking for sessions with greater training volumes. This could be an interesting approach for such sports as wrestling or weightlifting.

  14. Healing of the Achilles tendon in rabbits--evaluation by magnetic resonance imaging and histopathology.

    Science.gov (United States)

    Tavares, Wilson Campos; de Castro, Ubiratam Brum; Paulino, Eduardo; Vasconcellos, Leonardo de Souza; Madureira, Ana Paula; Magalhães, Maria Angélica Baron; Mendes, Daniel Victor Moreira; Kakehasi, Adriana Maria; Resende, Vivian

    2014-12-12

    Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) could provide valuable findings for tendon regeneration. A non-invasive image method that can effectively evaluate the quality of the scar tissue has not yet been employed. Thirteen New Zealand rabbits were divided into two groups: group 1--non-treated control (n = 4); group 2--surgical intervention (n = 9). The central portion of the Achilles tendon was resected, and after 30 days, DCE-MRI was performed. Contrast enhancement methods were applied using the region of interest (ROI) technique. In the medium third of the Achilles tendon, the intra-substantial signal intensity and the presence of hyper-intense intra-tendon focus points and of signal heterogeneity were evaluated. Antero-posterior and transversal diameters of the tendon were measured. The Achilles tendon was removed and dissected free from other tissues. Sections from the central part of the tendon were stained for histological analysis. The difference between the contrast enhancement curves of the control and surgical groups (p tendon sheath, which presented irregular contours and intense contrast enhancement. On histology, the Achilles tendon presented diffuse widening of the tendon sheath and wedge-shaped areas with scarring tissue rich in disordered collagen fibres. These findings were related to alteration in the intra-substantial signal intensity, with hyper-signal focus points in the DCE-MRI. MRI with perfusion could be a useful technique for evaluating tissue and fibrous scarring in tendons.

  15. The prevalence of tenosynovitis of the interosseous tendons of the hand in patients with rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Rowbotham, Emma L. [Leeds Teaching Hospitals NHS Trust, Musculoskeletal Radiology Department, Leeds (United Kingdom); Freeston, Jane E. [Department of Rheumatology, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Emery, Paul [University of Leeds, Arthritis Research UK, Leeds Musculoskeletal Biomedical Research Unit, LTHT Leeds Institute of Rheumatic Musculoskeletal Medicine, Leeds (United Kingdom); Grainger, Andrew J. [Leeds Teaching Hospitals NHS Trust, Musculoskeletal Radiology Department, Leeds (United Kingdom); Chapel Allerton Hospital, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds (United Kingdom)

    2016-02-15

    The aim of this study was to establish the prevalence of tenosynovitis affecting the interosseous tendons of the hand in a rheumatoid arthritis (RA) population and to assess for association with metacarpophalangeal (MCP) joint synovitis, flexor tendon tenosynovitis or ulnar drift. Forty-four patients with RA underwent hand MRI along with 20 normal controls. Coronal 3D T1 VIBE sequences pre- and post-contrast were performed and reconstructed. The presence of interosseous tendon tenosynovitis was recorded alongside MCP joint synovitis, flexor tendon tenosynovitis and ulnar drift. Twenty-one (47.7 %) patients with RA showed interosseous tendon tenosynovitis. Fifty-two (14.8 %) interosseous tendons showed tenosynovitis amongst the RA patients. Interosseous tendon tenosynovitis was more commonly seen in association with adjacent MCP joint synovitis (p < 0.001), but nine MCP joints (5.1 %) showed adjacent interosseous tenosynovitis in the absence of joint synovitis. Interosseous tendon tenosynovitis was more frequently seen in fingers which also showed flexor tendon tenosynovitis (p < 0.001) and in patients with ulnar drift of the fingers (p = 0.01). Tenosynovitis of the hand interosseous tendons was found in 47.7 % of patients with RA. In the majority of cases this was adjacent to MCP joint synovitis; however, interosseous tendon tenosynovitis was also seen in isolation. (orig.)

  16. The prevalence of tenosynovitis of the interosseous tendons of the hand in patients with rheumatoid arthritis

    International Nuclear Information System (INIS)

    Rowbotham, Emma L.; Freeston, Jane E.; Emery, Paul; Grainger, Andrew J.

    2016-01-01

    The aim of this study was to establish the prevalence of tenosynovitis affecting the interosseous tendons of the hand in a rheumatoid arthritis (RA) population and to assess for association with metacarpophalangeal (MCP) joint synovitis, flexor tendon tenosynovitis or ulnar drift. Forty-four patients with RA underwent hand MRI along with 20 normal controls. Coronal 3D T1 VIBE sequences pre- and post-contrast were performed and reconstructed. The presence of interosseous tendon tenosynovitis was recorded alongside MCP joint synovitis, flexor tendon tenosynovitis and ulnar drift. Twenty-one (47.7 %) patients with RA showed interosseous tendon tenosynovitis. Fifty-two (14.8 %) interosseous tendons showed tenosynovitis amongst the RA patients. Interosseous tendon tenosynovitis was more commonly seen in association with adjacent MCP joint synovitis (p < 0.001), but nine MCP joints (5.1 %) showed adjacent interosseous tenosynovitis in the absence of joint synovitis. Interosseous tendon tenosynovitis was more frequently seen in fingers which also showed flexor tendon tenosynovitis (p < 0.001) and in patients with ulnar drift of the fingers (p = 0.01). Tenosynovitis of the hand interosseous tendons was found in 47.7 % of patients with RA. In the majority of cases this was adjacent to MCP joint synovitis; however, interosseous tendon tenosynovitis was also seen in isolation. (orig.)

  17. Evaluation of the equine digital flexor tendon sheath using diagnostic ultrasound and contrast radiography

    International Nuclear Information System (INIS)

    Redding, W.R.

    1994-01-01

    This study was designed to evaluate the normal anatomy of the digital flexor tendon sheath using contrast radiography and diagnostic ultrasound. Iodinated contrast medium was injected into eight cadaver limbs and the limbs immediately frozen. Lateromedial and dorsopalmar/plantar radiographs were made. These limps were then cut transversely and proximal to distal radiographs of each slab were made. This cross sectional contrast methodology allowed the visualization of the relative size and shape of the superficial and deep digital flexor tendons as well as the potential space taken by effusions of the digital flexor tendon sheath. The second part of the study used twelve live animals with normal digital flexor tendon sheaths. Ultrasonographic measurement of the structures of the digital flexor tendon sheath at each level were compiled. This documented the ability of diagnostic ultrasound to image: 1) the superficial and deep digital flexor tendons, 2) the proximal and distal ring of the manica flexoria, 3) the straight and oblique sesamoidean ligaments, and 4) the mesotendinous attachments to the superficial and deep flexor tendons. Iodinated contrast medium was then injected into the digital flexor tendon sheath and the ultrasonography repeated. These images were compared with those obtained from contrast radiography and prosections of twenty normal limbs. The iodinated contrast medium enhanced sonographic imaging of the structures of the digital tendon sheath, particularly the abaxial borders of the superficial digital flexor tendon branches and the mesotendinous attachments to the superficial and deep digital flexor tendons

  18. Presence of a long acc