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Sample records for biceps brachii tendon

  1. Tenotomy versus Tenodesis in the treatment of the long head of biceps brachii tendon lesions

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    Galasso Olimpio

    2012-10-01

    Full Text Available Abstract Background The superiority of tenotomy vs. tenodesis for surgery on lesions of the long head of the biceps brachii tendon is still under debate. Indeed, high-quality evidence is lacking, mainly because of methodological problems, such as retrospective design, population sample size or lack of patient randomization. Methods/Design The study will be a two-center, double-blind, randomized, controlled trial to compare patients treated with biceps tenotomy or tenodesis for lesions of the long head of the biceps brachii tendon over a 2-year follow-up period. The study participants will be 128 adults with biceps brachii tendinopathy and supraspinatus tendon tears. The primary end point will be the postoperative difference in the Constant-Murley score (CMS between the 2 groups at the two-year follow-up. A comparison of the mean improvement with standard age- and gender-related CMS will be performed. The secondary end point will be evaluation of the postoperative general health of patients, as evaluated with Short Form 36 (SF-36 scores. The number and severity of complications associated with use of the different surgical techniques will be assessed. Discussion This study will be the first randomized and appropriately powered clinical trial to directly compare tenotomy and biceps tenodesis. The results of this study will help to establish clinical practice guidelines for patients suffering from lesions of the long head of the biceps brachii tendon, providing important information to patients and health care providers about the possible complications, outcome predictors and effectiveness of the targeted interventions. Trial Registration Current Controlled Trials ISRCTN38839558

  2. Unusual late sequel of ruptured distal tendon of biceps brachii mimicking a soft-tissue tumor

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    Qureshi, Sajid S.; Puri, Ajay; Agarwal, Manish [Department of Bone and Soft Tissue, Tata Memorial Hospital, E. Borges Road, Parel, Bombay (India); Merchant, N.H.; Sheth, Tanuja; Jambhekar, Nirmala [Department of Radiology, Tata Memorial Hospital, Bombay (India)

    2004-07-01

    We report a rare case of chronic, neglected rupture of the distal biceps brachii which presented with gradually increasing swelling over the left lower arm. Fine-needle aspiration cytology was reported as indicative of a soft-tissue neoplasm. Computed tomography and magnetic resonance imaging were unable to rule out a neoplastic mass. Final histopathology after surgical excision revealed a reparative process. Such a presentation of ruptured biceps brachii wherein the clinicoradiological features are misleading and suggestive of a soft-tissue tumor is quite unusual. (orig.)

  3. 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.)

  4. Avulsion of the distal tendon of the biceps brachii: reattachment to the radial tuberosity via 1-incision technique.

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    Gifuni, P; Strada, U

    2001-01-01

    Between 1995 and 1997 a total of 5 patients with injury of the distal tendon of the biceps brachii were treated by reattachment to the radial tuberosity using Henry anterior access to the elbow. The results obtained through a clinical and instrumental evaluation, and the answers to a questionnaire, were good or excellent. What was particular about our work was that we treated all of the patients by a single Henry anterior access and not a double Boyd and Anderson one, which is more commonly used. Our decision was based on the minor amount of surgical invasiveness, the simpler method of reinsertion of the tendon and the minor incidence of possible radio-ulnar synostoses. This surgical approach requires particular care with regard to possible injuries of the radial nerve, that, moreover, are easily avoidable if surgery is performed by experts, with accurate and limited preparation of the site of reattachment.

  5. Supernumerary head of biceps brachii

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    Balasubramanian A

    2010-01-01

    The biceps brachii muscle and the musculocutaneous nerve of arm are frequent in their variations. A third head of biceps brachii was noted unilaterally during routine anatomy dissection. Variation in musculocutaneous nerve was also seen on the same arm. The evolutionary and functional basis of such variations are discussed. Such variations become relevant during surgical intervention of the arm, especially after humeral fracture with subsequent unusual bone displacements.

  6. Supernumerary head of biceps brachii

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    Balasubramanian A

    2010-12-01

    Full Text Available The biceps brachii muscle and the musculocutaneous nerve of arm are frequent in their variations. A third head of biceps brachii was noted unilaterally during routine anatomy dissection. Variation in musculocutaneous nerve was also seen on the same arm. The evolutionary and functional basis of such variations are discussed. Such variations become relevant during surgical intervention of the arm, especially after humeral fracture with subsequent unusual bone displacements.

  7. Biomechanical evaluation of the long head of the biceps brachii tendon fixed by three techniques: a sheep model

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    Carlos Henrique Ramos

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the biomechanical properties of the fixation of the long head of the biceps brachii into the humeral bone with suture anchors, interference screw, and soft tissue suture, comparing strength, highest traction load, and types of fixation failure. METHODS: Thirty fresh-frozen sheep shoulders were used, separated into three groups of ten for each technique. After fixation, the tendons were subjected to longitudinal continuous loading, obtaining load-to-failure (N and displacement (mm. RESULTS: The mean load-to-failure for suture anchors was 95 ± 35.3 N, 152.7 ± 52.7 N for interference screw, and 104.7 ± 23.54 N for soft tissue technique. There was a statistically significant difference (p < 0.05, with interference screw demonstrating higher load-to-failure than suture anchor fixation (p = 0.00307 and soft tissue (p = 0.00473. The strength of interference screw was also superior when compared with the other two methods (p = 0.0000127 and p = 0.00000295, respectively. There were no differences between suture anchors and soft tissue technique regarding load-to-failure (p = 0.9420 and strength (p = 0.141. CONCLUSION: Tenodesis of the long head of the biceps brachii with interference screw was stronger than the suture anchors and soft tissue techniques. The other two techniques did not differ between themselves.

  8. Anomalies of the long head of the biceps brachii tendon: clinical significance, MR arthrographic findings, and arthroscopic correlation in two patients

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    Gaskin, Cree M.; Blount, Kevin J. [UVA Health Sciences Center, Department of Radiology, Charlottesville, VA (United States); Golish, S.R.; Diduch, David R. [UVA Health Sciences Center, Department of Orthopaedics, Charlottesville, VA (United States)

    2007-08-15

    Two patients with clinically relevant anomalies of the long head of the biceps brachii tendon (LHBT) are presented with MR arthrography and surgical correlation. Such variations in the LHBT can mimic tears of the tendon itself or the adjacent superior labrum both on MR arthrography and at surgery. MR arthrographic features are recognizable and allow for correct prospective diagnosis, possibly averting unnecessary surgery. Although further study is needed, patients with these anomalies may be at increased risk for developing shoulder instability. (orig.)

  9. Focal partial tears of the long head of the biceps brachii tendon at the entrance to the bicipital groove: MR imaging findings, surgical correlation, and clinical significance

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    Gaskin, Cree M.; Anderson, Mark W.; Choudhri, Asim [UVA Health System, Department of Radiology, Charlottesville, VA (United States); Diduch, David R. [UVA Health System, Department of Orthopedics, Charlottesville, VA (United States)

    2009-10-15

    The purpose of the study was to depict a subset of focal partial tears of the biceps brachii tendon, occurring at the entrance to the bicipital groove, which can be difficult to detect with MRI. The institutional review board approved this HIPAA-compliant study; informed consent was waived. The authors retrospectively reviewed imaging and medical records in 16 consecutive patients (12 men, 4 women; mean age, 57 years) who had prospective MRI diagnoses of tendinopathy and/or partial tearing of the intra-articular segment of the long head of the biceps brachii tendon (LHBT) at the entrance to the bicipital groove (restricted to within 1 cm of the groove entrance) and who also had surgical correlation within 4 months of imaging. Focal intrasubstance signal abnormality was noted in the tendons of 16 out of 16 (100%) patients. Focal tendon enlargement was noted in 8 out of 16 patients (50%). Fifteen out of 16 biceps partial tears (94%) were treated surgically. Shoulder pathology was restricted to the groove entrance in 4 out of 16 patients (25%). We depict a subset of focal partial tears of the biceps tendon, which can be difficult to detect on MRI because of their anatomical location at the entrance to the bicipital groove. Although they may coexist with other causes of shoulder pain, these lesions can also occur in isolation. In either case, they are potential causes of pain that can be addressed surgically. (orig.)

  10. ADDITIONAL TENDINOUS INSERTION OF BICEPS BRACHII: A CASE REPORT

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    Daimi S.R

    2010-03-01

    Full Text Available In view of the variable presentations of biceps brachii, a proper understanding of the anatomy of the muscle, and possible anatomical variants is a pre-requisite in managing distal biceps injury. We present the case of a 65 years old male cadaver showing variationin the insertion pattern of biceps brachii muscle unilaterally on the left arm. Although the origin of the muscle was normal, its insertion was by two separate tendons; a common and an accessory; both inserting on diverse regions of the radial tuberosity. The common tendon was formed by the tendons from short head and long head. The accessory tendon was the extension of the fleshy belly on the lateral side of the main muscle (Accessory Muscle Belly towards its lower third. Knowledge of the accessory tendon of the biceps iscrucial while performing tendon reconstruction and repair and it may also lead to unusual displacement of the bone fragment, subsequent to fracture.

  11. Arthroscopic evaluation and treatment of biceps brachii long head tendon injuries: A survey of the MOON shoulder group

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    Timothy Miller

    2011-01-01

    Full Text Available Context: Injuries to the biceps brachii long head tendon commonly occur in conjunction with tears in the rotator cuff and glenoid labrum. Consensus on treatment of varying levels of severity is undetermined. Settings and Design: We surveyed members of the Multicenter Orthopedic Outcomes Network (MOON Shoulder Group, to determine a consensus on arthroscopic grading and treatment. Aims: We hypothesized that the Lafosse classification system would show a high level of inter- and intraobserver agreement regarding grading/treatment. Materials and Methods: Arthroscopic videos of 30 patients determined to have biceps brachii long head tendon injuries were viewed by 13 surgeons. The surgeons graded the severity of the injury macrostructure based on the Lafosse classification system and chose from a list of treatment options. Four months later the same surgeons viewed the same videos and repeated the survey. Statistical Analysis Used: Analysis with weighted and non-weighted Kappa values was performed to determine intra- and interobserver reliability for severity grading and to determine the preferred treatments for each level of severity. Results: Intraobserver reliability testing for the Lafosse system showed substantial agreement after two rounds (81.28%, K=0.7006. Interobserver testing demonstrated substantial agreement for Grade 0 (K=0.7152, fair agreement for Grade 1 (K=0.3803, and moderate agreement for Grade 2 (K=0.5156. Combined responses recommended no surgical treatment for 95.4% of the lesions classified as grade 0 (62/65. No surgical treatment was recommended for Grade 1 lesions in 24.1% of the cases (35/145, debridement in 38.6% (56/145, and tenotomy or tenodesis in 37.2% (54/145. Evaluators preferred tenotomy or tenodesis for 98.3% of the Grade 2 lesions (177/180. Conclusions: Analysis of the Lafosse system indicated substantial intraobserver reliability for all grades. As Grades 1 and 2 showed only fair and moderate agreement, a need for a

  12. [New arthroscopic portal for performing tenotomy/tenodesis procedures on the long head of the biceps brachii tendon].

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    Gutiérrez-de la O, Jorge; Espinosa-Uribe, Abraham Guadalupe; Morales-Avalos, Rodolfo; Vílchez-Cavazos, Félix; Elizondo-Omaña, Rodrigo Enrique; Guzmán-López, Santos

    2016-01-01

    Shoulder arthroscopy is the standard technique for performing procedures involving the intertubercular groove. Current techniques continue to produce excessive soft tissue manipulation and neurovascular injury. A cross-sectional, observational and descriptive study was conducted on a cohort of 24 shoulders following the standard surgical protocol and using punch dissection. The neurovascular structures with risk of damage by the standard lateral portal were evaluated during the study to establish a secure area for a new arthroscopic portal. Finally, the safety of the new proposed site was evaluated. The presence of 24 venous structures, with a mean diameter was 1.05mm (SD: 0.71) was documented. A tendency was observed in locating these structures in the lower half of the dissecting field for the left shoulders and a hypovascular area between the 7 and 10hours circle dissected relative to the right shoulder. The new site was determined at a point 1.5 cm anterolateral to the anterolateral border of the acromion at an angle of 60° degrees to the horizontal axis of the acromion and towards the intertubercular groove of the humerus. The methodology used in this study is innovative, reproducible and applicable for the study of all existing shoulder arthroscopic portals procedures, as well as any joint. The results provided by this study will be helpful for clinicians to improve tenotomy/tendon tenodesis procedures of the long head of the biceps brachii tendon. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  13. Development of the Human Biceps Brachii Tendon and Coracoglenoid Ligament (7th-12th Week of Development).

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    de la Cuadra-Blanco, Crótida; Arráez-Aybar, Luis A; Murillo-González, Jorge A; Herrera-Lara, Manuel E; Mérida-Velasco, Juan A; Mérida-Velasco, José R

    2017-01-01

    The goal of this study is to clarify the development of the long head of the biceps brachii tendon (LHBT) and to verify the existence and development of the coracoglenoid ligament. Histological preparations of 22 human embryos (7-8 weeks of development) and 43 human fetuses (9-12 weeks of development) were studied bilaterally using a conventional optical microscope. The articular interzone gives rise to the LHBT, glenoid labrum, and articular capsule. During the fetal period, it was observed that in 50 cases (58%), the LHBT originated from both the glenoid labrum and the scapula, while in 36 cases (42%), it originated only from the glenoid labrum. The coracoglenoid ligament, first described by Sappey in 1867, is a constant structure that originates at the base of the coracoid process and projects toward the glenoid labrum zone, which is related to the origin of the LHBT. The coracoglenoid ligament was more easily identifiable in the 36 cases in which the LHBT originated only from the glenoid labrum. We suggest that the coracoglenoid ligament is a constant anatomical structure, is not derived from the articular interzone unlike the LHBT, and contributes to the fixation of the glenoid labrum in the scapula in cases in which the LHBT originated only from the glenoid labrum. We postulate that, when the LHBT is fixed only at the glenoid labrum, alterations in the coracoglenoid ligament could lead to a less sufficient attachment of the glenoid labrum to the scapula which could predispose to a superior labral lesion. © 2017 S. Karger AG, Basel.

  14. 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.

  15. Biomechanical comparison of interference screw and cortical button with screw hybrid technique for distal biceps brachii tendon repair.

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    Arianjam, Afshin; Camisa, William; Leasure, Jeremi M; Montgomery, William H

    2013-11-01

    Various fixation techniques have been described for ruptured distal biceps tendons. The authors hypothesized that no significant differences would be found between the mean failure strength, maximum strength, and stiffness of the interference screw and hybrid technique. Fourteen fresh-frozen human cadaveric elbows were prepared. Specimens were randomized to either interference screw or hybrid cortical button with screw fixation. The tendon was pulled at a rate of 4 mm/s until failure. Failure strength, maximum strength, and stiffness were measured and compared. Failure strength, maximum strength, and stiffness were 294±81.9 N, 294±82.1 N, and 64.4±40.5 N/mm, respectively, for the interference screw technique and 333±129 N, 383±121 N, and 56.2±40.5 N/mm, respectively, for the hybrid technique. No statistically significant difference existed between the screw and hybrid technique in failure strength, maximum strength, or stiffness (P>.05). The interference screws primarily failed by pullout of the screw and tendon, whereas in the hybrid technique, failure occurred with screw pullout followed by tearing of the biceps tendon. The results suggest that this hybrid technique is nearly as strong and stiff as the interference screw alone. Although the hybrid technique facilitates tensioning of the reconstructed tendon, the addition of the cortical button did not significantly improve the failure strength of the interference screw alone. Copyright 2013, SLACK Incorporated.

  16. Distal Biceps Tendon Rupture

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    2010-06-01

    distal tendon . Although these findings overlap with those seen in tendinopathy , the presence of bone marrow edema at the radial tuberosity and fluid in...the bicipitoradial bursa suggests a partial tear rather than tendinopathy .3 When the distal biceps tendon tear is complete, MR imaging shows...Distal Biceps Tendon Rupture Military Medicine Radiology Corner, 2006 Radiology Corner Distal Biceps Tendon Rupture Contributors: CPT Michael

  17. Proximal Biceps Tendonitis

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    ... tendons that attach the top of the biceps muscle to the shoulder are the proximal tendons . There are two proximal ... ll want to do exercises that strengthen the muscles of your shoulder and upper arm. Strong muscles will keep the ...

  18. 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.)

  19. Ultrasonographic Validation of Anatomical Landmarks for Localization of the Tendon of the Long Head of Biceps Brachii

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    Hou, Saiyun; Harrell, John

    2017-01-01

    Objectives. To establish anatomical landmarks for biceps tendon groove localization based on intrinsic anatomical relations and to validate the localization with ultrasonographic measurement. Design. Perspective, observational, single-blinded pilot study. Participants. 25 healthy male and female volunteers ages 24–50 years. Methods. We used two anatomical landmarks, the medial epicondyle vertical line related landmark and the coracoid process landmark. The distance from the groove skin mark to the medial epicondyle vertical line and the coracoid process was measured horizontally and was measured at 0° and 45° of shoulder external rotation, respectively. Results. Medial epicondyle vertical lines were 9.3 mm/21.5 mm medial to the groove at 0°/45° of shoulder external rotation, respectively. Correlation coefficients were 0.04/0.10, 0.32/0.42, and 0.26/0.37 for weight, height, and BMI in 0°/45° of shoulder external rotation, respectively. The distance between the coracoid process and the groove was 44.0 mm/62.2 mm in 0°/45° of shoulder external rotation, respectively. Correlation coefficients were 0.36/0.41, 0.36/0.54, and 0.18/0.12 for weight, height, and BMI in 0°/45° of shoulder external rotation, respectively. Conclusions. The medial epicondyle vertical line and the coracoid process landmark are both useful anatomical landmarks to localize the biceps groove. The anatomical landmark based localization is essentially not correlated with subject's weight, height, or BMI.

  20. Closed proximal muscle rupture of the biceps brachii in wakeboarders.

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    Pascual-Garrido, Cecilia; Swanson, Britta L; Bannar, Stephen M

    2012-06-01

    Closed proximal muscle rupture of the biceps brachii is a rare injury. In this report, two cases of closed proximal muscle rupture of the biceps brachii after wakeboard traumas are described. Both patients presented with a swollen arm, weakness during flexion, and a mass in the affected forearm. Magnetic resonance imaging showed displacement of the biceps brachii into the forearm. The rupture was successfully treated with muscle removal in one case and muscle repair in the other. In patients with a wakeboard trauma and similar presentations, closed proximal muscle rupture of the biceps brachii should be suspected.

  1. Calcifying tendinopathy of the biceps brachii in a dog.

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    Muir, P; Goldsmid, S E; Rothwell, T L; Bellenger, C R

    1992-12-01

    Calcifying tendinopathy of the biceps brachii was associated with lameness in a 1.5-year-old Rottweiler. Lameness was relieved by excision of the calcified mass and suture repair of the partially ruptured tendon. Calcifying tendinopathy is not well described in dogs, but it is a recognized clinical syndrome in human beings. The etiopathogenesis of the condition in human beings and dogs is poorly understood. Wider recognition of calcifying tendinopathy in dogs should lead to a better understanding of the disease and development of appropriate clinical treatments.

  2. 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.

  3. 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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    Baggio, Marcelo; Martinelli, Fabrício; Netto, Martins Back; Martins, Rafael Olívio; da Cunha, Romilton Crozetta; Stipp, Willian Nandi

    2016-01-01

    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. PMID:27069883

  4. Variations of Origin of Long Head of Biceps Brachii Muscle from Glenoid Labrum of Scapula

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    Ketan Chauhan; Meenakshi Bansal; Pratik Mistry; Dhananjay Patil; Sanjay Modi; Chandrakant Mehta

    2013-01-01

    Introduction: The origin of the long head of the biceps brachii tendon in the majority of literature is not same. The relationships of the tendon with the glenoid labrum of the scapula also vary. Methodology: Dissection of 50 shoulder joints of adult human cadavers of both sexes done. The joint cavity was exposed by making an incision in the posterior part of the capsule of the joint to see the extent of its attachment on gleniod labrum. Results: In all specimens, the biceps tendon was found ...

  5. Rupture of the distal biceps brachii tendon: isokinetic power analysis and complications after anatomic reinsertion compared with fixation to the brachialis muscle.

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    Klonz, Andreas; Loitz, Dietmar; Wöhler, Peter; Reilmann, Heinrich

    2003-01-01

    Anatomic reattachment of the distal biceps tendon is well established but bears the risk of complications including loss of motion and nerve damage. We questioned whether nonanatomic repair by tenodesis to the brachialis muscle is able to accomplish similar results with less risk. We compared the results of anatomic repair with suture anchors (n = 6) with the results of nonanatomic repair (n = 8). Anatomic reattachment of the biceps tendon can restore full power of flexion in most cases as determined by isokinetic muscle tests (mean, 96.8% compared with the contralateral side). Nonanatomic repair also restores flexion strength to a mean of 96%. Supination power averaged 91% after anatomic repair. Supination strength after nonanatomic repair did not improve in 4 of 8 patients (42%-56% of the uninjured arm). The other 4 patients were able to produce 80% to 150% of the strength of the contralateral side. Major complications such as radioulnar synostosis or motor nerve damage were not encountered in either group. Heterotopic ossification was seen in 4 cases after reinsertion to the tuberosity. One of these patients was not satisfied with the procedure because of anterior elbow pain, even at rest. After tenodesis to the brachialis, one patient was unsatisfied because of considerable weakness. We concluded that major complications after anatomic repair are rare but must not be ignored. Tenodesis of the distal biceps tendon is a safe alternative procedure. We inform our patients about the benefits and risks of anatomic and nonanatomic repair as well as those of nonoperative treatment. The decision concerning the type of therapy best suited for an individual patient should be made on an informed consent basis.

  6. 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

  7. Kinesio taping effect on biceps brachii muscle strength

    OpenAIRE

    Králová Dagmar; Novotný Jan; Řezaninová Jana

    2013-01-01

    This work aimed at presenting the idea of inventor Dr. Kenzo Kase that kinesio tape application with proximal base leads to muscle contraction facilitation and application with distal base leads to muscle contraction inhibition. Twenty male volleyball players with the dominant shoulder girdle muscle imbalance between the ages of 25 and 30 participated in this study. There were compared two techniques which were placed on biceps brachii muscle in shoulder and elbow joint extension. Isokinetic ...

  8. The anatomy of the short head of biceps - not a tendon

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    Crichton James

    2009-01-01

    Full Text Available Background: The short head of biceps brachii has been the subject of little investigation when compared to the long head or distal biceps tendons. The aim of this study was to dissect and describe the origin and proximal portion of the short head of biceps brachii. Materials and Methods: Three left and two right (n = 5 fresh-frozen human cadaver shoulders were dissected and the proximal short head was measured and photographed. Results: The origin of the short head of biceps consisted of muscle fibres attaching directly to the tip of the coracoid process, with a thin, tendinous aponeurosis covering its anterior surface, rather than a true tendon as previously described. Conclusion: The short head of biceps does not attach to the coracoid process via a true tendon. These findings have implications for procedures that utilise the short head of biceps. Level of Evidence: Basic science study.

  9. Variations of Origin of Long Head of Biceps Brachii Muscle from Glenoid Labrum of Scapula

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    Ketan Chauhan

    2013-04-01

    Full Text Available Introduction: The origin of the long head of the biceps brachii tendon in the majority of literature is not same. The relationships of the tendon with the glenoid labrum of the scapula also vary. Methodology: Dissection of 50 shoulder joints of adult human cadavers of both sexes done. The joint cavity was exposed by making an incision in the posterior part of the capsule of the joint to see the extent of its attachment on gleniod labrum. Results: In all specimens, the biceps tendon was found to be attached to the supraglenoid tubercle as well as to the gleniod labrum. In 74% of specimens, the major part of the tendon was attached to the posterior aspect of the labrum while in 26% it was seen in the anterior aspect as well. The posterior labral attachment extended up to the lower part whereas the anterior attachment was limited to the upper part only. On the basis of the biceps attachment to the anterior or posterior labrum, we categorized them into three types of origin. Conclusion: The awareness of these normal anatomical variations are significant for arthroscopic diagnosis and may help to explain the various patterns of injury seen in partial or complete detachment of the tendon, the labrum or both. [Natl J Med Res 2013; 3(2.000: 137-139

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

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    Tagliafico, Alberto; Capaccio, Enrico; Derchi, Lorenzo E.; Martinoli, Carlo [Universita di Genova, Cattedra di Radiologia ' ' R' ' - DICMI, Genoa (Italy); Michaud, Johan [University of Montreal, Department of Physiatry, Montreal, QC (Canada)

    2010-01-15

    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.)

  11. A third head of the biceps brachii and coexisting fused higher origin of brachioradialis

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    Fating AS

    2011-02-01

    Full Text Available The biceps brachii is a large fusiform muscle in the flexor compartment of the arm. Brachioradialis is the most superficial muscle of the forearm. It has been reported that in 10% cases the third head of biceps brachii may arise from the supero-medial part of the brachialis and is attached to the bicipital apponeurosis. The presence of the third head is important for academic and clinical purpose. During routine dissection of a middle aged male cadaver at the Dr. PSIMS & RF, Gannavaram (INDIA; third head of biceps brachii and fused higher origin of brachioradialis were found in the left upper limb. The third head of biceps brachii arose from superomedial part of brachialis. Brachioradialis had higher additional origin beside its usual origin from proximal 2/3 of the lateral supracondylar crest of humerus. A variation in the heads of the biceps brachii muscle has already been reported to cause compression of surrounding neurovascular structures.

  12. FUNCTIONAL OUTCOMES AFTER DISTAL BICEPS BRACHII REPAIR: A CASE SERIES

    Science.gov (United States)

    Morris, Tim; Otto, Charissa; Zerella, Tanisha; Semmler, John G; Human, Taaibos; Phadnis, Joideep; Bain, Gregory I

    2016-01-01

    Objectives To investigate outcomes after surgical repair of distal biceps tendon rupture and the influence of arm dominance on isokinetic flexion and supination results. Background/Purpose While relatively uncommon, rupture of the distal biceps tendon can result in significant strength deficits, for which surgical repair is recommended. The purpose of this study was to assess patient reported functional outcomes and muscle performance following surgery. Methods A sample of 23 participants (22 males, 1 female), who had previously undergone surgical repair of the distal biceps tendon, were re-examined at a minimum of one year after surgery. Biodex isokinetic elbow flexion and supination testing was performed to assess strength (as measured by peak torque) and endurance (as measured by total work and work fatigue). The Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Mayo Elbow Performance Scale (MEPS) were used to assess participants' subjectively reported functional recovery. Results At a mean of 7.6 years after surgical repair, there were no differences between the repaired and uninvolved elbows in peak torque (p = 0.47) or total work (p = 0.60) for flexion or supination. There was also no difference in elbow flexion work fatigue (p = 0.22). However, there was significantly less work fatigue in supination, which was likely influenced by arm dominance, as most repairs were to the dominant arm, F(1,22)=5.67, p = 0.03. Conclusion The long-term strength of the repaired elbow was similar to the uninvolved elbow after surgery to the distal biceps tendon. Endurance of the repaired elbow was similar in flexion but greater in supination, probably influenced by arm dominance. Study design Retrospective case series Level of Evidence Level 4 PMID:27904798

  13. 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.

  14. Muscular coordination of biceps brachii and brachioradialis in elbow flexion with respect to hand position

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    Tim eKleiber

    2015-08-01

    Full Text Available Contribution of synergistic muscles towards specific movements over multi joint systems may change with varying position of distal or proximal joints. Purpose of this study is to reveal the relationship of muscular coordination of brachioradialis and biceps brachii during elbow flexion with respect to hand position and biomechanical advantages and disadvantages of biceps brachii. A group of 16 healthy subjects has been advised to perform 20 repetitions of single elbow flexion movements in different hand positions (pronated, neutral and supinated. With a speed of 20°/s, simultaneously sEMG of biceps brachii and brachioradialis and kinematics of the movement were recorded in a motion analysis laboratory. Normalized to MVC the sEMG amplitudes of both muscles contributing to elbow flexion movements were compared in pronated, supinated and neutral hand position over elbow joint angle. Significant differences in the contribution of brachioradialis were found in pronated hand position compared to supinated and neutral hand position while the muscular activity of biceps brachii shows no significant changes in any hand position.In conclusion, a statistical significant dependency of the inter-muscular coordination between biceps brachii and brachioradialis during elbow flexion with respect to hand position has been observed depending on a biomechanical disadvantage of biceps brachii.

  15. Four-headed biceps and triceps brachii muscles, with neurovascular variation.

    Science.gov (United States)

    Nayak, Soubhagya R; Soubhagya, R Nayak; Krishnamurthy, Ashwin; Ashwin, Krishnamurthy; Kumar, Madhan; Madhan, Kumar S J; Prabhu, Latha V; Latha, V Prabhu; Saralaya, Vasudha; Vasudha, Saralaya; Thomas, Merin M; Merin, M Thomas

    2008-06-01

    Anatomical variations of the biceps brachii and triceps brachii have been described by various authors, but the occurrence of four-headed biceps brachii and triceps brachii in an ipsilateral arm is rare and has not been reported before in the literature. During routine cadaveric dissection in the department of anatomy, Kasturba Medical College, Mangalore, India, various unusual variants were noted in the left arm of a cadaver of a 67-year-old man. The variants include a four-headed biceps, a four-headed triceps, communication between the musculocutaneous and median nerves, and a high origin of deep brachial artery from the axillary artery. The occurrence of these anomalies and the clinical and morphological significance are discussed.

  16. Distal biceps tendon injuries: diagnosis and management.

    Science.gov (United States)

    Ramsey, M L

    1999-01-01

    Rupture of the distal biceps tendon occurs most commonly in the dominant extremity of men between 40 and 60 years of age when an unexpected extension force is applied to the flexed arm. Although previously thought to be an uncommon injury, distal biceps tendon ruptures are being reported with increasing frequency. The rupture typically occurs at the tendon insertion into the radial tuberosity in an area of preexisting tendon degeneration. The diagnosis is made on the basis of a history of a painful, tearing sensation in the antecubital region. Physical examination demonstrates a palpable and visible deformity of the distal biceps muscle belly with weakness in flexion and supination. The ability to palpate the tendon in the antecubital fossa may indicate partial tearing of the biceps tendon. Plain radiographs may show hypertrophic bone formation at the radial tuberosity. Magnetic resonance imaging is generally not required to diagnose a complete rupture but may be useful in the case of a partial rupture. Early surgical reattachment to the radial tuberosity is recommended for optimal results. A modified two-incision technique is the most widely used method of repair, but anterior single-incision techniques may be equally effective provided the radial nerve is protected. The patient with a chronic rupture may benefit from surgical reattachment, but proximal retraction and scarring of the muscle belly can make tendon mobilization difficult, and inadequate length of the distal biceps tendon may necessitate tendon augmentation. Postoperative rehabilitation must emphasize protected return of motion for the first 8 weeks after repair. Formal strengthening may begin as early as 8 weeks, with a return to unrestricted activities, including lifting, by 5 months.

  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. [Evaluation of surgical repair of distal biceps tendon ruptures].

    Science.gov (United States)

    Behounek, J; Hrubina, M; Skoták, M; Krumpl, O; Zahálka, M; Dvorák, J; Fucík, M

    2009-02-01

    PURPOSE OF THE STUDY To present the results of surgical repair of ruptures of the distal tendon of the biceps brachii muscle and thus show the adequacy of this treatment. MATERIAL Between 1987 and 2006, 19 patients had surgery for distal biceps tendon rupture. Only one side was affected in each patient. All patients were men between 28 and 69 years (average age, 47.5 years) at the time of injury (surgery). When the patients were evaluated at the end of 2007, 18 patients were included, because one died a year after surgery. METHODS The surgical repair always included a single-incision anatomical reattachment into the radial tuberosity. In 11 patients, a modified Mac Reynolds method with screw and washer fixation was used; in seven patients the insertion was fixed with Mitek anchors and, in one, it was sutured to the adjacent soft tissues. The average follow-up was 7 years (range, 1 to 20.5 years). The patients were evaluated for the cause of injury, their physical activity, age, dominance of the injured arm, surgical procedure and complications. RESULTS In 18 patients surgical repair was done early and, in one, at 16 days after injury. In all of them the tendon was detached from its site of insertion, but never torn. The intra-operative complications included, in one patient, bleeding owing to iatrogenic damage to a branch of the brachial artery, and difficult separation of the tendon due to its previous healed injury in another patient. Early post-operative complications included superficial skin necrosis in one patient and transient neurological deficit of the dorsal brand of the radial nerve and of the lateral cutaneous nerve of the forearm in two and one patient, respectively. The late complications were heterotropic ossification in three patients and screw migration in the one treated by the Mac Reynolds method. Excellent results were recorded in 11 patients (61 %), and good outcomes with a slight restriction of motion or muscle strength not limiting the

  19. 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.

  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. Four-headed biceps brachii muscle with variant course of musculocutaneous nerve: anatomical and clinical insight

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    Aggarwal A

    2009-10-01

    Full Text Available A rare case of four-headed biceps brachii muscle with variation in the course of musculocutaneous nerve was observed in left arm of a 48-year-old embalmed male cadaver. One of the extra head (third was fleshy throughout, originated from anteromedial surface of shaft of humerus and merged with the deep surface of short head. Fourth thin tendinous head originated just below lesser tuberosity of humerus and joined with the third head. Both accessory heads were lying under cover of short head of biceps. Musculocutaneous nerve was coursing between two supernumerary heads and subsequently between third head and short head of biceps brachii muscle. Origin of third head from shaft of humerus led to passage of nerve between this head and short head, before acquiring normal position between biceps brachii and brachialis muscles, and emerging out as lateral cutaneous nerve of forearm. Intramuscular course of nerve may be a potential site for nerve compression by hypertrophied biceps associated with strenuous regular physical activity of biceps or weight lifting.

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Motor unit properties of biceps brachii during dynamic contractions in chronic stroke patients

    NARCIS (Netherlands)

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

    The aim of this study was to investigate motor unit (MU) characteristics of the biceps brachii during sinusoidal contractions in chronic stroke patients using high-density surface electromyography. Ten sinusoidal elbow flexion and extension movements were performed both passively and actively by 18

  4. [The laterocranial fascia structures in the upper and forearm and the differences in the insertion of the M. biceps brachii in domestic mammals].

    Science.gov (United States)

    Künzel, W; Forstenpointner, G; Skolek-Winnisch, R

    1993-03-01

    The laterocranial fascia of the upper arm and forearm, as well as aponeurotic relationships of the Musculus biceps brachii were investigated on each of ten forelimbs from horses, cattle and swine. Ten canine biceps were also investigated. Equine and bovine fascia contain elastic components. An as-yet undescribed ligament-like aponeuroses of the laterocranial forearm fascia to the Fossa radialis humeri was seen in all three species studied. The laterocranial fascia of the upper and forearm form a common passage for the Musculi brachialis et extensor carpi radialis. In the case of the horse, the ulnar aponeurotic tendon of the biceps muscle crosses below the Ligamentum collaterale cubiti medialis. In cattle, on the other hand, it runs between the two branches of the collateral ligament, to attach on the olecranon. This portion of the equine tendon protrudes into the joint. It has connective tissue character in young animals, but becomes fibrocartilaginous in older horses. The radial aponeuroses of the canine biceps exhibits two branches. A situation similar to that seen for the ulnar aponeuroses of the equine Musculus biceps brachii is observed on the inside surface of the porcine Ligamentum cubiti mediale, in which a wedge of connective tissue protrudes into the joint, taking on fibrocartilaginous character in older animals.

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

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    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.

  6. Ruptures of the distal biceps tendon.

    Science.gov (United States)

    Ward, James P; Shreve, Mark C; Youm, Thomas; Strauss, Eric J

    2014-01-01

    Distal biceps ruptures occur most commonly in middle-aged males and result from eccentric contraction of the biceps tendon. The injury typically presents with pain and a tearing sensation in the antecubital fossa with resultant weakness in flexion and supination strength. Physical exam maneuvers and diagnostic imaging aid in determining the diagnosis. Nonoperative management is reserved for elderly, low demand patients, while operative intervention is generally pursued for younger patients and can consist of nonanatomic repair to the brachialis or anatomic repair to the radial tuberosity. Anatomic repair through a one-incision or two-incision approach is commonplace, while the nonanatomic repairs are rarely performed. No clear advantage exists in operative management with a one-incision versus two-incision techniques. Chronic ruptures present a more difficult situation, and allograft augmentation is often necessary. Common complications after repair include transient nerve palsy, which often resolves, and heterotopic ossification. Despite these possible complications, most studies suggest that better patient outcomes are obtained with operative, anatomic reattachment of the distal biceps tendon.

  7. Phase- and Workload-Dependent Changes in Corticospinal Excitability to the Biceps and Triceps Brachii during Arm Cycling

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    Alyssa-Joy Spence

    2016-12-01

    Full Text Available This is the first study to examine corticospinal excitability (CSE to antagonistic muscle groups during arm cycling. Transcranial magnetic stimulation (TMS of the motor cortex and transmastoid electrical stimulation (TMES of the corticospinal tract were used to assess changes in supraspinal and spinal excitability, respectively. TMS induced motor evoked potentials (MEPs and TMES induced cervicomedullary evoked potentials (CMEPs were recorded from the biceps and triceps brachii at two positions, mid-elbow flexion and extension, while cycling at 5% and 15% of peak power output. While phase-dependent modulation of MEP and CMEP amplitudes occurred in the biceps brachii, there was no difference between flexion and extension for MEP amplitudes in the triceps brachii and CMEP amplitudes were higher during flexion than extension. Furthermore, MEP amplitudes in both biceps and triceps brachii increased with increased workload. CMEP amplitudes increased with higher workloads in the triceps brachii, but not biceps brachii, though the pattern of change in CMEPs was similar to MEPs. Differences between changes in CSE between the biceps and triceps brachii suggest that these antagonistic muscles may be under different neural control during arm cycling. Putative mechanisms are discussed.

  8. Ultrasound-guided injection for the biceps brachii tendinitis: results and experience.

    Science.gov (United States)

    Zhang, Jingwei; Ebraheim, Nabil; Lause, Gregory E

    2011-05-01

    The purpose of this study was to identify the results of ultrasound-guided injection of corticosteroid for biceps brachii tendinitis. In this randomized and prospective study, we evaluated 45 patients who were treated by free-hand injection without ultrasound guidance (group A) and 53 patients who were treated by ultrasound-guided injection (group B). The mean age was 47 y (range, 28 to 72). The average follow-up was 33 weeks (range, 24 to 56). The visual analog scale score decreased from 7.1 ± 2.3 before injection to 4.2 ± 3.1 at follow-up in group A and from 6.9 ± 2.6 to 2.1 ± 1.9 in group B (p biceps brachii tendinitis.

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

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    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.

  10. A 3-Dimensional Anatomic Study of the Distal Biceps Tendon

    Science.gov (United States)

    Walton, Christine; Li, Zhi; Pennings, Amanda; Agur, Anne; Elmaraghy, Amr

    2015-01-01

    Background Complete rupture of the distal biceps tendon from its osseous attachment is most often treated with operative intervention. Knowledge of the overall tendon morphology as well as the orientation of the collagenous fibers throughout the musculotendinous junction are key to intraoperative decision making and surgical technique in both the acute and chronic setting. Unfortunately, there is little information available in the literature. Purpose To comprehensively describe the morphology of the distal biceps tendon. Study Design Descriptive laboratory study. Methods The distal biceps terminal musculature, musculotendinous junction, and tendon were digitized in 10 cadaveric specimens and data reconstructed using 3-dimensional modeling. Results The average length, width, and thickness of the external distal biceps tendon were found to be 63.0, 6.0, and 3.0 mm, respectively. A unique expansion of the tendon fibers within the distal muscle was characterized, creating a thick collagenous network along the central component between the long and short heads. Conclusion This study documents the morphologic parameters of the native distal biceps tendon. Reconstruction may be necessary, especially in chronic distal biceps tendon ruptures, if the remaining tendon morphology is significantly compromised compared with the native distal biceps tendon. Knowledge of normal anatomical distal biceps tendon parameters may also guide the selection of a substitute graft with similar morphological characteristics. Clinical Relevance A thorough description of distal biceps tendon morphology is important to guide intraoperative decision making between primary repair and reconstruction and to better select the most appropriate graft. The detailed description of the tendinous expansion into the muscle may provide insight into better graft-weaving and suture-grasping techniques to maximize proximal graft incorporation. PMID:26665092

  11. 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.

    2012-01-01

    Background: 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. Methods: 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. Results: 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). Conclusions: 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

  12. 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

  13. An unusual case of an intramuscular lipoma of the biceps brachii.

    Science.gov (United States)

    Lahrach, Kamal; el Kadi, Khalid Ibn; Mezzani, Amine; Marzouki, Amine; Boutayeb, Fawzi

    2013-01-01

    Lipomas are common benign neoplasms consisting of mature fatty tissue. They are usually of roundish or ovoid shape and are situated in a single anatomical region. They most frequently occur on the back and in the extremities. Most lipomas are subcutaneous and require no imaging evaluation. When deep, large and unusual in location, MRI can identify and localise these tumours and is the best exploration to differentiate lipoma and lipo-sarcoma. We describe a case of a patient with an intramuscular lipoma of the biceps brachii.

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

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    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.

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

    NARCIS (Netherlands)

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

    2009-01-01

    Motor unit properties of the biceps brachii and Fugl-Meyer score were assessed in stroke patients and healthy controls during passive and active elbow flexion and extension contractions. The level of motor recovery as assessed with the Fugl-Meyer was correlated with the ration of the size of the

  16. 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

  17. 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 co...

  18. A SLAP lesion associated with calcific tendinitis of the long head of the biceps brachii at its origin.

    Science.gov (United States)

    Kim, Kyung Cheon; Rhee, Kwang Jin; Shin, Hyun Dae; Kim, Young Mo

    2007-12-01

    Calcific tendinitis is a common condition with characteristic clinical and radiological findings. Although we do not know which condition initiated the pathologic cascade, we present a rare case of calcific tendinitis of the long head of the biceps brachii at its origin, associated with a SLAP lesion. The calcium deposit was removed and the SLAP lesion was repaired with a suture anchor arthroscopically.

  19. Elbow tendinopathy and tendon ruptures: epicondylitis, biceps and triceps ruptures.

    Science.gov (United States)

    Rineer, Craig A; Ruch, David S

    2009-03-01

    Lateral and medial epicondylitis are common causes of elbow pain in the general population, with the lateral variety being more common than the medial by a ratio reportedly ranging from 4:1 to 7:1. Initially thought to be an inflammatory condition, epicondylitis has ultimately been shown to result from tendinous microtearing followed by an incomplete reparative response. Numerous nonoperative and operative treatment options have been employed in the treatment of epicondylitis, without the emergence of a single, consistent, universally accepted treatment protocol. Tendon ruptures about the elbow are much less frequent, but result in more significant disability and loss of function. Distal biceps tendon ruptures typically occur in middle-aged males as a result of an event that causes a sudden, eccentric contraction of the biceps. Triceps tendon ruptures are exceedingly rare but usually have a similar etiology with a forceful eccentric contraction of the triceps that causes avulsion of the tendon from the olecranon. The diagnosis of these injuries is not always readily made. Complete ruptures of the biceps or triceps tendons have traditionally been treated surgically with good results. With regard to biceps ruptures, there continues to be debate about the best surgical approach, as well as the best method of fixation of tendon to bone. This article is not meant to be an exhaustive review of the broad topics of elbow tendinopathy and tendon ruptures, but rather is a review of recently published information on the topics that will assist the clinician in diagnosis and management of these conditions.

  20. [Systematization of the musculo-tendinous architecture of the human biceps (musculus biceps brachii)].

    Science.gov (United States)

    Farisse, J; Guidon, P; Seriat-Gautier, B; Brunet, C; Gambarelli, J

    1984-09-01

    The structure of the brachial biceps is studied based upon the bilateral dissections of six subjects. The object of this work consists of determining the distribution of the group and muscular fibers in relation to the two proximal insertions and the two distal insertions. It is possible to describe the subgroups within each structure. The objective of each of these subgroups is considered within the framework of the coordination between the two muscular formation and the double insertions on the structure of the forearm. It is probable that this muscular formation corresponds to two different movements of the forearm during the locomotory progression. This work can be utilised in the sphere of the comparative biomechanical observation. Also electromyographic and the histochemical characteristics of the muscular group.

  1. Analysis of activity of motor units in the biceps brachii muscle after intercostal-musculocutaneous nerve transfer.

    Science.gov (United States)

    Sakuta, Naoki; Sasaki, Sei-Ichi; Ochiai, Naoyuki

    2005-04-01

    We examined respiratory activity of motor units (MUs) in the internal intercostal nerves (IICNs)-transferred biceps brachii muscle (IC-biceps) in cats. MUs of IC-biceps showed respiratory discharges in inspiratory and expiratory phases, and these were enhanced by CO2 inhalation. Narrowing the airway also enhanced inspiratory and expiratory MUs activity. A mechanical load to the thorax immediately enhanced inspiratory MUs activity and weakened expiratory MUs activity. We analyzed the cross-correlation of MUs activity in interchondral muscle and IC-biceps to characterize the respiratory spinal descending inputs to motoneurons. We confirmed the short-term synchronization from interchondral muscles indicating divergence of a single respiratory presynaptic axon to thoracic motoneurons, but could not find synchronization from IC-biceps. The motor axonal conduction velocity (axonal CV) of IC-biceps MUs was lower than that of interchondral muscles. There was no correlation between the respiratory recruitment order of IC-biceps MUs and their axonal CV. These results indicate that IC-biceps shows the respiratory activities and afferent inputs from intercostal muscle spindles in the neighboring segments remain influential on activity of IC-biceps. In addition, the short-term synchronization from IC-biceps could not be found, suggesting that the intercostal nerve transfer alters the respiratory spinal descending inputs to thoracic motoneurons.

  2. Quantitative Mechanical Properties of the Relaxed Biceps and Triceps Brachii Muscles in Patients with Subacute Stroke: A Reliability Study of the Myoton-3 Myometer

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    Li-ling Chuang

    2012-01-01

    Full Text Available Objective. Test-retest reliability of the myotonometer was investigated in patients with subacute stroke. Methods. Twelve patients with substroke (3 to 9 months poststroke were examined in standardized testing position twice, 60 minutes apart, with the Myoton-3 myometer to measure tone, elasticity, and stiffness of relaxed bilateral biceps and triceps brachii muscles. Intrarater reliability of muscle properties was determined using intraclass correlation coefficient (ICC, the standard error of measurement (SEM, and the minimal detectable change (MDC. Results. Intrarater reliability of muscle properties of bilateral biceps and triceps brachii muscles were good (ICCs=0.79–0.96 except for unaffected biceps tone (ICC=0.72. The SEM and MDC of bilateral biceps and triceps brachii muscles indicated small measurement error (SEM% <10%, MDC% <25%. Conclusion. The Myoton-3 myometer is a reliable tool for quantifying muscle tone, elasticity, and stiffness of the biceps and triceps brachii in patients with subacute stroke.

  3. Age independent and position-dependent alterations in motor unit activity of the biceps brachii.

    Science.gov (United States)

    Harwood, B; Edwards, D L; Jakobi, J M

    2010-09-01

    In the biceps brachii, age-related differences in synaptic excitability and muscle architecture may affect motor unit (MU) activity differently depending on the position of the forearm. It was hypothesised that as a result of these age-related differences, greater changes in MU activity would accompany a change in forearm position in old when compared with young men. Six young (22 +/- 3 years) and six old (84 +/- 3 years) men maintained isometric elbow flexion at 10% of maximal voluntary contraction (MVC) during changes in forearm position. Forty-nine MUs in the short (SBB) and long (LBB) heads of the biceps brachii were followed. Motor unit recruitment and de-recruitment thresholds, motor unit discharge rates (MUDRs), and MU discharge variability were measured. Although an age-related decrease in MU recruitment thresholds, and increase in MU discharge variability was evident, changes in forearm position influenced MUDRs similarly in young and old men (P = 0.27). Motor unit recruitment thresholds of the SBB were highest in the pronated position (8.2 +/- 2.9 %MVC), whereas in the LBB they were highest in the supinated position (8.6 +/- 2.0 %MVC). Motor unit discharge rates of the LBB did not change with forearm position. In the SBB, MUDRs were highest when the forearm was supinated, and also greater when compared with the LBB in this position. No position-dependent changes were observed for MU discharge variability in the LBB, but the SBB exhibited greatest MU discharge variability in the pronated position. The results suggest that MU activity is modulated following a change in forearm position, but the response is similar in young and old adults.

  4. 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

  5. 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.

  6. Modified arthroscopic transfer of the long head of the biceps tendon to the conjoint tendon

    Institute of Scientific and Technical Information of China (English)

    MA Yong; CUI Guo-qing; AO Ying-fang; XIAO Jian; YAN Hui; YANG Yu-ping; XIE Xing

    2009-01-01

    @@ The long head of the biceps tendon (LHBT) pathology has been implicated as a common source of shoulder pain. The patients may be more resistant to conservative treatment than those with isolated subacromial impingement.1 Even though, the surgical options of this disease remain controversial. It has been reported that tenotomy and tenodesis of the biceps tendon were usually utilized. However, persistent pain, deformity, and muscle cramping were frequently observed.1-5

  7. Intracapsular origin of the long head of the biceps tendon

    Energy Technology Data Exchange (ETDEWEB)

    Yeh, L.R. [Department of Radiology, Veterans Affairs Medical Center, San Diego, CA (United States)]|[Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung (Taiwan, Province of China); Pedowitz, R. [Department of Orthopedics, Veterans Affairs Medical Center, San Diego, CA (United States); Kwak, S.; Muhle, C.; Trudell, D.; Resnick, D. [Department of Radiology, Veterans Affairs Medical Center, San Diego, CA (United States); Haghighi, P. [Department of Pathology, Veterans Affairs Medical Center, San Diego, CA (United States)

    1999-03-01

    A developmental anomaly of the long head of the biceps tendon was found in a cadaveric shoulder. Findings on arthroscopy, routine MR imaging, and MR arthrography were compared and correlated with results of anatomic dissection. MR arthrography appears to be a very good diagnostic imaging method for depicting this anomaly prior to arthroscopy. (orig.) With 3 figs., 8 refs.

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

    OpenAIRE

    Streit JJ; Shishani Y; Rodgers M; Gobezie R

    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...

  9. Chemical composition of Infraspinatus, #Triceps brachii, Longissimus thoraces, Biceps femoris, Semitendinosus#, and #Semimembranosus# of Bactrian (#Camelus bactrianus#) camel muscles

    OpenAIRE

    Raiymbek, Gulzhan; Faye, Bernard; Serikbayeva, Assiya; Konuspayeva, Gaukhar; Kadim, Isam T.

    2013-01-01

    The objective of this study was to determine chemical composition of Infraspinatus, Triceps brachii, Longissimus thoraces, Biceps femoris, Semitendinosus, and Semimembranosus muscles from nine Bactrian carcasses (2-3 years of age). The left side muscles were collected and kept in a chiller (3-4ºC) for 48 hrs then stored at -20ºC. Chemical analyses were carried out to determine moisture, crude protein, fat (ether extract), ash, essential and non-essential element contents. The Infraspinatus, T...

  10. [Results of transosseous reattachment for distal rupture of the biceps tendon. Evaluation of results].

    Science.gov (United States)

    Abalo, A; Tomta, K; James, N; Walla, A; Agounke, W; Dossim, A

    2011-02-01

    Avulsion of the distal biceps brachii tendon is an uncommon injury. This is a retrospective review of cases operated in our department by transosseous suture fixation on the radial tuberosity, using the single anterior incision. Between 2000 and 2007, a total of 10 patients with distal biceps tendon injury were included. All were men, with an average age of 39 years. The most common mechanism was passive extension against active flexion. The dominant limb was affected in all patients. Clinical diagnosis was the rule. Surgical reattachment to the radial tuberosity through the anterior approach to the elbow was performed. The preoperative period was one week in three cases, between one and three weeks in five cases, and superior to three weeks in two cases. Clinical and instrumental evaluation of the results was done. Average follow-up was 48 months. Subjective results were good in seven cases, acceptable in two cases and poor in one case. Nine patients return to their previous level activity with no limitations. The average range of motion was 0° of extension to 135° of flexion. Strength testing of the injured limbs, compared to the contralateral, using the criteria described by Baker and Bierwagen, revealed a loss of 22% of supination strength and 32% of supination endurance. There was a loss of 14% of flexion strength and 27% of flexion endurance. There were two cases of superficial surgical site infection. There were no cases of nerve damage or heterotopic bone formation. Two main factors were found to explain the poor outcomes: experience of the surgeon and a long preoperative delay. Despite the limitations of this study, we found that transosseous reattachment of the biceps' distal tendon to the radial tuberosity can restore supination. Strength and endurance for supination can be better restored by early intervention. Complications are easily avoided if surgery is performed early and by experts.

  11. Motor unit synchronization in FDI and biceps brachii muscles of strength-trained males.

    Science.gov (United States)

    Fling, Brett W; Christie, Anita; Kamen, Gary

    2009-10-01

    Motor unit (MU) synchronization is the simultaneous or near-simultaneous firing of two MUs which occurs more often than would be expected by chance. The present study sought to investigate the effects of exercise training, muscle group, and force level, by comparing the magnitude of synchronization in the biceps brachii (BB) and first dorsal interosseous (FDI) muscles of untrained and strength-trained college-aged males at two force levels, 30% of maximal voluntary contraction (MVC) and 80% MVC. MU action potentials were recorded directly via an intramuscular needle electrode. The magnitude of synchronization was assessed using previously-reported synchronization indices: k', E, and CIS. Synchronization was significantly higher in the FDI than in the BB. Greater synchronization was observed in the strength-trained group with CIS, but not with E or k'. Also, synchronization was significantly greater at 80% MVC than at 30% MVC with E, but only moderately greater with CIS and there was no force difference with k'. Synchronization prevalence was found to be greater in the BB (80.1%) than in the FDI (71.5%). Thus, although the evidence is a bit equivocal, it appears that MU synchronization is greater at higher forces, and greater in strength-trained individuals than in untrained subjects.

  12. 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.

  13. ELECTROMYOGRAPHIC ACTIVITY OF THE BICEPS BRACHII AFTER EXERCISE-INDUCED MUSCLE DAMAGE

    Directory of Open Access Journals (Sweden)

    Sirous Ahmadi

    2007-12-01

    Full Text Available It is well known that strenuous eccentric exercise may result in muscle damage. We proposed that vigorous eccentric exercise (EE would impair myoelectric activity of the biceps brachii. This study utilised a 7-day prospective time-series design. Ten healthy males performed a session of 70 maximal EE elbow flexion contractions. Analysis of surface electromyography activity (sEMG was performed on the signals recorded during isometric contractions at 50% (IC50 and 80% (IC80 of maximum voluntary isometric torque (MVT, deriving RMS and MDF as sEMG parameters. Linear regression of the RMS and MDF time-series (20-s sustained IC50 and IC80 was used to extract intercepts and slopes of these signals on each day. Plasma creatine kinase activity (CK, MVT, arm circumference, subjective perception of soreness and elbow joint range of motion were also measured to assess effectiveness of EE to evoke muscle damage. CK increased over resting values until day 5 after EE, and remained significantly (p < 0.05 elevated even on day 7. MVT had decreased to 45% of its initial value by day 2 after EE, and remained significantly depressed for the following 6 days. In addition, muscle soreness and arm circumference increased, and range of motion decreased after EE. A significant shift of MDF intercept towards lower frequencies at both IC50 and IC80 was observed after EE in the exercised arm, and these values gradually recovered within the next 3 days during IC50. Although there were some changes in RMS values, these alterations were persistent in both control and exercised arms, and did not follow a consistent pattern. In conclusion, a prolonged reduction in MDF intercept was observed after EE, but this was not closely time-associated with the biochemical, anthropometric or functional markers of muscle damage. Compared to RMS, MDF was a more consistent measure to reflect changes in sEMG

  14. Biceps tendon sheath effusion as a diagnostic clue to rotator cuff pathology.

    Science.gov (United States)

    Yadav, Pankaj K; Shah, Bhavin; Shende, Amol; Rajesh, S

    2014-02-01

    The objective of this study was to evaluate the role of biceps tendon sheath effusion detected on ultrasound as a diagnostic clue to rotator cuff pathology. Despite being the most common cause of shoulder pain in adults early sonographic changes of rotator cuff tendinopathy are easy to miss. A total of 31 patients out of whom 27 had unilateral shoulder pain and 4 had bilateral complaints under- went ultrasonographic examination of shoulder joint using high frequency linear array transducer. Any fluid surrounding the long head of biceps tendon was noted followed by a careful search for any associated sonographic abnormality involving the rotator cuff. Eighteen out of the 35 had presence of fluid in their biceps tendon sheath. Twelve had presence of both biceps tendon sheath effusion and rotator cuff pathologies. Among 17 patients, who had no fluid in their biceps tendon sheath, only 2 had rotator cuff involvement whereas rest 15 had neither biceps tendon sheath fluid nor rotator cuff pathologies. A significant association was found between presence of fluid in long head of biceps tendon sheath and rotator cuff pathologies. Thus the most common finding observed in association with the presence of fluid around the long head of biceps tendon sheath in this study was tendinosis of rotator cuff. On ultrasonography simple presence of fluid around the long head of biceps tendon sheath demands careful examination of rotator cuff.

  15. Inter-Gender sEMG Evaluation of Central and Peripheral Fatigue in Biceps Brachii of Young Healthy Subjects

    Science.gov (United States)

    Meduri, Federico; Beretta-Piccoli, Matteo; Calanni, Luca; Segreto, Valentina; Giovanetti, Giuseppe; Barbero, Marco; Cescon, Corrado; D’Antona, Giuseppe

    2016-01-01

    Purpose The purpose of the present study was to evaluate inter-arm and inter-gender differences in fractal dimension (FD) and conduction velocity (CV) obtained from multichannel surface electromyographic (sEMG) recordings during sustained fatiguing contractions of the biceps brachii. Methods A total of 20 recreationally active males (24±6 years) and 18 recreationally active females (22±9 years) performed two isometric contractions at 120 degrees elbow joint angle: (1) at 20% maximal voluntary contraction (MVC) for 90 s, and (2) at 60% MVC until exhaustion the time to perform the task has been measured. Signals from sEMG were detected from the biceps brachii using bidimensional arrays of 64 electrodes and initial values and rate of change of CV and FD of the sEMG signal were calculated. Results No difference between left and right sides and no statistically significant interaction effect of sides with gender were found for all parameters measured. A significant inter-gender difference was found for MVC (p0.05). During the sustained 60% MVC no statistical correlation was found between MVC and CV or FD initial estimates nor between MVC and CV or FD slopes both in males and females whereas. A significant positive correlation between CV and FD slopes was found in both genders (males: r = 0,61; females: r = 0,55). Conclusions Fatigue determines changes in FD and CV values in biceps brachii during sustained contractions at 60% MVC. In particular males show greater increase in the rate of change of CV and FD than females whereas no difference in percentage change of these sEMG descriptors of fatigue was found. A significant correlation between FD and CV slopes found in both genders highlights that central and peripheral myoelectric components of fatigue may interact during submaximal isometric contractions. PMID:28002429

  16. 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

  17. 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

    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. PMID:25792859

  18. [Contribution of the biceps brachii and pronator teres muscles to the efforts of pronation or supination. I. Statistical work (author's transl)].

    Science.gov (United States)

    van Hoecke, J; Pérot, C; Goubel, F

    1978-03-20

    The electrical activity of the biceps brachii and pronator teres muscles is studied through the prono-supination of the forearm in some isometrical conditions (static work) with different loads and joint positions. If the pronator teres is always being active in pronation, this activity is a function of the load and of the wrist and elbow positions. The same phenomena can be observed for the biceps brachii but when in supination. From the curvilinear relationships between the integrated electrical activity and the load--observed on both muscles--some torque-angle relationships can be established for the biceps brachii which show that a bifunctional muscle seems to be characterized by a very and unique force-length relationship.

  19. The effect of elbow position on biceps tendon reflex

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    Keles Isik

    2004-07-01

    Full Text Available Background: Testing of tendon (T reflex is the basic method used in the diagnostic procedure of clinical neurology. Measurement of T reflexes precisely can be a valuable adjunct to clinical examination. Quantification of T reflexes may provide more accurate results. Aims: To analyze the effect of elbow position on biceps T reflex. Settings and Design: A self-controlled clinical trial of biceps T reflex testing at the Electrophysiology Unit of the Department of Physical Medicine and Rehabilitation. Methods and Materials: Biceps T reflex was obtained utilizing a hand-held electronic reflex hammer in 50 extremities of 25 healthy volunteers and the effect of elbow position (at 90°, 120° and 150° on reflex response was evaluated. Statistical Analysis: Repeated-measures analysis of variance by the General Linear Model and Pearson correlation test procedures. Results: Onset latency was significantly shorter at 120° of elbow position. The maximum amplitude value of biceps T reflex was obtained at 90° of elbow position. Onset latency of the reflex correlated significantly with the height and arm length but not with age. Conclusions: The electrophysiological measurement of T reflexes is an easy and useful method in the quantification of reflexes, supplying more objective data. However, when performing T reflex studies, the position of the extremity should be taken into consideration to achieve more reliable results.

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

    Science.gov (United States)

    De Maeseneer, Michel; Van Isacker, Tom; Lenchik, Leon; Van Caillie, Marie-Astrid; Shahabpour, Maryam

    2014-03-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Maeseneer, Michel de; Shahabpour, Maryam [Universitair Ziekenhuis Brussel, Department of Radiology, Brussels (Belgium); Isacker, Tom van [Sint-Lucas Hospital, Department of Orthopedic Surgery, Brugge (Belgium); Lenchik, Leon [Wake Forest School of Medicine, Department of Radiology, Winston Salem, NC (United States); Caillie, Marie-Astrid van [Sint-Lucas Hospital, Department of Pathology, Brugge (Belgium)

    2014-03-15

    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.)

  2. 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.

  3. 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.)

  4. 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.)

  5. Muscle spindle composition and distribution in human young masseter and biceps brachii muscles reveal early growth and maturation.

    Science.gov (United States)

    Osterlund, Catharina; Liu, Jing-Xia; Thornell, Lars-Eric; Eriksson, Per-Olof

    2011-04-01

    Significant changes in extrafusal fiber type composition take place in the human masseter muscle from young age, 3-7 years, to adulthood, in parallel with jaw-face skeleton growth, changes of dentitions and improvement of jaw functions. As motor and sensory control systems of muscles are interlinked, also the intrafusal fiber population, that is, muscle spindles, should undergo age-related changes in fiber type appearance. To test this hypothesis, we examined muscle spindles in the young masseter muscle and compared the result with previous data on adult masseter spindles. Also muscle spindles in the young biceps brachii muscle were examined. The result showed that muscle spindle composition and distribution were alike in young and adult masseter. As for the adult masseter, young masseter contained exceptionally large muscle spindles, and with the highest spindle density and most complex spindles found in the deep masseter portion. Hence, contrary to our hypothesis, masseter spindles do not undergo major morphological changes between young age and adulthood. Also in the biceps, young spindles were alike adult spindles. Taken together, the results showed that human masseter and biceps muscle spindles are morphologically mature already at young age. We conclude that muscle spindles in the human young masseter and biceps precede the extrafusal fiber population in growth and maturation. This in turn suggests early reflex control and proprioceptive demands in learning and maturation of jaw motor skills. Similarly, well-developed muscle spindles in young biceps reflect early need of reflex control in learning and performing arm motor behavior. Copyright © 2011 Wiley-Liss, Inc.

  6. Nerve root distribution of deltoid and biceps brachii muscle in cervical spondylotic myelopathy: a potential risk factor for postoperative shoulder muscle weakness after posterior decompression.

    Science.gov (United States)

    Yonemura, Hiroshi; Kaneko, Kazuo; Taguchi, Toshihiko; Fujimoto, Hideaki; Toyoda, Kouichiro; Kawai, Shinya

    2004-01-01

    To investigate the nerve root distribution of deltoid and biceps brachii muscle, compound muscle action potentials (CMAPs) were recorded intraoperatively following nerve root stimulation in cervical spondylotic myelopathy. A total of 19 upper limbs in 12 patients aged 55-72 years (mean, 65.5 years) with cervical spondylotic myelopathy were examined. CMAPs were recorded from deltoid and biceps brachii muscle following C5 and C6 root stimulation. Although both C5 and C6 roots were innervated for deltoid and biceps brachii muscle in all subjects, the amplitude ratio of CMAPs (C5/C6) differed individually depending on the symptomatic intervertebral levels of the spinal cord. The C5 root predominantly innervated both deltoid and biceps brachii in patients with symptomatic cord lesions at the C4-C5 intervertebral level compared to patients with symptomatic cord lesions at the C5-C6 intervertebral level. Although no patients sustained postoperative radiculopathy in our study, severe weakness and unfavorable recovery are expected when the C5 root in patients with C4-C5 myelopathy is damaged. From the electrophysiological aspect, C4-C5 cord lesions are likely to be a potential risk factor for postoperative shoulder muscle weakness in patients with compressive cervical myelopathy.

  7. Spontaneous resorption of calcification at the long head of the biceps tendon

    OpenAIRE

    Amri, Adriansyah; Yukata, Kiminori; Nakai, Sho; Hara, Michiharu; Yamanaka, Issei; Hamawaki, Jun-ichi

    2015-01-01

    Calcific tendinitis of the long head of the biceps tendon is a rare cause of shoulder pain. Calcium deposits are often spontaneously resorbed or reduced in size in the rotator cuff tendons, which represent the most common sites of calcific tendinitis around the shoulder. To our knowledge, no case of spontaneous resorption of calcification in the long head of the biceps tendon has been reported in the literature. Here, we report one such case and describe its successful treatment using a conse...

  8. Immediate electromyographic changes of the biceps brachii and upper rectus abdominis muscles due to the Pilates centring technique.

    Science.gov (United States)

    Barbosa, Alexandre Wesley Carvalho; Martins, Fábio Luiz Mendonça; Vitorino, Débora Fernandes de Melo; Barbosa, Michelle Cristina Sales Almeida

    2013-07-01

    To evaluate the electrical behaviour of the biceps brachii (BB) and upper rectus abdominis (URA) by surface electromyography (sEMG) during a forearm flexion with and without the Pilates centring technique. Ten female subjects (with a minimum of one week of experience with the Pilates method) were recruited. The long head of the BB and URA were evaluated while an isotonic contraction of the BB was performed using the Pilates breathing technique and powerhouse contraction, followed by another contraction without these techniques. The data were normalised by a maximal voluntary isometric contraction. Normality was accepted, and the paired t-test was used to determine data differences (p concentric compared to the eccentric phase. In addition, this last phase, the centring activation was greater than without the Pilates technique. The Pilates method seems to influence the increase in BB activity during dynamic contraction, especially during the eccentric phase. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Behaviour of the electrical impedance myography in isometric contraction of biceps brachii at different elbow joint angles

    Science.gov (United States)

    Coutinho, A. B. B.; Jotta, B.; Pino, A. V.; Souza, M. N.

    2012-12-01

    Electrical impedance myography (EIM) can be understood as an experimental technique applied to evaluate bioelectrical impedance associated to the muscular activity. With the development of technique, some studies are trying to associate the EIM parameters with the morphological and physiological changes that occur in the muscle during contraction. In this context this work sought to associate EIM parameters observed during isometric contractions of the biceps brachii muscle at different elbow joint angles with the correspondent muscular force. Differently from previous works that did not observe significant correlation between those data, our findings point to high correlations between the some EIM resistive parameters and the muscle force. Despite the need of further investigation, our results indicated that EIM technique can be used to estimate muscle force in a noninvasive way.

  10. Reconstruction of posterior interosseous nerve injury following biceps tendon repair: case report and cadaveric study.

    Science.gov (United States)

    Mokhtee, David B; Brown, Justin M; Mackinnon, Susan E; Tung, Thomas H

    2009-06-01

    Surgical repair of distal biceps tendon rupture is a technically challenging procedure that has the potential for devastating and permanently disabling complications. We report two cases of posterior interosseous nerve (PIN) injury following successful biceps tendon repair utilizing both the single-incision and two-incision approaches. We also describe our technique of posterior interosseous nerve repair using a medial antebrachial cutaneous nerve graft (MABC) and a new approach to the terminal branches of the posterior interosseous nerve that makes this reconstruction possible. Finally, we advocate consideration for identification of the posterior interosseous nerve prior to reattachment of the biceps tendon to the radial tuberosity.

  11. 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.

  12. Subpectoral biceps tenodesis for bicipital tendonitis with SLAP tear.

    Science.gov (United States)

    Gupta, Anil K; Chalmers, Peter N; Klosterman, Emma L; Harris, Joshua D; Bach, Bernard R; Verma, Nikhil N; Cole, Brian J; Romeo, Anthony A

    2015-01-01

    The purpose of this study was to evaluate the outcomes of patients undergoing subpectoral biceps tenodesis for bicipital tendonitis with a superior labral anterior-posterior (SLAP) tear. Patients undergoing primary subpectoral biceps tenodesis for arthroscopically confirmed SLAP tears with signs or findings of bicipital tendonitis were included. An independent observer collected data prospectively as part of a data repository, which was then analyzed retrospectively. Primary outcome measures were the American Shoulder and Elbow Surgeons (ASES) score and pain relief via visual analog scale (VAS). Secondary outcome measures included the Simple Shoulder Test (SST), Constant, Single Assessment Numeric Evaluation (SANE), and Short Form 12 (SF-12) scores. Twenty-eight patients with a mean±SD age of 43.7±13.4 years and a mean±SD follow-up of 2.0±1.0 years met inclusion criteria. Workers' compensation was involved with 43% of cases, and 46% of the included patients were manual laborers. Eight (32%) patients were athletes, and 88% of the athletes were overhead athletes. Intraoperatively, 15 (54%) patients had type I SLAP tears, 10 (36%) had type II SLAP tears, 1 (3%) had a type III SLAP tear, and 2 (7%) had type IV SLAP tears. Significant improvements were seen in the following outcome measures pre- vs postoperatively: ASES score (58±23 vs 89±18; P=.001), SST score (6.3±3.6 vs 10.6±3.3; P=.001), SANE score (54±24 vs 88±25; P=.003), VAS score (3.8±2.0 vs 1.1±1.8; P=.001), SF-12 overall score (35±6 vs 42±6; P=.001), and SF-12 physical component score (39±6 vs 50±10; P=.001). Overall satisfaction was excellent in 80% of patients. Subpectoral biceps tenodesis demonstrates excellent clinical outcomes in select patients with SLAP tears. [Orthopedics. 2015; 38(1):e48-e53.].

  13. Entrapment of Common Peroneal Nerve by Surgical Suture following Distal Biceps Femoris Tendon Repair

    Directory of Open Access Journals (Sweden)

    Aki Fukuda

    2016-01-01

    Full Text Available We describe entrapment of the common peroneal nerve by a suture after surgical repair of the distal biceps femoris tendon. Complete rupture of the distal biceps femoris tendon of a 16-year-old male athlete was surgically repaired. Postoperative common peroneal nerve palsy was evident, but conservative treatment did not cause any neurological improvement. Reexploration revealed that the common peroneal nerve was entrapped by the surgical suture. Complete removal of the suture and external neurolysis significantly improved the palsy. The common peroneal nerve is prone to damage as a result of its close proximity to the biceps femoris tendon and it should be identified during surgical repair of a ruptured distal biceps femoris tendon.

  14. Reconstruction of Posterior Interosseous Nerve Injury Following Biceps Tendon Repair: Case Report and Cadaveric Study

    OpenAIRE

    Mokhtee, David B.; Brown, Justin M.; Mackinnon, Susan E.; Tung, Thomas H.

    2008-01-01

    Surgical repair of distal biceps tendon rupture is a technically challenging procedure that has the potential for devastating and permanently disabling complications. We report two cases of posterior interosseous nerve (PIN) injury following successful biceps tendon repair utilizing both the single-incision and two-incision approaches. We also describe our technique of posterior interosseous nerve repair using a medial antebrachial cutaneous nerve graft (MABC) and a new approach to the termin...

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

    OpenAIRE

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

    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 patien...

  16. The role of biceps brachii and brachioradialis for the control of elbow flexion and extension movements.

    Science.gov (United States)

    von Werder, Sylvie Charlotte Frieda Anneliese; Disselhorst-Klug, Catherine

    2016-06-01

    How do synergistic muscles interact, when their contraction aims at stabilizing and fine-tuning a movement, which is induced by the antagonistic muscle? The aim of the study was to analyze the interaction of biceps and brachioradialis during fine-tuning control tasks in comparison to load bearing ones. The surface electromyogram of biceps, brachioradialis and triceps were examined in 15 healthy subjects in dynamic flexion and extension movements with different combinations of contraction levels, joint angles and angular velocities. The measurements were conducted in two configurations, where the torque due to an external load opposes the rotational direction of the elbow flexion (load bearing tasks) or the elbow extension (fine-tuning tasks). Whereas during load bearing control tasks, similar muscular activation of biceps and brachioradialis was observed for all joint angles, angular velocities and external loads, during fine-tuning control tasks a significant difference of the muscular activation of both flexors was observed for 1kg, F(3.639,47.305)=2.864, p=0.037, and 5kg of external load, F(1.570,21.976)=6.834, p=0.008. The results confirm the synergistic muscular activation of both flexors during load bearing tasks, but suggest different control strategies for both flexors when they comprise a fine-tuning control task.

  17. Intratendinous ganglion of the long head of the biceps tendon: US and MRI features (2010: 9b)

    Energy Technology Data Exchange (ETDEWEB)

    Rutten, Matthieu J.C.M.; Jong, Mathijn D.F. de; Jager, Gerrit J. [Jeroen Bosch Hospital, Department of Radiology, ' s-Hertogenbosch (Netherlands); Loon, Ton van [Jeroen Bosch Hospital, Department of Orthopedic Surgery, ' s-Hertogenbosch (Netherlands)

    2010-12-15

    We present a case report and literature review of the ultrasound (US) and magnetic resonance imaging (MRI) features of an intratendinous ganglion originating from the long head of the biceps tendon. Intratendinous ganglia are very rare entities and intratendinous ganglion of the long head of the biceps tendon has only been described once. To the best of our knowledge, this is the first case report presenting the sonographic features of an intratendinous ganglion originating from the long head of the biceps tendon. (orig.)

  18. Electromyographic Responses during Elbow Movement at Two Angles with Voluntary Contraction: Influences of Muscle Activity on Upper Arm Biceps Brachii

    Directory of Open Access Journals (Sweden)

    Nizam Uddin Ahamed

    2012-11-01

    Full Text Available Analysis of Electromyography (EMG signals generated by individuals is part of human musculoskeletal system research and signals are always influenced by the electrode placement in the muscle. This characteristic is also obvious at Biceps Brachii (BB muscles during the movement of elbow at different angles. The purpose of this study was to monitor and determine the BB muscle function in 3 conditions: (i electrodes were placed at 3 locations on the BB, (ii elbow was fixed at the two angles (90° and 150° and (iii isometric contractions were performed to record EMG data. EMG data were obtained from six healthy subjects (n = 6, mean±SD age = 24.4±3.1 years, body mass = 68±6.3 kg, height = 164±4.1 cm, BMI = 21.2±2.3, right arm dominated. A Bluetooth-enabled laptop, wireless EMG sensors, digital dynamometer and angle meter were used for data recording. EMG data were calculated and analyzed by average value, standard deviation, Root Mean Square (RMS and highest peak of the signal during maximum voluntary contraction. All the dependent variables were calculated using repeated measures Analysis of Variance (ANOVA. The results from the research showed that (i according to the calculation of average RMS and the maximum peaks of EMG signals, there was a significant difference between 2 angles (p = 0.047, i.e., p<0.05, but no interaction at the same angles when overall average EMG and standard deviation value are considered and (ii majority of the outcomes showed that EMG activity is higher in the order of middle, upper and lower BB muscle. It is therefore important that electrical signals generated upon different electrode placements and angles on the BB muscle are used for biceps rehabilitation and other physiological measurements on upper arm.

  19. Localized Electrical Impedance Myography of the Biceps Brachii Muscle during Different Levels of Isometric Contraction and Fatigue.

    Science.gov (United States)

    Li, Le; Shin, Henry; Li, Xiaoyan; Li, Sheng; Zhou, Ping

    2016-04-22

    This study assessed changes in electrical impedance myography (EIM) at different levels of isometric muscle contraction as well as during exhaustive exercise at 60% maximum voluntary contraction (MVC) until task failure. The EIM was performed on the biceps brachii muscle of 19 healthy subjects. The results showed that there was a significant difference between the muscle resistance (R) measured during the isometric contraction and when the muscle was completely relaxed. Post hoc analysis shows that the resistance increased at higher contractions (both 60% MVC and MVC), however, there were no significant changes in muscle reactance (X) during the isometric contractions. The resistance also changed during different stages of the fatigue task and there were significant decreases from the beginning of the contraction to task failure as well as between task failure and post fatigue rest. Although our results demonstrated an increase in resistance during isometric contraction, the changes were within 10% of the baseline value. These changes might be related to the modest alterations in muscle architecture during a contraction. The decrease in resistance seen with muscle fatigue may be explained by an accumulation of metabolites in the muscle tissue.

  20. Localized Electrical Impedance Myography of the Biceps Brachii Muscle during Different Levels of Isometric Contraction and Fatigue

    Directory of Open Access Journals (Sweden)

    Le Li

    2016-04-01

    Full Text Available This study assessed changes in electrical impedance myography (EIM at different levels of isometric muscle contraction as well as during exhaustive exercise at 60% maximum voluntary contraction (MVC until task failure. The EIM was performed on the biceps brachii muscle of 19 healthy subjects. The results showed that there was a significant difference between the muscle resistance (R measured during the isometric contraction and when the muscle was completely relaxed. Post hoc analysis shows that the resistance increased at higher contractions (both 60% MVC and MVC, however, there were no significant changes in muscle reactance (X during the isometric contractions. The resistance also changed during different stages of the fatigue task and there were significant decreases from the beginning of the contraction to task failure as well as between task failure and post fatigue rest. Although our results demonstrated an increase in resistance during isometric contraction, the changes were within 10% of the baseline value. These changes might be related to the modest alterations in muscle architecture during a contraction. The decrease in resistance seen with muscle fatigue may be explained by an accumulation of metabolites in the muscle tissue.

  1. Motor unit activity in biceps brachii of left-handed humans during sustained contractions with two load types.

    Science.gov (United States)

    Gould, Jeffrey R; Cleland, Brice T; Mani, Diba; Amiridis, Ioannis G; Enoka, Roger M

    2016-09-01

    The purpose of the study was to compare the discharge characteristics of single motor units during sustained isometric contractions that required either force or position control in left-handed individuals. The target force for the two sustained contractions (24.9 ± 10.5% maximal force) was identical for each biceps brachii motor unit (n = 32) and set at 4.7 ± 2.0% of maximal voluntary contraction (MVC) force above its recruitment threshold (range: 0.5-41.2% MVC force). The contractions were not sustained to task failure, but the duration (range: 60-330 s) was identical for each motor unit and the decline in MVC force immediately after the sustained contractions was similar for the two tasks (force: 11.1% ± 13.7%; position: 11.6% ± 9.9%). Despite a greater increase in the rating of perceived exertion during the position task (task × time interaction, P contractions requiring either force or position control.

  2. Changes in cortical beta activity related to a biceps brachii movement task while experiencing exercise induced muscle damage.

    Science.gov (United States)

    Plattner, Kristina; Lambert, Michael I; Tam, Nicholas; Lamberts, Robert P; Baumeister, Jochen

    2014-01-17

    Exercise-induced-muscle-damage (EIMD) is a well-described phenomenon which leads to decreased force output and altered neuromuscular function. How these symptoms of EIMD affect brain function, in particular cortical activity has not been described. Therefore the aim of this study was to investigate the relationship between the symptoms of EIMD and cortical beta (β) activity during a submaximal biceps brachii movement. Half of the subjects participated in an EIMD protocol. Control and EIMD groups were monitored for 132h thereafter. Muscle pain scores in the EIMD group peaked after 36h with the lowest muscle torque reported at 12h. Beta-1 and -2 activity was increased in the frontal and parietal area in the experimental group at 12h. This suggests an impact of EIMD induced neuromuscular changes on the cortical proprioceptive and motor perceptive networks. Beta-2 activity decreased in the control group over time suggesting a loss in focused attention and greater familiarization with the protocol as the study progressed. These data suggest that a change in β-1 and -2 activity is associated with integrating movement perception and proprioception post-EIMD.

  3. The effects of kinesio taping on architecture, strength and pain of muscles in delayed onset muscle soreness of biceps brachii.

    Science.gov (United States)

    Lee, Yong Sin; Bae, Sea Hyun; Hwang, Jin Ah; Kim, Kyung Yoon

    2015-02-01

    [Purpose] This study aimed to confirm the effects of kinesio taping (KT) on muscle function and pain due to delayed onset muscle soreness (DOMS) of the biceps brachii. [Subjects and Methods] Thirty-seven subjects with induced DOMS were randomized into either Group I (control, n=19) or Group II (KT, n=18). Outcome measures were recorded before the intervention (application of KT) and at 24, 48, and 72 hours after the intervention. DOMS was induced, and muscle thickness was measured using ultrasonic radiography. Maximal voluntary isometric contraction (%MVIC) was measured via electromyography (EMG). Subjective pain was measured using a visual analogue scale (VAS). [Results] Group I exhibited a positive correlation between muscle thickness and elapsed time from intervention (24, 48, and 72 hours post induction of DOMS); they also showed a significant decrease in MVIC(%). Group II showed significant increases in muscle thickness up to the 48-hour interval post induction of DOMS, along with a significant decrease in MVIC (%). However, in contrast to Group I, Group II did not show a significant difference in muscle thickness or MVIC (%) at the 72-hour interval in comparison with the values prior to DOMS induction. [Conclusion] In adults with DOMS, activation of muscles by applying KT was found to be an effective and faster method of recovering muscle strength than rest alone.

  4. Acute effects of direct inhibitory pressure over the biceps brachii myotendinous junction on skeletal muscle activation and force output.

    Science.gov (United States)

    Cè, Emiliano; Longo, Stefano; McCoy, Emily; Bisconti, Angela Valentina; Tironi, Davide; Limonta, Eloisa; Rampichini, Susanna; Rabuffetti, Marco; Esposito, Fabio

    2017-08-12

    Force (F) reduction is reported with myotendinous junction (MTJ) manipulation. Autogenic inhibition reflex (AIR) activation is supposed to be the main mechanism. Still, its role remains unclear. The study aimed at assessing the effects of MTJ direct inhibitory pressure (DIP) on neuromuscular activation and F in the elbow flexor (agonist) and extensor (antagonist) muscles. After maximum voluntary contraction (MVC) assessment, thirty-five participants randomly performed submaximal contractions at 20, 40, 60, and 80% MVC. Electromyographic (EMG), mechanomyographic (MMG), and F signals were recorded. Protocol was repeated under (i) DIP (10-s pressure on the biceps brachii MTJ) with the elbow at 120° (DIP120), (ii) DIP with the elbow at 180° (DIP180), and (iii) without DIP (Ctrl). Electromechanical delay (EMD) components, EMG and MMG root mean square (RMS), and rate of force development (RFD) were calculated. Independently from the angle, DIP induced decrements in MVC, RFD, and RMS of EMG and MMG signals and lengthened the EMD components in agonist muscles (P<0.05). The DIP-induced decrease in F output of the agonist muscles seems to be possibly due to a concomitant impairment of the neuromuscular activation and a transient decrease in stiffness. After DIP, the antagonist muscle displayed no changes; therefore, the intervention of AIR remains questionable. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Anatomy of the biceps tendon: implications for restoring physiological length-tension relation during biceps tenodesis with interference screw fixation.

    Science.gov (United States)

    Denard, Patrick J; Dai, Xuesong; Hanypsiak, Brian T; Burkhart, Stephen S

    2012-10-01

    The purpose of this study was to characterize the normal length and diameter of the long head of the biceps tendon (BT) to provide guidelines for interference screw tenodesis. Twenty-one cadaveric shoulders were dissected. The BT length was measured from its origin to the humeral head articular margin (AM), lower subscapularis, upper pectoralis major, musculotendinous junction of the biceps (MTJ), and lower pectoralis major (LPM). Tendon diameter was measured at levels corresponding to tenodesis: (1) at the AM, (2) suprapectorally, and (3) subpectorally. The mean tendon length was 24.9 mm from the origin to the AM, 56.1 mm to the lower subscapularis, 73.8 mm to the upper pectoralis major, 98.5 mm to the MTJ, and 118.4 mm to the LPM. The mean tendon diameter was 6.6 mm for tenodesis at the AM, 5.1 mm for suprapectoral tenodesis, and 5.3 mm for subpectoral tenodesis. During biceps tenodesis with interference screw fixation, restoring the normal length-tension relation of the BT depends on the site of tenodesis and the depth of the bone socket. At the AM, a 25-mm bone socket on average will maintain the length-tension relation. For tenodesis more distally, the length of tendon resection varies with bone socket length. Because the MTJ is above the LPM, subpectoral tenodesis should be performed proximal to the LPM. This study provides guidelines for restoring the normal length-tension relation during biceps tenodesis with interference screw fixation. The simplest way to restore this relation is with tenodesis adjacent to the humeral head AM and a bone socket of 25 mm in depth. For tenodesis at more distal locations, both the length of the BT and the depth of the bone socket must be considered. Information about the normal BT may be useful in preserving the physiological length-tension relation during biceps tenodesis. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  6. The impact of rectification on the electrically evoked long-latency reflex of the biceps brachii muscle.

    Science.gov (United States)

    Alaid, Ssuhir; Kornhuber, Malte E

    2013-11-27

    Long latency reflexes (LLR) were elicited electrically and obtained by full wave rectified and non-rectified data recordings in 10 healthy subjects. After single or train stimuli (sensory radial nerve; interstimulus interval 3ms) amplitude and peak latency values were measured over the bent biceps brachii (BB) muscle, either without or with 1.5kg weight load. After rectification, mean LLR amplitude values made up 30% of the non-rectified data, independent from the stimulus type and weight load. In the non-rectified data, a significant gain in amplitude resulted from train stimuli compared with single stimuli, and from weight load compared to no weight load. No such significant difference was detected when rectified data were analysed. Furthermore, average amplitude values of rectified and non-rectified curves were studied using 11 sine waves and damped sine waves with equal phase intervals that were varied from 0° up to 34.4°. Phase shifts ranging from 10° to 25° resulted in excess amplitude decline of rectified data compared with non-rectified data. The long and polysynaptic course that LLR information takes leads to considerable overlap of responses to subsequent stimuli. This overlap of motor unit potentials forming the LLR obviously results in excess amplitude cancellation after rectification as shown for sine and damped sine waves. Rectification leads to an increase in the frequency content of the data that renders it prone to phase cancellation. In the present study, this cancellation was harmful as it prevented detection of important factors of influence such as stimulus strength and motor unit recruitment level.

  7. Analysis of concentric and eccentric contractions in biceps brachii muscles using surface electromyography signals and multifractal analysis.

    Science.gov (United States)

    Marri, Kiran; Swaminathan, Ramakrishnan

    2016-06-23

    Muscle contractions can be categorized into isometric, isotonic (concentric and eccentric) and isokinetic contractions. The eccentric contractions are very effective for promoting muscle hypertrophy and produce larger forces when compared to the concentric or isometric contractions. Surface electromyography signals are widely used for analyzing muscle activities. These signals are nonstationary, nonlinear and exhibit self-similar multifractal behavior. The research on surface electromyography signals using multifractal analysis is not well established for concentric and eccentric contractions. In this study, an attempt has been made to analyze the concentric and eccentric contractions associated with biceps brachii muscles using surface electromyography signals and multifractal detrended moving average algorithm. Surface electromyography signals were recorded from 20 healthy individuals while performing a single curl exercise. The preprocessed signals were divided into concentric and eccentric cycles and in turn divided into phases based on range of motion: lower (0°-90°) and upper (>90°). The segments of surface electromyography signal were subjected to multifractal detrended moving average algorithm, and multifractal features such as strength of multifractality, peak exponent value, maximum exponent and exponent index were extracted in addition to conventional linear features such as root mean square and median frequency. The results show that surface electromyography signals exhibit multifractal behavior in both concentric and eccentric cycles. The mean strength of multifractality increased by 15% in eccentric contraction compared to concentric contraction. The lowest and highest exponent index values are observed in the upper concentric and lower eccentric contractions, respectively. The multifractal features are observed to be helpful in differentiating surface electromyography signals along the range of motion as compared to root mean square and median

  8. Short-interval intracortical inhibition is not affected by varying visual feedback in an isometric task in biceps brachii muscle

    Directory of Open Access Journals (Sweden)

    Timo eRantalainen

    2013-03-01

    Full Text Available Short-interval intracortical inhibition (SICI of the primary motor cortex (M1 appears to play a significant role in skill acquisition. Consequently, it is of interest to find out which factors cause modulation of SICI. Purpose: To establish if visual feedback and force requirements influence SICI. Methods: SICI was assessed from 10 healthy adults (5 males and 5 females aged between 21 and 35 years in three submaximal isometric elbow flexion torque levels (5%, 20% and 40% of maximal voluntary contraction [MVC] and with two tasks differing in terms of visual feedback. Single-pulse and paired-pulse motor evoked potentials (MEPs, supramaximal M-wave and background surface electromyogram (sEMG were recorded from the biceps brachii muscle. Results: Repeated measures MANOVA was used for statistical analyses. Background sEMG did not differ between tasks (F = 0.4, P = 0.68 nor was task × torque level interaction observed (F = 1.2, P = 0.32, whereas background sEMG increased with increasing torque levels (P = 0.001. SICI did not differ between tasks (F = 0.9, P = 0.43 and no task × torque level interaction was observed (F = 2.3, P = 0.08. However, less SICI was observed at 40% MVC compared to the 5% and 20% MVC torque levels (P = 0.01 to 0.001. Conclusion: SICI was not altered by performing the same task with differing visual feedback. However, SICI decreased with increasing submaximal torque providing further evidence that SICI is one mechanism of modulating cortical excitability and plays a role in force gradation.

  9. "Relaxed" biceps proximal tenodesis: an arthroscopic technique with decreased residual tendon tension.

    Science.gov (United States)

    Valenti, Philippe; Benedetto, Ivan; Maqdes, Ali; Lima, Sara; Moraiti, Constantina

    2014-10-01

    Tenodesis of the long head of the biceps tendon (LHB) at the upper part of the bicipital groove has been related to persistent postoperative bicipital pain. This is possibly due to the inflammation of the remaining tendon within the groove. This, in turn, could be attributed to the continual mechanical stress placed on the tendon in the narrow bicipital groove. Theoretically, should the LHB be more "relaxed," the mechanical stress applied on it would be diminished. On the basis of this rationale, we present an arthroscopic biceps tenodesis technique, according to which the tendon is fixed at the entrance of the bicipital groove, using a bioabsorbable screw, relaxed by 5 mm. In this lax position, the residual LHB tension is expected to be decreased compared with the initial tension, whereas no cosmetic deformity (Popeye sign) or impaired muscular performance is anticipated.

  10. Histomorphologic changes of the long head of the biceps tendon in common shoulder pathologies.

    Science.gov (United States)

    Mazzocca, Augustus D; McCarthy, Mary Beth R; Ledgard, Felicia A; Chowaniec, David M; McKinnon, William J; Delaronde, Steven; Rubino, Louis J; Apolostakos, John; Romeo, Anthony A; Arciero, Robert A; Beitzel, Knut

    2013-06-01

    To assess molecular and histologic differences between the proximal (intra-articular) and distal (extra-articular) portions of the long head of the biceps (LHB) tendon in 3 different disease states (biceps instability, tendinosis, and degenerative joint disease [DJD]) compared with a healthy tendon (fresh frozen). We used 32 LHB tendons of patients undergoing tenodesis (mean age, 54.7 ± 10.1 years) and 9 harvested tissue donors. Tendons were divided according to 4 diagnostic groups: (1) biceps instability, (2) tendinosis, (3) DJD, and (4) normal control. After sectioning, tendons were fixed in formalin and stained with H&E and alcian blue for histologic analysis. Measurements of collagen organization by use of polarized light microscopy was then performed, and protein expression for type I and type III collagen, tenascin C, and decorin was determined. There were no statistical differences found for protein expression of type I or type III collagen, tenascin C, or decorin. The proximal and distal regions of the tendons had statistically significant differences in alcian blue staining, with the proximal portion containing a higher amount of proteoglycan (instability, P = .001; tendinosis, P = .005; DJD, P = .008; control, P = .011). When compared with the nonpathologic control tendons, a significant increase in alcian blue staining for the proximal region was seen in all 3 groups. Total polarized light analysis showed that the distal tendon had a significantly higher intensity (organization) compared with the proximal tendon (P tendon when compared with the distal regions in all pathologic groups. However, no major differences at the cellular level were found among groups. The pathomechanisms of the various forms of known LHB diagnoses are not yet fully understood and basic science studies may help in understanding their etiology and therefore optimizing treatment options. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All

  11. [Contribution of the biceps brachii and pronator teres muscles to the efforts of pronation or supination. II. dynamic work (author's transl)].

    Science.gov (United States)

    van Hoecke, J; Pérot, C; Goubel, F

    1978-03-20

    The electrical activity of the biceps brachii and pronator teres muscles is studied through the prono-supination of the forearm in some anisometrical conditions (dynamic work) when the inertia of the mobile system and the elbow position are being varied. The subjects are required to perform pronation, supination and flexion movements, either isolated or combined. From the findings obtained when the integrated electrical activity (Q) is related to the mechanical work (W), one can conclude that a. the Q-W linear relationship seems to characterize the chief function of a muscle, b. the slope of the Q-W relationship depends on the elbow position, c. the pronator muscles do not inhibit in a selective manner the biceps supinating function. So a bifunctional muscle seems to act as a whole.

  12. Tendinopathy of the tendon of the long head of the biceps.

    Science.gov (United States)

    Longo, Umile Giuseppe; Loppini, Mattia; Marineo, Gianluca; Khan, Wasim S; Maffulli, Nicola; Denaro, Vincenzo

    2011-12-01

    Pathologies of tendon of the long head of the biceps (LHB) are an important cause of shoulder pain. They include tendinopathy, rupture, superior labrum anterior and posterior lesions, pulley tears, and tendon instability. Conservative management of symptomatic LHB tendinopathy is commonly accepted as the first-line treatment. It consists of rest, nonsteroidal anti-inflammatory drugs, corticosteroid injections, and physical therapy. Biceps tenotomy and tenodesis are the most common surgical procedures to manage both isolated LHB pathology and biceps-glenoid complex tears combined with rotator cuff tears. However, controversy persists about the superiority of one of them because there is no evidence of significant differences in functional scores or patient satisfaction between the 2 techniques. This article provides an overview on biomechanical function of the LHB and current strategies for treatment of LHB disorders.

  13. [Bilateral calcifying tendinitis of the long tendon of the biceps associated with a SLAP lesion].

    Science.gov (United States)

    Mayayo Sinués, Esteban; Soriano Guillén, Antonia Pilar; Vela Marín, Ana Carmen; Martínez Pérez, Belén

    2010-01-01

    Calcifying tendinitis is a common disorder related to deposition of hidroxyapatite crystals, which is most common around the shoulder joint, involving the supraespinosus tendon. It can however, affect almost any tendon at its insertion. Clinical features are variable and include pain and inflammation that often resolves spontaneously. We present a case of bilateral calcifying tendinitis of the long head of the biceps tendon at its insertion on the superior glenoid rim associated with superior labrum antero-posterior tears (SLAP) confirmed by arthroscopy. Calcium deposits were surgically removed and the SLAP lesions were repaired.

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

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    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.)

  15. 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.

  16. Bilateral Superior Labrum Anterior to Posterior (SLAP) Tears With Abnormal Anatomy of Biceps Tendon.

    Science.gov (United States)

    Morris, Dan; Guettler, Joseph; Morris, Sean

    2015-08-01

    There have been several descriptions of variant anatomy of the long head of the biceps tendon (LHBT). A recent literature review identified 8 cases of anomalous intracapsular attachment of the LHBT. In this report, we discuss a distinctive case of a young athlete who presented with symptoms consistent with bilateral superior labrum anterior to posterior (SLAP) tears that were unresponsive to conservative measures. Magnetic resonance imaging and arthroscopic findings of this patient confirmed that the patient had type II SLAP tears, a Buford complex anteriorly, and perhaps most important, confluence of the biceps tendon itself to the undersurface of the capsule within the rotator interval. Our case proposes that anomalous insertion of the LHBT, as well as other labral and biceps anchor variations, are not always a benign finding at the time of arthroscopy. In this particular case, the tethering of the biceps tendon to the capsule is thought to have increased stress on the superior labrum and contributed to the development of the bilateral symptomatic type II SLAP tears that were identified and treated in this young athlete.

  17. Relationship between chronic pathologies of the supraspinatus tendon and the long head of the biceps tendon: systematic review

    OpenAIRE

    Redondo-Alonso, Lucía; Chamorro-Moriana, Gema; Jiménez-Rejano, José Jesús; López-Tarrida, Patricio; Ridao-Fernández, Carmen

    2014-01-01

    Background Chronic supraspinatus tendinopathy is a common clinical problem that causes functional and labor disabilities in the population. It is the most frequent cause of shoulder pain. This pathology may be frequently associated to the affectation of the long head of biceps tendon (LHBT), the main stabilizer of the glenohumeral joint together with the supraspinatus. The main aim of this work is to study the prevalence of lesions in LHBT associated to the chronic pathology of the supraspina...

  18. 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.

  19. Posterior dislocation of the long head of biceps tendon: case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Mullaney, P.J.; Bleakney, R.; White, L. [Mount Sinai Hospital, Department of Medical Imaging, Toronto, ON, M5G 1X5 (Canada); Tuchscherer, P. [Toronto Western Hospital, Department of Medical Imaging, Toronto, ON (Canada); Boynton, E. [Mount Sinai Hospital, Department of Orthopaedic and Trauma Surgery, Toronto, ON (Canada)

    2007-08-15

    Posterior or lateral dislocation of the long head of biceps is a rare complication of shoulder dislocation that can result in inability to relocate the humerus. The diagnosis should be suspected when certain radiographic features are present at the initial presentation. Other imaging modalities can aid diagnosis when clinical management is unsuccessful or protracted. We present a case of surgically proven posterior dislocation of the biceps tendon with conventional radiographic, computed tomography and magnetic resonance imaging assessment. The literature on this subject is reviewed, and imaging features associated with the diagnosis are described. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Spritzer, C.E.; Collins, A.J. [Dept. of Radiology, Duke University Medical Center, Durham, NC (United States); Cooperman, A. [Center for Diagnostic Imaging, Winter Park, FL (United States); Speer, K.P. [Dept. of Orthopaedic Sports Medicine, Duke University Medical Center, Durham, NC (United States)

    2001-04-01

    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.)

  2. The surface mechanomyogram as a tool to describe the influence of fatigue on biceps brachii motor unit activation strategy. Historical basis and novel evidence.

    Science.gov (United States)

    Orizio, Claudio; Gobbo, Massimiliano; Diemont, Bertrand; Esposito, Fabio; Veicsteinas, Arsenio

    2003-10-01

    The surface mechanomyogram (MMG) (detectable at the muscle surface as MMG by accelerometers, piezoelectric contact sensors or other transducers) is the summation of the activity of single motor units (MUs). Each MU contribution is related to the pressure waves generated by the active muscle fibres. The first part of this article will review briefly the results obtained by our group studying the possible role of motor unit recruitment and firing rate in determining the characteristics of the MMG during stimulated and voluntary contractions. The second part of this article will study the MMG and EMG during a short isometric force ramp from 0 to 90% of the maximal voluntary contraction (MVC) in fresh and fatigued biceps brachii. The aim is to verify whether changes in motor unit activation strategy in voluntarily fatigued muscle could be specifically reflected in the time and frequency domain parameters of the MMG. MMG-RMS vs. %MVC: at fatigue the MMG-RMS did not present the well known increment, when effort level increases, followed by a clear decrement at near-maximal contraction levels. MMG-MF vs. %MVC: compared to fresh muscle the fatigued biceps brachii showed an MF trend significantly shifted towards lower values and the steeper MF increment, from 65 to 85% MVC, was not present. The alteration in the MMG and EMG parameters vs. %MVC relationships at fatigue seems to be related to the impossibility of recruiting fast, but more fatigable MUs, and to the lowering of the global MUs firing during the short isometric force ramp investigated.

  3. 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.

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

    OpenAIRE

    Samir Nayyar; Martin Quirno; Saqib Hasan; Leon Rybak; 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...

  5. 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.

  6. Proximal coracobrachialis tendon rupture, subscapularis tendon rupture, and medial dislocation of the long head of the biceps tendon in an adult after traumatic anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Bryan M Saltzman

    2015-01-01

    Full Text Available Rupture of the coracobrachialis is a rare entity, in isolation or in combination with other muscular or tendinous structures. When described, it is often a result of direct trauma to the anatomic area resulting in rupture of the muscle belly. The authors present a case of a 57-year-old female who suffered a proximal coracobrachialis tendon rupture from its origin at the coracoid process, with concomitant subscapularis tear and medial dislocation of the long head of biceps tendon after first time traumatic anterior shoulder dislocation. Two weeks after injury, magnetic resonance imaging suggested the diagnosis, which was confirmed during combined arthroscopic and open technique. Soft-tissue tenodesis of coracobrachialis to the intact short head of the biceps, tenodesis of the long head of biceps to the intertubercular groove, and double-row anatomic repair of the subscapularis were performed. The patient did well postoperatively, and ultimately at 6 months follow-up, she was without pain, and obtained 160΀ of active forward elevation, 45΀ of external rotation, internal rotation to T8, 5/5 subscapularis and biceps strength. Scoring scales had improved from the following preoperative to final follow-up: American Shoulder and Elbow Surgeons, 53.33-98.33; constant, 10-100; visual analogue scale-pain, 4-0. DASH score was 5.

  7. Biceps tendon disorders: ultrasound, MR imaging and MR arthrography; Bizepsprobleme: Ultraschall, Magnetresonanztomographie und MR-Arthrographie

    Energy Technology Data Exchange (ETDEWEB)

    Zanetti, M.; Pfirrmann, C.W.A. [Radiologie, Uniklinik Balgrist Zuerich (Switzerland)

    2004-06-01

    Ultrasound and MR imaging are competitive imaging modalities for the diagnosis of pathologic conditions of the biceps tendon. MR imaging has substantial advantages over ultrasound because biceps tendon lesions are most commonly located in the proximal part where lesions are hidden under the acromion for ultrasound assessment. The value of MR arthrography is substantiated by the capability to assess associated diagnoses which are otherwise difficult to assess. Associated diagnoses include full- and partial thickness tears of supraspinatus and subscapularis tendons, pulley lesions, and adhesive capsulitis (frozen shoulder). Moreover, MR arthrography is the method of choice for the assessment of superior labral anterior posterior (SLAP) lesions. (orig.) [German] Der nachfolgende Uebersichtsartikel beschreibt die haeufigsten Bizepsprobleme der Schulter, wie sie in einem orthopaedisch ausgerichteten Radiologieinstitut gesehen werden. Ultraschall und MRT sind geeignet zur Evaluation von Bizepsproblemen. Der Ultraschall weist Vorteile in der dynamischen Untersuchung auf, vermag aber die proximal gelegenen Laesionen nicht zuverlaessig zu erfassen. Die MRT liefert Zusatzinformationen zu den haeufig assoziierten Begleitpathologien an der Rotatorenmanschette und an den Kapsel- und Ligamentstrukturen. Die MR-Arthrographie ist die Methode der Wahl zur Diagnose der SLAP-(superior-labral-anterior-posterior-)Laesion. (orig.)

  8. Tendon of the long head of the biceps originating from the rotator cuff - An uncommon anatomical variation: case report

    Directory of Open Access Journals (Sweden)

    Carlos Vicente Andreoli

    2016-02-01

    Full Text Available ABSTRACT Anatomical variations at the origin of the biceps tendon have been described by several authors, but occurrences of an origin in the supraspinatus are rare. It is unclear whether this variation might contribute toward pathological conditions of the shoulder. Our objective here was to describe a case of an anatomical variation in the origin of the tendon of the long head of the biceps. The clinical information, preoperative images and arthroscopic images relating to a patient with an aberrant origin of the long head of the biceps, which was observed during shoulder arthroscopy, were reviewed. In this case study, the origin of the biceps was found in the rotator cuff, without any origin from the supraglenoid tubercle or upper labrum. This variant did not seem to contribute toward the pathological condition of the shoulder, and standard treatment for the concomitant condition was sufficient for treating it.

  9. Radiological and Clinical Evaluation of the Transosseous Cortical Button Technique in Distal Biceps Tendon Repair.

    Science.gov (United States)

    Caekebeke, Pieter; Vermeersch, Nicolas; Duerinckx, Joris; van Riet, Roger

    2016-12-01

    One of the options to repair a ruptured distal biceps tendon to the radial tuberosity is by means of a transosseous cortical button. Although excellent functional outcomes have been reported, no studies have been performed to quantify the effect of the transosseous fixation technique on the radius. Our study evaluated the clinical outcome and radiological outcome of this technique. The main goal of this study was to evaluate the radiographic evolution of the bone tunnel in the radius. Patients with an acute distal biceps tendon rupture treated with a transosseous cortical button were invited to take part in the study. Fourteen patients were included in the final analysis. All patients were evaluated both clinically and by computed tomography scanning of the proximal radius after a minimum follow-up of 2 years. Outcomes were recorded using the visual analog scale score for pain, the Mayo Elbow Performance Score, and Disabilities of the Arm, Shoulder, and Hand scores. Bone tunnel volume was measured with semiautomated computed tomography segmentation using image-processing software. There were no failures of fixation in the patient group examined. Elbow mobility, arm, and forearm circumference were symmetric for all patients. Average visual analog scale for pain was less than 2. Mean Disabilities of the Arm, Shoulder, and Hand score and Mayo Elbow Performance Score were 2.3 and 97.6, respectively. Computed tomography images showed an average closure of the radial bony tunnel of 64% of the initial volume. Biceps tendon repair with cortical button fixation only shows partial tunnel closure. This could reduce the risk of potential complications due to osteolysis, such as radius fracture or hardware failure. Functional results were excellent and comparable to other fixation methods. The role of interference screws in transosseous cortical button techniques to strengthen the repair and to avoid osteolysis may therefore be questioned. Therapeutic IV. Copyright © 2016

  10. 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: e98004

    National Research Council Canada - National Science Library

    Charles H Rundle; Shin-Tai Chen; Michael J Coen; Jon E Wergedal; Virginia Stiffel; Kin-Hing William Lau

    2014-01-01

      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...

  11. Differences in corticospinal excitability to the biceps brachii between arm cycling and tonic contraction are not evident at the immediate onset of movement.

    Science.gov (United States)

    Forman, Davis A; Philpott, Devin T G; Button, Duane C; Power, Kevin E

    2016-08-01

    This is the first study to examine changes in corticospinal excitability to the biceps brachii during the onset of arm cycling from a resting position to a point when steady-state arm cycling was obtained. Supraspinal and spinal excitability were assessed using motor-evoked potentials (MEPs) elicited via transcranial magnetic stimulation and cervicomedullary evoked potentials (CMEPs) elicited via transmastoid electrical stimulation, respectively. Evoked responses were recorded from the biceps brachii during elbow flexion (6 o'clock relative to a clock face) for both arm cycling and an intensity-matched tonic contraction at three separate periods: (1) immediately at the onset of motor output and after completion of the (2) 4th revolution and (3) 9th revolution. There was no difference during initiation between tasks for MEP (P = 0.79) or CMEP amplitudes (P = 0.57). However, MEP amplitudes were significantly larger during arm cycling than an intensity-matched tonic contraction after the completion of the 4th (Cycling 76.48 ± 17.35 % of M max, Tonic 63.45 ± 18.45 % of M max, P Cycling 72.37 ± 15.96 % of M max, Tonic 58.1 ± 24.23 % of M max, P Cycling 49.6 ± 25.4 % of M max, Tonic 41.6 ± 11.2 % of M max, P = 0.31) or the 9th revolution (Cycling 47.2 ± 17.0 % of M max, Tonic 40.8 ± 13.6 % of M max, P = 0.29). These results demonstrate that corticospinal excitability is not different between arm cycling and a tonic contraction at motor output onset, but supraspinal excitability is enhanced during steady-state arm cycling. This suggests a similarity in the way the corticospinal tract initiates motor outputs in humans, regardless of the differences that present themselves in the later, steady-state stages.

  12. Analyzing the influence of curl speed in fatiguing biceps brachii muscles using sEMG signals and multifractal detrended moving average algorithm.

    Science.gov (United States)

    Marri, Kiran; Swaminathan, Ramakrishnan

    2016-08-01

    In this work, an attempt has been made to analyze surface electromyography (sEMG) signals of fatiguing biceps brachii muscles at different curl speeds using multifractal detrended moving average (MFDMA) algorithm. For this purpose, signals are recorded from fifty eight healthy subjects while performing curl exercise at their comfortable speed until fatigue. The signals of first and last curls are considered as nonfatigue and fatigue conditions, respectively. Further, the number of curls performed by each subject and the endurance time is used for computing the normalized curl speed. The signals are grouped into fast, medium and slow using curl speeds. The curl segments are subjected to MFDMA to derive degree of multifractality (DOM), maximum singularity exponent (MXE) and exponent length multifractality index (EMX). The results show that multifractal features are able to differentiate sEMG signals in fatiguing conditions. The multifractality increased with faster curls as compared with slower curl speed by 12%. High statistical significance is observed using EMX and DOM values between curl speed and fatigue conditions. It appears that this method of analyzing sEMG signals with curl speed can be useful in understanding muscle dynamics in varied neuromuscular conditions and sports medicine.

  13. The Effects of Positive and Negative Feedback on Maximal Voluntary Contraction Level of the Biceps Brachii Muscle: Moderating Roles of Gender and Conscientiousness.

    Science.gov (United States)

    Sarıkabak, Murat; Yaman, Çetin; Tok, Serdar; Binboga, Erdal

    2016-11-02

    We investigated the effect of positive and negative feedback on maximal voluntary contraction (MVC) of the biceps brachii muscle and explored the mediating effects of gender and conscientiousness. During elbow flexion, MVCs were measured in positive, negative, and no-feedback conditions. Participants were divided into high- and low-conscientiousness groups based on the median split of their scores on Tatar's five-factor personality inventory. Considering all participants 46 college student athletes (21 female, 28 male), positive feedback led to a greater MVC percentage change (-5.76%) than did negative feedback (2.2%). MVC percentage change in the positive feedback condition differed significantly by gender, but the negative feedback condition did not. Thus, positive feedback increased female athletes' MVC level by 3.49%, but decreased male athletes' MVC level by 15.6%. For conscientiousness, MVC percentage change in the positive feedback condition did not differ according to high and low conscientiousness. However, conscientiousness interacted with gender in the positive feedback condition, increasing MVC in high-conscientiousness female athletes and decreasing MVC in low-conscientiousness female athletes. Positive feedback decreased MVC in both high- and low-conscientiousness male athletes.

  14. Effects of Extracorporeal Shock Wave on Spasticity of Biceps Brachii after Stroke%体外冲击波缓解脑卒中后肱二头肌痉挛的效果

    Institute of Scientific and Technical Information of China (English)

    徐思维; 缪芸; 郁嫣嫣; 瞿强; 陈文华

    2014-01-01

    目的:观察体外冲击波对脑卒中后肱二头肌痉挛的治疗效果。方法12例脑卒中后肱二头肌痉挛患者分成对照组(n=6)和治疗组(n=6)。治疗组予单次体外冲击波治疗,对照组予安慰性治疗。两组患者在治疗前、治疗后即刻采用改良Ashworth量表(MAS)、上肢肩肘部分Fugl-Meyer评分(FMA)进行评定,表面肌电图测定肘伸展最大等长收缩时肱二头肌、肱三头肌的积分肌电值及协同收缩率。结果治疗组治疗后MAS、FMA评分,肱二头肌积分肌电值及协同收缩率均较治疗前改善(P<0.05),并优于对照组(P<0.05)。结论体外冲击波可以即刻缓解脑卒中后肱二头肌痉挛,降低肘伸展时肱二头肌的协同激活水平及协同收缩率,改善上肢运动功能。%Objective To observe the effects of extracorporeal shock wave therapy (ESWT) on spasticity of biceps brachii after stroke. Methods 12 patients with spasticity of biceps brachii after stroke were divided into control group (n=6) and ESWT group (n=6). The ESWT group received a session of ESWT and the control group received placebo treatment. All patients were assessed before and immediately after treatment, including integrated electromyogram (iEMG) and co-contraction ratio during maximum isometric voluntary contraction (MIVC) of elbow extension with surface electromyography, the modified Ashworth Scale (MAS) and content of shoulder and elbow of Fugl-Meyer Assessment (FMA). Results The scores of MAS and FMA, the iEMG and the cocontraction ratio of biceps brachii improved in the ESWT group after the treatment (P<0.05), and improved more than those in the control group (P<0.05). Conclusion ESWT can immediately re-lieve the spasticity of biceps brachii, inhibit the cocontraction of biceps brachii during elbow extension and improve the motor function of upper limb in patients post stroke.

  15. Quantitative ultrasound facilitates the exploration of morphological association of the long head biceps tendon with supraspinatus tendon full thickness tear.

    Directory of Open Access Journals (Sweden)

    Ke-Vin Chang

    Full Text Available Pathology of the long head biceps tendon (LHBT is associated with rotator cuff tears but whether the LHBT texture changes following supraspinatus tendon full thickness tear (SSFT can be detected at the extra-articular segment remains unknown. This cross-sectional study aimed to explore the morphological differences of the LHBT in shoulders with and without deficient rotator cuffs by using quantitative ultrasound.We selected 145 cases with SSFT and 145 age-and- gender-matched controls. The width, thickness, flattening ratio, cross-sectional area, and echogenicity ratio of the LHBT were measured and a general linear model was used to clarify the relationship between rotator cuff pathology and LHBT morphology. The receiver operating characteristic curves of each parameter were constructed for SSFT discrimination and the maximal Youden indexes were used to define the best cut-off points.We found increased thickness and cross-sectional area but decreased flattening ratio in shoulders with SSFT, and no between-group differences in the width and echogenicity ratio. The LHBT appearance was modified by biceps peritendinous effusion and medial subluxation, but not by the size of SSFT. The flattening ratio was the best discriminator for SSFT with an area under curve of 0.81 (95% confidence interval, 0.76-0.86. The cut-off values to differentiate between the non-tear and tear groups were 2.00 mm of the thickness, 1.73 of the flattening ratio and 10.53 mm(2 of the cross-sectional area.Quantitative ultrasound facilitated the detection of the LHBT morphological changes following SSFT and demonstrated its potential utility in discriminating rotator cuff deficiency.

  16. 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

  17. Pain and the pathogenesis of biceps tendinopathy

    Science.gov (United States)

    Raney, Elise B; Thankam, Finosh G; Dilisio, Matthew F; Agrawal, Devendra K

    2017-01-01

    Biceps tendinopathy is a relatively common ailment that typically presents as pain, tenderness, and weakness in the tendon of the long head of the biceps brachii. Though it is often associated with degenerative processes of the rotator cuff and the joint, this is not always the case, thus, the etiology remains considerably unknown. There has been recent interest in elucidating the pathogenesis of tendinopathy, since it can be an agent of chronic pain, and is difficult to manage. The purpose of this article is to critically evaluate relevant published research that reflects the current understanding of pain and how it relates to biceps tendinopathy. A review of the literature was conducted to create an organized picture of how pain arises and manifests itself, and how the mechanism behind biceps tendinopathy possibly results in pain. Chronic pain is thought to arise from neurogenic inflammation, central pain sensitization, excitatory nerve augmentation, inhibitory nerve loss, and/or dysregulation of supraspinal structures; thus, the connections of these theories to the ones regarding the generation of biceps tendinopathy, particularly the neural theory, are discussed. Pain mediators such as tachykinins, CGRP, and alarmins, in addition to nervous system ion channels, are highlighted as possible avenues for research in tendinopathy pain. Recognition of the nociceptive mechanisms and molecular of biceps tendinopathy might aid in the development of novel treatment strategies for managing anterior shoulder pain due to a symptomatic biceps tendon. PMID:28670360

  18. Biceps tendinitis in chronic rotator cuff tears: a histologic perspective.

    Science.gov (United States)

    Singaraju, Vamsi M; Kang, Richard W; Yanke, Adam B; McNickle, Allison G; Lewis, Paul B; Wang, Vincent M; Williams, James M; Chubinskaya, Susan; Romeo, Anthony A; Cole, Brian J

    2008-01-01

    Patients with chronic rotator cuff tears frequently have anterior shoulder pain attributed to the long head of the biceps brachii (LHBB) tendon. In this study, tenodesis or tenotomy samples and cadaveric controls were assessed by use of immunohistochemical and histologic methods to quantify inflammation, vascularity, and neuronal plasticity. Patients had moderate pain and positive results on at least 1 clinical test of shoulder function. The number of axons in the distal LHBB was significantly less in patients with biceps tendinitis. Calcitonin gene-related peptide and substance P immunostaining was predominantly within nerve roots and blood vessels. A moderate correlation (R = 0.5) was identified between LHBB vascularity and pain scores. On the basis of these results, we conclude that, in the context of rotator cuff disease, the etiology of anterior shoulder pain with macroscopic changes in the biceps tendon is related to the complex interaction of the tendon and surrounding soft tissues, rather than a single entity.

  19. DISSEMINATED REFRACTARY TUBERCULOSIS WITH BICEPS TENDON INVOLVEMENT IN AN IMMUNOCOMPETENT PATIENT

    Science.gov (United States)

    dos Reis Oliveira, Marcelo; Schiefer, Márcio; da Silva, Marcos Britto; Fontenelle, César; Júnior, Yonder Archanjo Ching-San; Franco, José Sérgio

    2015-01-01

    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 inflammatory joint disease, even in immunocompetent patients. PMID:27004180

  20. 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

  1. 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

  2. Effects of Pre-Exhausting the Biceps Brachii Muscle on the Performance of the Front Lat Pull-Down Exercise Using Different Handgrip Positions

    Directory of Open Access Journals (Sweden)

    Vilaça-Alves José

    2014-10-01

    Full Text Available The aim of the present study was to investigate the effects of pre-exhaustion (PE of the biceps brachii muscle (BB on the number of repetitions and the rate of perceived exertion (RPE in the front lat pull-down (FLPD using different handgrip positions. Additionally, the effect of sex and its interaction with performance and the RPE were also examined. The participants were 19 healthy subjects: 8 men (age: 27.13±2.85 years; body height: 180.63±6.65 cm; body mass: 82.05±8.92 kg; and body fat: 14.67±6.09%; and 11 women (age: 28.81±3.68 years; body height: 162.91±6.51 cm; body mass 59.63±6.47 kg; and body fat: 24.11±4.33%. The number of repetitions and the RPE in the FLPD exercise with different handgrip positions, with and without PE of the BB, was documented. The following main significant effects were seen: i PE of the BB decreased the number of repetitions (p<0.001 and increased the RPE (p<0.001; ii the narrow handgrip width elicited a higher RPE (p<0.001 and iii women performed fewer repetitions than men in all FLPD exercise variations (p=0.023. Significant interactions were also observed between: i PE or sex and the RPE (p=0.024; and ii PE or handgrip width and the number of repetitions (p<0.001. In conclusion, PE of the BB promotes a decreased performance in the FLPD exercise along with a greater RPE, especially when using a narrow handgrip position

  3. Arthroscopic tenodesis in the treatment of long head of biceps tendon lesions%关节镜下肌腱固定术治疗肱二头肌腱近端病损

    Institute of Scientific and Technical Information of China (English)

    高庆峰; 鄂刚; 何耀华; 张尧; 赵金忠; 皇甫小桥; 沈继; 刘闻欣

    2015-01-01

    目的:探讨关节镜下通过肌腱固定术治疗肱二头肌腱近端病损的手术方法及临床效果。方法2010年1月至2012年6月关节镜下通过肌腱固定术治疗肱二头肌腱近端病损49例,患者诊断明确,肱二头肌长头肌腱近端病损为其症状产生的主要原因,其中男性21例,女性28例。年龄37~60岁。分别记录术前及最终随访时疼痛、活动范围、前屈上举肌力以及功能评分,并进行统计学分析。结果所有患者术程顺利,术后顺利愈合并获随访平均18(12~34)个月。术前 Constant 评分为平均39.4分,UCLA 评分为平均15.4分;术后 Constant 评分为平均89.1分,UCLA 评分为平均31.2分。术后与术前相比,在疼痛、活动范围、屈肘、肌力及功能恢复方面差异均有统计学意义(P <0.05)。结论关节镜下通过肌腱固定技术治疗肱二头肌腱近端病损的临床效果满意。%Background The purpose of this study is to evaluate operative technique and clinical results of Arthroscopic Biceps Tenodesis for proximal lesion of the long head of biceps tendon. Methods Inclusion criteria:patient was younger than 60 years old;confirmed diagnosis of proximal lesion of biceps brachii tendon;conservative treatment was failed;biceps tendon lesion was supposed to be the main cause of shoulder symptoms.Exclusion criteria:other shoulder diseases such as neuropathy.From January 2010 to June 2012,49 patients underwent arthroscopic biceps Tenodesis for proximal lesion of long head of biceps tendon using suture anchor technique.There were 21 males and 28 females.Thirty-nine cases were diagnosed as bicipital tendinitis;5 cases as tendon tear;2 cases as biceps tendon instability and tendinitis with tears in 3 cases.Operatiive technique:patients were positioned in lateral decubitus position with 40 degrees of abduction,1 5 degrees of flexion and 4KG longitudinal traction.The viewing portal was routine posterior portal.Arthroscopic gleno-humeral joint

  4. Intra-articular changes precede extra-articular changes in the biceps tendon following rotator cuff tears in a rat model

    Science.gov (United States)

    Peltz, Cathryn D.; Hsu, Jason E.; Zgonis, Miltiadis H.; Trasolini, Nicholas A.; Glaser, David L.; Soslowsky, Louis J.

    2011-01-01

    Background Biceps tendon pathology is common with rotator cuff tears. The mechanisms for biceps changes, and therefore its optimal treatment, are unknown. Our objective was to determine the effect of rotator cuff tears on regional biceps tendon pathology. We hypothesized that histological and compositional changes would appear before organizational changes, both would appear before mechanical changes, and changes would begin at the tendon’s insertion site. Methods Sixty-five Sprague-Dawley rats received either detachment of supraspinatus and infraspinatus tendons or sham surgery. Rats were sacrificed at 1, 4 or 8 weeks for regional measurements of histological, compositional, organizational (1, 4 and 8 weeks) or mechanical properties (4 and 8 weeks only). Results One week following tendon detachments, decreased organization and more rounded cell shape were found in the intra-articular space of the biceps tendon. Aggrecan expression was increased along the entire length of the tendon while all other compositional changes were at the tendon’s proximal insertion into bone only. With time, this disorganization and more rounded cell shape extended the length of the tendon. Organizational and cell shape changes also preceded detrimental mechanical changes, as decreased modulus in the intra-articular space was found after 8 weeks. Conclusions Results support a degenerative component to pathology in the biceps tendon. Additionally, changes resembling a tendon exposed to compressive loading occurring first in the intra-articular space indicate that the biceps tendon plays an increased role as a load bearing structure against the humeral head in the presence of rotator cuff tears. PMID:21816629

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

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    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.

  6. Biomechanical in vitro validation of intramedullary cortical button fixation for distal biceps tendon repair: a new technique.

    Science.gov (United States)

    Siebenlist, Sebastian; Lenich, Andreas; Buchholz, Arne; Martetschläger, Frank; Eichhorn, Stefan; Heinrich, Petra; Fingerle, Alexander; Doebele, Stefan; Sandmann, Gunther H; Millett, Peter J; Stöckle, Ulrich; Elser, Florian

    2011-08-01

    Extramedullary cortical button-based fixation for distal biceps tendon ruptures exhibits maximum load to failure in vitro but cannot restore the anatomic footprint and has the potential risk for injury to the posterior interosseous nerve. Double intramedullary cortical button fixation repair provides superior fixation strength to the bone when compared with single extramedullary cortical button-based repair. Controlled laboratory study. The technique of intramedullary cortical button fixation with 1 or 2 buttons was compared with single extramedullary cortical button-based repair using 12 paired human cadaveric elbows. All specimens underwent computed tomography analysis to determine intramedullary dimensions of the radial tuberosity as well as the thickness of the anterior and posterior cortices before biomechanical testing. Maximum load to failure and failure modes were recorded. For baseline measurements, the native tendon was tested for maximum load to failure. The intramedullary area of the radial tuberosity provides sufficient space for single or double intramedullary cortical button implantation. The mean thickness of the anterior cortex was 1.13 ± 0.15 mm, and for the posterior cortex it was 1.97 ± 0.48 mm (P button fixation with a mean load to failure of 455 ± 103 N, versus 275 ± 44 N for single intramedullary cortical button fixation (P button-based technique (P = .003). There were no statistically significant differences between single intramedullary and single extramedullary button fixation repair (P = .081). The mean load to failure for the native tendon was 379 ± 87 N. Double intramedullary cortical button fixation provides the highest load to failure in the specimens tested. Double intramedullary cortical button fixation provides reliable fixation strength to the bone for distal biceps tendon repair and potentially minimizes the risk of posterior interosseous nerve injury. Further, based on a 2-point-fixation, this method may offer a wider, more

  7. Variation of tension in the long head of the biceps tendon as a function of limb position with simulated biceps contraction

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    Gramstad Gregory

    2010-01-01

    Full Text Available Purpose: This study was designed to quantify tensile forces within the intra-articular long head of the bicep tendon (LHBT under conditions of passive limb positioning and physiologic load, which simulate contraction of the LHBT. Materials and Methods: A force probe was inserted into the intra-articular LHBT, just distal to its supra-glenoid origin, in six fresh-frozen cadaveric specimens. Initially, specimens were manually manipulated through 30 glenohumeral joint positions, combining humeral rotation and elbow/forearm position. In the second phase, a 55 N tensile load was applied through the LHBT in 18 limb positions. Intra-tendinous tension was recorded in all positions under both conditions. Results: External humeral rotation significantly increased tension with glenohumeral forward flexion (P<0.0001. Conversely, internal humeral rotation significantly increased tension with glenohumeral abduction and extension (P<0.0001. A position of glenohumeral extension and internal rotation, with the elbow extended and forearm pronated, produced the highest tension in the intra-articular LHBT (P<0.0001. Under applied load conditions, observed LHTB tension was not statistically different in any glenohumeral position (P=0.1468, power = 88%. The greater tuberosity was noted to impinge on the force probe in forward flexion and internal rotation in two specimens. Conclusions: Variable tensile forces are seen in the intra-articular LHBT as a function of both limb position and simulated biceps contraction. Our findings provide a thorough data set that may be used to help substantiate or refute current or future hypotheses regarding LHBT function, pathology, and clinical tests. Clinical Relevance: Identifying positions of glenohumeral motion, which affect LHBT tension will provide an anatomic basis for clinical tests proposed to be for diagnosing LHBT lesions, including superior labral anterior and posterior tears.

  8. Variation of tension in the long head of the biceps tendon as a function of limb position with simulated biceps contraction

    Science.gov (United States)

    Gramstad, Gregory G.; Sears, Benjamin W.; Marra, Guido

    2010-01-01

    Purpose: This study was designed to quantify tensile forces within the intra-articular long head of the bicep tendon (LHBT) under conditions of passive limb positioning and physiologic load, which simulate contraction of the LHBT. Materials and Methods: A force probe was inserted into the intra-articular LHBT, just distal to its supra-glenoid origin, in six fresh-frozen cadaveric specimens. Initially, specimens were manually manipulated through 30 glenohumeral joint positions, combining humeral rotation and elbow/forearm position. In the second phase, a 55 N tensile load was applied through the LHBT in 18 limb positions. Intra-tendinous tension was recorded in all positions under both conditions. Results: External humeral rotation significantly increased tension with glenohumeral forward flexion (P<0.0001). Conversely, internal humeral rotation significantly increased tension with glenohumeral abduction and extension (P<0.0001). A position of glenohumeral extension and internal rotation, with the elbow extended and forearm pronated, produced the highest tension in the intra-articular LHBT (P<0.0001). Under applied load conditions, observed LHTB tension was not statistically different in any glenohumeral position (P=0.1468, power = 88%). The greater tuberosity was noted to impinge on the force probe in forward flexion and internal rotation in two specimens. Conclusions: Variable tensile forces are seen in the intra-articular LHBT as a function of both limb position and simulated biceps contraction. Our findings provide a thorough data set that may be used to help substantiate or refute current or future hypotheses regarding LHBT function, pathology, and clinical tests. Clinical Relevance: Identifying positions of glenohumeral motion, which affect LHBT tension will provide an anatomic basis for clinical tests proposed to be for diagnosing LHBT lesions, including superior labral anterior and posterior tears. PMID:20922087

  9. A Experimental Study:the Contractile Properties of Triceps Brachii whiel Triceps Brachii Tendon Injured%肱三头肌肌腱损伤对其收缩性能影响的试验研究

    Institute of Scientific and Technical Information of China (English)

    陈勇; 张英泽; 王文辉

    2014-01-01

    Objective:To study the changes of the contractive property of tendon -injured skeletal muscle in animals ,and then discuss the effect of injured triceps brachii tendon on the patients with olecranon fracture .Methods:Take seven normal Japanese White rabbits as study participants and establish sciatic nerve -gastrocnemius muscle specimen in vivo .Each specimen was intervened successively in five levels:the gastrocnemius muscle tendon was kept intact ,the tendon was transversly cut off by 20% at the central section ,the tendon was transversly cut off by 40%at the central section , the tendon was transversly cut off by 60% at the central section , and the tendon was transversely cut off by 80%at the central section .In every level the maximum strength of the muscle and the mean were measured by dig -ital force gauge when the sciatic nerves were excited by impulse current of 3v and 50 Hz.Input data of the five levels and carry on statistics analysis with SAS the v9 ( two way ANOVA) .Results:Eleven specimens were successfully established and measured in all .There were significant differences for muscle strength (both the maximum and the mean) of the five levels(P<0.05).In multiple comparison, signifi-cant differences were found among these five levels (P<0.05),except that there was no significant difference in the muscle strength (both the maximum and the mean ) between the 40%group and the 60%group.In linear correlation analysis , there was a significant negative correlation (P <0.05) between the muscle strength and the cut off percentage (per cut) of the tendon.Conclusion:The skeletal muscle strength is inversely proportional to the severing percentage of its tendon in the experimental rabbits .That is, the severing percentage of the skeletal muscle tendon increased while the muscle strength significantly reduced gradually .%目的:通过动物试验研究骨骼肌肌腱损伤后其肌肉收缩性能的改变。方法:以日本大耳白兔为试验对象,制

  10. 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.)

  11. 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.

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

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    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Marnitz, T.; Steffen, I.G.; Denecke, T.; Elgeti, F.A. [Charite - Universitaetsmedizin Berlin (Germany). Klinik fuer Radiologie; Spiegel, D.; Hug, K.; Hueper, M.; Gerhardt, C; Greiner, S.; Scheibel, M. [Charite - Universitaetsmedizin Berlin (Germany). Centrum fuer Muskuloskeletale Chirurgie

    2012-05-15

    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). Crosssectional areas of operated and uninvolved tendons were measured and evaluated with the Wilcoxon signed rank test (p < 0.05). Results: FABS views enabled good evaluation in 96 % of tendons. Rerupture was present in 3 of 25 elbows. Tendinous signal increase was seen in 59 % of intact tendons. We found activity-related pain or pain at rest in 32 % and a loss of flexion strength in 27 % of these cases. Testing revealed no significant correlation for any of the MRI features with any of the clinical parameters (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.)

  14. 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.)

  15. Loop Biceps Tenotomy: An Arthroscopic Technique for Long Head of Biceps Tenotomy

    OpenAIRE

    Goubier, Jean-Noel; Bihel, Thomas; Dubois, Elodie; Teboul, Frédéric

    2014-01-01

    The long head of the biceps tendon is frequently involved in shoulder pathologies, often in relation to inflammatory or degenerative damage to the rotator cuff. Biceps tenodesis in the bicipital groove and tenotomy are the main treatment options. Tenotomy of the long head of the biceps tendon is a simpler and quicker procedure than tenodesis, and it does not require the use of implants. However, retraction of the biceps tendon, leading to Popeye deformity, and biceps muscle cramps are common ...

  16. Ultrasound evaluation of the distal migration of the long head of biceps tendon following tenotomy in patients undergoing arthroscopic repair of tears of the rotator cuff.

    Science.gov (United States)

    Karataglis, D; Papadopoulos, P; Boutsiadis, A; Fotiadou, A; Ditsios, K; Hatzokos, I; Christodoulou, A

    2012-11-01

    This study evaluates the position of the long head of biceps tendon using ultrasound following simple tenotomy, in patients with arthroscopically repaired rotator cuff tears. In total, 52 patients with a mean age of 60.7 years (45 to 75) underwent arthroscopic repair of the rotator cuff and simple tenotomy of the long head of biceps tendon. At two years post-operatively, ultrasound revealed that the tendon was inside the bicipital groove in 43 patients (82.7%) and outside in nine (17.3%); in six of these it was lying just outside the groove and in the remaining three (5.8%) it was in a remote position with a positive Popeye Sign. A dynamic ultrasound scan revealed that the tenotomised tendons had adhered to the surrounding tissues (autotenodesis).The initial condition of the tendon influenced its final position (p Popeye sign was statistically influenced by the pre-operative co-existence of supraspinatus and subscapularis tears (p Popeye sign.

  17. 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.

  18. Soft tissue tenodesis of the long head of the biceps tendon associated to the Roman Bridge repair

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    Maffulli Nicola

    2008-06-01

    Full Text Available Abstract Background Rotator cuff tears are frequently associated with pathologies of the long head of the biceps tendon (LHBT. Tenotomy and tenodesis of the LHBT are commonly used to manage disorders of the LHBT. Methods We present an arthroscopic soft tissue LHBT tenodesis associated with a Roman Bridge (double pulley – suture bridges repair Results Two medial row 5.5-mm Bio-Corkscrew suture anchors (Arthrex, Naples, FL, double-loaded with No. 2 FiberWire sutures (Arthrex, Naples, FL, are placed in the medial aspect of the footprint. A shuttle is passed through an anterior point of the rotator cuff and through the LHBT by means of a Penetrator or a BirdBeak suture passer (Arthrex, Naples, FL. A tenotomy of the LHBT is performed. All the sutures from the anteromedial anchor are passed through a single anterior point in the rotator cuff using a shuttle technique. All the sutures from the posteromedial anchor are passed through a single posterior point in the rotator cuff. The sutures in the medial row are tied using the double pulley technique. A suture limb is retrieved from each of the medial anchors and manually tied as a six-throw surgeon's knot over a metal rod. The two free suture limbs are pulled to transport the knot over the top of the tendon bridge. The two free suture limbs are then used to produce suture bridges over the tendon, using a Pushlock (Arthrex, Naples, FL, placed 1 cm distal to the lateral edge of the footprint. The same double pulley – suture bridges technique is repeated for the other two suture limbs from the two medial anchors. Conclusion This technique allows to perform a double pulley – suture bridges repair for a rotator cuff tear, associated with a soft tissue tenodesis for the management of LHBT pathology. The tenodesis of the LHBT is performed just with the passage of a shuttle inside the LHBT, after passing it through the anterior portion of the rotator cuff, with successive detachment of the LHBT from the

  19. A rare variation of the biceps brachi muscle

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    Paval J

    2006-01-01

    Full Text Available Biceps brachii muscle is very variable. Biceps may be composed of one to five heads. Although the variations in the origin are plenty, there are a very few cases reported on the variations in the insertion of the biceps brachii muscle. In this report we present a variant biceps brachii muscle which gives an abnormal muscle fasciculus from its medial side which continues as a narrow tendinous slip and is inserted in to the medial supracondylar ridge of humerus. We discuss in this report, the possible median nerve entrapment due to the presence of such a variation.

  20. 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.

  1. Arthroscopic tenodesis with tendon preservation for biceps long head tendinitis%关节镜下保留肌腱的固定术治疗肱二头肌长头肌腱炎

    Institute of Scientific and Technical Information of China (English)

    张尧; 何耀华; 白真龙; 章志望; 丁振禹; 孙奔奔

    2015-01-01

    Objective To explore the early clinical efficacy of arthroscopic tenodesis with tendon preservation for biceps long head tendinitis .Methods From October 2013 to April 2014 ,43 patients of biceps long head tendinitis were treated with arthroscopic tenodesis with tendon preservation .There were 16 males and 27 females ,with an average age of 50 .6 years (range ,39‐60 years) .American shoulder and elbow surgeons (ASES) ,Constant‐Murley shoulder score and the University of California at Los Angeles (UCLA) shoulder scale were assessed in pre‐operation and 3 ,6 ,12 months after opertion .Results All patients successfully completed the surgery .The average follow‐up period was 14 .2 months (range ,12‐18 months) .The mean of ASES score ,Constant‐Murley shoulder score and UCLA shoulder scale were 15 .65 ± 6 .06 ,39 .80 ± 11 .21 and 13 .25 ± 3 .77 in pre‐operation respectively ,and they were 34 .70 ± 2 .47 ,86 .00 ± 6 .35 and 31 .75 ± 2 .40 in 12 months after operation respectively . The outcomes demonstrated that all scores in 12 months after operation significantly improved(P<0 .05) .There was no pain recurrence and Popeye syndrome caused by transposition of tendon among these patients after operation . Conclusion Arthroscopic tenodesis with tendon preservation could achieve a satisfactory efficacy in the treatment of biceps long head tendinitis . This surgical method that preserves biceps brachii can effectively avoid the complications caused by transposition of tendon during fixation ,thus it is a better treatment method for biceps long head tendinitis .%目的:探讨肩关节镜下保留肱二头肌长头腱的肌腱固定术治疗肱二头肌长头肌腱炎早期临床疗效。方法2013年10月至2014年4月,对43例肱二头肌长头肌腱炎患者施行保留肱二头肌长头腱的肌腱固定术,其中男16例,女27例,年龄39~60岁,平均50.6岁。术前与术后3、6、12个月进行Constant‐Murley肩关节评分、加利

  2. Quantitative measurement of the elastic modulus of the biceps brachii during muscle relaxation and tension by shear-wave elasto-sonography%实时定量超声弹性成像技术检测肱二头肌松弛和紧张状态下弹性模量值差异

    Institute of Scientific and Technical Information of China (English)

    温朝阳; 范春芝; 安力春; 徐建红; 陈浩; 王月香; 唐杰

    2011-01-01

    Objective To explore the difference of Young' s modulus in the biceps brachii during muscle relaxation and tension. Methods A total of 141 healthy male volunteers with age range from 16 to 34 years ( mean 22 years old ) were included in the study. A shear-wave elasto-sonography ( AixPlorer model, Supersonic Imagine,Aix en Provence, France ) coupled with a linear array transducer array ( 4-15 MHz )was used. The scanner was set at the SWE mode and then at Q-BOX mode and the ultrasound transducer was placed directly above the biceps brachii belly and carefully aligned with the muscle bundle. The elastic moduli of the biceps brachii were measured during muscle relaxation and tension in all 141 volunteers. Results The Young ' s modulus of biceps brachii was 123. 658 ± 31. 392 kPa during muscle tension and 45. 658 ± 13. 479 kPa during muscle relaxation, respectively with statistical significance ( P =0. 0000 ), Conclusion The Young' s modulus of the biceps brachii was higher during muscle tension than those during muscle relaxation.%目的 研究松弛和紧张状态下肱二头肌肌腹的杨氏模量值差异.方法 141例男性健康志愿者,年龄16~34岁, 中位年龄22岁.使用法国Supersonic 公司的AixPlore型实时定量剪切波弹性成像超声诊断仪,L4-15线阵探头沿肱二头肌肌腹肌束方向检查,启动超声仪器弹性成像模式(SWE)模式,然后使用其定量分析系统Q-BOX分别测量二头肌处于松弛与紧张状态下的杨氏模量值.结果 紧张状态下肱二头肌肌腹杨氏模量值为(123.658±31.392) kPa,松弛状态下杨氏模量值为(45.658±13.479) kPa,两者比较差异具有统计学意义(P=0.0000).结论 剪切波弹性成像技术可检测肱二头肌肌腹在松弛和紧张状态下杨氏模量值差异,紧张状态下较松弛状态下模量值大;定量超声弹性成像技术用于肌肉组织疾病检查,使提供常规超声之外的诊断信息成为可能.

  3. 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.

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    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

  4. Glenoid labrum tears related to the long head of the biceps.

    Science.gov (United States)

    Andrews, J R; Carson, W G; McLeod, W D

    1985-01-01

    Tears of the glenoid labrum were observed in 73 baseball pitchers and other throwing athletes who underwent arthroscopic examination of the dominant shoulder. Most of the tears were located over the anterosuperior portion of the glenoid labrum near the origin of the tendon of the long head of the biceps muscle into the glenoid. At arthroscopy, the tendon of the long head of the biceps appeared to originate through and be continuous with the superior portion of the glenoid labrum. In many cases it appeared to have pulled the anterosuperior portion of the labrum off the glenoid. This observation was verified at arthroscopy by viewing the origin of the biceps tendon into the glenoid labrum as the muscle was electrically stimulated. With stimulation of the muscle, the tendinous portion became quite taut, particularly near its attachment to the glenoid labrum, and actually lifted the labrum off the glenoid. Three-dimensional high-speed cinematography with computer analysis revealed that the moment acting about the elbow joint to extend the joint through an arc of about 50 degrees was in excess of 600 inch-pounds. The extremely high velocity of elbow extension which is generated must be decelerated through the final 30 degrees of elbow extension. Of the muscles of the arm that provide the large deceleration forces in the follow-through phase of throwing, only the biceps brachii traverses both the elbow joint and the shoulder joint. Additional forces are generated in the biceps tendon in its function as a "shunt" muscle to stabilize the glenohumeral joint during the throwing act.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. 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

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    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.

  6. 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.

  7. How Accurate Are We in Detecting Biceps Tendinopathy?

    Science.gov (United States)

    Carr, Ryan M; Shishani, Yousef; Gobezie, Reuben

    2016-01-01

    Biceps tendon pain is frequently called biceps "tendinitis," or inflammation of the biceps tendon. Histologic analysis of biceps tendon biopsies demonstrates changes in tenocyte size, ground substance, collagen organization, and vascularity observed with many different tendinopathies. There are distinct symptoms of biceps tendinopathy and a few provocative maneuvers can help make the diagnosis. Imaging studies (eg, MRI) can show changes in signal sequence or tears. However, MRI has a low sensitivity and frequently results in missed or misdiagnosed biceps pathology. Clinical decision making is best guided by a strong clinical suspicion based on patient history, physical examination, and MRI.

  8. Loop biceps tenotomy: an arthroscopic technique for long head of biceps tenotomy.

    Science.gov (United States)

    Goubier, Jean-Noel; Bihel, Thomas; Dubois, Elodie; Teboul, Frédéric

    2014-08-01

    The long head of the biceps tendon is frequently involved in shoulder pathologies, often in relation to inflammatory or degenerative damage to the rotator cuff. Biceps tenodesis in the bicipital groove and tenotomy are the main treatment options. Tenotomy of the long head of the biceps tendon is a simpler and quicker procedure than tenodesis, and it does not require the use of implants. However, retraction of the biceps tendon, leading to Popeye deformity, and biceps muscle cramps are common complications after tenotomy. Therefore we propose an arthroscopic technique for tenotomy that limits the risk of Popeye deformity. This procedure consists of creating a loop at the severed end of the biceps tendon, which prevents the tendon from retracting into the bicipital groove.

  9. 实时定量超声弹性成像技术检测肱二头肌横切面与纵切面弹性差异%Quantitative measurement for the elastic modulus of the cross section and longitudinal section of biceps brachii by shear-wave elasto-sonography

    Institute of Scientific and Technical Information of China (English)

    范春芝; 安力春; 徐建红; 王真; 孙静; 唐杰; 温朝阳

    2011-01-01

    目的 研究声束平行于肌纤维(纵切面)和声束垂直于肌纤维(横切面)时肱二头肌的杨氏模量值差异.方法 141例男性志愿者,年龄16~34岁,平均22岁,均无上肢外伤史、重症肌无力、进行性肌营养不良、周期性瘫痪、代谢性肌病等病史.使用法国Supersonic Imagine公司的AixPlore型实时定量剪切波超声弹性成像超声诊断仪,L4-15线阵探头.探头平行于肱二头肌肌纤维(纵切面)和垂直于肱二头肌肌纤维(横切面)时分别测量肱二头肌杨氏模量值并进行比较.结果 松弛状态下,肱二头肌纵切面杨氏模量值为(45.658±13.479)kPa,横切面杨氏模量值为(7.334±1.612) kPa,差异有统计学意义(P=0.0000);收缩状态下,肱二头肌纵切面杨氏模量值为(123.658±31.392) kPa,横切面杨氏模量值为(13.261±4.045)kPa,差异有统计学意义(P=0.0000).结论 肱二头肌纵切面杨氏模量值明显大于横切面杨氏模量值;肱二头肌弹性模量的各向异性,提示在检查心肌、肾脏等组织结构具有各向异性的脏器时,应注意到超声检查切面角度可能会影响其杨氏模量测量值大小;横切面检查和纵切面检查相结合也许能为疾病的诊断提供更多的信息和依据.%Objective To assess the elastic modulus difference of the ultrasonic beam parallel to the biceps brachii fiber( longitudinal section )and the ultrasonic beam perpendicular to the biceps brachii fibers( cross section ). Methods A total of 141 male volunteers aged 16 to 34 years ( mean 22 years old ), who had no history of upper extremity trauma, myasthenia gravis, progressive muscular dystrophy, periodic paralysis and metabolic myopathy were included in the study. A shear-wave elasto-sonography ( AixPlorer model, Supersonic Imagine, Aix en Provence, France ) coupled with a linear array transducer array ( 4-15 MHz ) was employed. The ultrasound transducer was parallel to the biceps brachii muscle fiber and then it was

  10. 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.

  11. The effects of aging on biceps brachii muscle fibers: a morphometrical study from biopsies and autopsies Efeitos do envelhecimento sobre as fibras do músculo biceps braquial: estudo morfométrico em biópsias e autópsias

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    Ana Cláudia Mattiello-Sverzut

    2003-09-01

    Full Text Available OBJECTIVES: In order to study the morphology and size of muscle fibers, cross sections of biceps brachii samples from autopsies, up to 9 hours after death, and biopsies of 72 subjects were compared. The subjects aged 13 to 84 years in both sexes. METHODS: The samples obtained from autopsies (n=47 were from subjects with sudden death, or who died after acute disease without evidence of neuromuscular involvement. The biopsies (n=25 were from patients with symptoms suggestive of inflammatory or metabolic myopathy, not confirmed morphologically. The lesser diameter of muscle fibers was measured using the ATPase reaction. RESULTS: Morphological analysis showed that aging changes were present from the sixth decade in autopsies, and consisted of atrophy and/or type-grouping. The statistical models adjusted for females in both autopsies and biopsies were linear straight with no variation in fiber size with increasing age. The models adjusted for males in both groups were quadratic, indicating that age influenced the size of different type fibers. In males type 2 were larger than type 1 fibers, and than fibers in females. CONCLUSIONS: These values might be useful as controls, helping interpretation of changes in fiber size in samples obtained from biopsies and autopsies.OBJETIVOS: Para estudar a morfologia e o tamanho das fibras musculares, foram comparadas cortes transversos do bíceps braquial autopsiados, até 9 horas após o óbito, com biopsias musculares, em 72 indivíduos de ambos os sexos e idades entre 13 e 84 anos. MÉTODO: As amostras das autópsias (n=47 foram obtidas de indivíduos que morreram subitamente, ou após uma doença aguda sem evidência de comprometimento neuromuscular. As biópsias (n=25 foram obtidas de pacientes com sintomas sugestivos de miopatias inflamatória ou metabólica, não confirmadas morfologicamente. O diâmetro menor das fibras foi obtido usando a reação de ATPase. RESULTADOS: A análise morfológica mostrou que

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

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    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

  13. 肩袖及肱二头肌能量技术对肱二头肌长头肌腱炎的远期疗效观察%Long term effect of muscle energy technique compared to corticosteroid injection in treating tendinitis of long head of bi-ceps brachii

    Institute of Scientific and Technical Information of China (English)

    朱迪; 张大威; 章丽雅

    2016-01-01

    Objective:To observe the long term effect of muscle energy technique (MET)used in the treatment of tendinitis of long head of biceps brachii.Methods:Forty-two patients with tendinitis of long head of biceps brachii were randomly assigned into 2 groups (n = 21 each).The control group was treated with corticosteroid injection, and the observation group was given MET.The two groups were assessed with muscle strength test and visual ana-logue scale (VAS)before treatment and at the end of the treatment period (3 weeks),and assessed with Constant at 3rd month,6th month and 1st year during the follow-up period after the treatment.Results:At the end of treatment (3 weeks),the strength of the biceps was significantly higher than before treatment (P <0.01),more significantly in the observation group than in the control group (P <0.01).The VAS scores in the two groups were significantly decreased after treatment as compared with those before treatment (P < 0.01),more significantly in the control group than in the observation group (P <0.01).At 3rd month,6th month,and 1st year during the follow-up peri-od after the treatment,the Constant scores in two groups were higher than pretreatment,and those in the observa-tion group were significantly higher than those in the control group (P <0.01).Conclusion:The short-term analge-sic efficacy of corticosteroid injection in the tendinitis of long head of biceps brachii is better than MET,but the long-term effect of MET in treating tendinitis of long head of biceps brachii is affirmative,and was obviously better than corticosteroid injection.%目的:应用肌肉能量技术(MET)对肩袖及肱二头肌进行干预,观察其对肱二头肌长头肌腱炎的远期疗效。方法:选取肱二头肌长头肌腱炎患者42例,随机分为观察组和对照组各21例,对观察组患者肩袖及肱二头肌应用MET 治疗,对照组进行鞘内注射封闭治疗,共治疗3周。分别于治疗前后进行疼痛视觉模拟

  14. Proximal Biceps Tenodesis

    Science.gov (United States)

    Kovack, Thomas J.; Idoine, John D.; Jacob, Paul B.

    2014-01-01

    Purpose: To (1) better define the anatomy of the proximal shoulder in relation to the long head of the biceps tendon, (2) compare the length-tension relationship of the biceps tendon in the native shoulder with that after arthroscopic and open tenodesis techniques using interference screws, and (3) provide surgical recommendations for both procedures based on study findings. Study Design: Descriptive laboratory study. Methods: Twenty fresh-frozen cadaveric shoulders were dissected for analysis. Initial anatomic measurements involving the proximal long head of the biceps tendon (BT) were made, which included: the labral origin to the superior bicipital groove (LO-SBG), the total tendon length (TTL), the musculotendinous junction (MTJ) to the inferior pectoralis major tendon border, the MTJ to the superior pectoralis major tendon border, and the biceps tendon diameter (BTD) at 2 different tenodesis locations. These same measurements were made again after completing a simulated suprapectoral arthroscopic and open subpectoral tenodesis, both with interference screw fixation. Statistical comparisons were then made between the native anatomy and that after tenodesis, with the goal of assessing the accuracy of re-establishing the normal length-tension relationship of the long head of the BT after simulated arthroscopic suprapectoral and open subpectoral tenodesis with tenodesis screws. Results: For all cadavers, the mean TTL was 104.1 mm. For the arthroscopic suprapectoral technique, the mean LO-SBG was 33.6 mm, and the mean tendon resection length was 12.8 mm in males and 5.0 mm in females. The mean BTD was 6.35 mm at the arthroscopic suprapectoral tenodesis site and 5.75 mm at the open subpectoral tenodesis site. Males were found to have statistically longer TTL and LO-SBG measurements (111.6 vs 96.5 mm [P = .027] and 37.2 vs 30.0 mm [P = .009], respectively). In the native shoulder, the mean distances from the MTJ to the superior and inferior borders of the pectoralis

  15. Relevant anatomic landmarks and measurements for biceps tenodesis.

    Science.gov (United States)

    Lafrance, Russell; Madsen, Wes; Yaseen, Zaneb; Giordano, Brian; Maloney, Michael; Voloshin, Ilya

    2013-06-01

    Biceps tenodesis around the pectoralis major insertion may alter resting tension on the biceps, leading to unfavorable clinical outcomes. The anatomic relationship between the musculotendinous junction (MTJ) of the biceps and the pectoralis major tendon will provide guidelines for anatomic location to perform biceps tenodesis with the goal of re-establishing biceps tension. Descriptive laboratory study. Cadaveric dissections were performed that reflected the pectoralis major tendon and exposed the long head of the biceps tendon (LHBT). Calipers were used to measure the longitudinal width of the pectoralis major tendon at the humerus, 2 cm away from the humerus, and at its proximal expansion on the humerus. The distance from the proximal extent of the pectoralis major tendon footprint to the beginning of the MTJ of the biceps and the length of the MTJ of the biceps were recorded. The location of the distal end of the MTJ of the biceps relevant to the inferior border of the pectoralis major tendon was calculated. The average longitudinal width of the pectoralis major tendon at its humeral insertion was 76.8 mm, the width 2 cm away from the humerus averaged 37.3 mm, and the proximal expansion averaged 13.3 mm. The MTJ of the biceps began an average of 32.4 mm distal from the proximal aspect of the pectoralis major footprint and extended for an average of 78.1 mm. The MTJ of the LHBT was calculated to extend 3.3 cm distal to the inferior border of the pectoralis major footprint. The MTJ of the biceps begins further proximal than may be appreciated intraoperatively. Knowledge of the anatomic relationships between the LHBT, its MTJ, and the pectoralis major tendon provides helpful guidelines for the biceps tenodesis site. The final resting spot of the most distal aspect of the MTJ of the LHBT after tenodesis should be approximately 3 cm distal to the inferior edge of the pectoralis major tendon footprint on the humerus.

  16. Long head of the biceps tendinopathy: diagnosis and management.

    Science.gov (United States)

    Nho, Shane J; Strauss, Eric J; Lenart, Brett A; Provencher, Matthew T; Mazzocca, Augustus D; Verma, Nikhil N; Romeo, Anthony A

    2010-11-01

    Tendinopathy of the long head of the biceps brachii encompasses a spectrum of pathology ranging from inflammatory tendinitis to degenerative tendinosis. Disorders of the long head of the biceps often occur in conjunction with other shoulder pathology. A thorough patient history, physical examination, and radiographic evaluation are necessary for diagnosis. Nonsurgical management, including rest, nonsteroidal anti-inflammatory drugs, physical therapy, and injections, is attempted first in patients with mild disease. Surgical management is indicated for refractory or severe disease. In addition to simple biceps tenotomy, a variety of tenodesis techniques has been described. Open biceps tenodesis has been used historically. However, promising results have recently been reported with arthroscopic tenodesis.

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

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    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

  18. BICEP's bispectrum

    CERN Document Server

    Horner, Jonathan S

    2014-01-01

    The simplest interpretation of the Bicep2 result is that the scalar primordial power spectrum is slightly suppressed at large scales. These models result in a large tensor-to-scalar ratio $r$. In this work we show that the type of inflationary trajectory favoured by Bicep2 also leads to a larger non-Gaussian signal at large scales, roughly an order of magnitude larger than a standard slow-roll trajectory.

  19. Hydatid cyst of biceps brachii associated with peripheral neuropathy

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    Serkan Tuna

    2015-01-01

    Conclusion: Cases of concomitant neurologic findings and complaints secondary to peripheral nerve compression are very rare. The clinical findings should not be ruled out even if the EMG result is negative.

  20. 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,

  1. 肩关节上盂唇前后部及肱二头肌长头肌腱损伤手术方式的选择及临床疗效%SLAP lesion and disorders of the long head of biceps tendon:surgical treatment methods and clinical outcomes

    Institute of Scientific and Technical Information of China (English)

    张磊; 张晟; 李智尧; 马佳

    2016-01-01

    目的:分析肩关节上盂唇前后部(superior labrum anterior and posterior,SLAP)及肱二头肌长头肌腱损伤病例,观察关节镜下手术治疗 SLAP 及肱二头肌长头肌腱损伤的临床疗效。方法回顾性分析中国中医科学院望京医院2008年2月至2014年5月收治肩关节镜手术患者400例,其中85例存在 SLAP 或肱二头肌长头肌腱损伤。患者平均年龄55岁(25~82岁),均为非职业运动员,其中男50例,女35例。单纯 SLAP 或肱二头肌长头肌腱损伤25例,平均年龄30岁(25~45岁);合并肩袖损伤52例,平均年龄65岁(42~82岁),其中50岁以下6例,50岁以上46例;合并肩关节不稳7例;合并肩锁关节脱位1例。根据作者制定的手术指征分别行 SLAP 缝合修复、肱二头肌肌腱固定术及肱二头肌肌腱切断术,同时处理合并病变。术后采用简明肩关节功能测试(simple shoulder test,SST)、美国肩肘外科协会评分(American shoulder and elbow surgeons′form,ASES)、视觉模拟评分法(visual analogue score,VAS)及患者满意度进行疗效评估。结果85例均顺利完成手术。SLAP 缝合70例,肱二头肌肌腱固定术10例,肱二头肌肌腱切断术5例。术后患者功能评分较术前均明显改善,ASES 评分术前为(69.0±19.0)分,术后为(83.9±18.3)分(P 50 years,rotator cuff lesions with suspected damage of the SLAP,negative in physical examination of the biceps tendons,SLAP lesions were observed intraoperative and the long head of biceps tendon in good condition (articular cavity and intertubercular groove),SLAP suture repair should be performed even if giant tear exists;SLAP suture should also be applied for shoulder joint instability.(2 ) Tenodesis or tenotomy of biceps tendon:positive physical signs in biceps tendon in preoperative physical examination,degeneration > 30% of the long head of bieceps tendon in articular cavity, inflammation or lesions extends to intertubercular groove part of the long head tendon

  2. Comparison of the electromyographic activity in the upper trapezius and bicepts brachii muscle in subjects with muscular disorders: a pilot study

    NARCIS (Netherlands)

    Schulte, E.; Kallenberg, L.A.C.; Christensen, H.; Disselhorst-Klug, C.; Hermens, H.J.; Rau, G.; Sogaard, K.

    2006-01-01

    The aim of the present study was to investigate the extent to which work-related muscular disorders of the upper trapezius affect the activity of other pain-free muscles, in particular in the biceps brachii. Two groups of female subjects (age >43 years) participated in the study: seven affected subj

  3. Illusory movements induced by tendon vibration in right- and left-handed people.

    Science.gov (United States)

    Tidoni, Emmanuele; Fusco, Gabriele; Leonardis, Daniele; Frisoli, Antonio; Bergamasco, Massimo; Aglioti, Salvatore Maria

    2015-02-01

    Frequency-specific vibratory stimulation of peripheral tendons induces an illusion of limb movement that may be useful for restoring proprioceptive information in people with sensorimotor disability. This potential application may be limited by inter- and intra-subject variability in the susceptibility to such an illusion, which may depend on a variety of factors. To explore the influence of stimulation parameters and participants' handedness on the movement illusion, we vibrated the right and left tendon of the biceps brachii in a group of right- and left-handed people with five stimulation frequencies (from 40 to 120 Hz in step of 20 Hz). We found that all participants reported the expected illusion of elbow extension, especially after 40 and 60 Hz. Left-handers exhibited less variability in reporting the illusion compared to right-handers across the different stimulation frequencies. Moreover, the stimulation of the non-dominant arm elicited a more vivid illusion with faster onset relative to the stimulation of the dominant arm, an effect that was independent from participants' handedness. Overall, our data show that stimulation frequency, handedness and arm dominance influence the tendon vibration movement illusion. The results are discussed in reference to their relevance in linking motor awareness, improving current devices for motor ability recovery after brain or spinal damage and developing prosthetics and virtual embodiment systems.

  4. Biceps tendinitis as a cause of acute painful knee after total knee arthroplasty.

    Science.gov (United States)

    Pandher, Dilbans Singh; Boparai, Randhir Singh; Kapila, Rajesh

    2009-12-01

    The case report highlights an unusual case of posterolateral knee pain after total knee arthroplasty. Tendinitis of the patellar tendon or pes anserinus is a common complication after total knee arthroplasty; however, there is no report in the literature regarding the biceps femoris tendinitis causing acute pain in the early postoperative period. In this case, the biceps tendinitis was diagnosed and treated by ultrasound-guided injection into the tendon sheath.

  5. Evaluation of the effect of plucking manipulation and rubbing manipulation in alleviating biceps brachii fatigue by sEMG%通过表面肌电信号分析拨法及揉法缓解肱二头肌运动性疲劳作用的研究

    Institute of Scientific and Technical Information of China (English)

    吴剑聪; 王俊杰; 姚斌彬; 鲁梦倩; 王磊; 耿楠; 叶宜颖; 于天源

    2013-01-01

    目的:运用表面肌电分析拨法及揉法缓解肱二头肌运动性疲劳的作用,从肌肉层面揭示推拿作用机制.方法:以30名男性大学生为受试对象,随机分为休息组,拨法组,揉法组,首先以60%最大随意收缩力(MVC)为负重,使肱二头肌静力收缩至力竭以建立疲劳模型,并获取收缩时长(T),中值频率(MF)变化率,MF变化百分比,平均功率频率(MPF)变化率,MPF变化百分比,其次进行干预或休息,随后再进行静力收缩至力竭,再次获取表面肌电值,最后统计分析.结果:各组干预前后T、MF变化率、MPF变化率等比较均有统计学意义(P<0.05),拨法组及揉法组与休息组的干预后T、MF变化率和MPF变化率等比较有统计学意义(P<0.05),拨法组与揉法组之间比较无统计学意义.结论:拨法和揉法缓解肌肉疲劳的效果优于休息,两手法均能缓解肌肉疲劳,效果没有明显差异.%Objective: Analyzing the effect of massage in alleviating muscle fatigue by sEMG to reveal the action mechanism of massage from muscle-level. Methods: Thirty Male volunteers from college were randomly divided into 3 groups, included rest group (control group), plucking manipulation group (group A), and rubbing manipulation group (group B). Then volunteers were asked to contract their biceps isometrically to exhaustion in order to collect data: the contraction duration, MF slope, and MPF slope. Then the subjects were allowed to rest, received plucking manipulation treatment or rubbing method treatment. After the intervention, another 60%MVC isometric bicep contraction to exhaustion were carried out again, and sEMG data was collected again. Results: In comparison among groups, there was difference before and after intervention in the contraction duration, MF slope and MPF slope (P<0.05). After intervention, group A and group B were better than control group in contraction duration, MF slope, MPF slope (P<0.05). There was no difference between

  6. Biceps Lesion Associated With Rotator Cuff Tears

    Science.gov (United States)

    Jeong, Ho Yeon; Kim, Jung Youn; Cho, Nam Su; Rhee, Yong Girl

    2016-01-01

    Background: Various tenodesis methods are being used for long head of the biceps tendon lesions. However, there is no consensus on the most appropriate surgical method. Hypothesis: There are significant differences in incidence of cosmetic deformity and persistent bicipital pain between open subpectoral and arthroscopic intracuff tenodesis groups. Study Design: Cohort study; Level of evidence, 3. Methods: This study included 72 patients who underwent biceps tenodesis and rotator cuff repair between January 2009 and May 2014 and who were followed for at least 1 year. Open subpectoral tenodesis was performed in 39 patients (group A), and arthroscopic intracuff tenodesis was performed in 33 patients (group B). Results: In group A, the mean visual analog scale (VAS) score for pain during motion and mean University of California, Los Angeles (UCLA) and Constant scores significantly improved from 4.6, 18.6, and 64.5 preoperatively to 1.9, 30.5, and 86.5 at last follow-up, respectively (P Popeye deformity was noted in 2 (5.2%) patients from group A and 5 (15.6%) patients from group B (P = .231). Additionally, persistent bicipital tenderness was noted in 1 (2.6%) patient from group A and 8 (24.2%) patients from group B (P = .012). Conclusion: Both open subpectoral tenodesis and arthroscopic intracuff tenodesis show good clinical outcomes for long head of the biceps tendon lesions. However, open subpectoral tenodesis may be more appropriate, considering the low incidence of Popeye deformity and tenderness. PMID:27231699

  7. Lateral antebrachial cutaneous neuropathy following the long head of the biceps rupture.

    Science.gov (United States)

    Brogan, David M; Bishop, Allen T; Spinner, Robert J; Shin, Alexander Y

    2012-04-01

    Lateral antebrachial cutaneous neuropathies present as purely sensory lesions, manifesting as elbow pain or dysesthetic pain over the lateral forearm. Classically, entrapment of the lateral antebrachial cutaneous nerve has been documented at the lateral edge of the biceps tendon as it exits the deep fascia in the antecubital fossa. We report a case of lateral antebrachial cutaneous nerve traction neuritis, rather than entrapment, resulting from a rupture of the long head of the biceps. The biceps displaced the nerve laterally, resulting in sensory loss and severe allodynia. The patient's symptoms were relieved with proximal biceps tenodesis.

  8. 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.

  9. 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

  10. The Clinical Research Progress on Therapy of Traditional Chinese Medicine in Treating Long Head of Biceps Femoris Tendonitis%中医药疗法治疗肱二头长头肌腱炎的临床研究进展

    Institute of Scientific and Technical Information of China (English)

    王雷; 赵志恒; 祝贺旗

    2015-01-01

    肱二头长头肌腱炎是一种临床常见的肩关节疾病。对于肱二头长头肌腱炎的治疗,首选保守治疗。中医药疗法,尤其是针灸和手法疗法,在保守治疗本病方面有着巨大的优势和显著的疗效,本文对近年来使用针灸和手法治疗该病的文献进行分析,希望为该病的治疗找到一种更加合适有效的手段。%Long head of biceps femoris tendonitis is one of common shoulder joint diseases. For the treatment of the long head of the biceps femoris tendinitis, the first choice is conservative treatment. Therapy of traditional Chinese medicine, especially acupuncture and moxibustion and manipulation therapy, has a huge edge in conservative treatment of this disease and significant results. In this paper, literatures of acupuncture and moxibustion and manipulation therapy for the disease were analyzed in recent years, and we hoped to find a more appropriate and effective treatment measure for the disease.

  11. Glycosaminoglycans of human rotator cuff tendons: changes with age and in chronic rotator cuff tendinitis.

    OpenAIRE

    Riley, G P; Harrall, R. L.; Constant, C R; Chard, M D; Cawston, T E; Hazleman, B L

    1994-01-01

    OBJECTIVES--To analyse the glycosaminoglycans of the adult human rotator cuff tendon matrix, to characterise changes in the glycosaminoglycan composition with age and in chronic rotator cuff tendinitis. METHODS--Rotator cuff (supraspinatus) tendons (n = 84) and common biceps tendons (n = 26) were obtained from cadavers with no history of tendon pathology (age range 11-95 years). Biopsies of rotator cuff tendons (supraspinatus and subscapularis tendons, n = 53) were obtained during open should...

  12. Dor lateral no joelho do atleta: um raro caso de luxação do tendão do bíceps femoral Lateral pain in an athlete's knee: a rare case of dislocation of the femoral biceps tendon

    Directory of Open Access Journals (Sweden)

    Aires Duarte Junior

    2012-01-01

    Full Text Available A luxação do tendão do bíceps femoral é uma condição rara, descrita na literatura clinicamente com uma dor lateral do joelho e inicialmente relatada como uma inserção anômala da cabeça longa do bíceps femoral. Depois se verificou que a causa é uma mobilidade anormal do tendão sobre a proeminência da cabeça da fíbula em determinados ângulos de flexão do joelho. O objetivo deste relato de caso raro é descrever e discutir sobre o quadro de dor lateral no joelho num atleta de natação que iniciou a subluxação do bíceps femoral durante a prática esportiva, que o incapacitava de realizar provas e torneios. O caso é discutido frente à literatura levantada, à provável etiologia traumática de repetição que levou a essa condição, além do tratamento cirúrgico que foi realizado, obtendo excelente resultado e retorno a prática esportiva habitual.Dislocation of the femoral biceps tendon is rare and is described clinically in the literature as a lateral pain in the knee. It was initially reported as an anomalous insertion of the long head of the femoral biceps. Subsequently, it was found to be caused by abnormal mobility of the tendon over the prominence of the fibu lar head at certain angles of knee flexion. The objective of the present report was to describe and discuss a condition of lateral knee pain in a swimmer who started to present subluxation of the femoral biceps during sports practice, which incapacitated him from taking part in trials and competitions. The case is dis cussed in the light of the literature surveyed; the likelihood that the etiology for the trauma leading to this condition was repeti tion; and the surgical treatment instituted, which led to excellent results and the patient's return to his habitual sports practice.

  13. Resultados e técnica da reparação do tendão bicipital distal através de duas mini-incisões anteriores Technique and results after distal braquial biceps tendon reparation, through two anterior mini-incisions

    Directory of Open Access Journals (Sweden)

    Luciano Pascarelli

    2013-04-01

    Full Text Available OBJETIVO: Avaliação do resultado pós-operatório da ruptura do bíceps distal após emprego da técnica cirúrgica através de duas mini-incisões anteriores. MÉTODOS: Foram operados, através de uma técnica cirúrgica de duas mini-incisões, nove pacientes com diagnóstico clínico e por imagem (ressonância nuclear magnética de lesão total do bíceps braquial na região insercional entre 2008 e 2011. Os pacientes foram avaliados com três meses de evolução e todos recuperaram a flexão e extensão totalmente. RESULTADOS: Em dois pacientes (22,2% houve uma limitação da supinação em 20 graus. Em um paciente (11,1% houve praxia do nervo radial que durou por um período de cinco meses, porém com recuperação total. Houve uma diminuição da força em todos os pacientes. Em um paciente (11,1% o músculo do bíceps se manteve retraído, mas a inserção estava refeita. Em três pacientes (33,3% foi observada aderência sobre a cicatriz proximal. Não houve evidência clínica ou radiográfica de sinostose radioulnar após seis meses de evolução. Todos os pacientes referiram satisfação com o tratamento. CONCLUSÃO: Concluímos que o método apresentado apresenta bom resultados assim como as demais técnicas, diminuido o risco de aderência sobre a prega flexora do cotovelo. Nível de evidência IV, Série de Casos.OBJECTIVE: Evaluation of postoperative results of repair of distal biceps brachii ruptures through a two anterior mini-incisions. METHODS: Nine patients with clinical and imaging (mRi diagnosis of total lesion of the biceps brachii at its insertion were operated with a surgical technique with two mini-incisions between 2008 and 2011. the patients were evaluated after three months of evolution and all of them recovered the fully flexion-extension arch. RESULTS: Two patients (22.2% presented a limitation of 20 degrees of supination. one patient (11.1% had radial nerve palsy, but was totally recovered after five months. in

  14. Correlação entre a proporção de fibras rápidas do músculo bíceps braquial e o torque relativo da flexão do cotovelo em sujeitos com hipótese clínica de miopatia Correlation between the proportion of fast fibers in the biceps brachii muscle and the relative torque during elbow flexion in subjects with clinical hypothesis of myopathy

    Directory of Open Access Journals (Sweden)

    CGN Back

    2008-04-01

    findings may be related to the predominant fiber type expressed in the muscle analyzed. OBJECTIVE: To correlate the proportion of type 2 fibers in the biceps brachii muscles of subjects with a clinical hypothesis of myopathy with their peak isometric and isokinetic torque during elbow flexion. METHOD: Seven subjects with a clinical hypothesis of myopathy participated in this study: four females of mean age 37 years (sd = 9, weight 73kg (sd= 26 and height 155cm (sd= 6; and three males of mean age 39 years (sd= 1, weight 88kg (sd= 5 and height 172cm (sd= 4. The muscle fiber proportion was analyzed using the mATPase technique. One month after taking biopsies, the subjects performed concentric isometric and isokinetic strength tests for elbow flexion and extension using an isokinetic dynamometer. The isometric and isokinetic peak torques at 90°s-¹ and 180°s-¹ were evaluated and the relative 90° (RT90 and 180° (RT180 torques were calculated. Spearman’s correlation (r was used for statistical analyses. RESULTS: The proportion of type 2 fibers correlated positively with RT180 (r= 0.89, p= 0.01, and there was a moderate correlation with RT90 (r= 0.75, p= 0.05. CONCLUSIONS: The results suggest that the contractile behavior of type 2 fibers was not modified in these subjects. The isokinetic dynamometer was shown to be an instrument capable of noninvasively evaluating muscle fiber type predominance.

  15. Use of a Bicortical Button to Safely Repair the Distal Biceps in a Two-Incision Approach: A Cadaveric Analysis.

    Science.gov (United States)

    Barlow, Jonathan D; McNeilan, Ryan J; Speeckaert, Amy; Beals, Corey T; Awan, Hisham M

    2017-07-01

    No consensus has been reached on the most effective anatomic approach or fixation method for distal biceps repair. It is our hypothesis that, using a cortical biceps button through a 2-incision technique, the distal biceps can be safely and anatomically repaired. A 2-incision biceps button distal biceps repair was completed on 10 fresh-frozen cadavers. The proximity of the guide pin to the critical structures of the forearm, including the posterior interosseous nerve and recurrent radial artery, was measured. The location of repair was mapped and compared with anatomic insertion. The average distance from the tip of the guide pin to the posterior interosseous nerve was 11.4 mm (range, 8-14 mm). The average distance from the tip of the guide pin to the recurrent radial artery was 12.5 mm (range, 8-19 mm). The distal biceps tendon was repaired to the anatomic insertion site on the tuberosity using the biceps button technique in all specimens. The 2-incision biceps button repair described here allows safe and accurate repair of the tendon to the radial tuberosity in this cadaveric study. The goal of distal biceps repair is to safely, securely, and anatomically repair the torn biceps tendon to the radial tuberosity. The most commonly performed techniques (single anterior incision with cortical button and the double-incision procedure with bone tunnels and trough) have limitations. A 2-incision button repair safely and anatomically repairs the distal biceps tendon. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  16. Tendonitis (image)

    Science.gov (United States)

    Tendonitis is the inflammation, irritation, and swelling of a tendon. It can occur as a result of ... repetitive strain on the forearm muscles can cause tendonitis. The most common symptom of tendonitis is pain, ...

  17. Tendon repair

    Science.gov (United States)

    Repair of tendon ... Tendon repair can be performed using: Local anesthesia (the immediate area of the surgery is pain-free) ... a cut on the skin over the injured tendon. The damaged or torn ends of the tendon ...

  18. Endoscopic Repair of Acute and Chronic Retracted Distal Biceps Ruptures.

    Science.gov (United States)

    Bhatia, Deepak N

    2016-12-01

    Distal biceps tendon (DBT) ruptures are infrequent injuries that result in pain, weakness, and cosmetic deformity. Severe retraction of the ruptured DBT can occur at the time of injury, or in chronic neglected ruptures, and surgical exposure is performed using a single incision or a 2-incision technique. The technique presented here describes an endoscopic approach using 3 portals that provide access to the retracted DBT, biceps sheath, and radial tuberosity. Preoperative sonographic localization of the retracted DBT and neurovascular structures is used to guide portal placement. The parabiceps portal is used for visualization of the biceps sheath remnant, and the midbiceps portal is used to visualize and retrieve the retracted tendon in the arm. The retracted DBT is shuttled through the biceps sheath into the upper forearm, and 2 suture anchors are passed into the radial tuberosity under direct endoscopic vision. The DBT is whipstitched via the distal anterior portal, and nonsliding knots are tied to securely reattach the DBT to the prepared radial tuberosity. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  19. Low incidence of failure after proximal biceps tenodesis with unicortical suture button.

    Science.gov (United States)

    Cook, Jay B; Sedory, David M; Freidl, Michael C; Adams, Douglas R

    2017-09-01

    Recent interest in suture button fixation has developed with regard to proximal biceps tenodesis fixation. Biomechanical studies have demonstrated viability of a unicortical suture button technique in vitro. Despite this, no clinical data has been reported to validate the biomechanical data. The purpose of this study is to report on complication and failure rates in the early postoperative period after bicep tenodesis with a unicortical suture button. A retrospective review was performed of all biceps tenodesis performed at our institution over a 36-month period using a unicortical suture button for fixation. All included patients had a minimum 12 weeks follow up. Failures were defined as complete loss of fixation, change in biceps contour during the early postoperative period, acute pain at the tenodesis site, or acute loss of supination strength. 145 of 166 biceps tenodesis procedures performed by the 4 surgeons at our institution met inclusion criteria. 80.1% of the patients were active duty military at the time of surgery. The average age was 38.2 years. There were 7 total complications (4.8%), including one failure (0.7%) requiring revision. Failure and complication rates in the early postoperative period using a unicortical suture button for biceps tenodesis fixation are consistent with other reported techniques. This study adds clinical data to the existing biomechanical reports that this technique is strong enough to provide stable fixation of the biceps tendon to allow healing of the tendon to the humerus.

  20. Comparison of maximum voluntary isometric contraction of the biceps on various posture and respiration conditions for normalization of electromyography data

    OpenAIRE

    Lee, Sang-Yeol; Jo, Marg-Eun

    2016-01-01

    [Purpose] Maximum voluntary isometric contraction can increase the reliability of electromyography data by controlling respiration; however, many studies that use normalization of electromyography data fail to account for this. This study aims to check changes in maximum voluntary isometric contraction based on changes in posture and respiration conditions. [Subjects and Methods] Twenty-two healthy volunteers were included in this study. Using 22 healthy subjects, MVIC of the biceps brachii m...

  1. Surgical correction of the "Popeye biceps" deformity: dual-window approach for combined subpectoral and deltopectoral access and proximal biceps tenodesis.

    Science.gov (United States)

    Bhatia, Deepak N; DasGupta, Bibhas

    2012-09-01

    "Popeye biceps" deformity represents the appearance of a distally retracted biceps muscle resulting from either a traumatic long biceps tendon (LBT) rupture or an iatrogenic LBT tenotomy. Cosmetic and functional problems associated with the deformity may necessitate surgical correction, and surgical exposure using multiple incisions is recommended. The technique presented here describes a novel mini-open approach using a single 1-in incision that provides access to 3 peripectoral anatomical zones. Preoperative sonographic localization of the ruptured and retracted LBT is used to guide incision placement, and facilitates intraoperative tendon retrieval via a limited incision and minimal dissection. Inferolateral retraction of the mini-incision window permits infrapectoral and subpectoral LBT mobilization and dissection. Deltopectoral access via superomedial retraction of the same skin window is used to expose the suprapectoral zone and is employed for LBT retrieval and proximal tenodesis. Technical tips for safe dissection via a mini-incision, and methods for biological LBT augmentation are discussed.

  2. Tendon degeneration and chronic shoulder pain: changes in the collagen composition of the human rotator cuff tendons in rotator cuff tendinitis.

    OpenAIRE

    Riley, G P; Harrall, R. L.; Constant, C R; Chard, M D; Cawston, T E; Hazleman, B L

    1994-01-01

    OBJECTIVES--To analyse the collagen composition of normal adult human supraspinatus tendon and to compare with: (1) a flexor tendon (the common biceps tendon) which is rarely involved in any degenerative pathology; (2) degenerate tendons from patients with chronic rotator cuff tendinitis. METHODS--Total collagen content, collagen solubility and collagen type were investigated by hydroxyproline analysis, acetic acid and pepsin digestion, cyanogen bromide peptide analysis, SDS-PAGE and Western ...

  3. 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

    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....

  4. An unusual case of an intramuscular lipoma of the biceps brachii

    OpenAIRE

    Lahrach, Kamal; El Kadi, Khalid Ibn; Mezzani, Amine; Marzouki, Amine; Boutayeb, Fawzi

    2013-01-01

    Lipomas are common benign neoplasms consisting of mature fatty tissue. They are usually of roundish or ovoid shape and are situated in a single anatomical region. They most frequently occur on the back and in the extremities. Most lipomas are subcutaneous and require no imaging evaluation. When deep, large and unusual in location, MRI can identify and localise these tumours and is the best exploration to differentiate lipoma and lipo-sarcoma. We describe a case of a patient with an intramuscu...

  5. Motor unit properties in the biceps brachii of stroke patients assessed with surface array EMG

    NARCIS (Netherlands)

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

    2007-01-01

    As a consequence of a stroke, both motor control as well as motor unit (MU) characteristics may change, e.g. MU size has been reported to increase due to reinnervation. The aim of the present study was to investigate how differences between the affected and unaffected side of hemiparetic stroke

  6. Intra-tendinous ganglion in the long head of the biceps humeri

    Energy Technology Data Exchange (ETDEWEB)

    Kishimoto, Kenta; Akisue, Toshihiro; Fujimoto, Takuya; Kawamoto, Teruya; Hara, Hitomi; Kurosaka, Masahiro [Kobe University Graduate School of Medicine, Department of Orthopaedic Surgery, Kobe (Japan); Hitora, Toshiaki; Yamamoto, Tetuji [Kagawa University Graduate School of Medicine, Department of Orthopaedic Surgery, Kita-gun, Kagawa (Japan)

    2008-03-15

    We present details of a case of intra-tendinous ganglion arising from the long head of the biceps at an unusual location. MRI scans have important implications for surgical planning and treatment. After excision of the ganglion, the tendon remaining could be repaired. Five months after surgery, there was no sign of recurrence. (orig.)

  7. 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.

  8. Muscle-tendon units localization and activation level analysis based on high-density surface EMG array and NMF algorithm

    Science.gov (United States)

    Huang, Chengjun; Chen, Xiang; Cao, Shuai; Zhang, Xu

    2016-12-01

    Objective. Some skeletal muscles can be subdivided into smaller segments called muscle-tendon units (MTUs). The purpose of this paper is to propose a framework to locate the active region of the corresponding MTUs within a single skeletal muscle and to analyze the activation level varieties of different MTUs during a dynamic motion task. Approach. Biceps brachii and gastrocnemius were selected as targeted muscles and three dynamic motion tasks were designed and studied. Eight healthy male subjects participated in the data collection experiments, and 128-channel surface electromyographic (sEMG) signals were collected with a high-density sEMG electrode grid (a grid consists of 8 rows and 16 columns). Then the sEMG envelopes matrix was factorized into a matrix of weighting vectors and a matrix of time-varying coefficients by nonnegative matrix factorization algorithm. Main results. The experimental results demonstrated that the weightings vectors, which represent invariant pattern of muscle activity across all channels, could be used to estimate the location of MTUs and the time-varying coefficients could be used to depict the variation of MTUs activation level during dynamic motion task. Significance. The proposed method provides one way to analyze in-depth the functional state of MTUs during dynamic tasks and thus can be employed on multiple noteworthy sEMG-based applications such as muscle force estimation, muscle fatigue research and the control of myoelectric prostheses. This work was supported by the National Nature Science Foundation of China under Grant 61431017 and 61271138.

  9. 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

    2017-08-01

    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

  10. Tendinopathy of the long head of the biceps.

    Science.gov (United States)

    Snyder, Garrett M; Mair, Scott D; Lattermann, Christian

    2012-01-01

    Tendinopathy of the long head of the biceps is a common cause of anterior shoulder pain. As such, the anatomy and function of the tendon as well as its pathophysiology and different treatment methods have been studied extensively. The pathophysiology is a spectrum beginning with inflammation and leading to tendon degeneration. Different clinical tests and imaging modalities may all be employed to help aid in diagnosis. Conservative management is the first-line treatment, but surgical intervention may be warranted. In general, tenotomy or tenodesis is performed depending, among other things, on the age and activity level of the patient. There are several different methods for tenodesis, each with certain advantages and disadvantages. Patient factors must be considered when choosing the optimal treatment.

  11. Biceps Tenotomy Versus Tenodesis in Active Patients Younger Than 55 Years

    Science.gov (United States)

    Friedman, Jamie L.; FitzPatrick, Jennifer L.; Rylander, Lucas S.; Bennett, Christine; Vidal, Armando F.; McCarty, Eric C.

    2015-01-01

    Background: Proximal biceps pathology is a significant factor in shoulder pain. Surgical treatment options include biceps tenotomy and subpectoral biceps tenodesis. Tenotomy is a simple procedure, but it may produce visible deformity, subjective cramping, or loss of supination strength. Tenodesis is a comparatively technical procedure involving a longer recovery, but it has been hypothesized to achieve better outcomes in younger active patients (Popeye” deformity, compared with 18.2% (4/22) of tenodesis patients. Strength prior to fatiguing exercise was similar between tenodesis and tenotomy for FS (6.9 vs 7.3 lbs; P < .05), EF in neutral (35.4 vs 35.4 lbs), and EF in supination (33.8 vs 34.2 lbs). Strength was not significantly different between groups for isometric strength and endurance measures. Subjective functional outcome measured by the DASH, ASES, and VAS scores were similar between groups. Frequency of complaints of cramping was higher in the tenotomy group (4/20 vs 1/22), and complaints of pain were higher in the tenodesis group (11/22 vs 5/20). Conclusion: Despite increased demands and activity placed on biceps function in a younger population, this study showed no differences in functional and subjective outcome measurements. The choice between biceps tenotomy and tenodesis for pathology of the proximal biceps tendon can continue to be based on surgeon and patient preference. PMID:26535382

  12. Biomechanical characterization of unicortical button fixation: a novel technique for proximal subpectoral biceps tenodesis.

    Science.gov (United States)

    DeAngelis, Joseph P; Chen, Alvin; Wexler, Michael; Hertz, Benjamin; Grimaldi Bournissaint, Leandro; Nazarian, Ara; Ramappa, Arun J

    2015-05-01

    Proximal biceps tenodesis is one method for treating biceps-related pain. Tenodesis protects the length-tension relationship of the biceps muscle, maintains strength, and provides a better cosmetic appearance than tenotomy. The purpose of this investigation was to compare the mechanical properties of a unicortical metal button and an interference screw in proximal biceps tenodesis. Six pairs of fresh-frozen shoulders were dissected, leaving the proximal biceps tendon as a free graft. On each pair of shoulders, a biceps tenodesis was performed using an interference screw or a unicortical metal button. The specimens were mounted and a cyclic load (10-60 N) was applied at 1 Hz for 200 cycles, followed by an axial load to failure. The displacement, ultimate load to failure, and mode of failure were recorded. Displacement in response to cyclic loading was 3.7 ± 2.2 mm for the interference screw and 1.9 ± 1.0 mm for the cortical button (P = 0.03). Load at failure for the interference screw was 191 ± 64 N (stiffness: 24 ± 11 N/mm) and 183 ± 61 N (stiffness: 24 ± 7. N/mm) for the unicortical button (P = n.s. for both cases). As a novel technique for subpectoral biceps tenodesis, a unicortical button demonstrated significantly less displacement in response to cyclic loading than the interference screw. The ultimate load to failure and stiffness for the two methods were not different. In this way, a unicortical button may provide a reliable alternative method of fixation with a potentially lower risk of post-operative humeral fracture and a construct that permits early mobilization following biceps tenodesis.

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    Fabiano Rebouças Ribeiro

    Full Text Available ABSTRACT 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.

  15. Tendon's ultrastructure.

    Science.gov (United States)

    Tresoldi, Ilaria; Oliva, Francesco; Benvenuto, Monica; Fantini, Massimo; Masuelli, Laura; Bei, Roberto; Modesti, Andrea

    2013-01-01

    The structure of a tendon is an important example of complexity of ECM three-dimensional organization. The extracellular matrix (ECM) is a macromolecular network with both structural and regulatory functions. ECM components belong to four major types of macromolecules: the collagens, elastin, proteoglycans, and noncollagenous glycoproteins. Tendons are made by a fibrous, compact connective tissue that connect muscle to bone designed to transmit forces and withstand tension during muscle contraction. Here we show the ultrastructural features of tendon's components.

  16. Peroneal Tendon Injuries

    Science.gov (United States)

    ... page. Please enable Javascript in your browser. Peroneal Tendon Injuries What Are the Peroneal Tendons? A tendon is a band of tissue that ... protect them from sprains. Causes & Symptoms of Peroneal Tendon Injuries Peroneal tendon injuries may be acute (occurring ...

  17. 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}.

  18. Biomechanical comparison of intramedullary cortical button fixation and interference screw technique for subpectoral biceps tenodesis.

    Science.gov (United States)

    Buchholz, Arne; Martetschläger, Frank; Siebenlist, Sebastian; Sandmann, Gunther H; Hapfelmeier, Alexander; Lenich, Andreas; Millett, Peter J; Stöckle, Ulrich; Elser, Florian

    2013-05-01

    The purpose of this study was to biomechanically evaluate a new technique of intramedullary cortical button fixation for subpectoral biceps tenodesis and to compare it with the interference screw technique. We compared intramedullary unicortical button fixation (BicepsButton; Arthrex, Naples, FL) with interference screw fixation (Bio-Tenodesis screw; Arthrex) for subpectoral biceps tenodesis using 10 pairs of human cadaveric shoulders and ovine superficial digital flexor tendons. After computed tomography analysis, the specimens were mounted in a testing machine. Cyclic loading was performed (preload, 5 N; 5 to 70 N at 1.5 Hz for 500 cycles), recording the displacement of the tendon. Load to failure and stiffness were subsequently evaluated with a load-to-failure test (1 mm/s). Cyclic loading showed a displacement of 11.3 ± 2.8 mm for intramedullary cortical button fixation and 9 ± 1.7 mm for interference screw fixation (P = .112). All specimens within the cortical button group passed the cyclic loading test, whereas 3 of 10 specimens within the interference screw group failed by tendon slippage at the screw-tendon-bone interface after a mean of 252 cycles (P = .221). Load-to-failure testing showed a mean load to failure of 218.8 ± 40 N and stiffness of 27.2 ± 7.2 N/mm for the intramedullary cortical button technique. For the interference screw, the mean load to failure was 212.1 ± 28.3 N (P = .625) and stiffness was 40.4 ± 13 N/mm (P = .056). We could not find any major differences in load to failure when comparing the tested techniques for subpectoral biceps tenodesis. Intramedullary cortical button fixation showed no failure during cyclic testing. However, we found a 30% failure rate (3 of 10) for the interference screw fixation. Intramedullary cortical button fixation provides an alternative technique for subpectoral biceps tenodesis with comparable and, during cyclic loading, even superior biomechanical properties to interference screw fixation

  19. Proximal Biceps Tenodesis: An Anatomic Study and Comparison of the Accuracy of Arthroscopic and Open Techniques Using Interference Screws.

    Science.gov (United States)

    Kovack, Thomas J; Idoine, John D; Jacob, Paul B

    2014-02-01

    To (1) better define the anatomy of the proximal shoulder in relation to the long head of the biceps tendon, (2) compare the length-tension relationship of the biceps tendon in the native shoulder with that after arthroscopic and open tenodesis techniques using interference screws, and (3) provide surgical recommendations for both procedures based on study findings. Descriptive laboratory study. Twenty fresh-frozen cadaveric shoulders were dissected for analysis. Initial anatomic measurements involving the proximal long head of the biceps tendon (BT) were made, which included: the labral origin to the superior bicipital groove (LO-SBG), the total tendon length (TTL), the musculotendinous junction (MTJ) to the inferior pectoralis major tendon border, the MTJ to the superior pectoralis major tendon border, and the biceps tendon diameter (BTD) at 2 different tenodesis locations. These same measurements were made again after completing a simulated suprapectoral arthroscopic and open subpectoral tenodesis, both with interference screw fixation. Statistical comparisons were then made between the native anatomy and that after tenodesis, with the goal of assessing the accuracy of re-establishing the normal length-tension relationship of the long head of the BT after simulated arthroscopic suprapectoral and open subpectoral tenodesis with tenodesis screws. For all cadavers, the mean TTL was 104.1 mm. For the arthroscopic suprapectoral technique, the mean LO-SBG was 33.6 mm, and the mean tendon resection length was 12.8 mm in males and 5.0 mm in females. The mean BTD was 6.35 mm at the arthroscopic suprapectoral tenodesis site and 5.75 mm at the open subpectoral tenodesis site. Males were found to have statistically longer TTL and LO-SBG measurements (111.6 vs 96.5 mm [P = .027] and 37.2 vs 30.0 mm [P = .009], respectively). In the native shoulder, the mean distances from the MTJ to the superior and inferior borders of the pectoralis major tendon were 23.8 and 31.7 mm

  20. Increase in heterogeneity of biceps brachii activation during isometric submaximal fatiguing contractions: a multichannel surface EMG study

    NARCIS (Netherlands)

    Staudenmann, D.; Dieen, J.H. van; Stegeman, D.F.; Enoka, R.M.

    2014-01-01

    The effects of fatigue emerge from the beginning of sustained submaximal contractions, as shown by an increase in the amplitude of the surface electromyogram (EMG). The increase in EMG amplitude is attributed to an augmentation of the excitatory drive to the motor neuron pool that, more importantly

  1. 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.

    2006-01-01

    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" contractio

  2. 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.

    2006-01-01

    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"

  3. 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.

  4. Calcific tendinitis of biceps femoris: an unusual site and cause for lateral knee pain.

    Science.gov (United States)

    Chan, Warwick; Chase, Helen Emily; Cahir, John G; Walton, Neil Patrick

    2016-07-29

    A 37-year-old man presented to the acute knee and sports medicine clinic with atraumatic lateral knee pain. He had point tenderness over the lateral aspect of his knee which had not settled with anti-inflammatory medications. Imaging revealed a large opaque lesion lateral to the knee and although there was no clear mechanism, injury to the posterolateral corner was considered. An MRI subsequently revealed a rare case of calcific tendinitis to the biceps femoris tendon insertion. This condition was self-limiting and did not require interventions such as steroid injections. This is the first reported case of calcific tendinitis of biceps femoris as a cause of acute knee pain. 2016 BMJ Publishing Group Ltd.

  5. Bursae and tendon sheaths around the shoulder joints of the dog and their radiographic anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Kuenzel, W. (Veterinaermedizinische Univ., Vienna (Austria). Inst. fuer Anatomie)

    1983-01-01

    The relationships of bursae, pouches and tendon sheaths around the shoulder joints of 25 dogs were examined by preparation, X-ray photographs and casts. The casts were done with a mixture of Technovit 7143 and pumbiferous colour. In this way X-ray photographs could be done without influence on the shape of the shoulder joints and the surrounding bursae, pouches and tendon sheaths. Afterwards the casts could be compared with the photographs. A bursa subdeltoidea was found in no case. The m. infraspinatus has two bursae. The bursa subtendinea m. infraspinati lies between the tuberculum majus humeri and the tendon of the muscle. Proximal to this bursa is constantly found the bursa acromialis m. infraspinati. The articular capsule possesses a lateral pouch under the tendon of m. supraspinatus. The tendon and the proximal part of the m. coracobrachialis is surrounded by the vagina synovialis m. coracobrachialis. The distal end of the tendon sheath of m. biceps is divided by synovial folds.

  6. Long Head of the Biceps Pathology Combined with Rotator Cuff Tears

    Directory of Open Access Journals (Sweden)

    Konstantinos Ditsios

    2012-01-01

    Full Text Available The long head of the biceps tendon (LHBT is an anatomic structure commonly involved in painful shoulder conditions as a result of trauma, degeneration, or overuse. Recent studies have pointed out the close correlation between LHBT lesions and rotator cuff (RCT tears. Clinicians need to take into account the importance of the LHBT in the presence of other shoulder pathologies. This paper provides an up-to-date overview of recent publications on anatomy, pathophysiology, diagnosis, classification, and current treatment strategies.

  7. Achilles tendon rupture - aftercare

    Science.gov (United States)

    Heel cord tear; Calcaneal tendon rupture ... MRI scan to see what type of Achilles tendon tear you have. An MRI is a type ... partial tear means at least some of the tendon is still OK. A full tear means your ...

  8. Achilles tendon repair

    Science.gov (United States)

    Achilles tendon rupture-surgery; Percutaneous Achilles tendon rupture repair ... To fix your torn Achilles tendon, the surgeon will: Make a cut down the back of your heel Make several small cuts rather than one large cut ...

  9. Posterior Tibial Tendon Dysfunction

    Science.gov (United States)

    .org Posterior Tibial Tendon Dysfunction Page ( 1 ) Posterior tibial tendon dysfunction is one of the most common problems of the foot and ankle. It occurs when the posterior tibial tendon becomes inflamed or torn. As a result, the ...

  10. Achilles Tendon Rupture

    Science.gov (United States)

    Achilles tendon rupture Overview By Mayo Clinic Staff Achilles (uh-KILL-eez) tendon rupture is an injury that affects the back ... but it can happen to anyone. The Achilles tendon is a strong fibrous cord that connects the ...

  11. Incidence of Major Tendon Ruptures and Anterior Cruciate Ligament Tears in US Army Soldiers

    Science.gov (United States)

    2007-08-01

    patients who rupture their AT and patients who rupture other ten- dons ( proximal biceps , extensor pollicis longus, quadriceps, and others) was 35.2 and...Interview Survey, 1999. Vital Health Stat 10. 2003;212:1-137. 25. Puranik GS, Faraj A. Outcome of quadriceps tendon repair . Acta Orthop Belg. 2006;72:176

  12. Characterization of tendon cell cultures of the human rotator cuff.

    Science.gov (United States)

    Pauly, S; Klatte, F; Strobel, C; Schmidmaier, G; Greiner, S; Scheibel, M; Wildemann, B

    2010-07-26

    Rotator cuff tears are common soft tissue injuries of the musculoskeletal system that heal by formation of repair tissue and may lead to high retear rates and joint dysfunction. In particular, tissue from chronic, large tendon tears is of such degenerative nature that it may be prone to retear after surgical repair. Besides several biomechanical approaches, biologically based strategies such as application of growth factors may be promising for increasing cell activity and production of extracellular tendon matrix at the tendon-to-bone unit. As a precondition for subsequent experimental growth factor application, the aim of the present study was to establish and characterize a human rotator cuff tendon cell culture. Long head biceps (LHB)- and supraspinatus muscle (SSP)- tendon samples from donor patients undergoing shoulder surgery were cultivated and examined at the RNA level for expression of collagen type-I, -II and -III, biglycan, decorin, tenascin-C, aggrecan, osteocalcin, tenomodulin and scleraxis (by Real-time PCR). Finally, results were compared to chondrocytes and osteoblasts as control cells. An expression pattern was found which may reflect a human rotator cuff tenocyte-like cell culture. Both SSP and LHB tenocyte-like cells differed from chondrocyte cell cultures in terms of reduced expression of collagen type-II (ptendon matrix and osteofibroblastic integration at the tendon-bone unit following tendon repair.

  13. The "anchor shape" technique for long head of the biceps tenotomy to avoid the popeye deformity.

    Science.gov (United States)

    Narvani, A Ali; Atoun, Ehud; Van Tongel, Alexander; Sforza, Giuseppe; Levy, Ofer

    2013-05-01

    Surgical options for symptomatic pathologies of the long head of the biceps (LHB) include tenotomy and tenodesis. Tenotomy is surgically simple and quick, does not require immobilization, and avoids implant complications. However, it is associated with residual "Popeye" muscle deformity and biceps muscle cramps. Tenodesis avoids Popeye deformity, but it is technically a more difficult operation with a longer rehabilitation period and possible implant complications. The purpose of this report is to describe a novel technique for LHB tenotomy that avoids the Popeye muscle deformity. Before releasing the LHB from its anchor over the superior labrum, this technique consists of making an oblique incision, involving 50% of the tendon, distal to its attachment at the superior labrum. A second standard complete tenotomy incision is made about 1.5 cm medial to the oblique incision. The remaining stump of the LHB at the tendon-labrum junction is resected. The first incision, an oblique incomplete incision, allows the remnant of the LHB to open up and form an "anchor shape" that anchors the LHB at the articular entrance of the bicipital groove, thus decreasing the risk of Popeye deformity.

  14. BICEP3 focal plane design and detector performance

    CERN Document Server

    Hui, H; Ahmed, Z; Alexander, K D; Amiri, M; Barkats, D; Benton, S J; Bischoff, C A; Bock, J J; Boenish, H; Bowens-Rubin, R; Buder, I; Bullock, E; Buza, V; Connors, J; Filippini, J P; Fliescher, S; Grayson, J A; Halpern, M; Harrison, S; Hilton, G C; Hristov, V V; Irwin, K D; Kang, J; Karkare, K S; Karpel, E; Kefeli, S; Kernasovskiy, S A; Kovac, J M; Kuo, C L; Leitch, E M; Lueker, M; Megerian, K G; Monticue, V; Namikawa, T; Netterfield, C B; Nguyen, H T; O'Brient, R; Ogburn, R W; Pryke, C; Reintsema, C D; Richter, S; Schwarz, R; Sorensen, C; Sheehy, C D; Staniszewski, Z K; Steinbach, B; Teply, G P; Thompson, K L; Tolan, J E; Tucker, C; Turner, A D; Vieregg, A G; Wandui, A; Weber, A C; Wiebe, D V; Willmert, J; Wu, W L K; Yoon, K W

    2016-01-01

    BICEP3, the latest telescope in the BICEP/Keck program, started science observations in March 2016. It is a 550mm aperture refractive telescope observing the polarization of the cosmic microwave background at 95 GHz. We show the focal plane design and detector performance, including spectral response, optical efficiency and preliminary sensitivity of the upgraded BICEP3. We demonstrate 9.72$\\mu$K$\\sqrt{\\textrm{s}}$ noise performance of the BICEP3 receiver.

  15. 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.

  16. Iliopsoas tendon reformation after psoas tendon release.

    Science.gov (United States)

    Garala, K; Power, R A

    2013-01-01

    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.

  17. Endoscopic adhesiolysis for extensive tibialis posterior tendon and Achilles tendon adhesions following compound tendon rupture

    OpenAIRE

    Lui, Tun Hing

    2013-01-01

    Tendon adhesion is one of the most common causes of disability following tendon surgery. A case of extensive peritendinous adhesions of the Achilles tendon and tibialis posterior tendon after compound rupture of the tendons was reported. This was managed by endoscopic adhesiolysis of both tendons. The endoscopic approach allows early postoperative mobilisation which can relieve the tendon adhesion.

  18. Endoscopic adhesiolysis for extensive tibialis posterior tendon and Achilles tendon adhesions following compound tendon rupture

    OpenAIRE

    Lui, Tun Hing

    2013-01-01

    Tendon adhesion is one of the most common causes of disability following tendon surgery. A case of extensive peritendinous adhesions of the Achilles tendon and tibialis posterior tendon after compound rupture of the tendons was reported. This was managed by endoscopic adhesiolysis of both tendons. The endoscopic approach allows early postoperative mobilisation which can relieve the tendon adhesion.

  19. Endoscopic adhesiolysis for extensive tibialis posterior tendon and Achilles tendon adhesions following compound tendon rupture

    Science.gov (United States)

    Lui, Tun Hing

    2013-01-01

    Tendon adhesion is one of the most common causes of disability following tendon surgery. A case of extensive peritendinous adhesions of the Achilles tendon and tibialis posterior tendon after compound rupture of the tendons was reported. This was managed by endoscopic adhesiolysis of both tendons. The endoscopic approach allows early postoperative mobilisation which can relieve the tendon adhesion. PMID:24045762

  20. 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.)

  1. Associations of sonographic abnormalities of the shoulder with various grades of biceps peritendinous effusion (BPE).

    Science.gov (United States)

    Chang, Ke-Vin; Chen, Wen-Shiang; Wang, Tyng-Guey; Hung, Chen-Yu; Chien, Kuo-Liong

    2014-02-01

    Bicipital peritendinous effusion (BPE), a common ultrasonographic finding of the long head of the biceps tendon, may be associated with shoulder joint derangement, but supporting evidence from large-scale studies is lacking. The aim of this cross-sectional study was to determine the strength of the association between BPE and sonographic abnormalities of the shoulder joint. We reviewed the sonographic reports of patients with suspected shoulder disorders investigated ultrasonographically between January 2011 and January 2012. BPE was graded according to its measured thickness as absent (3 mm). The associations between BPE and sonographic abnormalities were examined using multinomial logistic regression adjusted for age, gender, affected side and clinical diagnosis of frozen shoulder. The prevalence rates of absent, mild, moderate and severe BPE among the 907 shoulders examined were 64.1%, 17.8%, 10.4% and 7.7%, respectively. Frozen shoulder was associated with mild BPE (relative risk [RR] vs. participants without BPE = 1.83, 95% confidence interval [CI] = 1.28-2.50). Sonographic findings of biceps tendinopathy, subdeltoid bursitis and full-thickness tears of the supraspinatus tendon were significantly associated with the entire spectrum of BPE, whereas subscapularis tendon tears were significantly associated with moderate (RR = 2.47, 95% CI = 1.29-4.69) and severe (RR = 3.11, 95% CI = 1.51-6.33) BPE. Severe BPE was associated with articular-sided partial-thickness tears of the supraspinatus tendon (RR = 14.32, 95% CI = 4.30-34.35), posterior recess effusion (RR, 7.98, 95% CI = 1.44-34.93) and biceps medial subluxation (RR = 7.25, 95% CI = 1.90-22.33). Our study indicates that BPE is related to various shoulder abnormalities and that the strengths of these associations depend on the severity of BPE. Clinicians encountering BPE should grade its severity and be alert for hidden lesions of the shoulder joint.

  2. “ROCAMBOLE-LIKE” BICEPS TENODESIS: TECHNIQUE AND RESULTS

    Science.gov (United States)

    Godinho, Glaydson Gomes; Mesquita, Fabrício Augusto Silva; França, Flávio de Oliveira; Freitas, José Márcio Alves

    2015-01-01

    Objective: To present a new technique for bicipital tenodesis and its results: accomplished partially via arthroscopy and grounded in concepts of the normal and pathological anatomy of the tendon of the biceps long head. It is based on the predisposition of this tendon towards becoming attached to the intertubercular sulcus after rupture or tenotomy (auto-tenodesis). Methods: Evaluations were conducted on 63 patients (63 shoulders), aged from 32 to 77 years (average 55), consisting of 32 females (51%) and 31 males (49%). Thirty-five of the patients (55.6%) were over 60 years of age and 28 patients (44.4%) were under 60 years of age. Eighteen were sports participants (28.6%). Fourteen had injuries associated with the subscapularis (22.2%). The average follow up was 43 months (ranging from 12 to 74 months). The right shoulder accounted for 48 cases (76.2%), of which one was a left-handed individual and 47 were right-handed. The left shoulder accounted for 15 (23%) of the patients, of whom two were left-handed and 13 were right-handed. There were no bilateral occurrences. The statistical analysis were done using SPSS version 18. Pearson's chi-square test and continuity corrections were used to investigate the statistical significance of associations between variables. Associations were taken to be statistically significant when p was less than 0.05. Results: Residual Popeye deformity was perceived by seven patients (11.1%); it was only observed by the examiner in 15 cases (23.8%); and neither the patient nor the examiner observed it in 41 cases (65%). There were no statistically valid influences from age, participation in contact or throwing sports, subscapularis tendon-associated injury or Popeye deformity. Fifty-eight patients (92.06%) were satisfied, two patients were dissatisfied (3.17%) and three patients were indifferent (4.76%). Conclusion: The technique presented high patient satisfaction rates (92.06%) and residual deformity was perceived by 11.1% of the

  3. Biomechanical evaluation of a unicortical button versus interference screw for subpectoral biceps tenodesis.

    Science.gov (United States)

    Arora, Amarpal S; Singh, Anshu; Koonce, Ryan C

    2013-04-01

    The purpose of this study was to evaluate and compare the biomechanical properties of a unicortical button with an interference screw used for subpectoral biceps tenodesis. We also describe the anatomic dangers of bicortical button use in the subpectoral location. Twenty-eight fresh-frozen human cadaveric shoulders with a mean age of 52 years were studied. The specimens were randomly divided into 4 experimental biceps tenodesis groups (n = 7): unicortical button, interference screw, bicortical suspensory button, and bicortical suspensory with interference screw (Arthrex, Naples, FL). Each tenodesis specimen was mounted on a mechanical testing machine, preloaded for 2 minutes at 5 N, cycled from 5 to 70 N for 500 cycles (1 Hz), and loaded to failure (1 mm/s). We determined the mode of failure and computed the ultimate load to failure, yield load, pullout stiffness, and displacement at peak load. Calculations of the distance between the axillary and radial nerves with respect to the bicortical buttons were also calculated in 6 specimens. There was no statistically significant difference (P > .05) among groups in terms of age, ultimate load to failure, pullout stiffness, or displacement at peak load. Suture-tendon interface failure was the most commonly observed mode of failure. The axillary nerve was on average 7.8 mm from the bicortical button; however, in 6 specimens the nerve was less than 3 mm away. The use of a unicortical button for subpectoral biceps tenodesis provides biomechanical properties similar to the use of an interference screw. In addition, the use of a bicortical button in this area of the proximal humerus puts the axillary nerve at risk. Using a unicortical button subpectoral biceps method may provide a surgeon with a safe and technically easy and reproducible technique while providing similar biomechanical properties to a known standard implant. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights

  4. Diseases of the tendons and tendon sheaths.

    Science.gov (United States)

    Steiner, Adrian; Anderson, David E; Desrochers, André

    2014-03-01

    Contracted flexor tendon leading to flexural deformity is a common congenital defect in cattle. Arthrogryposis is a congenital syndrome of persistent joint contracture that occurs frequently in Europe as a consequence of Schmallenberg virus infection of the dam. Spastic paresis has a hereditary component, and affected cattle should not be used for breeding purposes. The most common tendon avulsion involves the deep digital flexor tendon. Tendon disruptions may be successfully managed by tenorrhaphy and external coaptation or by external coaptation alone. Medical management alone is unlikely to be effective for purulent tenosynovitis. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Transverse Compression of Tendons.

    Science.gov (United States)

    Salisbury, S T Samuel; Buckley, C Paul; Zavatsky, Amy B

    2016-04-01

    A study was made of the deformation of tendons when compressed transverse to the fiber-aligned axis. Bovine digital extensor tendons were compression tested between flat rigid plates. The methods included: in situ image-based measurement of tendon cross-sectional shapes, after preconditioning but immediately prior to testing; multiple constant-load creep/recovery tests applied to each tendon at increasing loads; and measurements of the resulting tendon displacements in both transverse directions. In these tests, friction resisted axial stretch of the tendon during compression, giving approximately plane-strain conditions. This, together with the assumption of a form of anisotropic hyperelastic constitutive model proposed previously for tendon, justified modeling the isochronal response of tendon as that of an isotropic, slightly compressible, neo-Hookean solid. Inverse analysis, using finite-element (FE) simulations of the experiments and 10 s isochronal creep displacement data, gave values for Young's modulus and Poisson's ratio of this solid of 0.31 MPa and 0.49, respectively, for an idealized tendon shape and averaged data for all the tendons and E = 0.14 and 0.10 MPa for two specific tendons using their actual measured geometry. The compression load versus displacement curves, as measured and as simulated, showed varying degrees of stiffening with increasing load. This can be attributed mostly to geometrical changes in tendon cross section under load, varying according to the initial 3D shape of the tendon.

  6. [Tendon ruptures of the shoulder].

    Science.gov (United States)

    Habermeyer, P

    1989-08-01

    Common sports, involving raising the arms above the head, i.e., throwing, racquet games and swimming, often result in rotator cuff tendinitis. During the throwing motion, the humeral head and its overlying biceps tendon and rotator cuff must pass rapidly under the coraco-acromial arch. Damage to these structures can occur by several mechanism. First, an increase in the size of the structures passing underneath the arch may lead to impingement. This can occur either by way of hypertrophy of the musculotendinous cuff or by way of inflammation of the cuff. Second, a decreased space available underneath the arch secondary to osteophyte formation of the acromion and fibrosis of the subacromial space may lead to impingement. Third, weakness or incompetence of the rotator cuff allows the humerus to ride up and impinge on the coracoacromial arch with motion of the shoulder. Tendinitis can be combined with increased laxity of the glenohumeral joint and/or acquired instability due to a labral tear. Prevention of overuse injuries is a cornerstone of our treatment concept. The muscle tendon unit requires passive and neuromuscular facilitated streching after warming-up exercises. Muscular imbalance and weakness are prevented by balanced eccentric strenthening with particular attention to the external rotators and scapular muscles. Knowledge of the mechanics of the pitching motion, tennis serve, swimming stroke, etc. is of paramount importance in the prevention of injuries. As the onset of shoulder problems contributes to a particularly fatiguing situation, extreme fatique performance severity should be avoided. Every effort must be made to apply conservative treatment when overuse problems arise in the athlete's shoulder.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Achilles tendon: US examination

    Energy Technology Data Exchange (ETDEWEB)

    Fornage, B.D.

    1986-06-01

    Real-time ultrasonography (US) using linear-array probes and a stand-off pad as a ''waterpath'' was performed to evaluate the Achilles tendon in 67 patients (including 24 athletes) believed to have acute or chronic traumatic or inflammatory pathologic conditions. Tendons in 23 patients appeared normal on US scans. The 44 abnormal tendons comprised five complete and four partial ruptures, seven instances of postoperative change, and 28 cases of tendonitis. US depiction of the inner structure of the tendon resulted in the diagnosis of focal abnormalities, including partial ruptures, nodules, and calcifications. Tendonitis was characterized by enlargement and decreased echogenicity of the tendon. The normal US appearance of the Achilles tendon is described.

  8. Flexor Tendon Injuries

    Science.gov (United States)

    ... Media Find a Hand Surgeon Home Anatomy Flexor Tendon Injuries Email to a friend * required fields From * ... move the fingers through cord-like extensions called tendons, which connect the muscles to bone. The flexor ...

  9. Extensor Tendon Injuries

    Science.gov (United States)

    ... Media Find a Hand Surgeon Home Anatomy Extensor Tendon Injuries Email to a friend * required fields From * ... to straighten one or more joints. Common Extensor Tendon Injuries Mallet Finger refers to a drooping end- ...

  10. Percutaneous Achilles Tendon Lengthening

    Science.gov (United States)

    ... All Site Content AOFAS / FootCareMD / Treatments Percutaneous Achilles Tendon Lengthening Page Content ​ Pre-operative incision markings along ... What is the goal of a percutaneous Achilles tendon lengthening? The goal of this procedure is to ...

  11. Characterization of tendon cell cultures of the human rotator cuff

    Directory of Open Access Journals (Sweden)

    S Pauly

    2010-07-01

    Full Text Available tator cuff tears are common soft tissue injuries of the musculoskeletal system that heal by formation of repair tissue and may lead to high retear rates and joint dysfunction. In particular, tissue from chronic, large tendon tears is of such degenerative nature that it may be prone to retear after surgical repair. Besides several biomechanical approaches, biologically based strategies such as application of growth factors may be promising for increasing cell activity and production of extracellular tendon matrix at the tendon-to-bone unit. As a precondition for subsequent experimental growth factor application, the aim of the present study was to establish and characterize a human rotator cuff tendon cell culture.Long head biceps (LHB- and supraspinatus muscle (SSP- tendon samples from donor patients undergoing shoulder surgery were cultivated and examined at the RNA level for expression of collagen type-I, -II and -III, biglycan, decorin, tenascin-C, aggrecan, osteocalcin, tenomodulin and scleraxis (by Real-time PCR. Finally, results were compared to chondrocytes and osteoblasts as control cells.An expression pattern was found which may reflect a human rotator cuff tenocyte-like cell culture. Both SSP and LHB tenocyte-like cells differed from chondrocyte cell cultures in terms of reduced expression of collagen type-II (p≤0.05 and decorin while higher levels of collagen type-I were seen (p≤0.05. With respect to osteoblasts, tenocyte-like cells expressed lower levels of osteocalcin (p≤0.05 as well as tenascin C, biglycan and collagen type-III. Expression of scleraxis, tenomodulin and aggrecan was similar between all cell types.This study represents a characterization of tenocyte-like cells from the human rotator cuff as close as possible. It helps analyzing their biological properties and allows further studies to improve production of tendon matrix and osteofibroblastic integration at the tendon-bone unit following tendon repair.

  12. Biologics for tendon repair☆

    Science.gov (United States)

    Docheva, Denitsa; Müller, Sebastian A.; Majewski, Martin; Evans, Christopher H.

    2015-01-01

    Tendon injuries are common and present a clinical challenge to orthopedic surgery mainly because these injuries often respond poorly to treatment and require prolonged rehabilitation. Therapeutic options used to repair ruptured tendons have consisted of suture, autografts, allografts, and synthetic prostheses. To date, none of these alternatives has provided a successful long-term solution, and often the restored tendons do not recover their complete strength and functionality. Unfortunately, our understanding of tendon biology lags far behind that of other musculoskeletal tissues, thus impeding the development of new treatment options for tendon conditions. Hence, in this review, after introducing the clinical significance of tendon diseases and the present understanding of tendon biology, we describe and critically assess the current strategies for enhancing tendon repair by biological means. These consist mainly of applying growth factors, stem cells, natural biomaterials and genes, alone or in combination, to the site of tendon damage. A deeper understanding of how tendon tissue and cells operate, combined with practical applications of modern molecular and cellular tools could provide the long awaited breakthrough in designing effective tendon-specific therapeutics and overall improvement of tendon disease management. PMID:25446135

  13. Biologics for tendon repair.

    Science.gov (United States)

    Docheva, Denitsa; Müller, Sebastian A; Majewski, Martin; Evans, Christopher H

    2015-04-01

    Tendon injuries are common and present a clinical challenge to orthopedic surgery mainly because these injuries often respond poorly to treatment and require prolonged rehabilitation. Therapeutic options used to repair ruptured tendons have consisted of suture, autografts, allografts, and synthetic prostheses. To date, none of these alternatives has provided a successful long-term solution, and often the restored tendons do not recover their complete strength and functionality. Unfortunately, our understanding of tendon biology lags far behind that of other musculoskeletal tissues, thus impeding the development of new treatment options for tendon conditions. Hence, in this review, after introducing the clinical significance of tendon diseases and the present understanding of tendon biology, we describe and critically assess the current strategies for enhancing tendon repair by biological means. These consist mainly of applying growth factors, stem cells, natural biomaterials and genes, alone or in combination, to the site of tendon damage. A deeper understanding of how tendon tissue and cells operate, combined with practical applications of modern molecular and cellular tools could provide the long awaited breakthrough in designing effective tendon-specific therapeutics and overall improvement of tendon disease management.

  14. 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

  15. Tensors, BICEP2, prior dependence, and dust

    CERN Document Server

    Cortês, Marina; Parkinson, David

    2014-01-01

    We investigate the prior dependence on the inferred spectrum of primordial tensor perturbations, in light of recent results from BICEP2 and taking into account a possible dust contribution to polarized anisotropies. We highlight an optimized parameterization of the tensor power spectrum, and adoption of a logarithmic prior on its amplitude $A_T$, leading to results that transform more evenly under change of pivot scale. In the absence of foregrounds the tension between the results of BICEP2 and Planck drives the tensor spectral index $n_T$ to be blue-tilted in a joint analysis, which would be in contradiction to the standard inflation prediction ($n_T<0$). When foregrounds are accounted for, the BICEP2 results no longer require non-standard inflationary parameter regions. We present limits on primordial $A_T$ and $n_T$, adopting foreground scenarios put forward by Mortonson & Seljak and motivated by Planck 353 GHz observations, and assess what dust contribution leaves a detectable cosmological signal. ...

  16. Biceps Tenodesis for Type II SLAP Tears.

    Science.gov (United States)

    Tayrose, Gregory A; Karas, Spero G; Bosco, Joseph

    2015-06-01

    Tears of the superior glenoid labrum are a common cause of shoulder pain and disability, especially in overhead athletes such as pitchers, swimmers, and volleyball players. Type II SLAP lesions have been the most clinically important superior labral pathology, and the management of this lesion has been a very controversial topic. Currently, there are no high level studies in the literature to guide treatment. While the few level 3 and level 4 evidence studies that are available following arthroscopic repair of type II SLAP lesions all report reasonable overall patient satisfaction, persistent postoperative pain is common and associated with a low return to pre-injury level of sports participation. There has been a recent school of thought that biceps tenodesis, which maintains the length-tension relationship of the long head of biceps, should be the procedure of choice for patients with isolated type II SLAP lesions. The current paper reviews the role biceps tenodesis plays in the management of type II SLAP tears.

  17. Achilles tendon disorders.

    Science.gov (United States)

    Weinfeld, Steven B

    2014-03-01

    Achilles tendon disorders include tendinosis, paratenonitis, insertional tendinitis, retrocalcaneal bursitis, and frank rupture. Patients present with pain and swelling in the posterior aspect of the ankle. Magnetic resonance imaging and ultrasound are helpful in confirming the diagnosis and guiding treatment. Nonsurgical management of Achilles tendon disorders includes nonsteroidal anti-inflammatory drugs, physical therapy, bracing, and footwear modification. Surgical treatment includes debridement of the diseased area of the tendon with direct repair. Tendon transfer may be necessary to augment the strength of the Achilles tendon. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. 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.

  19. CMB Polarization with BICEP2 and Keck-Array

    Science.gov (United States)

    Pryke, Clement; BICEP2 and Keck-Array Collaborations

    2013-01-01

    BICEP2 is an evolution from the highly successful BICEP CMB polarization experiment. In turn Keck-Array is an array of BICEP2 like receivers to achieve an additional increase in sensitivity. All these experiments are located at the South Pole in Antarctica and target the CMB B-mode polarization signal which is predicted to exist in many simpler models of Inflation at angular scales of several degrees. The design and performance of BICEP2 and Keck-Array is described and some preliminary polarization maps are presented.

  20. 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.

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

    Science.gov (United States)

    Kellis, Eleftherios; Galanis, Nikiforos; Chrysanthou, Chrysanthos; Kofotolis, Nikolaos

    2016-03-01

    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. Key pointsChanges in fascicle orientation after biceps femoris mild tear were reduced after a 28 day intervention and remained similar one year after injury.Tendon/aponeurosis strain per unit of moment of force decreased during the course of the therapeutic intervention.Future studies could utilize ultrasonography to monitor mechanical responses after various types of hamstring injury and interventions in order to improve criteria for a safe return to sport.

  2. COLLISIONS IN THE CLASSIFICATION OF SLAP LESIONS

    Directory of Open Access Journals (Sweden)

    V. G. Yevsyeyenko

    2012-01-01

    Full Text Available There is no agreement among experts on the classification of injury of o the long head tendon of biceps brachii in the area of its attachment to the shoulder blade. Some authors take the Snyder’s classification as basis; others describe it as a separate injury. The authors presented the review of existing classifications of the labrum shoulder injury (so-called SLAP lesions and traumas of the tendon of the long head biceps.

  3. Atraumatic quadriceps tendon tear associated with calcific tendonitis.

    Science.gov (United States)

    Abram, Simon G F; Sharma, Akash D; Arvind, Chinnakonda

    2012-11-27

    Calcific tendonitis of the quadriceps tendon is an uncommon condition. We present the first case of a quadriceps tendon tear associated with calcific tendonitis. In this case, the patient presented with symptoms mimicking a rupture of the quadriceps tendon. This case illustrates that although calcific tendonitis of the quadriceps is a rare condition it is not benign and should be considered when investigating acute symptoms associated with the extensor mechanism of the knee.

  4. [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.

  5. Calcific tendonitis : a model.

    Science.gov (United States)

    Gohr, Claudia M; Fahey, Mark; Rosenthal, Ann K

    2007-01-01

    Calcific tendonitis is a common clinical condition associated with high rates of tendon rupture, prolonged symptoms, and poor response to therapy. Little is known about the pathogenesis of calcifications in tendons and consequently few effective therapies are available. We hypothesized that tendon calcification, like pathologic calcification in other sites, was generated by extracellular organelles known as matrix vesicles and that isolated matrix vesicles would constitute the basis for a useful model of this process. Tendon matrix vesicles were isolated from adult porcine patellar tendons using enzymatic digestion and differential centrifugation. Vesicle morphology was examined with electron microscopy. Levels of calcium, phosphate, pyrophosphate, ATP, and mineralization-associated enzymes were measured and compared with articular cartilage vesicles from porcine articular cartilage. Vesicles were embedded in agarose gels with or without type I collagen or dermatan sulfate and incubated in calcifying salt solution trace labeled with (45)calcium. (45)Calcium in the vesicle fraction was measured after 5-7 days. The type of mineral formed was determined by micro-x-ray diffraction. Matrix vesicles isolated from adult porcine tendon were similar morphologically to those obtained from articular cartilage. They contained mineralization-related enzymes and formed hydroxyapatite mineral in vitro. Mineralization was suppressed by levamisole and modulated by extracellular matrix components. Matrix vesicles isolated from tendons mineralize in vitro. This model may aid in the study of the pathogenesis of calcific tendonitis as well as serve as a means to identify effective therapies for this common disorder.

  6. Tendon and ligament imaging

    Science.gov (United States)

    Hodgson, R J; O'Connor, P J; Grainger, A J

    2012-01-01

    MRI and ultrasound are now widely used for the assessment of tendon and ligament abnormalities. Healthy tendons and ligaments contain high levels of collagen with a structured orientation, which gives rise to their characteristic normal imaging appearances as well as causing particular imaging artefacts. Changes to ligaments and tendons as a result of disease and injury can be demonstrated using both ultrasound and MRI. These have been validated against surgical and histological findings. Novel imaging techniques are being developed that may improve the ability of MRI and ultrasound to assess tendon and ligament disease. PMID:22553301

  7. Camel Tendon Soup

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    Ingredients: about 400 grams of camel tendon Supplementary ingredients: mushrooms, green beans, winter bamboo shoots, cooking wine, sesame oil, salt, pepper, sugar, vinegar, Chinese onion and ginger. Directions: 1. Soak the tendons in water and take away the bone and hair, and boil the tendons in broth to remove the strong smell. Then cut the tendons, mushrooms and winter bamboo shoots into small cubes. 2. Heat oil in a wok and fry the pepper until it’s aromatic. Add mushrooms, winter bamboo shoots and green beans and stir.

  8. Gauged M-flation After BICEP2

    CERN Document Server

    Ashoorioon, A

    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 in the M-flation model induced from a supersymmetric 10d background probed by a stack of $N$ D3-branes, the "effective inflaton" $\\phi$ has a double-well Higgs-like potential, with minima at $\\phi=0,\\mu$. We focus on the $\\phi>\\mu$, symmetry-breaking region. We thoroughly examine predictions of the model for $r$ in the $2\\sigma$ 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 $r\\simeq 0.2$, which sits in the sweet spot of BICEP2 region for $r$. We find that with increasing $\\mu$ arbitrarily, $n_S$ cannot go beyond ...

  9. Features of surface myoelectric signals taken from the triceps brachii and biceps brachii of stroke patients%脑卒中偏瘫患者肱二、三头肌表面肌电特征的研究

    Institute of Scientific and Technical Information of China (English)

    齐瑞; 严隽陶; 房敏; 朱燕; 张宏

    2006-01-01

    目的观察和分析脑卒中偏瘫患者在最大等长收缩(MIVC)过程中肱二、三头肌表面肌电图的特征,为脑卒中后偏瘫上肢训练提供电生理依据.方法选择18例轻偏瘫或处于恢复期的脑卒中患者,在进行肘关节屈、伸肌MIVC时,检测其力矩和肱二、三头肌表面肌电信号.结果 MIVC状态下,肘屈曲时肱二头肌健侧的积分肌电值(iEMG)明显大于患侧(P<0.05),肱三头肌健、患侧iEMG比较,差异无统计学意义(P>0.05);肘伸展时肱三头肌健侧iEMG明显大于患侧(P<0.01),肱二头肌患侧iEMG明显大于健侧(P<0.05).肱三头肌患侧协同收缩率明显大于健侧(P<0.01),肱二头肌患侧协同收缩率有大于健侧的趋势,但差异无统计学意义(P>0.05).无论是屈肌收缩还是伸肌收缩,患侧的峰力矩均明显小于健侧(P<0.01).结论脑卒中偏瘫患者肘关节痉挛以屈肌为主,提示脑卒中后偏瘫上肢的康复治疗应以训练伸肌侧肌力和抑制拮抗肌协同收缩为主.

  10. 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.)

  11. The aponeurotic expansion of the supraspinatus tendon: anatomy and prevalence in a series of 150 shoulder MRIs

    Energy Technology Data Exchange (ETDEWEB)

    Moser, Thomas P.; Bureau, Nathalie J. [Centre Hospitalier de l' Universite de Montreal, Department of Radiology and Research Center, Montreal, QC (Canada); Cardinal, Etienne [Radiologie Laennec, Montreal, QC (Canada); Guillin, Raphael [Centre Hospitalier Universitaire de Rennes, Radiology Department, Rennes (France); Lanneville, Pascale [Hopital du Centre-de-la-Mauricie, Pathology Department, Shawinigan, QC (Canada); Grabs, Detlev [Universite du Quebec a Trois-Rivieres, Anatomy Department, Trois-Rivieres, QC (Canada)

    2014-09-02

    To describe the aponeurotic expansion of the supraspinatus tendon with anatomic correlations and determine its prevalence in a series of patients imaged with MRI. In the first part of this HIPAA-compliant and IRB-approved study, we retrospectively reviewed 150 consecutive MRI studies of the shoulder obtained on a 1.5-T system. The aponeurotic expansion at the level of the bicipital groove was classified as: not visualized (type 0), flat-shaped (type 1), oval-shaped and less than 50 % the size of the adjacent long head of the biceps section (type 2A), or oval-shaped and more than 50 % the size of the adjacent long head of the biceps section (type 2B). In the second part of this study, we examined both shoulders of 25 cadavers with ultrasound. When aponeurotic expansion was seen at US, a dissection was performed to characterize its origin and termination. An aponeurotic expansion of the supraspinatus located anterior and lateral to the long head of the biceps in its groove was clearly demonstrated in 49 % of the shoulders with MRI. According to our classification, its shape was type 1 in 35 %, type 2A in 10 % and type 2B in 4 %. This structure was also identified in 28 of 50 cadaveric shoulders with ultrasound and confirmed at dissection in 10 cadavers (20 shoulders). This structure originated from the most anterior and superficial aspect of the supraspinatus tendon and inserted distally on the pectoralis major tendon. The aponeurotic expansion of the supraspinatus tendon can be identified with MRI or ultrasound in about half of the shoulders. It courses anteriorly and laterally to the long head of the biceps tendon, outside its synovial sheath. (orig.)

  12. 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.

  13. Dynamometer Elbow Strength and Endurance Testing After Distal Biceps Reconstruction w/Allograft

    Science.gov (United States)

    McGee, Alan; Strauss, Eric Jason; Jazrawi, Laith M.

    2015-01-01

    Objectives: The purpose of the current study is to investigate the functional strength outcomes of late distal biceps reconstruction using allograft tissue. Methods: Patients who underwent distal biceps reconstruction with allograft tissue between May 2007 and May 2013 were identified. Charts were retrospectively reviewed for post-operative complications, gross flexion and supination strength, and range of motion (ROM). Isokinetic strength and endurance in elbow flexion and forearm supination were measured in both arms. Tests were conducted using a dynamometer at 60o per second for isokinetic strength and 240o per second for endurance. Isometric strength testing was also measured for elbow flexion and forearm supination. Paired t tests were used for statistical analysis. Results: Ten patients with a mean age of 48 years (range 42 - 61 years) were included in the study. Distal biceps reconstruction was performed using an Achilles tendon allograft in 9 patients and a combination of tibialis anterior allograft and gracilis allograft in 1 patient. Of the reconstructions, 50% involved the dominant arm. Full ROM was observed in all patients at the time of their final follow up assessment. The mean follow-up for dynamometer strength testing was 34 months (range 13-81 months). No statistical differences were noted between data obtained from operative and contralateral extremities. The average peak torque of the operative limb (38.5± 5.9 Nm) was 91.7% of that of the contralateral limb (41.8±4.9 Nm) in flexion and 93.4% (operative, 5.7±1.3 Nm; contralateral, 6.1± 1.0 Nm) in supination. No significant differences were found in fatigue index between operative or contralateral limbs for flexion (operative, 34.1±17.1%; contralateral, 30.8±17.1%; p = 0.29) or supination (operative, 38.2±16.5%; contralateral, 42.1±11.9%; p = 0.65). . The only complication observed was a transient PIN palsy in one patient which resolved by 3 months post-operatively. All patients reported

  14. Tendon Transfer Surgery

    Science.gov (United States)

    ... Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is ... include: Repair or transfer of nerves Repair of muscle or tendon Splinting or fusion of joints Find a hand surgeon in your area to discuss the best ...

  15. 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....

  16. BICEP3 performance overview and planned Keck Array upgrade

    Science.gov (United States)

    Grayson, J. A.; Ade, P. A. R.; Ahmed, Z.; Alexander, K. D.; Amiri, M.; Barkats, D.; Benton, S. J.; Bischoff, C. A.; Bock, J. J.; Boenish, H.; Bowens-Rubin, R.; Buder, I.; Bullock, E.; Buza, V.; Connors, J.; Filippini, J. P.; Fliescher, S.; Halpern, M.; Harrison, S.; Hilton, G. C.; Hristov, V. V.; Hui, H.; Irwin, K. D.; Kang, J.; Karkare, K. S.; Karpel, E.; Kefeli, S.; Kernasovskiy, S. A.; Kovac, J. M.; Kuo, C. L.; Leitch, E. M.; Lueker, M.; Megerian, K. G.; Monticue, V.; Namikawa, T.; Netterfield, C. B.; Nguyen, H. T.; O'Brient, R.; Ogburn, R. W.; Pryke, C.; Reintsema, C. D.; Richter, S.; Schwarz, R.; Sorenson, C.; Sheehy, C. D.; Staniszewski, Z. K.; Steinbach, B.; Teply, G. P.; Thompson, K. L.; Tolan, J. E.; Tucker, C.; Turner, A. D.; Vieregg, A. G.; Wandui, A.; Weber, A. C.; Wiebe, D. V.; Willmert, J.; Wu, W. L. K.; Yoon, K. W.

    2016-07-01

    Bicep3 is a 520mm aperture, compact two-lens refractor designed to observe the polarization of the cosmic microwave background (CMB) at 95 GHz. Its focal plane consists of modularized tiles of antenna-coupled transition edge sensors (TESs), similar to those used in Bicep2 and the Keck Array. The increased per-receiver optical throughput compared to Bicep2/Keck Array, due to both its faster f=1:7 optics and the larger aperture, more than doubles the combined mapping speed of the Bicep/Keck program. The Bicep3 receiver was recently upgraded to a full complement of 20 tiles of detectors (2560 TESs) and is now beginning its second year of observation (and first science season) at the South Pole. We report on its current performance and observing plans. Given its high per-receiver throughput while maintaining the advantages of a compact design, Bicep3- class receivers are ideally suited as building blocks for a 3rd-generation CMB experiment, consisting of multiple receivers spanning 35 GHz to 270 GHz with total detector count in the tens of thousands. We present plans for such an array, the new "BICEP Array" that will replace the Keck Array at the South Pole, including design optimization, frequency coverage, and deployment/observing strategies.

  17. 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.

  18. Can weak lensing surveys confirm BICEP2 ?

    CERN Document Server

    Chisari, Nora Elisa; Schmidt, Fabian

    2014-01-01

    The detection of B-modes in the Cosmic Microwave Background (CMB) polarization by the BICEP2 experiment, if interpreted as evidence for a primordial gravitational wave background, has enormous ramifications for cosmology and physics. It is crucial to test this hypothesis with independent measurements. A gravitational wave background leads to B-modes in galaxy shape correlations (shear) both through lensing and tidal alignment effects. Since the systematics and foregrounds of galaxy shapes and CMB polarization are entirely different, a detection of a cross-correlation between the two observables would provide conclusive proof for the existence of a primordial gravitational wave background. We find that upcoming weak lensing surveys will be able to detect the cross-correlation between B-modes of the CMB and galaxy shapes. However, this detection is not sufficient to confirm or falsify the hypothesis of a primordial origin for CMB B-mode polarization.

  19. Biomechanical performance of subpectoral biceps tenodesis: a comparison of interference screw fixation, cortical button fixation, and interference screw diameter.

    Science.gov (United States)

    Sethi, Paul M; Rajaram, Arun; Beitzel, Knut; Hackett, Thomas R; Chowaniec, David M; Mazzocca, Augustus D

    2013-04-01

    Subpectoral biceps tenodesis with interference screw fixation allows reproducible positioning of the tendon to help maintain the length-tension relationship. The aim of our study was to evaluate the role of cortical button fixation in isolation or as an augment to interference screw fixation and to determine if the diameter of the interference screw affected fixation strength. Thirty-two cadaveric shoulders were dissected and randomized to 1 of 4 groups: (1) 7-mm interference screw and cortical button, (2) cortical button alone, (3) 7-mm interference screw, or (4) 8-mm interference screw. Testing was performed on a materials testing system with a 100-N load cycled at 1 Hz for 5000 cycles, followed by an axial load to failure test. Cyclic displacement, ultimate load to failure, and site of failure were recorded for each specimen. The mean ultimate failure loads were 7-mm interference screw with cortical button augmentation, 237.8 ± 120.4 N; cortical button alone, 99.4 ± 16.9 N; 7-mm interference screw, 275.5 ± 56 N; 8-mm interference screw, 277.1 ± 42.1 N. All specimens failed through tendon failure at the screw-tendon-bone interface. The biomechanical performance of subpectoral biceps tenodesis with interference screw fixation was not improved with cortical button augmentation. In addition, cortical button fixation alone yielded a significantly lower ultimate load to failure compared with interference screws. Finally, the biomechanical performance of smaller-diameter interference screws with matching bone tunnels was not affected by interference screw diameter. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  20. MRI-Arthroscopic Correlation in Rotator Cuff Tendon Pathologies; A Comparison between Various Centers

    Directory of Open Access Journals (Sweden)

    Sepideh Sefidbakht

    2016-04-01

    Full Text Available Background: Magnetic resonance imaging (MRI has long been considered a perfect imaging study for evaluation of shoulder pathologies despite occasional discrepancies between MR reports and arthroscopic findings. In this study we aim to evaluate impact of imaging center as an indicator of image quality on accuracy of MRI reports in diagnosis of rotator cuff tendon pathologies. Methods: We reviewed MR reports of 64 patients who underwent arthroscopy in university center hospital. MRIs were done in various centers including both university-affiliated and out-centers. All studies were reported by two radiologists in consensus unaware of the arthroscopic results or previous reports. An inter-observer agreement analysis using the kappa statistics was performed to determine consistency among imaging and surgical reports. Results: Kappa values for out-centers were as follows: 0.785 for biceps, 0.469 for suscapularis, 0.846 for supraspinatus and 0.785 for infraspinatus tendons. In university centers values were 0.799 for biceps, 0.802 for suscapularis, 0.789 for supraspinatus and 0.770 for infraspinatus tendons. Conclusion: Image reporting in university centers with proficient sequences increased accuracy of diagnosis in 3/4 of evaluated features and showed subtle decreased inter-observer agreement in 1/4 of features. Uniformity of the scanners and protocols as well as evaluation on a workstation rather than hard copies cumulatively resulted in a meaningful increase in the accuracy of the same radiologists in diagnosis of rotator cuff tendon tear.

  1. Do Mixed States save Effective Field Theory from BICEP?

    CERN Document Server

    Collins, Hael; Vardanyan, Tereza

    2014-01-01

    The BICEP2 collaboration has for the first time observed the B-mode polarization associated with inflationary gravitational waves. Their result has some discomfiting implications for the validity of an effective theory approach to single-field inflation since it would require an inflaton field excursion larger than the Planck scale. We argue that if the quantum state of the gravitons is a mixed state based on the Bunch-Davies vacuum, then the tensor to scalar ratio r measured by BICEP is different than the quantity that enters the Lyth bound. When this is taken into account, the tension between effective field theory and the BICEP result is alleviated.

  2. 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

  3. Tendon Gradient Mineralization for Tendon to Bone Interface Integration

    Science.gov (United States)

    Qu, Jin; Thoreson, Andrew R.; Chen, Qingshan; An, Kai-Nan; Amadio, Peter C.; Zhao, Chunfeng

    2014-01-01

    Tendon-to-bone integration is a great challenge for tendon or ligament reconstruction regardless of use of autograft or allograft tendons. We mineralized the tendon, thus transforming the tendon-to-bone into a “bone-to-bone” interface for healing. Sixty dog flexor digitorum profundus (FDP) tendons were divided randomly into 5 groups: 1) normal FDP tendon, 2) CaP (Non-extraction and mineralization without fetuin), 3) CaPEXT (Extraction by Na2HPO4 and mineralization without fetuin), 4) CaPFetuin (Non-extraction and mineralization with fetuin), and 5) CaPEXTFetuin (Extraction and mineralization with fetuin). The calcium and phosphate content significantly increased in tendons treated with combination of extraction and fetuin compared to the other treatments. Histology also revealed a dense mineral deposition throughout the tendon outer layers and penetrated into the tendon to a depth of 200 μm in a graded manner. Compressive moduli were significantly lower in the four mineralized groups compared with normal control group. No significant differences in maximum failure strength or stiffness were found in the suture pull-out test among all groups. Mineralization of tendon alters the interface from tendon to bone into mineralized tendon to bone, which may facilitate tendon-to-bone junction healing following tendon or ligament reconstruction. PMID:23939935

  4. Tendon gradient mineralization for tendon to bone interface integration.

    Science.gov (United States)

    Qu, Jin; Thoreson, Andrew R; Chen, Qingshan; An, Kai-Nan; Amadio, Peter C; Zhao, Chunfeng

    2013-11-01

    Tendon-to-bone integration is a great challenge for tendon or ligament reconstruction regardless of use of autograft or allograft tendons. We mineralized the tendon, thus transforming the tendon-to-bone into a "bone-to-bone" interface for healing. Sixty dog flexor digitorum profundus (FDP) tendons were divided randomly into five groups: (1) normal FDP tendon, (2) CaP (non-extraction and mineralization without fetuin), (3) CaPEXT (Extraction by Na2 HPO4 and mineralization without fetuin), (4) CaPFetuin (non-extraction and mineralization with fetuin), and (5) CaPEXTFetuin (extraction and mineralization with fetuin). The calcium and phosphate content significantly increased in tendons treated with combination of extraction and fetuin compared to the other treatments. Histology also revealed a dense mineral deposition throughout the tendon outer layers and penetrated into the tendon to a depth of 200 µm in a graded manner. Compressive moduli were significantly lower in the four mineralized groups compared with normal control group. No significant differences in maximum failure strength or stiffness were found in the suture pull-out test among all groups. Mineralization of tendon alters the interface from tendon to bone into mineralized tendon to bone, which may facilitate tendon-to-bone junction healing following tendon or ligament reconstruction.

  5. Peroneal tendon disorders

    Science.gov (United States)

    Davda, Kinner; Malhotra, Karan; O’Donnell, Paul; Singh, Dishan; Cullen, Nicholas

    2017-01-01

    Pathological abnormality of the peroneal tendons is an under-appreciated source of lateral hindfoot pain and dysfunction that can be difficult to distinguish from lateral ankle ligament injuries. Enclosed within the lateral compartment of the leg, the peroneal tendons are the primary evertors of the foot and function as lateral ankle stabilisers. Pathology of the tendons falls into three broad categories: tendinitis and tenosynovitis, tendon subluxation and dislocation, and tendon splits and tears. These can be associated with ankle instability, hindfoot deformity and anomalous anatomy such as a low lying peroneus brevis or peroneus quartus. A thorough clinical examination should include an assessment of foot type (cavus or planovalgus), palpation of the peronei in the retromalleolar groove on resisted ankle dorsiflexion and eversion as well as testing of lateral ankle ligaments. Imaging including radiographs, ultrasound and MRI will help determine the diagnosis. Treatment recommendations for these disorders are primarily based on case series and expert opinion. The aim of this review is to summarise the current understanding of the anatomy and diagnostic evaluation of the peroneal tendons, and to present both conservative and operative management options of peroneal tendon lesions. Cite this article: EFORT Open Rev 2017;2:281-292. DOI: 10.1302/2058-5241.2.160047 PMID:28736620

  6. How Obesity Affects Tendons?

    Science.gov (United States)

    Abate, Michele; Salini, Vincenzo; Andia, Isabel

    Several epidemiological and clinical observations have definitely demonstrated that obesity has harmful effects on tendons. The pathogenesis of tendon damage is multi-factorial. In addition to overload, attributable to the increased body weight, which significantly affects load-bearing tendons, systemic factors play a relevant role. Several bioactive peptides (chemerin, leptin, adiponectin and others) are released by adipocytes, and influence tendon structure by means of negative activities on mesenchymal cells. The ensuing systemic state of chronic, sub-clinic, low-grade inflammation can damage tendon structure. Metabolic disorders (diabetes, impaired glucose tolerance, and dislipidemia), frequently associated with visceral adiposity, are concurrent pathogenetic factors. Indeed, high glucose levels increase the formation of Advanced Glycation End-products, which in turn form stable covalent cross-links within collagen fibers, modifying their structure and functionality.Sport activities, so useful for preventing important cardiovascular complications, may be detrimental for tendons if they are submitted to intense acute or chronic overload. Therefore, two caution rules are mandatory: first, to engage in personalized soft training program, and secondly to follow regular check-up for tendon pathology.

  7. 'Serious thigh muscle strains': beware the intramuscular tendon which plays an important role in difficult hamstring and quadriceps muscle strains.

    Science.gov (United States)

    Brukner, Peter; Connell, David

    2016-02-01

    Why do some hamstring and quadriceps strains take much longer to repair than others? Which injuries are more prone to recurrence? Intramuscular tendon injuries have received little attention as an element in 'muscle strain'. In thigh muscles, such as rectus femoris and biceps femoris, the attached tendon extends for a significant distance within the muscle belly. While the pathology of most muscle injures occurs at a musculotendinous junction, at first glance the athlete appears to report pain within a muscle belly. In addition to the musculotendinous injury being a site of pathology, the intramuscular tendon itself is occasionally injured. These injuries have a variety of appearances on MRIs. There is some evidence that these injuries require a prolonged rehabilitation time and may have higher recurrence rates. Therefore, it is important to recognise the tendon component of a thigh 'muscle strain'.

  8. 探讨肱二头肌长头肌腱炎的手术策略%Surgical Strategy on Tendinitis of Iong Head of Biceps Brachii

    Institute of Scientific and Technical Information of China (English)

    陆锋伟; 史继祥; 丁国平; 李立强; 张伟; 孙青刚; 顾欣

    2012-01-01

    目的 探讨手术松解配合药物注射治疗顽固性肱二头肌长头肌腱炎的疗效.方法 2010年7月-2011年12月,该院对22例顽固性肱二头肌长头肌腱炎患者行松解术,术中配合使用复方倍他米松及透明质酸钠,术后2周和3个月随访肩部活动范围,并采用美国肩肘协会评分(ASES)评估.结果 手术时间60~80 min,平均75 min,术中及术后未出现并发症.20例术后2周肩关节外展、前屈、后伸及外旋与术前比较明显改善,术后3个月改善更明显(P<0.01),22例术后2周及3个月ASES评分(88.7±5.2,89.2±6.6)与术前(39.5±10.1)比较,差异有统计学意义(n=22 t=20.7,21.1; P<0.01).结论 肱二头肌长头肌腱松解术配合复方倍他米松及透明质酸钠注射是治疗顽固性肱二头肌长头肌腱炎最直接和有效的方法.

  9. S-dual inflation: BICEP2 data without unlikeliness

    Energy Technology Data Exchange (ETDEWEB)

    Anchordoqui, Luis A. [Department of Physics and Astronomy, Lehman College at CUNY, Bronx NY 10468 (United States); Department of Physics, University of Wisconsin–Milwaukee, Milwaukee, WI 53201 (United States); Barger, Vernon [Department of Physics, University of Wisconsin, Madison, WI 53706 (United States); Goldberg, Haim [Department of Physics, Northeastern University, Boston, MA 02115 (United States); Huang, Xing [Department of Physics, National Taiwan Normal University, Taipei, 116, Taiwan (China); Marfatia, Danny [Department of Physics and Astronomy, University of Hawaii, Honolulu, HI 96822 (United States)

    2014-06-27

    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.

  10. Constraints on cosmological parameters from Planck and BICEP2 data

    CERN Document Server

    Anchordoqui, Luis A

    2014-01-01

    We show that the tension introduced by the detection of large amplitude gravitational wave power by the BICEP2 experiment with temperature anisotropy measurements by the Planck mission is alleviated in models where extra light species contribute to the effective number of relativistic degrees of freedom. We also show that inflationary models based on S-dual potentials are in agreement with Planck and BICEP2 data.

  11. Adequacy of palmaris longus and plantaris tendons for tendon grafting.

    Science.gov (United States)

    Jakubietz, Michael G; Jakubietz, Danni F; Gruenert, Joerg G; Zahn, Robert; Meffert, Rainer H; Jakubietz, Rafael G

    2011-04-01

    The reconstruction of tendon defects is challenging. The palmaris longus and plantaris tendon are generally considered best for tendon grafting. Only a few studies have examined whether these tendons, when present, meet criteria for successful grafting. The purpose of this study was to evaluate these tendons in regard to adequacy as tendon grafts. To evaluate adequacy for grafting, the palmaris longus and plantaris tendons were harvested from 92 arms and legs of 46 cadavers. Macroscopic evaluation and measurements concerning presence, length, and diameter of the tendons were obtained. Criteria for adequacy were a minimum length of 15 cm with diameter of 3 mm or, alternatively, 30 cm with a diameter of 1.5 mm. The palmaris longus tendon was present bilaterally in 36 cases and was absent bilaterally in 4 cases. The plantaris tendon was present bilaterally in 38 cases and absent bilaterally in 4 cases. In 29 cadavers, the palmaris longus tendon did not meet the criteria to be used as a tendon graft. Only in 8 cases were the tendons satisfactory for grafting bilaterally. The plantaris tendon met criteria for grafting in 20 cases bilaterally. In 17 cases, the tendons were considered inadequate bilaterally. Despite their presence, the palmaris longus and plantaris tendons are adequate for grafting less often than previously thought. In less than 50%, the tendons, although present, would serve as useful grafts. Our findings underscore the importance of choosing a second donor site before surgery in case the primarily selected tendon is not found to be suitable. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  12. BICEP3 performance overview and planned Keck Array upgrade

    CERN Document Server

    Grayson, J A; Ahmed, Z; Alexander, K D; Amiri, M; Barkats, D; Benton, S J; Bischoff, C A; Bock, J J; Boenish, H; Bowens-Rubin, R; Buder, I; Bullock, E; Buza, V; Connors, J; Filippini, J P; Fliescher, S; Halpern, M; Harrison, S; Hilton, G C; Hristov, V V; Hui, H; Irwin, K D; Kang, J; Karkare, K S; Karpel, E; Kefeli, S; Kernasovskiy, S A; Kovac, J M; Kuo, C L; Leitch, E M; Lueker, M; Megerian, K G; Monticue, V; Namikawa, T; Netterfield, C B; Nguyen, H T; O'Brient, R; Ogburn, R W; Pryke, C; Reintsema, C D; Richter, S; Schwarz, R; Sorensen, C; Sheehy, C D; Staniszewski, Z K; Steinbach, B; Teply, G P; Thompson, K L; Tolan, J E; Tucker, C; Turner, A D; Vieregg, A G; Wandui, A; Weber, A C; Wiebe, D V; Willmert, J; Wu, W L K; Yoon, K W

    2016-01-01

    BICEP3 is a 520 mm aperture, compact two-lens refractor designed to observe the polarization of the cosmic microwave background (CMB) at 95 GHz. Its focal plane consists of modularized tiles of antenna-coupled transition edge sensors (TESs), similar to those used in BICEP2 and the Keck Array. The increased per-receiver optical throughput compared to BICEP2/Keck Array, due to both its faster f/1.7 optics and the larger aperture, more than doubles the combined mapping speed of the BICEP/Keck program. The BICEP3 receiver was recently upgraded to a full complement of 20 tiles of detectors (2560 TESs) and is now beginning its second year of observation (and first science season) at the South Pole. We report on its current performance and observing plans. Given its high per-receiver throughput while maintaining the advantages of a compact design, BICEP3-class receivers are ideally suited as building blocks for a 3rd-generation CMB experiment, consisting of multiple receivers spanning 35 GHz to 270 GHz with total de...

  13. Gauged M-flation after BICEP2

    Directory of Open Access Journals (Sweden)

    A. Ashoorioon

    2014-12-01

    Full Text Available 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 nS by the Planck experiment. As computed in [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.

  14. 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

  15. Tendon transfer or tendon graft for ruptured finger extensor tendons in rheumatoid hands.

    Science.gov (United States)

    Chung, U S; Kim, J H; Seo, W S; Lee, K H

    2010-05-01

    We evaluated the clinical outcome of tendon reconstruction using tendon graft or tendon transfer and the parameters related to clinical outcome in 51 wrists of 46 patients with rheumatoid arthritis with finger extensor tendon ruptures. At a mean follow-up of 5.6 years, the mean metacarpophalangeal (MP) joint extension lag was 8 degrees (range, 0-45) and the mean visual analogue satisfaction scale was 74 (range, 10-100). Clinical outcome did not differ significantly between tendon grafting and tendon transfer. The MP joint extension lag correlated with the patient's satisfaction score, but the pulp-to-palm distance did not correlate with patient satisfaction. We conclude that both tendon grafting and tendon transfer are reliable reconstruction methods for ruptured finger extensor tendons in rheumatoid hands.

  16. Regulation of tendon differentiation by scleraxis distinguishes force-transmitting tendons from muscle-anchoring tendons.

    Science.gov (United States)

    Murchison, Nicholas D; Price, Brian A; Conner, David A; Keene, Douglas R; Olson, Eric N; Tabin, Clifford J; Schweitzer, Ronen

    2007-07-01

    The scleraxis (Scx) gene, encoding a bHLH transcription factor, is expressed in the progenitors and cells of all tendon tissues. To determine Scx function, we produced a mutant null allele. Scx-/- mice were viable, but showed severe tendon defects, which manifested in a drastically limited use of all paws and back muscles and a complete inability to move the tail. Interestingly, although the differentiation of all force-transmitting and intermuscular tendons was disrupted, other categories of tendons, the function of which is mainly to anchor muscles to the skeleton, were less affected and remained functional, enabling the viability of Scx-/- mutants. The force-transmitting tendons of the limbs and tail varied in the severity to which they were affected, ranging from dramatic failure of progenitor differentiation resulting in the loss of segments or complete tendons, to the formation of small and poorly organized tendons. Tendon progenitors appeared normal in Scx-/- embryos and a phenotype resulting from a failure in the condensation of tendon progenitors to give rise to distinct tendons was first detected at embryonic day (E)13.5. In the tendons that persisted in Scx-/- mutants, we found a reduced and less organized tendon matrix and disorganization at the cellular level that led to intermixing of tenocytes and endotenon cells. The phenotype of Scx-/- mutants emphasizes the diversity of tendon tissues and represents the first molecular insight into the important process of tendon differentiation.

  17. Complete Achilles tendon ruptures.

    Science.gov (United States)

    Landvater, S J; Renström, P A

    1992-10-01

    Achilles tendon ruptures can be treated nonsurgically in the nonathletic or low-end recreational athletic patient, particularly those more than 50 years of age, provided the treating physician does not delay in the diagnosis and treatment (preferably less than 48 hrs and possibly less than 1 week). The patient should be advised of the higher incidence of re-rupture of the tendon when treated nonsurgically. Surgical treatment is recommended for patients who are young and athletic. This is particularly true because the major criticism of surgical treatment has been the complication rate, which has decreased to a low level and to a mild degree, usually not significantly affecting the repair over time. Surgical treatment in these individuals seems to be superior not only in regard to re-rupture but also in assuring the correct apposition of the tendon ends and in placing the necessary tension on the tendon to secure appropriate orientation of the collagen fibers. This in turn allows them to regain full strength, power, endurance, and an early return to sports. Surgery is also recommended for late diagnosed ruptures where there is significant lengthening of the tendon. Surgical technique should involve a medial incision to avoid the sural nerve, absorbable suture, and augmentation with fascia or tendon where there is a gap or late rupture. Postoperatively, the immobilization should be 7 to 10 days in a splint. A walking boot with early motion in plantar flexion or a short leg cast with the tendon under slight tension should thereafter be used for 4 to 5 weeks. An early and well-supervised rehabilitation program should be initiated to restore the patient to the preinjury activity level.

  18. [Simultaneous rupture of a patellar tendon and contralateral quadriceps tendon].

    Science.gov (United States)

    Horas, U; Ernst, S; Meyer, C; Halbsguth, A; Herbst, U

    2006-09-01

    The simultaneous bilateral rupture of the quadriceps tendon is a rare injury; only occasional reports exist about the bilateral simultaneous rupture of the patellar tendon. Degenerative changes of the tendon due to drugs or diseases lead to the rupture. We describe two cases of simultaneous rupture of the patellar and contralateral quadriceps tendons; only one patient had special risks. We report the management of therapy and the functional results using the Lysholm score and Knee Rating Scale.

  19. Autologous hamstring tendon used for revision of quadiceps tendon tears.

    Science.gov (United States)

    McCormick, Frank; Nwachukwu, Benedict U; Kim, Jaehon; Martin, Scott D

    2013-04-01

    A paucity of literature exists on quadriceps tendon reruptures. Failed quadriceps tendon repair can cause significant morbidity and disability. Surgical management of quadriceps tendon rerupture can be challenging due to tissue degeneration, tendon retraction, muscle atrophy, and poor bone fixation. A lack of guidance in the literature exists on the appropriate surgical techniques for managing quadriceps tendon reruptures.This article describes the case of a male recreational athlete with a failed primary quadriceps tendon repair who presented 10 months after rerupture. Examination was significant for morbid obesity, assisted ambulation, and a significant defect at the superior pole of the patella on the affected side. Intraoperative findings were consistent with a 2.0- to 4.5-cm tendon defect across the extensor mechanism with complete retinaculi tears. The authors performed a novel surgical approach for revision of quadriceps tears using a bilateral hamstring autograft through a quadriceps tendon weave and a transosseous patellar repair. Tendon length was restored, and extensor mechanism tension was reapproximated. Postoperatively, the patient achieved a good outcome and had returned to full, painless, sport participation at 2-year follow-up.This surgical technique is suitable for revision quadriceps tendon repairs of large tendon gap defects, repairs desiring tendon-to-bone in-growth, and repairs requiring large-force transmission across the repair.

  20. Tendon sheath fibroma of the medial canthal tendon.

    Science.gov (United States)

    Andrew, Nicholas; Dodd, Tom; Selva, Dinesh; Davis, Garry

    2013-01-01

    Fibromas of the tendon sheath are slow-growing, benign tumors most commonly found on the hands and wrist. A fibroma of the tendon sheath arising from the medial canthal tendon presented as an enlarging nodule that had been present for 40 years. The fibroma was identified by microscopy and immunohistochemistry, and surgical resection appears to have been curative.

  1. Steroid injections - tendon, bursa, joint

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007678.htm Steroid injections - tendon, bursa, joint To use the sharing features on ... painful. It can be injected into a joint, tendon, or bursa. Description Your health care provider inserts ...

  2. [Quadriceps and patellar tendon ruptures].

    Science.gov (United States)

    Grim, C; Lorbach, O; Engelhardt, M

    2010-12-01

    Ruptures of the quadriceps or patellar tendon are uncommon but extremely relevant injuries. Early diagnosis and surgical treatment with a stable suture construction are mandatory for a good postoperative clinical outcome. The standard methods of repair for quadriceps and patellar tendon injuries include the placement of suture loops through transpatellar tunnels. Reinforcement with either a wire cerclage or a PDS cord is used in patellar tendon repair. The PDS cord can also be applied as augmentation in quadriceps tendon repair. In secondary patellar tendon repair an autologous semitendinosus graft can be used. For chronic quadriceps tendon defects a V-shaped tendon flap with a distal footing is recommended. The different methods of repair should lead to early functional postoperative treatment. The clinical outcome after surgical treatment of patellar and quadriceps tendon ruptures is mainly good.

  3. 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

  4. Arthroscopic Treatment of Calcific Tendonitis

    OpenAIRE

    2014-01-01

    Calcific tendonitis, or calcifying tendonitis, is a common disorder characterized by the multifocal accumulation of basic calcium phosphate crystals within the rotator cuff tendons. In most cases, the multifocal calcifications are located 1 to 2 cm from the insertion of the supraspinatus tendon on the greater tuberosity. The initial treatment should be nonoperative including oral anti-inflammatory medication and physical therapy. If this is unsuccessful, arthroscopic debridement of the deposi...

  5. Tendon Driven Finger Actuation System

    Science.gov (United States)

    Ihrke, Chris A. (Inventor); Reich, David M. (Inventor); Bridgwater, Lyndon (Inventor); Linn, Douglas Martin (Inventor); Askew, Scott R. (Inventor); Diftler, Myron A. (Inventor); Platt, Robert (Inventor); Hargrave, Brian (Inventor); Valvo, Michael C. (Inventor); Abdallah, Muhammad E. (Inventor); hide

    2013-01-01

    A humanoid robot includes a robotic hand having at least one finger. An actuation system for the robotic finger includes an actuator assembly which is supported by the robot and is spaced apart from the finger. A tendon extends from the actuator assembly to the at least one finger and ends in a tendon terminator. The actuator assembly is operable to actuate the tendon to move the tendon terminator and, thus, the finger.

  6. 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

  7. 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

  8. Unusual nerve supply of biceps from ulnar nerve and median nerve and a third head of biceps

    Directory of Open Access Journals (Sweden)

    Arora L

    2006-01-01

    Full Text Available Variations in branching pattern of the brachial plexus are common and have been reported by several investigators. Of the four main nerves traversing the arm, namely median, ulnar, radial and musculocutaneous, the ulnar and median nerve do not give any branches to muscles of the arm. Ulnar nerve after taking origin from medial cord of brachial plexus runs distally through axilla on medial side of axillary artery till middle of arm, where it pierces the medial intermuscular septum and enters the posterior compartment of arm. Ulnar nerve enters forearm between two heads of flexor carpi ulnaris from where it continues further. It supplies flexor carpi ulnaris , flexor digitorum profundus and several intrinsic muscles of hand . We recently observed dual supply of biceps muscle from ulnar and median nerves in arm. Musculocutaneous nerve was absent. Although communications between nerves in arm is rare, the communication between median nerve and musculocutaneous nerve were described from the 19th century which could explain innervation of biceps from median nerve. But no accurate description of ulnar nerve supplying biceps could be found in literature. Knowledge of anatomical variation of these nerves at level of upper arm is essential in light of the frequency with which surgery is performed to transfer nerve fascicles from ulnar nerve to biceps in case of brachial plexus injuries. We also observed third head of biceps, our aim is to describe the exact topography of this variation and to discuss its morphological.

  9. 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.

  10. Common Acupoints in the Upper Limb

    Institute of Scientific and Technical Information of China (English)

    Journal of Acupuncture and Tuina Science editor; CUI Xue-jun

    2003-01-01

    @@ Chize (LU 5) Location: On the cubital crease, near the radial border of the tendon of m.biceps brachii (Fig. 1). Indications: Cough, asthma, hemoptysis, tidal fever,fullness in the chest, sore throat, infantile convulsion,vomiting, diarrhea, spasmodic pain of the elbow and arm.

  11. 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.

  12. Identification of a Remodeled Neo-tendon After Arthroscopic Latarjet Procedure.

    Science.gov (United States)

    Smolen, Daniel; Went, Philip; Tomala, Dirk; Sternberg, Christoph; Lafosse, Laurent; Leuzinger, Jan

    2017-03-01

    To macroscopically, histologically, and radiologically describe a time-dependent remodeling process of a neo-tendon or -ligament in the shoulder after the arthroscopic Latarjet procedure. During follow-up surgery after the arthroscopic Latarjet procedure, 17 shoulders in 16 patients were evaluated for a remodeled tendon-like structure. The mean overall follow-up period was 27.4 months. The mean time between the arthroscopic Latarjet procedure and revision was 11.6 months. All shoulders were evaluated with magnetic resonance imaging, and seven histologic specimens were obtained during revision surgery. A distinct, oriented strand of tissue was found in 16 of 17 shoulders on revision surgery. Postoperative magnetic resonance imaging analyses showed a signal-free, longitudinal tendon-like structure originating at the tip of the acromion, traversing the space of the former subcoracoid bursa to attach in the course of the transposed conjoint tendon or the proximal short head of the biceps. Histologic analysis of seven specimens showed a characteristic timeline of remodeling. A tendon- or ligament-like structure is remodeled between the anterior bottom tip of the acromion and the transposed coracoid process in a time-dependent manner after the arthroscopic Latarjet procedure. Level IV, therapeutic case series. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  13. 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.

  14. CMB polarimetry with BICEP: instrument characterization, calibration, and performance

    CERN Document Server

    Takahashi, Yuki D; Battle, John O; Bierman, Evan M; Bock, James J; Chiang, H Cynthia; Dowell, C Darren; Hivon, Eric F; Holzapfel, William L; Hristov, Viktor V; Jones, William C; Kaufman, J P; Keating, Brian G; Kovac, John M; Kuo, Chao-Lin; Lange, Andrew E; Leitch, Erik M; Mason, Peter V; Matsumura, Tomotake; Nguyen, Hien T; Ponthieu, Nicolas; Rocha, Graca M; Yoon, Ki Won; Ade, P; Duband, L

    2008-01-01

    BICEP is a ground-based millimeter-wave bolometric array designed to target the primordial gravity wave signature on the polarization of the cosmic microwave background (CMB) at degree angular scales. Currently in its third year of operation at the South Pole, BICEP is measuring the CMB polarization with unprecedented sensitivity at 100 and 150 GHz in the cleanest available 2% of the sky, as well as deriving independent constraints on the diffuse polarized foregrounds with select observations on and off the Galactic plane. Instrument calibrations are discussed in the context of rigorous control of systematic errors, and the performance during the first two years of the experiment is reviewed.

  15. Tree Level Potential on Brane after Planck and BICEP2

    Indian Academy of Sciences (India)

    M. Ferricha-Alami; A. Safsafi; L. Lahlou; H. Chakir; M. Bennai

    2015-06-01

    The recent detection of degree scale B-mode polarization in the Cosmic Microwave Background (CMB) by the BICEP2 experiment implies that the inflationary ratio of tensor-to-scalar fluctuations is = 0.2$^{+0.07}_{-0.05}$, which has opened a new window in the cosmological investigation. In this regard, we propose a study of the tree level potential inflation in the framework of the Randall–Sundrum type-2 braneworld model. We focus on three branches of the potential, where we evaluate some values of brane tension . We discuss how the various inflationary perturbation parameters can be compatible with recent Planck and BICEP2 observations.

  16. Quantitative Diagnostic Method for Biceps Long Head Tendinitis by Using Ultrasound

    OpenAIRE

    Shih-Wei Huang; Wei-Te Wang

    2013-01-01

    Objective. To investigate the feasibility of grayscale quantitative diagnostic method for biceps tendinitis and determine the cut-off points of a quantitative biceps ultrasound (US) method to diagnose biceps tendinitis. Design. Prospective cross-sectional case controlled study. Setting. Outpatient rehabilitation service. Methods. A total of 336 shoulder pain patients with suspected biceps tendinitis were recruited in this prospective observational study. The grayscale pixel data of the range ...

  17. Anatomy of the long head of biceps femoris: An ultrasound study.

    Science.gov (United States)

    Tosovic, D; Muirhead, J C; Brown, J M M; Woodley, S J

    2016-09-01

    Hamstring strains, particularly involving the long head of biceps femoris (BFlh) at the proximal musculotendinous junction (MTJ), are commonly experienced by athletes. With the use of diagnostic ultrasound increasing, an in-depth knowledge of normal ultrasonographic anatomy is fundamental to better understanding hamstring strain. The aim of this study was to describe the architecture of BFlh, using ultrasonography, in young men and cadaver specimens. BFlh morphology was examined in 19 healthy male participants (mean age 21.6 years) using ultrasound. Muscle, tendon and MTJ lengths were recorded and architectural parameters assessed at four standardised points along the muscle. Measurement accuracy was validated by ultrasound and dissection of BFlh in six male cadaver lower limbs (mean age 76 years). Intra-rater reliability of architectural parameters was examined for repeat scans, image analysis and dissection measurements. Distally the BFlh muscle had significantly (P MTJ length. All other measures demonstrated good-excellent repeatability. BFlh is not uniform in architecture when imaged using ultrasound. It is likely that its distal-most segment is better suited for force production in comparison to the more proximal segments, which show excursive potential, traits which possibly contribute to the high rate of injury at the proximal MTJ. The data presented in this study provide specific knowledge of the normal ultrasonographic anatomy of BFlh, which should be of assistance in analysing BFlh injury via imaging. Clin. Anat. 29:738-745, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. Inflamed shoulder tendons (image)

    Science.gov (United States)

    Tearing and inflammation of the tendons of the shoulder muscles can occur in sports which require the arm to be moved over the head repeatedly as in tennis, pitching, swimming, and lifting weights. Most often the shoulder will heal if a break is taken from ...

  19. 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 (Pcountry of origin has less effect on consumer acceptability.

  20. Magnetic resonance imaging in acute tendon ruptures

    Energy Technology Data Exchange (ETDEWEB)

    Daffner, R.H.; Lupetin, A.R.; Dash, N.; Riemer, B.L.

    1986-11-01

    The diagnosis of acute tendon ruptures of the extensor mechanism of the knee or the Achilles tendon of the ankle may usually be made by clinical means. Massive soft tissue swelling accompanying these injuries often obscures the findings, however. Magnetic resonance imaging (MRI) can rapidly demonstrate these tendon ruptures. Examples of the use of MRI for quadriceps tendon, and Achilles tendon rupture are presented.

  1. 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.

  2. Combined Ultrasound Imaging and Biomechanical Modeling to Estimate Triceps Brachii Musculotendon Changes in Stroke Survivors

    Directory of Open Access Journals (Sweden)

    Le Li

    2016-01-01

    Full Text Available The aim of this study was to investigate the changes of musculotendon parameters of triceps brachii in persons after stroke based on subject-specific biomechanical modeling technique combined with in vivo ultrasound measurement. Five chronic stroke survivors and five normal control subjects were recruited. B-mode ultrasound was applied to measure muscle pennation angle and the optimal length of three heads of triceps’ brachii at different joint angle positions in resting and isometric contraction. Measured ultrasound data were used to reduce the unknown parameters during the modeling optimization process. The results showed that pennation angles varied with joint angles, and the longhead TRI pennation from stroke group was smaller than the literature value. The maximum isometric muscle stress from persons after stroke was significantly smaller than that found in the unimpaired subjects. The prediction of joint torque fits well with the measured data from the control group, whereas the prediction error is larger in results from persons after stroke. In vivo parameters from ultrasound data could help to build a subject-specific biomechanical model of elbow extensor for both unimpaired and hemiplegic subjects, and then the results driven from the model could enhance the understanding of motor function changes for persons after stroke.

  3. [Damage to large tendons: Achilles, patellar and quadriceps tendons].

    Science.gov (United States)

    Amlang, M H; Zwipp, H

    2006-07-01

    The etiology and mechanisms of Achilles, patellar and quadriceps tendon ruptures are very similar. Age dependent changes in tendon structure and disorders such gout, diabetes, rheumatic diseases and chronic renal failure are associated causes. The main mechanism of rupture is indirect trauma. Although clinical diagnosis is easy, ruptures are still frequently missed. Sonography is the main standard diagnostic tool. MRI is indicated only in special cases. Open operative repair is the most common treatment for quadriceps and patellar tendon ruptures. Treatment of Achilles tendon ruptures is moving towards an individualized choice of therapy. Percutaneous and other "minimally invasive" techniques will play an increasingly important role.

  4. Improving the accuracy of the preoperative diagnosis of long head of the biceps pathology: the biceps resisted flexion test

    Science.gov (United States)

    ARRIGONI, PAOLO; RAGONE, VINCENZA; D’AMBROSI, RICCARDO; DENARD, PATRICK; RANDELLI, FILIPPO; BANFI, GIUSEPPE; CABITZA, PAOLO; RANDELLI, PIETRO

    2014-01-01

    Purpose the purpose of this study was to describe a new test for identifying lesions of the long head of the biceps (LHB) and to evaluate its diagnostic performance in comparison with selected traditional clinical tests. Methods one hundred and nine consecutive candidates for arthroscopic rotator cuff repair were prospectively recruited. The BRF test, which measures biceps resisted flexion strength, was performed with the patient seated (armat the side and elbow flexed at 90°). The patient was asked to maintain maximal resistance for five seconds while strength was assessed with a digital dynamometer. Since the dynamometer expresses a continuous variable in kilograms, the measure was dichotomized using a threshold value (cut-off) value-able to simultaneously maximize the sensitivity and specificity. This cut-off value was derived from receiver operating characteristic (ROC) curve analysis. Speed’s test and the O’Brien test were also performed. During arthroscopy the presence of LHB pathology was assessed. Results biceps resisted flexion strength was significantly higher in patients without associated LHB lesions [median (range): 3 kg (0–9.5 kg) versus 0 kg (0–8.5 kg); plesions. Conclusions the dBRF test showed higher accuracy than traditional clinical tests in diagnosing LHB lesions. This novel test for biceps pathology may be advantageous because it is objective and therefore likely reproducible. Level of Evidence Level II, Development of diagnostic test on basis of consecutive patients (with universally applied reference “gold” standard). PMID:25606543

  5. MRI of the Achilles tendon

    Energy Technology Data Exchange (ETDEWEB)

    Naegele, M.; Lienemann, A.; Hahn, D.; Lissner, J.; Boehm, P.

    1987-06-01

    The Achilles tendon and preachillar space of 30 patients was studied by MRI. A surface coil (Helmholtz' principle) was applied and all patients were examined with a superconducting magnet operating at 1.0 Tesla field strength. The purpose of the study was to illustrate pathological changes of the tendon and the surrounding soft tissue. In 3 cases MRI diagnosed a total rupture of the Achilles tendon. Furthermore, the strain of the tendon and side effects of an inflammatory process could be demonstrated. The use of a surface coil yields a high resolution of the normal anatomy of the region and of the pathological changes of the tendon and the surrounding soft tissue structures. The advantages of MRI for Achilles tendon diagnostics against competitive modalities are 1) excellent soft tissue contrast, 2) multiplanar imaging, 3) as well as exact delineation and visualisation of the lesion.

  6. Scaffolds in Tendon Tissue Engineering

    Directory of Open Access Journals (Sweden)

    Umile Giuseppe Longo

    2012-01-01

    Full Text Available Tissue engineering techniques using novel scaffold materials offer potential alternatives for managing tendon disorders. Tissue engineering strategies to improve tendon repair healing include the use of scaffolds, growth factors, cell seeding, or a combination of these approaches. Scaffolds have been the most common strategy investigated to date. Available scaffolds for tendon repair include both biological scaffolds, obtained from mammalian tissues, and synthetic scaffolds, manufactured from chemical compounds. Preliminary studies support the idea that scaffolds can provide an alternative for tendon augmentation with an enormous therapeutic potential. However, available data are lacking to allow definitive conclusion on the use of scaffolds for tendon augmentation. We review the current basic science and clinical understanding in the field of scaffolds and tissue engineering for tendon repair.

  7. Biologics for tendon repair ☆

    OpenAIRE

    2014-01-01

    Tendon injuries are common and present a clinical challenge to orthopedic surgery mainly because these injuries often respond poorly to treatment and require prolonged rehabilitation. Therapeutic options used to repair ruptured tendons have consisted of suture, autografts, allografts, and synthetic prostheses. To date, none of these alternatives has provided a successful long-term solution, and often the restored tendons do not recover their complete strength and functionality. Unfortunately,...

  8. Quadriceps tendon injuries

    Directory of Open Access Journals (Sweden)

    Ristić Vladimir

    2013-01-01

    Full Text Available Introduction. The aim of study was to analyze risk factors, mechanisms of injury, symptoms and time that elapsed from injury until operation of complete quadriceps tendon ruptures. Material and Methods. This retrospective multicenter study included 30 patients operated for this injury, of whom 28 (93.3% were men. The average age was 53.7 years (18-73. Twenty-six patients had reconstruction of unilateral rupture and four of bilateral one. Results. Eighty percent of them had some risk factors for rupture of the tendon with degenerative changes. Eight patients had diabetes, seven patients were on renal dialysis, two patients had secondary hyperparathyroidism, five patients were obese and two patients had former knee operations. These injuries occurred in 80% following minor trauma caused by falls on stairs, on flat surfaces and squatting. The most frequent symptoms were: pain, swelling, lack of extension of knee and defect above patella, and three cases were initially misdiagnosed. During the first 10 days after injury, acute and chronic ruptures were reconstructed in 22 (73.3% and 8 patients, respectively. Conclusion. Quadriceps tendon injuries most often happen to male patients with predisposing conditions in their fifth and sixth decade of life due to trivial trauma. Patients on renal dialysis are the most vulnerable population group.

  9. Fibroma of tendon sheath.

    Science.gov (United States)

    Smith, P S; Pieterse, A S; McClure, J

    1982-01-01

    A series of nine cases of fibroma of tendon sheath is described including details of the ultrastructural features of two cases. The series was composed of lesions from six males and three females with a mean age of 38 yr. The most common site of involvement was the hand (including fingers) and the mean greater diameter was 19 mm. Typically the tumours were lobulated and microscopically there was a collagenous stroma with spindle and stellate cells in a moderate degree of cellularity. One recurrence was noted in the series. The lesion was distinguished from circumscribed fibromatosis, nodular fasciitis, neurofibroma, leiomyoma, scar tissue, giant cell tumour of tendon sheath (localised nodular tenosynovitis) and fibrous histiocytoma. Ultrastructural studies revealed that the large majority of cells present in the two cases studied were myofibroblasts and fibroma of tendon sheath is therefore the third instance of a benign tumour containing these cells (the other two being dermatofibroma and giant cell fibroma of the oral mucosa). Images PMID:7107956

  10. Arthroscopic treatment of calcific tendonitis.

    Science.gov (United States)

    Barber, F Alan; Cowden, Courtney H

    2014-04-01

    Calcific tendonitis, or calcifying tendonitis, is a common disorder characterized by the multifocal accumulation of basic calcium phosphate crystals within the rotator cuff tendons. In most cases, the multifocal calcifications are located 1 to 2 cm from the insertion of the supraspinatus tendon on the greater tuberosity. The initial treatment should be nonoperative including oral anti-inflammatory medication and physical therapy. If this is unsuccessful, arthroscopic debridement of the deposit is effective. The technique used is an arthroscopic localization and debridement without associated subacromial decompression. The rotator cuff should be evaluated for partial- and full-thickness tears before and after the debridement of calcifications. If a partial- or full-thickness rotator cuff tendon tear is identified, it should be treated in a fashion consistent with those without associated calcium deposits. In our hands, tears 5 mm or greater in depth are repaired using a tendon-to-tendon or tendon-to-bone technique. Tears with less depth are debrided and then left alone. Arthroscopic debridement of calcific tendonitis can yield excellent functional results and high patient satisfaction.

  11. Wide-Awake Primary Flexor Tendon Repair, Tenolysis, and Tendon Transfer

    OpenAIRE

    Tang, Jin Bo

    2015-01-01

    Tendon surgery is unique because it should ensure tendon gliding after surgery. Tendon surgery now can be performed under local anesthesia without tourniquet, by injecting epinephrine mixed with lidocaine, to achieve vasoconstriction in the area of surgery. This method allows the tendon to move actively during surgery to test tendon function intraoperatively and to ensure the tendon is properly repaired before leaving the operating table. I applied this method to primary flexor tendon repair ...

  12. Gastrocnemius tendon length and strain are different when assessed using straight or curved tendon model

    OpenAIRE

    Stosic, Jelena; Finni Juutinen, Taija

    2011-01-01

    The present study investigated the effects of tendon curvature on measurements of tendon length using 3D-kinematic analysis. Curved and straight tendon models were employed for assessing medial gastrocnemius tendon length and strain during hopping (N = 8). Tendon curvature was identified using small reflective markers placed on the skin surface along the length of the tendon and a sum of vectors between the markers from the calcaneous up to the marker at the origin of tendon was calculated. T...

  13. Wide-Awake Primary Flexor Tendon Repair, Tenolysis, and Tendon Transfer

    OpenAIRE

    Tang, Jin Bo

    2015-01-01

    Tendon surgery is unique because it should ensure tendon gliding after surgery. Tendon surgery now can be performed under local anesthesia without tourniquet, by injecting epinephrine mixed with lidocaine, to achieve vasoconstriction in the area of surgery. This method allows the tendon to move actively during surgery to test tendon function intraoperatively and to ensure the tendon is properly repaired before leaving the operating table. I applied this method to primary flexor tendon repair ...

  14. Gastrocnemius tendon length and strain are different when assessed using straight or curved tendon model

    OpenAIRE

    Stosic, Jelena; Finni Juutinen, Taija

    2011-01-01

    The present study investigated the effects of tendon curvature on measurements of tendon length using 3D-kinematic analysis. Curved and straight tendon models were employed for assessing medial gastrocnemius tendon length and strain during hopping (N = 8). Tendon curvature was identified using small reflective markers placed on the skin surface along the length of the tendon and a sum of vectors between the markers from the calcaneous up to the marker at the origin of tendon was calculated. T...

  15. Gravitational quantum effects in the light of BICEP2 results

    CERN Document Server

    Zhu, Tao

    2014-01-01

    Recently BICEP2 found that the vanishing of the tensor-to-scalar ratio $r$ is excluded at $7\\sigma$ level, and its most likely value is $r=0.2^{+0.07}_{-0.05}$ at $1 \\sigma$ level. This immediately causes a tension with the Planck constraint $r < 0.11$. In addition, it also implies that the inflaton experienced a Planck excursion during inflation $\\Delta\\phi /M_{Pl} \\geq {\\cal{O}}(1)$, whereby the effective theory of inflation becomes questionable. In this brief report, we show that the inflationary paradigm is still robust, even after the quantum effects are taken into account. Moreover, these effects even help to relax the tension on the different values of $r$ given by BICEP2 and Planck.

  16. Local Reconstruction of the Inflationary Potential with BICEP2 data

    CERN Document Server

    Ma, Yin-Zhe

    2014-01-01

    We locally reconstruct the inflationary potential by using the current constraints on $r$ and $n_{\\rm s}$ from BICEP2 data. Assuming small and negligible $\\alpha_{\\rm s}$, the inflationary potential is approximately linear in $\\Delta\\phi\\sim M_{\\rm pl}$ range but becomes non-linear in $\\Delta\\phi\\sim 10 M_{\\rm pl}$ range. However if we allow for higher value of $\\alpha_{\\rm s}$, as suggested by the tension between BICEP2 and WMAP / Planck measurements, the local reconstruction is only valid in the range of $\\Delta\\phi\\sim 0.4 M_{\\rm pl}$, which challenges the inflationary background from the point of view of effective field theory.

  17. [Precision of arthroscopic surgeons using ultrasound for the first time to measure tendon structures].

    Science.gov (United States)

    Erquicia, J I; Tey, M; Doreste, J L; Monllau, J C; Centenera, J M; Altisench, J M

    2016-01-01

    The precision of a group of arthroscopic surgeons using ultrasound for the first time was assessed when measuring shoulder and hip tendon structures. Twenty-two students and 3 professors participated in a one-day theoretical-practical course. Two measurement rounds were conducted, during which each student identified the greater and lesser axes and the cross-sectional area of the biceps tendon, the supraspinous depth, as well as the lesser and greater axes and the cross-sectional area of the iliac psoas. The mean of the two measurements made by each of the course professors was considered as the reference value. When the 2 measurements made by each of the students of each of the structures were assessed, no significant correlation was found in any of the cases, with a p 0.05. With the exception of the cross-sectional area of the biceps, where there was a significant undersizing of the structure, in the remaining 7 measurements a marked trend to oversize the structures was seen in both the first and second measurements, with a high statistical significance (p 0.05). Ultrasound is a useful method through which arthroscopic surgeons can identify structures. However, the marked trend to oversize structures compared to the reference values leads to think that the training courses and the daily practice are essential to improve the method.

  18. Spontaneous bilateral quadriceps tendon rupture.

    Science.gov (United States)

    Vigneswaran, N; Lee, K; Yegappan, M

    2007-11-01

    Spontaneous bilateral quadriceps tendon ruptures are uncommon. We present a 30-year-old man with end-stage renal failure, who sustained this injury, and subsequently had surgical repair of both tendons on separate occasions. He has since regained full range of movement of both knees.

  19. 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...

  20. Inflation After False Vacuum Decay: New Evidence from BICEP2

    CERN Document Server

    Bousso, Raphael; Senatore, Leonardo

    2014-01-01

    Last year we argued that if slow-roll inflation followed the decay of a false vacuum in a large landscape, the steepening of the scalar potential between the inflationary plateau and the barrier generically leads to a potentially observable suppression of the scalar power spectrum at large distances. Here we revisit this analysis in light of the recent BICEP2 results. Assuming that both the BICEP2 B-mode signal and the Planck analysis of temperature fluctuations hold up, we find that the data now discriminate more sharply between our scenario and $\\Lambda$CDM. Nonzero tensor modes exclude standard $\\Lambda$CDM with notable but not yet conclusive confidence: at $\\sim 3.8\\,\\sigma$ if $r\\approx0.2$, or at $\\sim 3.5\\,\\sigma$ if $r=0.15$. Of the two steepening models of our previous work, one is now ruled out by existing bounds on spatial curvature. The other entirely reconciles the tension between BICEP2 and Planck. Upcoming $EE$ polarization measurements have the potential to rule out unmodified $\\Lambda$CDM dec...

  1. Evidence for bouncing evolution before inflation after BICEP2.

    Science.gov (United States)

    Xia, Jun-Qing; Cai, Yi-Fu; Li, Hong; Zhang, Xinmin

    2014-06-27

    The BICEP2 Collaboration reports a detection of primordial cosmic microwave background (CMB) B mode with a tensor-to-scalar ratio r = 0.20(-0.05)(+0.07) (68% C.L.). However, this result disagrees with the recent Planck limit r inflation models. In this Letter we consider an inflationary cosmology with a preceding nonsingular bounce, which gives rise to observable signatures on primordial perturbations. One interesting phenomenon is that both the primordial scalar and tensor modes can have a step feature on their power spectra, which nicely cancels the tensor excess power on the CMB temperature power spectrum. By performing a global analysis, we obtain the 68% C.L. constraints on the parameters of the model from the Planck+WP and BICEP2 data together: the jump scale log(10)(k(B)/Mpc(-1)) = -2.4 ± 0.2 and the spectrum amplitude ratio of bounce to inflation r(B) ≡ P(m)/A(s) = 0.71 ± 0.09. Our result reveals that the bounce inflation scenario can simultaneously explain the Planck and BICEP2 observations better than the standard cold dark matter model with a cosmological constant, and can be verified by future CMB polarization measurements.

  2. Long head of biceps: from anatomy to treatment.

    Science.gov (United States)

    Sarmento, M

    2015-01-01

    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.

  3. Principles of tendon transfers.

    Science.gov (United States)

    Coulet, B

    2016-04-01

    Tendon transfers are carried out to restore functional deficits by rerouting the remaining intact muscles. Transfers are highly attractive in the context of hand surgery because of the possibility of restoring the patient's ability to grip. In palsy cases, tendon transfers are only used when a neurological procedure is contraindicated or has failed. The strategy used to restore function follows a common set of principles, no matter the nature of the deficit. The first step is to clearly distinguish between deficient muscles and muscles that could be transferred. Next, the type of palsy will dictate the scope of the program and the complexity of the gripping movements that can be restored. Based on this reasoning, a surgical strategy that matches the means (transferable muscles) with the objectives (functions to restore) will be established and clearly explained to the patient. Every paralyzed hand can be described using three parameters. 1) Deficient segments: wrist, thumb and long fingers; 2) mechanical performance of muscles groups being revived: high energy-wrist extension and finger flexion that require strong transfers with long excursion; low energy-wrist flexion and finger extension movements that are less demanding mechanically, because they can be accomplished through gravity alone in some cases; 3) condition of the two primary motors in the hand: extrinsics (flexors and extensors) and intrinsics (facilitator). No matter the type of palsy, the transfer surgery follows the same technical principles: exposure, release, fixation, tensioning and rehabilitation. By performing an in-depth analysis of each case and by following strict technical principles, tendon transfer surgery leads to reproducible results; this allows the surgeon to establish clear objectives for the patient preoperatively.

  4. Repair versus shaving of partial-thickness articular-sided tears of the upper subscapularis tendon. A prospective randomized controlled trial

    Science.gov (United States)

    RANDELLI, PIETRO; ARRIGONI, PAOLO; ALIPRANDI, ALBERTO; SDAO, SILVANA; RAGONE, VINCENZA; D’AMBROSI, RICCARDO; RANDELLI, FILIPPO; CABITZA, PAOLO; BANFI, GIUSEPPE

    2015-01-01

    Purpose the purpose of this study was to evaluate whether treating partial-thickness articular-sided tears of the upper subscapularis (SSC) tendon with a dedicated suture anchor would result in an internal rotation strength improvement compared with simple shaving of the SSC tendon and footprint. Methods twenty-six patients with a limited SSC tendon tear (equal or inferior to the most superior centimeter) in association with a posterosuperior cuff lesion were prospectively randomized to two treatments: repair with a dedicated suture anchor versus shaving of the tendon and footprint. The patients also underwent long head of the biceps (LHB) treatment and posterosuperior cuff tear repair. In each patient the following parameters were measured both preoperatively and at a minimum follow-up of 2.5 years: strength in internal rotation in the bear-hug testing position (using a digital tensiometer), DASH score and Constant scores. MRI assessment of tendon healing was performed at the final follow-up. Results twenty of the 26 patients (76%) were reviewed after a mean follow-up time of 42 months: 11 patients had undergone SSC tendon repair and nine simple shaving. At final follow-up no significant differences were found between the repaired and shaving group in strength in internal rotation (9.5 ± 3.8 kg versus 10.3±5.4 kg; p=0.7). The DASH score and Constant score also failed to show significant differences between the two groups. Furthermore, no significant difference in SSC tendon healing rate was observed on MRI evaluation. Conclusions partial-thickness articular-sided tear of the upper SSC tendon in association with a posterosuperior rotator cuff repair and LHB treatment, when limited to the superior centimeter of the SSC tendon, shows a comparable performance in terms of strength in internal rotation either after simple shaving or a tendon-to-bone repair. Level of evidence Level II, prospective comparative study. PMID:26889466

  5. BICEP2/SPUD: Searching for Inflation with Degree Scale Polarimetry from the South Pole

    Science.gov (United States)

    Nguyen, Hien Trong; Kovac, John; Adec, Peter; Aikin, Randol; Benton, Steve; Bock, Jamie; Brevik, Justus; Carlstrom, John; Dowell, Darren; Duband, Lionel; Golwala, Sunil; Halpern, Mark; Hasselfield, Matthew; Irwin, Kent; Jones, William; Kaufman, Jonathan; Keating, Brian; Kuo, Chao-Lin; Lange, Andrew; Matsumura, Tomotake; Netterfield, Barth; Pryke, Clem; Ruhl, John; Sheehy, Chris; Sudiwala, Rashmi

    2008-01-01

    BICEP2/SPUD is the new powerful upgrade of the existing BICEP1 experiment, a bolometric receiver to study the polarization of the cosmic microwave background radiation, which has been in operation at the South Pole since January 2006. BICEP2 will provide an improvement up to 10 times mapping speed at 150 GHz compared to BICEP1, using the same BICEP telescope mount. SPUD, a series of compact, mechanically-cooled receivers deployed on the DASI mount at the Pole, will provide similar mapping speed in to BICEP2 in three bands, 100, 150, and 220 GHz. The new system will use large TES focal plane arrays to provide unprecedented sensitivity and excellent control of foreground contamination.

  6. BICEP2/SPUD: Searching for Inflation with Degree Scale Polarimetry from the South Pole

    Science.gov (United States)

    Nguyen, Hien Trong; Kovac, John; Adec, Peter; Aikin, Randol; Benton, Steve; Bock, Jamie; Brevik, Justus; Carlstrom, John; Dowell, Darren; Duband, Lionel; hide

    2008-01-01

    BICEP2/SPUD is the new powerful upgrade of the existing BICEP1 experiment, a bolometric receiver to study the polarization of the cosmic microwave background radiation, which has been in operation at the South Pole since January 2006. BICEP2 will provide an improvement up to 10 times mapping speed at 150 GHz compared to BICEP1, using the same BICEP telescope mount. SPUD, a series of compact, mechanically-cooled receivers deployed on the DASI mount at the Pole, will provide similar mapping speed in to BICEP2 in three bands, 100, 150, and 220 GHz. The new system will use large TES focal plane arrays to provide unprecedented sensitivity and excellent control of foreground contamination.

  7. The role of stretching in tendon injuries.

    Science.gov (United States)

    Witvrouw, E; Mahieu, N; Roosen, P; McNair, P

    2007-04-01

    The function of tendons can be classified into two categories: tensile force transmission, and storage and release of elastic energy during locomotion. The action of tendons in storing and releasing energy is mainly seen in sports activities with stretch-shortening cycles (SSCs). The more intense the SSC movements are (jumping-like activities), the more frequently tendon problems are observed. High SSC movements impose high loads on tendons. Consequently, tendons that frequently deal with high SSC motion require a high energy-absorbing capacity to store and release this large amount of elastic energy. As the elasticity of tendon structures is a leading factor in the amount of stored energy, prevention and rehabilitation programmes for tendon injuries should focus on increasing this tendon elasticity in athletes performing high SSC movements. Recently, it has been shown that ballistic stretching can significantly increase tendon elasticity. These findings have important clinical implications for treatment and prevention of tendon injuries.

  8. Quantitative diagnostic method for biceps long head tendinitis by using ultrasound.

    Science.gov (United States)

    Huang, Shih-Wei; Wang, Wei-Te

    2013-01-01

    To investigate the feasibility of grayscale quantitative diagnostic method for biceps tendinitis and determine the cut-off points of a quantitative biceps ultrasound (US) method to diagnose biceps tendinitis. Design. Prospective cross-sectional case controlled study. Outpatient rehabilitation service. A total of 336 shoulder pain patients with suspected biceps tendinitis were recruited in this prospective observational study. The grayscale pixel data of the range of interest (ROI) were obtained for both the transverse and longitudinal views of the biceps US. A total of 136 patients were classified with biceps tendinitis, and 200 patients were classified as not having biceps tendinitis based on the diagnostic criteria. Based on the Youden index, the cut-off points were determined as 26.85 for the transverse view and 21.25 for the longitudinal view of the standard deviation (StdDev) of the ROI values, respectively. When the ROI evaluation of the US surpassed the cut-off point, the sensitivity was 68% and the specificity was 90% in the StdDev of the transverse view, and the sensitivity was 81% and the specificity was 73% in the StdDev of the longitudinal view to diagnose biceps tendinitis. For equivocal cases or inexperienced sonographers, our study provides a more objective method for diagnosing biceps tendinitis in shoulder pain patients.

  9. Ultrasonographic assessment of flexor tendon mobilization: Effect of different protocols on tendon excursion

    NARCIS (Netherlands)

    J.-W.H. Korstanje (Jan-Wiebe); J. Soeters (Johannes); A.R. Schreuders (Ton); P.C. Amadio (Peter ); S.E.R. Hovius (Steven); H.J. Stam (Henk); R.W. Selles (Ruud)

    2012-01-01

    textabstractBackground: Different mobilization protocols have been proposed for rehabilitation after hand flexor tendon repair to provide tendon excursion sufficient to prevent adhesions. Several cadaver studies have shown that the position of the neighboring fingers influences tendon excursions of

  10. Ultrasonographic assessment of flexor tendon mobilization: Effect of different protocols on tendon excursion

    NARCIS (Netherlands)

    J.-W.H. Korstanje (Jan-Wiebe); J. Soeters (Johannes); A.R. Schreuders (Ton); P.C. Amadio (Peter ); S.E.R. Hovius (Steven); H.J. Stam (Henk); R.W. Selles (Ruud)

    2012-01-01

    textabstractBackground: Different mobilization protocols have been proposed for rehabilitation after hand flexor tendon repair to provide tendon excursion sufficient to prevent adhesions. Several cadaver studies have shown that the position of the neighboring fingers influences tendon excursions of

  11. 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.

  12. Rectus Femoris Tendon Calcification

    Science.gov (United States)

    Zini, Raul; Panascì, Manlio; Papalia, Rocco; Franceschi, Francesco; Vasta, Sebastiano; Denaro, Vincenzo

    2014-01-01

    Background: Since it was developed, hip arthroscopy has become the favored treatment for femoroacetabular impingement. Due to recent considerable improvements, the indications for this technique have been widely extended. Injuries of the rectus femoris tendon origin, after an acute phase, could result in a chronic tendinopathy with calcium hydroxyapatite crystal deposition, leading to pain and loss of function. Traditionally, this condition is addressed by local injection of anesthetic and corticosteroids or, when conservative measures fail, by open excision of the calcific lesion by an anterior approach. Purpose: To assess whether arthroscopic excision of calcification of the proximal rectus is a safe and effective treatment. Study Design: Case series; Level of evidence, 4. Methods: Outcomes were studied from 6 top amateur athletes (age range, 30-43 years; mean, 32.6 years) affected by calcification of the proximal rectus who underwent arthroscopic excision of the calcification. Patients were preoperatively assessed radiographically, and diagnosis was confirmed by a 3-dimensional computed tomography scan. To evaluate the outcome, standardized hip rating scores were used pre- and postoperatively (at 6 and 12 months): the Hip disability and Osteoarthritis Outcome Score, Oxford Hip Score, and Modified Harris Hip Score. Moreover, visual analog scales (VAS) for pain, sport activity level (SAL), and activities of daily living (ADL) were also used. Results: One year after surgery, all patients reported satisfactory outcomes, with 3 of 6 rating their return-to-sport level as high as preinjury level, and the remaining 3 with a percentage higher than 80%. Five patients ranked their ability to carry on daily activities at 100%. Statistical analysis showed significant improvement of the Oxford Hip Score, the Modified Harris Hip Score, and all 3 VAS subscales (pain, SAL, and ADL) from pre- to latest postoperative assessment (P < .05). Conclusion: Arthroscopic excision of

  13. Nonsingular bouncing cosmologies in light of BICEP2

    Energy Technology Data Exchange (ETDEWEB)

    Cai, Yi-Fu; Quintin, Jerome [Department of Physics, McGill University, 3600 rue University, Montréal, QC, H3A 2T8 Canada (Canada); Saridakis, Emmanuel N. [Physics Division, National Technical University of Athens, 15780 Zografou Campus, Athens (Greece); Wilson-Ewing, Edward, E-mail: yifucai@physics.mcgill.ca, E-mail: jquintin@physics.mcgill.ca, E-mail: Emmanuel_Saridakis@baylor.edu, E-mail: wilson-ewing@phys.lsu.edu [Department of Physics and Astronomy, Louisiana State University, Tower Drive, Baton Rouge, 70803 (United States)

    2014-07-01

    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.

  14. Management of Extensor Tendon Injuries

    Science.gov (United States)

    Griffin, M; Hindocha, S; Jordan, D; Saleh, M; Khan, W

    2012-01-01

    Extensor tendon injuries are very common injuries, which inappropriately treated can cause severe lasting impairment for the patient. Assessment and management of flexor tendon injuries has been widely reviewed, unlike extensor injuries. It is clear from the literature that extensor tendon repair should be undertaken immediately but the exact approach depends on the extensor zone. Zone I injuries otherwise known as mallet injuries are often closed and treated with immobilisaton and conservative management where possible. Zone II injuries are again conservatively managed with splinting. Closed Zone III or ‘boutonniere’ injuries are managed conservatively unless there is evidence of displaced avulsion fractures at the base of the middle phalanx, axial and lateral instability of the PIPJ associated with loss of active or passive extension of the joint or failed non-operative treatment. Open zone III injuries are often treated surgically unless splinting enable the tendons to come together. Zone V injuries, are human bites until proven otherwise requires primary tendon repair after irrigation. Zone VI injuries are close to the thin paratendon and thin subcutaneous tissue which strong core type sutures and then splinting should be placed in extension for 4-6 weeks. Complete lacerations to zone IV and VII involve surgical primary repair followed by 6 weeks of splinting in extension. Zone VIII require multiple figure of eight sutures to repair the muscle bellies and static immobilisation of the wrist in 45 degrees of extension. To date there is little literature documenting the quality of repairing extensor tendon injuries however loss of flexion due to extensor tendon shortening, loss of flexion and extension resulting from adhesions and weakened grip can occur after surgery. This review aims to provide a systematic examination method for assessing extensor injuries, presentation and management of all type of extensor tendon injuries as well as guidance on

  15. The tendon approximator device in traumatic injuries.

    Science.gov (United States)

    Forootan, Kamal S; Karimi, Hamid; Forootan, Nazilla-Sadat S

    2015-01-01

    Precise and tension-free approximation of two tendon endings is the key predictor of outcomes following tendon lacerations and repairs. We evaluate the efficacy of a new tendon approximator device in tendon laceration repairs. In a comparative study, we used our new tendon approximator device in 99 consecutive patients with laceration of 266 tendons who attend a university hospital and evaluated the operative time to repair the tendons, surgeons' satisfaction as well as patient's outcomes in a long-term follow-up. Data were compared with the data of control patients undergoing tendon repair by conventional method. Totally 266 tendons were repaired by approximator device and 199 tendons by conventional technique. 78.7% of patients in first group were male and 21.2% were female. In approximator group 38% of patients had secondary repair of cut tendons and 62% had primary repair. Patients were followed for a mean period of 3years (14-60 months). Time required for repair of each tendon was significantly reduced with the approximator device (2 min vs. 5.5 min, ptendon repair were identical in the two groups and were not significantly different. 1% of tendons in group A and 1.2% in group B had rupture that was not significantly different. The new nerve approximator device is cheap, feasible to use and reduces the time of tendon repair with sustained outcomes comparable to the conventional methods.

  16. MicroRNAs Associated with Shoulder Tendon Matrisome Disorganization in Glenohumeral Arthritis

    Science.gov (United States)

    Thankam, Finosh G.; Boosani, Chandra S.; Dilisio, Matthew F.; Dietz, Nicholas E.

    2016-01-01

    The extracellular matrix (ECM) provides core support which is essential for the cell and tissue architectural development. The role of ECM in many pathological conditions has been well established and ECM-related abnormalities leading to serious consequences have been identified. Though much has been explored in regards to the role of ECM in soft tissue associated pathologies, very little is known about its role in inflammatory disorders in tendon. In this study, we performed microRNA (miRNA) expression analysis in the long head of the human shoulder biceps tendon to identify key genes whose expression was altered during inflammation in patients with glenohumeral arthritis. We identified differential regulation of matrix metalloproteinases (MMPs) that could be critical in collagen type replacement during tendinopathy. The miRNA profiling showed consistent results between the groups and revealed significant changes in the expression of seven different miRNAs in the inflamed tendons. Interestingly, all of these seven miRNAs were previously reported to have either a direct or indirect role in regulating the ECM organization in other pathological disorders. In addition, these miRNAs were also found to alter the expression levels of MMPs, which are the key matrix degrading enzymes associated with ECM-related abnormalities and pathologies. To our knowledge, this is the first report which identifies specific miRNAs associated with inflammation and the matrix reorganization in the tendons. Furthermore, the findings also support the potential role of these miRNAs in altering the collagen type ratio in the tendons during inflammation which is accompanied with differential expression of MMPs. PMID:27992561

  17. On the fail-safe design of tendon-driven manipulators with redundant tendons

    Energy Technology Data Exchange (ETDEWEB)

    Sheu, Jinn Biau; Liu, Tyng; Lee, Jyh Jone [National Taiwan University, Taipei (China)

    2012-06-15

    A tendon-driven manipulator having redundant tendons may possess more flexibility in operation, such as optimizing the performance of tendons, reducing the burden of each tendon, and providing fail-safe features. The purpose of this paper is to investigate the design of tendon-driven manipulators with a fail-safe feature, that is, to synthesize a system that may still remain controllable as any of the tendons have broken down or malfunctioned. Characteristics of tendon-driven manipulators are briefly discussed. Criteria for tendon-driven manipulators with redundant tendons and fail-safe feature are then established. Subsequently, constraints for such system are derived from the structure of tendon-driven manipulator. Associated with the criteria, manipulators can remain controllable when any of the tendons fails to function. Finally, a geometric method for determining the structure is developed. Examples of two-DOF and three-DOF tendondriven manipulators are demonstrated.

  18. 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.

  19. Bilateral additional slips of triceps brachii forming osseo-musculo-fibrous tunnels for ulnar nerves.

    Science.gov (United States)

    Swamy, Rs; Rao, Mkg; Somayaji, Sn; Raghu, J; Pamidi, N

    2013-07-01

    Rare additional slips of triceps brachii muscle was found bilaterally in a sixty two year old South Indian male cadaver during routine dissection of upper limb for undergraduate students at Melaka-Manipal Medical College, Manipal University, Manipal, India. On left side, the variant additional muscle slip took origin from the lower part of the medial intermuscular septum about 4 cm proximal to the medial humeral epicondyle. From its origin, the muscle fibres were passing over the ulnar nerve and were joining the triceps muscle to get inserted to the upper surface of olecranon process of ulna. On right side, the additional muscle slip was larger and bulkier and was arising from the lower part of the medial border of the humerus about 4 cm proximal to the medial epicondyle in addition to its attachment to the medial intermuscular septum. On both sides, the additional slips were supplied by twigs from the radial nerve. On both sides, the ulnar nerve was passing between variant additional slip and the lower part of the shaft of the humerus in an osseo-musculo-fibrous tunnel. Such variant additional muscle slips may affect the function of triceps muscle and can lead to snapping of medial head of triceps and ulnar nerve over medial epicondyle and also can dynamically compress the ulnar nerve during the contraction of triceps leading to ulnar neuropathy around the elbow.

  20. Demonstration of Achilles tendon on CT

    Energy Technology Data Exchange (ETDEWEB)

    Reiser, M.; Rupp, N.; Lehner, K.; Paar, O.; Gradinger, R.; Karpf, P.M.

    1985-08-01

    Ligaments and tendons, including the Achilles tendon, show the highest density among normal soft tissue structures in the body. Traumatic and degenerative changes of the Achilles tendon are often associated with marked thickening and reduction in density associated with increased opacity of the space in front of the Achilles tendon. These changes are easily demonstrated by CT, whereas conventional radiological techniques only show non-specific changes. Twenty-five patients were examined, including nine with pain, seven following rupture of the Achilles tendon and nine post-operative controls; it was found that CT can add information important for the diagnosis and treatment planning of abnormalities of the Achilles tendon.

  1. Tenotomy or tenodesis for the long head of biceps lesions in shoulders: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Heng'an Ge

    Full Text Available Both tenotomy and tenodesis have been widely used for the treatment of long head of biceps tendon (LHBT lesions, but the optimal strategy remains considerably controversial. In this meta-analysis of published studies, we compared the results of the two procedures.A literature search that compared tenotomy with tenodesis was performed using MEDLINE, and Embase until August 2014. A total of 7 studies reporting data on 622 subjects were included. Study quality was evaluated using the PEDro critical appraisal tool and the NO quality assessment tool.Data synthesis showed higher functional outcomes, a lower complication rate, and longer surgical time in patients managed with tenodesis compared to tenotomy (Constant score, P = 0.02; Popeye sign, P < 0.001; cramp pain, P = 0.04; surgical time, P < 0.001, respectively.This meta-analysis indicates that tenodesis results in better arm function and lower incidences of cramp pain and Popeye sign in LHBT lesions, while the procedure required longer surgical time compared to tenotomy. More sufficiently powered studies would be required to further determine the optimal strategy.

  2. Suitable long tendon technologies and practices

    CSIR Research Space (South Africa)

    Altounyan, P

    2001-10-01

    Full Text Available effective long tendon support systems suitable in South African coalmines. Appropriate test procedures for the evaluation of the performance of long tendon systems were also determined and are detailed in this report....

  3. Achilles tendon rupture; assessment of nonoperative treatment

    National Research Council Canada - National Science Library

    Barfod, Kristoffer Weisskirchner

    2014-01-01

    Acute Achilles tendon rupture is a frequent and potentially disabling injury. Over the past decade a change in treatment of acute Achilles tendon rupture away from operative towards non-operative treatment has taken place...

  4. Quadriceps and patellar tendon rupture.

    Science.gov (United States)

    Ramseier, L E; Werner, C M L; Heinzelmann, M

    2006-06-01

    Ruptures of the patellar and/or quadriceps tendon are rare injuries that require immediate repair to re-establish knee extensor continuity and to allow early motion. We evaluated 36 consecutive patients with quadriceps or patellar tendon rupture between 1993 and 2000. There were 37 primary ruptures, 3 reruptures, 21 quadriceps and 19 patellar tendon ruptures. Follow up examination (>24 months postoperatively) included the patient's history, assessment of risk factors, clinical examination of both knees, isometric muscle strength measurements and three specific knee scores, Hospital for Special Surgery Score, Knee Society Score and Turba Score, and a short form SF-36. We evaluated 29 patients (26 men) with 33 ruptures (16 patellar tendon, 17 quadriceps tendon). Seven patients were lost to follow up. We found no difference between the range of motion and muscle strength when the injured leg was compared to the non-injured leg. Risk factors did not influence the four scores, patient satisfaction, pain, muscle strength or range of motion. Multiple injured patients had a significant reduction in muscle strength and circumference, however patient satisfaction did not differ to the non-multiple injured patient group.

  5. Electromyographic tendon reflex recording: An accurate and comfortable method for diagnosis of charcot-marie-tooth disease type 1a.

    Science.gov (United States)

    García, Antonio; Pelayo-Negro, Ana L; Álvarez-Paradelo, Silvia; Antolín, Francisco M; Berciano, José

    2015-07-01

    We analyzed the utility of tendon reflex (T-reflex) testing in Charcot-Marie-Tooth disease type 1A (CMT1A). A total of 82 subjects from 27 unrelated CMT1A pedigrees were evaluated prospectively. The series also comprised 28 adult healthy controls. Electrophysiology included evaluation of biceps T-reflex and soleus T-reflex. Seventy-one individuals (62 adults and 9 children) had clinical and electrophysiological features of CMT1A. The remaining 11 (8 adults and 3 children) were unaffected. On electrophysiological testing, the biceps T-reflex was elicited in 58 of 62 (93%) adult CMT1A patients and in all 9 affected children. Latencies of the biceps T-reflex were always markedly prolonged, and a cut-off limit of 16.25 ms clearly separated adult patients and controls or unaffected kin adult individuals. In affected children, the soleus T-reflex latency was also prolonged when compared with age and height normative data. T-reflex testing is an accurate diagnostic technique for CMT1A patients. © 2014 Wiley Periodicals, Inc.

  6. Informing tendon tissue engineering with embryonic development

    OpenAIRE

    Glass, Zachary A.; Schiele, Nathan R.; Kuo, Catherine K

    2014-01-01

    Tendon is a strong connective tissue that transduces muscle-generated forces into skeletal motion. In fulfilling this role, tendons are subjected to repeated mechanical loading and high stress, which may result in injury. Tissue engineering with stem cells offers the potential to replace injured/damaged tissue with healthy, new living tissue. Critical to tendon tissue engineering is the induction and guidance of stem cells towards the tendon phenotype. Typical strategies hav...

  7. Midportion Achilles tendinosis and the plantaris tendon.

    Science.gov (United States)

    Alfredson, Håkan

    2011-10-01

    When re-operating patients with midportion Achilles tendinosis, having had a poor effect of ultrasound (US) and Doppler-guided scraping, the author found the involvement of the plantaris tendon to be a likely reason for the poor result. The aim of this study was to investigate the occurrence of a plantaris tendon in close relation to the Achilles tendon in consecutive patients with midportion Achilles tendinosis undergoing treatment with US and Doppler-guided scraping. This study includes 73 consecutive tendons with chronic painful midportion Achilles tendinosis, where US+Doppler examination showed thickening, irregular tendon structure, hypo-echoic regions, and localised high blood flow outside and inside the ventral Achilles midportion. The tendons were treated with US+Doppler-guided scraping, via a medial incision. If there was a plantaris tendon located in close relation to the medial Achilles, it was extirpated. An invaginated, or 'close by located', enlarged plantaris tendon was found in 58 of 73 (80%) tendons. Preliminary clinical results of the combined procedure, US + Doppler-guided surgical scraping and extirpation of the plantaris tendon, are very promising. A thickened plantaris tendon located in close relation to the medial Achilles seems common in patients with chronic painful midportion tendinosis. The role of the plantaris tendon in midportion Achilles tendinosis needs to be further evaluated and should be kept in mind when treating this condition.

  8. 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.

  9. Initial Performance of BICEP3: A Degree Angular Scale 95 GHz Band Polarimeter

    CERN Document Server

    Wu, W L K; Ahmed, Z; Alexander, K D; Amiri, M; Barkats, D; Benton, S J; Bischoff, C A; Bock, J J; Bowens-Rubin, R; Buder, I; Bullock, E; Buza, V; Connors, J A; Filippini, J P; Fliescher, S; Grayson, J A; Halpern, M; Harrison, S A; Hilton, G C; Hristov, V V; Hui, H; Irwin, K D; Kang, J; Karkare, K S; Karpel, E; Kefeli, S; Kernasovskiy, S A; Kovac, J M; Kuo, C L; Megerian, K G; Netterfield, C B; Nguyen, H T; O'Brient, R; Ogburn, R W; Pryke, C; Reintsema, C D; Richter, S; Sorensen, C; Staniszewski, Z K; Steinbach, B; Sudiwala, R V; Teply, G P; Thompson, K L; Tolan, J E; Tucker, C E; Turner, A D; Vieregg, A G; Weber, A C; Wiebe, D V; Willmert, J; Yoon, K W

    2016-01-01

    BICEP3 is a $550~mm$ aperture telescope with cold, on-axis, refractive optics designed to observe at the $95~GHz$ band from the South Pole. It is the newest member of the BICEP/Keck family of inflationary probes specifically designed to measure the polarization of the cosmic microwave background (CMB) at degree-angular scales. BICEP3 is designed to house 1280 dual-polarization pixels, which, when fully-populated, totals to $\\sim$9$\\times$ the number of pixels in a single Keck $95~GHz$ receiver, thus further advancing the BICEP/Keck program's $95~GHz$ mapping speed. BICEP3 was deployed during the austral summer of 2014-2015 with 9 detector tiles, to be increased to its full capacity of 20 in the second season. After instrument characterization measurements were taken, CMB observation commenced in April 2015. Together with multi-frequency observation data from Planck, BICEP2, and the Keck Array, BICEP3 is projected to set upper limits on the tensor-to-scalar ratio to $r$ $\\lesssim 0.03$ at $95\\%$ C.L..

  10. Initial Performance of Bicep3: A Degree Angular Scale 95 GHz Band Polarimeter

    Science.gov (United States)

    Wu, W. L. K.; Ade, P. A. R.; Ahmed, Z.; Alexander, K. D.; Amiri, M.; Barkats, D.; Benton, S. J.; Bischoff, C. A.; Bock, J. J.; Bowens-Rubin, R.; Buder, I.; Bullock, E.; Buza, V.; Connors, J. A.; Filippini, J. P.; Fliescher, S.; Grayson, J. A.; Halpern, M.; Harrison, S. A.; Hilton, G. C.; Hristov, V. V.; Hui, H.; Irwin, K. D.; Kang, J.; Karkare, K. S.; Karpel, E.; Kefeli, S.; Kernasovskiy, S. A.; Kovac, J. M.; Kuo, C. L.; Megerian, K. G.; Netterfield, C. B.; Nguyen, H. T.; O'Brient, R.; Ogburn, R. W.; Pryke, C.; Reintsema, C. D.; Richter, S.; Sorensen, C.; Staniszewski, Z. K.; Steinbach, B.; Sudiwala, R. V.; Teply, G. P.; Thompson, K. L.; Tolan, J. E.; Tucker, C. E.; Turner, A. D.; Vieregg, A. G.; Weber, A. C.; Wiebe, D. V.; Willmert, J.; Yoon, K. W.

    2016-08-01

    Bicep3 is a 550-mm aperture telescope with cold, on-axis, refractive optics designed to observe at the 95-GHz band from the South Pole. It is the newest member of the Bicep/ Keck family of inflationary probes specifically designed to measure the polarization of the cosmic microwave background (CMB) at degree angular scales. Bicep3 is designed to house 1280 dual-polarization pixels, which, when fully populated, totals to ˜ 9× the number of pixels in a single Keck 95-GHz receiver, thus further advancing the Bicep/ Keck program's 95 GHz mapping speed. Bicep3 was deployed during the austral summer of 2014-2015 with nine detector tiles, to be increased to its full capacity of 20 in the second season. After instrument characterization, measurements were taken, and CMB observation commenced in April 2015. Together with multi-frequency observation data from Planck, Bicep2, and the Keck Array, Bicep3 is projected to set upper limits on the tensor-to-scalar ratio to r lesssim 0.03 at 95 % C.L.

  11. MRI of normal achilles tendon

    Energy Technology Data Exchange (ETDEWEB)

    Rollandi, G.A. [Institute of Radiology, Univ. of Genoa (Italy); Bertolotto, M. [Institute of Radiology, Univ. of Genoa (Italy); Perrone, R. [Institute of Radiology, Univ. of Genoa (Italy); Garlaschi, G. [Institute of Radiology, Univ. of Genoa (Italy); Derchi, L.E. [Institute of Radiology, Univ. of Genoa (Italy)

    1995-12-01

    To investigate the normal internal structure of tendons 11 volunteers without clinical evidence of tendinopathy were examined using conventional spin-echo T1-, T2- and proton-density weighted sequences. The Achilles tendon was chosen because of its high frequency of injury in athletic activity, large size, superficial position and because it is oriented nearly parallel to the static magnetic field, therefore minimizing the ``magic angle phenomenon``. The tendons exhibited areas of slighly increased signal in four T1-weighted and in all but one proton-density-weighted scans. No intratendinous signal was detected in T2-weighted images. The possible origin of these findings is discussed. We conclude that the knowledge of these normal signals may be useful to avoid incorrectly diagnosing as pathological. (orig.). With 2 figs.

  12. [Graft reconstruction of flexor tendons].

    Science.gov (United States)

    Pauchard, N; Pedeutour, B; Dautel, G

    2014-12-01

    The improvement of primary flexor tendon repair has limited the indications of secondary repairs to neglected initial wound care and deficiencies in the surgical technique or rehabilitation. The surgical and rehabilitation care is complex and prolonged, requiring full cooperation of the patient. That is why the surgeon must evaluate patient's ability to integrate instructions and to comply with a long and demanding protocol. The functional needs of the patient are important in treatment decisions and the surgeon should not hesitate to use an appropriate surgical alternative (tenodesis, arthrodesis, tendon transfer, etc.). After a brief historical review, the authors discuss the indications, technical procedures and finally the results of one-stage and two-stage flexor tendon graft, which despite mixed results keep a real place in our current armamentarium.

  13. Radiative inflation and dark energy RIDEs again after BICEP2

    Energy Technology Data Exchange (ETDEWEB)

    Bari, Pasquale Di; King, Stephen F.; Merle, Alexander [Physics and Astronomy, University of Southampton, Highfield Campus, Southampton, SO17 1BJ (United Kingdom); Luhn, Christoph [Theoretische Physik 1, Naturwissenschaftlich-Technische Fakultät, Universität Siegen, Walter-Flex-Straße 3, Siegen, D-57068 (Germany); Schmidt-May, Angnis, E-mail: P.Di-Bari@soton.ac.uk, E-mail: S.F.King@soton.ac.uk, E-mail: Christoph.Luhn@uni-siegen.de, E-mail: A.Merle@soton.ac.uk, E-mail: Angnis.Schmidt-May@fysik.su.se [Department of Physics and The Oskar Klein Centre, Stockholm University, AlbaNova University Centre, Stockholm, SE-106 91 (Sweden)

    2014-08-01

    Following the ground-breaking measurement of the tensor-to-scalar ratio r=0.20{sup +0.07}{sub -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{sup 2}|Φ|{sup 2}ln(|Φ|{sup 2}/Λ{sup 2}) potential and compare its predictions to those based on the traditional chaotic inflation M{sup 2}|Φ|{sup 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{sub S}=0.96 in both models.

  14. Killing the Straw Man: Does BICEP Prove Inflation?

    CERN Document Server

    Dent, James B; 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 provides strong evidence for Inflation at the GUT scale. In order to provide compelling evidence, other possible sources of the signal need to be ruled out. While the Inflationary signal remains the best motivated source, the current measurement unfortunately still allows for the possibility that a comparable gravitational wave background might result from a self ordering scalar field transition that takes place later at somewhat lower energy. However even marginally improved limits on the possible isocurvature contribution to CMB anistropies could rule out this possibility, and essentially all other sources of the observed signal other than Inflation.

  15. BICEP2, non-Bunch–Davies and entanglement

    Directory of Open Access Journals (Sweden)

    Namit Mahajan

    2015-04-01

    Full Text Available BICEP2 result on the tensor to scalar ratio r indicates a blue tilt in the primordial gravitational wave spectrum. This blue tilt and the observed large value r=0.2 are difficult to accommodate within the single field inflationary scenarios under standard conditions. Non-Bunch–Davies vacuum states have been proposed as a possibility. Such vacua are known to lead to pathologies. In this note we point out that it is known that these states ought to be interpreted as excited/squeezed states built over the standard Bunch–Davies vacuum in order to avoid pathological issues. We discuss the associated entanglement properties due to de Sitter horizon, and how such an approach may be more natural in the context of inflation. In particular, we suggest to employ entanglement considerations in de Sitter background to study the nature and intrinsic properties of modified initial states.

  16. 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...

  17. Joint analysis of BICEP2/keck array and Planck Data.

    Science.gov (United States)

    Ade, P A R; Aghanim, N; Ahmed, Z; Aikin, R W; Alexander, K D; Arnaud, M; Aumont, J; Baccigalupi, C; Banday, A J; Barkats, D; Barreiro, R B; Bartlett, J G; Bartolo, N; Battaner, E; Benabed, K; Benoît, A; Benoit-Lévy, A; Benton, S J; Bernard, J-P; Bersanelli, M; Bielewicz, P; Bischoff, C A; Bock, J J; Bonaldi, A; Bonavera, L; Bond, J R; Borrill, J; Bouchet, F R; Boulanger, F; Brevik, J A; Bucher, M; Buder, I; Bullock, E; Burigana, C; Butler, R C; Buza, V; Calabrese, E; Cardoso, J-F; Catalano, A; Challinor, A; Chary, R-R; Chiang, H C; Christensen, P R; Colombo, L P L; Combet, C; Connors, J; Couchot, F; Coulais, A; Crill, B P; Curto, A; Cuttaia, F; Danese, L; Davies, R D; Davis, R J; de Bernardis, P; de Rosa, A; de Zotti, G; Delabrouille, J; Delouis, J-M; Désert, F-X; Dickinson, C; Diego, J M; Dole, H; Donzelli, S; Doré, O; Douspis, M; Dowell, C D; Duband, L; Ducout, A; Dunkley, J; Dupac, X; Dvorkin, C; Efstathiou, G; Elsner, F; Enßlin, T A; Eriksen, H K; Falgarone, E; Filippini, J P; Finelli, F; Fliescher, S; Forni, O; Frailis, M; Fraisse, A A; Franceschi, E; Frejsel, A; Galeotta, S; Galli, S; Ganga, K; Ghosh, T; Giard, M; Gjerløw, E; Golwala, S R; González-Nuevo, J; Górski, K M; Gratton, S; Gregorio, A; Gruppuso, A; Gudmundsson, J E; Halpern, M; Hansen, F K; Hanson, D; Harrison, D L; Hasselfield, M; Helou, G; Henrot-Versillé, S; Herranz, D; Hildebrandt, S R; Hilton, G C; Hivon, E; Hobson, M; Holmes, W A; Hovest, W; Hristov, V V; Huffenberger, K M; Hui, H; Hurier, G; Irwin, K D; Jaffe, A H; Jaffe, T R; Jewell, J; Jones, W C; Juvela, M; Karakci, A; Karkare, K S; Kaufman, J P; Keating, B G; Kefeli, S; Keihänen, E; Kernasovskiy, S A; Keskitalo, R; Kisner, T S; Kneissl, R; Knoche, J; Knox, L; Kovac, J M; Krachmalnicoff, N; Kunz, M; Kuo, C L; Kurki-Suonio, H; Lagache, G; Lähteenmäki, A; Lamarre, J-M; Lasenby, A; Lattanzi, M; Lawrence, C R; Leitch, E M; Leonardi, R; Levrier, F; Lewis, A; Liguori, M; Lilje, P B; Linden-Vørnle, M; López-Caniego, M; Lubin, P M; Lueker, M; Macías-Pérez, J F; Maffei, B; Maino, D; Mandolesi, N; Mangilli, A; Maris, M; Martin, P G; Martínez-González, E; Masi, S; Mason, P; Matarrese, S; Megerian, K G; Meinhold, P R; Melchiorri, A; Mendes, L; Mennella, A; Migliaccio, M; Mitra, S; Miville-Deschênes, M-A; Moneti, A; Montier, L; Morgante, G; Mortlock, D; Moss, A; Munshi, D; Murphy, J A; Naselsky, P; Nati, F; Natoli, P; Netterfield, C B; Nguyen, H T; Nørgaard-Nielsen, H U; Noviello, F; Novikov, D; Novikov, I; O'Brient, R; Ogburn, R W; Orlando, A; Pagano, L; Pajot, F; Paladini, R; Paoletti, D; Partridge, B; Pasian, F; Patanchon, G; Pearson, T J; Perdereau, O; Perotto, L; Pettorino, V; Piacentini, F; Piat, M; Pietrobon, D; Plaszczynski, S; Pointecouteau, E; Polenta, G; Ponthieu, N; Pratt, G W; Prunet, S; Pryke, C; Puget, J-L; Rachen, J P; Reach, W T; Rebolo, R; Reinecke, M; Remazeilles, M; Renault, C; Renzi, A; Richter, S; Ristorcelli, I; Rocha, G; Rossetti, M; Roudier, G; Rowan-Robinson, M; Rubiño-Martín, J A; Rusholme, B; Sandri, M; Santos, D; Savelainen, M; Savini, G; Schwarz, R; Scott, D; Seiffert, M D; Sheehy, C D; Spencer, L D; Staniszewski, Z K; Stolyarov, V; Sudiwala, R; Sunyaev, R; Sutton, D; Suur-Uski, A-S; Sygnet, J-F; Tauber, J A; Teply, G P; Terenzi, L; Thompson, K L; Toffolatti, L; Tolan, J E; Tomasi, M; Tristram, M; Tucci, M; Turner, A D; Valenziano, L; Valiviita, J; Van Tent, B; Vibert, L; Vielva, P; Vieregg, A G; Villa, F; Wade, L A; Wandelt, B D; Watson, R; Weber, A C; Wehus, I K; White, M; White, S D M; Willmert, J; Wong, C L; Yoon, K W; Yvon, D; Zacchei, A; Zonca, A

    2015-03-13

    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  deg^{2} 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 has observed the full sky in polarization at seven frequencies from 30 to 353 GHz, but much less deeply in any given region (1.2  μK deg in Q and U at 143 GHz). We detect 150×353 cross-correlation in B modes at high significance. We fit the single- and cross-frequency power spectra at frequencies ≥150  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 find strong evidence for dust and no statistically significant evidence for tensor modes. We probe various model variations and extensions, including adding a synchrotron component in combination with lower frequency data, and find that these make little difference to the r constraint. Finally, 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}<0.12 at 95% confidence. Marginalizing over dust and r, lensing B modes are detected at 7.0σ significance.

  18. Achilles tendon lesions in sport.

    Science.gov (United States)

    Williams, J G

    1993-09-01

    Achillodynia (Achilles tendon pain) is a significant source of disability to many people taking part in sports. Papers in the English language published since 1986 are reviewed here, grouped into specific subject areas including biomechanics, pathology, general clinical presentations, experimental treatments, steroids, podiatry and surgery. While there has been no dramatic breakthrough in the field, there have been various interesting advances with particular reference to imaging and conservative management, which will hopefully stimulate further studies. Many problems of Achilles tendon lesions in athletes remain unsolved, however, and much is yet to be done to provide adequate and generally effective methods of prevention and conservative treatment.

  19. Chronic Achilles tendon rupture reconstructed using hamstring tendon autograft.

    Science.gov (United States)

    Ellison, Philip; Mason, Lyndon William; Molloy, Andrew

    2016-03-01

    Chronic rupture of the Achilles tendon (delayed diagnosis of more than 4 weeks) can result in retraction of the tendon and inadequate healing. Direct repair may not be possible and augmentation methods are challenging when the defect exceeds 5-6 cm, especially if the distal stump is grossly tendinopathic. We describe our method of Achilles tendon reconstruction with ipsilateral semitendinosis autograft and interference screw fixation in a patient with chronic rupture, a 9 cm defect and gross distal tendinopathy. Patient reported outcome measures consistently demonstrated improved health status at 12 months post surgery: MOXFQ-Index 38-25, EQ5D-5L 18-9, EQ VAS 70-90 and VISA-A 1-64. The patient was back to full daily function, could single leg heel raise and was gradually returning to sport. No complications or adverse events were recorded. Reconstruction of chronic tears of the Achilles tendon with large defects and gross tendinopathy using an ipsilateral semitendinosis autograft and interference screw fixation can achieve satisfactory improvements in patient reported outcomes up to 1 year post-surgery. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. 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.

  1. What understanding tendon cell differentiation can teach us about pathological tendon ossification.

    Science.gov (United States)

    Magne, D; Bougault, C

    2015-08-01

    Tendons are the structures that attach muscles to bones and transmit mechanical forces. Tendon cells are composed of mature tenocytes and a rare population of tendon stem cells. Both cell types ensure homeostasis and repair of tendon extracellular matrix to guarantee its specific mechanical properties. Moreover, tendon cells seem to present a marked potential for trans-differentiation, predominantly into the chondrocyte and osteoblast lineages. In this review article, we first present chronic tendon pathologies associated with abnormal ossification, such as spondyloarthritis and calcifying tendinopathy, and discuss how tendon cell differentiation and trans-differentiation may participate in these diseases. We moreover present the factors known to influence tendon cell differentiation and trans-differentiation, with a particular emphasis on extracellular environment, mechanical stimulation and several soluble factors that can tip the balance toward one or another lineage. A better understanding of the neglected tendon cell biology may be extremely useful to understand the pathological mechanisms of spondyloarthritis and calcifying tendinopathy.

  2. Hamstring tendon harvesting--Effect of harvester on tendon characteristics and soft tissue disruption; cadaver study.

    Science.gov (United States)

    Charalambous, C P; Alvi, F; Phaltankar, P; Gagey, O

    2009-06-01

    The purpose of this study was to determine whether the type of hamstring tendon harvester used can influence harvested tendon characteristics and soft tissue disruption. We compared two different types of tendon harvesters with regard to the length of tendon obtained and soft tissue disruption during hamstring tendon harvesting. Thirty six semitendinosus and gracilis tendons were harvested using either a closed stripper or a blade harvester in 18 paired knees from nine human fresh cadavers. Use of the blade harvester gave longer lengths of usable tendon whilst minimising the stripping of muscle and of any non-usable tendon. Our results suggest that the type of harvester per se can influence the length of tendon harvested as well as soft tissue disruption. Requesting such data from the industry prior to deciding which harvester to use seems desirable.

  3. Histologic analysis of ruptured quadriceps tendons.

    Science.gov (United States)

    Trobisch, Per David; Bauman, Matthias; Weise, Kuno; Stuby, Fabian; Hak, David J

    2010-01-01

    Quadriceps tendon ruptures are uncommon injuries. Degenerative changes in the tendon are felt to be an important precondition for rupture. We retrospectively reviewed 45 quadriceps tendon ruptures in 42 patients. Quadriceps tendon ruptures occurred most often in the sixth and seventh decade of life. Men were affected six times as often as women. A tissue sample from the rupture-zone was obtained in 22 cases and histologic analysis was performed. Degenerative changes were present in only 14 (64%) of the 22 samples. We observed an increasing ratio of degenerative to nondegenerative tendons with increasing patient age. Our data suggests that quadriceps tendon rupture, especially in younger patients, can occur in the absence of pathologic tendon degeneration.

  4. 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

    2013-01-01

    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 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. PMID:23072472

  5. Functionally Distinct Tendons From Elastin Haploinsufficient Mice Exhibit Mild Stiffening and Tendon-Specific Structural Alteration.

    Science.gov (United States)

    Eekhoff, Jeremy D; Fang, Fei; Kahan, Lindsey G; Espinosa, Gabriela; Cocciolone, Austin J; Wagenseil, Jessica E; Mecham, Robert P; Lake, Spencer P

    2017-11-01

    Elastic fibers are present in low quantities in tendon, where they are located both within fascicles near tenocytes and more broadly in the interfascicular matrix (IFM). While elastic fibers have long been known to be significant in the mechanics of elastin-rich tissue (i.e., vasculature, skin, lungs), recent studies have suggested a mechanical role for elastic fibers in tendons that is dependent on specific tendon function. However, the exact contribution of elastin to properties of different types of tendons (e.g., positional, energy-storing) remains unknown. Therefore, this study purposed to evaluate the role of elastin in the mechanical properties and collagen alignment of functionally distinct supraspinatus tendons (SSTs) and Achilles tendons (ATs) from elastin haploinsufficient (HET) and wild type (WT) mice. Despite the significant decrease in elastin in HET tendons, a slight increase in linear stiffness of both tendons was the only significant mechanical effect of elastin haploinsufficiency. Additionally, there were significant changes in collagen nanostructure and subtle alteration to collagen alignment in the AT but not the SST. Hence, elastin may play only a minor role in tendon mechanical properties. Alternatively, larger changes to tendon mechanics may have been mitigated by developmental compensation of HET tendons and/or the role of elastic fibers may be less prominent in smaller mouse tendons compared to the larger bovine and human tendons evaluated in previous studies. Further research will be necessary to fully elucidate the influence of various elastic fiber components on structure-function relationships in functionally distinct tendons.

  6. Transcription factor EGR1 directs tendon differentiation and promotes tendon repair

    Science.gov (United States)

    Guerquin, Marie-Justine; Charvet, Benjamin; Nourissat, Geoffroy; Havis, Emmanuelle; Ronsin, Olivier; Bonnin, Marie-Ange; Ruggiu, Mathilde; Olivera-Martinez, Isabel; Robert, Nicolas; Lu, Yinhui; Kadler, Karl E.; Baumberger, Tristan; Doursounian, Levon; Berenbaum, Francis; Duprez, Delphine

    2013-01-01

    Tendon formation and repair rely on specific combinations of transcription factors, growth factors, and mechanical parameters that regulate the production and spatial organization of type I collagen. Here, we investigated the function of the zinc finger transcription factor EGR1 in tendon formation, healing, and repair using rodent animal models and mesenchymal stem cells (MSCs). Adult tendons of Egr1–/– mice displayed a deficiency in the expression of tendon genes, including Scx, Col1a1, and Col1a2, and were mechanically weaker compared with their WT littermates. EGR1 was recruited to the Col1a1 and Col2a1 promoters in postnatal mouse tendons in vivo. Egr1 was required for the normal gene response following tendon injury in a mouse model of Achilles tendon healing. Forced Egr1 expression programmed MSCs toward the tendon lineage and promoted the formation of in vitro–engineered tendons from MSCs. The application of EGR1-producing MSCs increased the formation of tendon-like tissues in a rat model of Achilles tendon injury. We provide evidence that the ability of EGR1 to promote tendon differentiation is partially mediated by TGF-β2. This study demonstrates EGR1 involvement in adult tendon formation, healing, and repair and identifies Egr1 as a putative target in tendon repair strategies. PMID:23863709

  7. 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.

  8. Morphometric analyses of normal pediatric brachial biceps and quadriceps muscle tissue

    National Research Council Canada - National Science Library

    Sallum, Adriana M E; Varsani, Hemlata; Holton, Janice L; Marie, Suely K N; Wedderburn, Lucy R

    2013-01-01

    Pediatric normal brachial biceps (14 specimens) and quadriceps muscles (14 specimens) were studied by immunohistochemistry to quantify fiber-type, diameter and distribution, capillary density, presence of inflammatory cells...

  9. Biceps Femoris Aponeurosis Size: A Potential Risk Factor for Strain Injury?

    National Research Council Canada - National Science Library

    EVANGELIDIS, PAVLOS E; MASSEY, GARRY J; PAIN, MATTHEW T G; FOLLAND, JONATHAN P

    2015-01-01

    PURPOSEA disproportionately small biceps femoris long head (BFlh) proximal aponeurosis has been suggested as a risk factor for hamstring strain injury by concentrating mechanical strain on the surrounding muscle tissue...

  10. 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...

  11. 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.

  12. Triple extensor digiti minimi tendon: An anatomic variation

    OpenAIRE

    Elif Sari

    2014-01-01

    This case report describes an unusual variation of the extensor digiti minimi tendon discovered during extensor tendon repair in the emergency room. Knowledge of this variation may be helpful for the tendon transfers and tendon surgery that need tendon graft. [Hand Microsurg 2014; 3(2.000): 56-58

  13. Anatomic variance of the iliopsoas tendon.

    Science.gov (United States)

    Philippon, Marc J; Devitt, Brian M; Campbell, Kevin J; Michalski, Max P; Espinoza, Chris; Wijdicks, Coen A; Laprade, Robert F

    2014-04-01

    The iliopsoas tendon has been implicated as a generator of hip pain and a cause of labral injury due to impingement. Arthroscopic release of the iliopsoas tendon has become a preferred treatment for internal snapping hips. Traditionally, the iliopsoas tendon has been considered the conjoint tendon of the psoas major and iliacus muscles, although anatomic variance has been reported. The iliopsoas tendon consists of 2 discrete tendons in the majority of cases, arising from both the psoas major and iliacus muscles. Descriptive laboratory study. Fifty-three nonmatched, fresh-frozen, cadaveric hemipelvis specimens (average age, 62 years; range, 47-70 years; 29 male and 24 female) were used in this study. The iliopsoas muscle was exposed via a Smith-Petersen approach. A transverse incision across the entire iliopsoas musculotendinous unit was made at the level of the hip joint. Each distinctly identifiable tendon was recorded, and the distance from the lesser trochanter was recorded. The prevalence of a single-, double-, and triple-banded iliopsoas tendon was 28.3%, 64.2%, and 7.5%, respectively. The psoas major tendon was consistently the most medial tendinous structure, and the primary iliacus tendon was found immediately lateral to the psoas major tendon within the belly of the iliacus muscle. When present, an accessory iliacus tendon was located adjacent to the primary iliacus tendon, lateral to the primary iliacus tendon. Once considered a rare anatomic variant, the finding of ≥2 distinct tendinous components to the iliacus and psoas major muscle groups is an important discovery. It is essential to be cognizant of the possibility that more than 1 tendon may exist to ensure complete release during endoscopy. Arthroscopic release of the iliopsoas tendon is a well-accepted surgical treatment for iliopsoas impingement. The most widely used site for tendon release is at the level of the anterior hip joint. The findings of this novel cadaveric anatomy study suggest that

  14. 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.

  15. Light microscopic histology of quadriceps tendon ruptures.

    Science.gov (United States)

    Maffulli, Nicola; Del Buono, Angelo; Spiezia, Filippo; Longo, Umile Giuseppe; Denaro, Vincenzo

    2012-11-01

    To assess histological changes and possible differences in the quadriceps of patients undergoing open repair of the tendon after spontaneous rupture, and subjects with no history of tendon pathology. Biopsies were harvested from the quadriceps tendon of 46 patients (34 men, 12 women) who had reported unilateral atraumatic quadriceps tendon rupture and had undergone surgical repair of the tendon. Samples were also harvested from both the tendons in 11 (N = 11 × 2) patients, nine males and two females, dying from cardiovascular disorders. For each tendon, three slides were randomly selected and examined under light microscopy, and assessed using a semiquantitative grading scale (range 0-21) which considers fibre structure, fibre arrangement, rounding of the nuclei, regional variations in cellularity, increased vascularity, decreased collagen stainability, and hyalinisation. The pathological sum-score averaged 19.2 ± 3.7 in ruptured tendons and 5.6 ± 2.0 in controls, and all variables considered were significantly different between the two groups, showing an association between tendon abnormalities and rupture (0.05 tendons increases the risk of rupture.

  16. Informing tendon tissue engineering with embryonic development

    Science.gov (United States)

    Glass, Zachary A.; Schiele, Nathan R.; Kuo, Catherine K.

    2014-01-01

    Tendon is a strong connective tissue that transduces muscle-generated forces into skeletal motion. In fulfilling this role, tendons are subjected to repeated mechanical loading and high stress, which may result in injury. Tissue engineering with stem cells offers the potential to replace injured/damaged tissue with healthy, new living tissue. Critical to tendon tissue engineering is the induction and guidance of stem cells towards the tendon phenotype. Typical strategies have relied on adult tissue homeostatic and healing factors to influence stem cell differentiation, but have yet to achieve tissue regeneration. A novel paradigm is to use embryonic developmental factors as cues to promote tendon regeneration. Embryonic tendon progenitor cell differentiation in vivo is regulated by a combination of mechanical and chemical factors. We propose that these cues will guide stem cells to recapitulate critical aspects of tenogenesis and effectively direct the cells to differentiate and regenerate new tendon. Here, we review recent efforts to identify mechanical and chemical factors of embryonic tendon development to guide stem/progenitor cell differentiation toward new tendon formation, and discuss the role this work may have in the future of tendon tissue engineering. PMID:24484642

  17. Informing tendon tissue engineering with embryonic development.

    Science.gov (United States)

    Glass, Zachary A; Schiele, Nathan R; Kuo, Catherine K

    2014-06-27

    Tendon is a strong connective tissue that transduces muscle-generated forces into skeletal motion. In fulfilling this role, tendons are subjected to repeated mechanical loading and high stress, which may result in injury. Tissue engineering with stem cells offers the potential to replace injured/damaged tissue with healthy, new living tissue. Critical to tendon tissue engineering is the induction and guidance of stem cells towards the tendon phenotype. Typical strategies have relied on adult tissue homeostatic and healing factors to influence stem cell differentiation, but have yet to achieve tissue regeneration. A novel paradigm is to use embryonic developmental factors as cues to promote tendon regeneration. Embryonic tendon progenitor cell differentiation in vivo is regulated by a combination of mechanical and chemical factors. We propose that these cues will guide stem cells to recapitulate critical aspects of tenogenesis and effectively direct the cells to differentiate and regenerate new tendon. Here, we review recent efforts to identify mechanical and chemical factors of embryonic tendon development to guide stem/progenitor cell differentiation toward new tendon formation, and discuss the role this work may have in the future of tendon tissue engineering.

  18. Surgical repair of acute Achilles tendon rupture with an end-to-end tendon suture and tendon flap.

    Science.gov (United States)

    Corradino, B; Di Lorenzo, S; Calamia, C; Moschella, F

    2015-08-01

    Achilles tendon ruptures are becoming more common. Complications after open or minimally invasive surgery are: recurrent rupture (2-8%), wound breakdown, deep infections, granuloma, and fistulas. The authors expose their experience with a personal technique. In 8 patients with acute rupture of Achilles tendon the surgery was performed at least 25 days after trauma. Clinical exam and MR demonstrated in all case a total lesion of tendon. After a posterolateral skin incision the tendon stumps were debrided and suture in end-to-end fashion. A tendon flap was harvested from the proximal part of the tendon, in order to protect and reinforce the suture itself. A plaster cast was applied for 3 weeks and the patients started the rehabilitation protocol. After 4 months all patients returned to pre-injury daily activities. The mean follow up was 13 months (ranged between 6 and 24 months). No major complications occurred. The posterolateral skin incision, not above the tendon, preserves the vascularity of the soft tissues, allows identifying and not accidentally injuring the sural nerve, and prevents the cutaneous scar is overlapped the tendon. In this way is favoured physiological tendon sliding. The preparation of the flap tendon does not weaken the overall strength of the tendon and protects the tendon suture. The tension on sutured stumps is less than being spread over a larger area. In our sample of 8 patients the absence of short-and long-term complications and the rapid functional recovery after surgery suggest that the technique used is safe and effective. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    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.

  1. Inflation in the light of BICEP2 and PLANCK

    Indian Academy of Sciences (India)

    Subhendra Mohanty

    2016-02-01

    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 (∼10−3). We survey the generalizations of the Starobinsky–Higgs models which would allow larger values ( ∼ 0.1). The Starobinsky–Higgs inflation models require an exponential potential which can be naturally derived from SUGRA models. We show that a variation of the no-scale SUGRA model can give rise to the generalized Starobinsky models which give large . We also examine non-standard boundary conditions which would allow a large deviation of the tensor spectral index from the slow roll values and propose that the presence of a thermal component in the tensor spectrum arises from Gibbons–Hawking temperature of the de-Sitter space.

  2. Axion cold dark matter in view of BICEP2 results.

    Science.gov (United States)

    Gondolo, Paolo; Visinelli, Luca

    2014-07-04

    The properties of axions that constitute 100% of cold dark matter (CDM) depend on the tensor-to-scalar ratio r at the end of inflation. If r=0.20(-0.05)(+0.07) as reported by the BICEP2 Collaboration, then "half" of the CDM axion parameter space is ruled out. Namely, in the context of single-field slow-roll inflation, for axions to be 100% of the CDM, the Peccei-Quinn symmetry must be broken after the end of inflation, so that axion nonadiabatic primordial fluctuations are compatible with observational constraints. The cosmic axion density is then independent of the tensor-to-scalar ratio r, and the axion mass is expected to be in a narrow range that, however, depends on the cosmological model before primordial nucleosynthesis. In the standard Lambda CDM cosmology, the CDM axion mass range is ma=(71±2  μeV)(αdec+1)6/7, where αdec is the fractional contribution to the cosmic axion density from decays of axionic strings and walls.

  3. Reconstructing the local potential of inflation with BICEP2 data

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Yin-Zhe [Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC, V6T 1Z1 Canada (Canada); Wang, Yi, E-mail: mayinzhe@phas.ubc.ca, E-mail: yw366@cam.ac.uk [Centre for Theoretical Cosmology, DAMTP, University of Cambridge, Wilberforce Rd, Cambridge, CB3 0WA U.K. (United Kingdom)

    2014-09-01

    We locally reconstruct the inflationary potential by using the current constraints on r and n{sub s} from BICEP2 data. Assuming small and negligible α{sub s}, the inflationary potential is approximately linear in Δφ∼ M{sub pl} range but becomes non-linear in Δφ∼ 10 M{sub pl} range. However if we vary the value of α{sub s} within the range given by constraints from Planck measurement, the local reconstruction is only valid in the range of Δφ∼ 0.4 M{sub pl}, which challenges the inflationary background from the point of view of effective field theory. We show that, within the range of Δ φ ∼ 0.4 M{sub pl}, the inflation potential can be precisely reconstructed. With the current reconstruction, we show that V(φ) ∼ φ{sup 2} and φ{sup 3} are consistent, while φ model is ruled out by 95% confidence level of the reconstructed range of potential. This sets up a strong limit of large-field inflation models.

  4. Axion cold dark matter in view of BICEP2 results

    CERN Document Server

    Visinelli, L

    2014-01-01

    The properties of axions that constitute 100% of cold dark matter (CDM) depend on the tensor-to-scalar ratio $r$ at the end of inflation. If $r=0.20^{+0.07}_{-0.05}$ as reported by the BICEP2 collaboration, then ``half'' of the CDM axion parameter space is ruled out. Namely, the Peccei-Quinn symmetry must be broken after the end of inflation, and axions do not generate non-adiabatic primordial fluctuations. The cosmic axion density is then independent of the tensor-to-scalar ratio $r$, and the axion mass is expected to be in a narrow range that however depends on the cosmological model before primordial nucleosynthesis. In the standard $\\Lambda$CDM cosmology, the CDM axion mass range is $m_a = \\left(71 \\pm 2\\right) \\mu{\\rm eV} \\, (\\alpha^{\\rm dec}+1)^{6/7}$, where $\\alpha^{\\rm dec}$ is the fractional contributions to the cosmic axion density from decays of axionic strings and walls.

  5. Biceps instability and Slap type II tear in overhead athletes.

    Science.gov (United States)

    Osti, Leonardo; Soldati, Francesco; Cheli, Andrea; Pari, Carlotta; Massari, Leo; Maffulli, Nicola

    2012-10-01

    Type II lesions are common lesions encountered in overhead athletes with controversies arising in term of timing for treatment, surgical approach, rehabilitation and functional results. The aim of our study was to evaluate the outcomes of arthroscopic repair of type II SLAP tears in overhead athletes, focusing on the time elapsed from diagnosis and treatment, time needed to return to sport, rate of return to sport and to previous level of performance, providing an overview concerning evidence for the effectiveness of different surgical approaches to type II SLAP tears in overhead athletes. A internet search on peer reviewed Journal from 1990, first descriprion of this pathology, to 2012, have been conducted evaluating the outcomes for both isolated Slap II tear overhead athletes and those who presented associated lesions treated. The results have been analyzed according to the scale reported focusing on return to sport and level of activity. Apart from a single study, non prospective level I and II studies were detected. Return to play at the same level ranged form 22% to 94% with different range of technique utilized with the majority of the authors recommending the fixation of these lesions but biceps tenodesis can lead to higher satisfaction racte when directly compated to the anchor fixation. Associated pathologies such as partial or full tickness rotator cuff tear did not clearly affect the outcomes and complications rate. There is no consensus regarding timing and treatment for type II SLAP, especially in overhead athletes who need to regain a high level of performance.

  6. 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...

  7. Multiple tendons of abductor pollicis longus

    Directory of Open Access Journals (Sweden)

    Mansur DI

    2010-02-01

    Full Text Available Anatomic variations of the tendons of the abductor pollicis longus (APL and its knowledge is important to assess the diseased and traumatized hand and when considering tendons for repair or graft. During routine dissection of a 63-year-old male cadaver, in the Department of Anatomy, Kasturba Medical College, Mangalore, Karnataka, India we came across an unusual APL in the right upper limb. The muscle had altogether 9 tendons and they were inserted to the lateral and anterolateral sides of the base of the 1st metacarpal bone, opponens pollicis (two tendons each, the abductor pollicis brevis, trapezium and thenar fascia (one tendon each. The number of accessory tendons of APL has functional significance in the development of de Quervain’s syndrome.

  8. Investigating tendon mineralisation in the avian hindlimb: a model for tendon ageing, injury and disease.

    Science.gov (United States)

    Agabalyan, Natacha A; Evans, Darrell J R; Stanley, Rachael L

    2013-09-01

    Mineralisation of the tendon tissue has been described in various models of injury, ageing and disease. Often resulting in painful and debilitating conditions, the processes underlying this mechanism are poorly understood. To elucidate the progression from healthy tendon to mineralised tendon, an appropriate model is required. In this study, we describe the spontaneous and non-pathological ossification and calcification of tendons of the hindlimb of the domestic chicken (Gallus gallus domesticus). The appearance of the ossified avian tendon has been described previously, although there have been no studies investigating the developmental processes and underlying mechanisms leading to the ossified avian tendon. The tissue and cells from three tendons - the ossifying extensor and flexor digitorum longus tendons and the non-ossifying Achilles tendon - were analysed for markers of ageing and mineralisation using histology, immunohistochemistry, cytochemistry and molecular analysis. Histologically, the adult tissue showed a loss of healthy tendon crimp morphology as well as markers of calcium deposits and mineralisation. The tissue showed a lowered expression of collagens inherent to the tendon extracellular matrix and presented proteins expressed by bone. The cells from the ossified tendons showed a chondrogenic and osteogenic phenotype as well as tenogenic phenotype and expressed the same markers of ossification and calcification as the tissue. A molecular analysis of the gene expression of the cells confirmed these results. Tendon ossification within the ossified avian tendon seems to be the result of an endochondral process driven by its cells, although the roles of the different cell populations have yet to be elucidated. Understanding the role of the tenocyte within this tissue and the process behind tendon ossification may help us prevent or treat ossification that occurs in injured, ageing or diseased tendon. © 2013 Anatomical Society.

  9. Quadriceps tendon allografts as an alternative to Achilles tendon allografts: a biomechanical comparison.

    Science.gov (United States)

    Mabe, Isaac; Hunter, Shawn

    2014-12-01

    Quadriceps tendon with a patellar bone block may be a viable alternative to Achilles tendon for anterior cruciate ligament reconstruction (ACL-R) if it is, at a minimum, a biomechanically equivalent graft. The objective of this study was to directly compare the biomechanical properties of quadriceps tendon and Achilles tendon allografts. Quadriceps and Achilles tendon pairs from nine research-consented donors were tested. All specimens were processed to reduce bioburden and terminally sterilized by gamma irradiation. Specimens were subjected to a three phase uniaxial tension test performed in a custom environmental chamber to maintain the specimens at a physiologic temperature (37 ± 2 °C) and misted with a 0.9 % NaCl solution. There were no statistical differences in seven of eight structural and mechanical between the two tendon types. Quadriceps tendons exhibited a significantly higher displacement at maximum load and significantly lower stiffness than Achilles tendons. The results of this study indicated a biomechanical equivalence of aseptically processed, terminally sterilized quadriceps tendon grafts with bone block to Achilles tendon grafts with bone block. The significantly higher displacement at maximum load, and lower stiffness observed for quadriceps tendons may be related to the failure mode. Achilles tendons had a higher bone avulsion rate than quadriceps tendons (86 % compared to 12 %, respectively). This was likely due to observed differences in bone block density between the two tendon types. This research supports the use of quadriceps tendon allografts in lieu of Achilles tendon allografts for ACL-R.

  10. Investigating tendon mineralisation in the avian hindlimb: a model for tendon ageing, injury and disease

    Science.gov (United States)

    Agabalyan, Natacha A; Evans, Darrell J R; Stanley, Rachael L

    2013-01-01

    Mineralisation of the tendon tissue has been described in various models of injury, ageing and disease. Often resulting in painful and debilitating conditions, the processes underlying this mechanism are poorly understood. To elucidate the progression from healthy tendon to mineralised tendon, an appropriate model is required. In this study, we describe the spontaneous and non-pathological ossification and calcification of tendons of the hindlimb of the domestic chicken (Gallus gallus domesticus). The appearance of the ossified avian tendon has been described previously, although there have been no studies investigating the developmental processes and underlying mechanisms leading to the ossified avian tendon. The tissue and cells from three tendons – the ossifying extensor and flexor digitorum longus tendons and the non-ossifying Achilles tendon – were analysed for markers of ageing and mineralisation using histology, immunohistochemistry, cytochemistry and molecular analysis. Histologically, the adult tissue showed a loss of healthy tendon crimp morphology as well as markers of calcium deposits and mineralisation. The tissue showed a lowered expression of collagens inherent to the tendon extracellular matrix and presented proteins expressed by bone. The cells from the ossified tendons showed a chondrogenic and osteogenic phenotype as well as tenogenic phenotype and expressed the same markers of ossification and calcification as the tissue. A molecular analysis of the gene expression of the cells confirmed these results. Tendon ossification within the ossified avian tendon seems to be the result of an endochondral process driven by its cells, although the roles of the different cell populations have yet to be elucidated. Understanding the role of the tenocyte within this tissue and the process behind tendon ossification may help us prevent or treat ossification that occurs in injured, ageing or diseased tendon. PMID:23826786

  11. Extensor tendon repair an overview

    Directory of Open Access Journals (Sweden)

    Mansoor Bin Fayed

    2015-04-01

    Full Text Available The incidence of extensor injuries is more than that of flexor tendon injuries. This is to a great extent because of the extensors being superficially placed and covered by skin and subcutaneous tissue over the distal part of the upper extremity. Thus they are more vulnerable to blunt and sharp trauma, the proximal and distal forearm present with laceration and cut with sharp weapon. Extensor tendon injuries are often taken lightly by many, repairs being taken-up at the ER. Repair is done in or if the retrieval of tendon ends is difficult or the wound is complicated with associated injuries such as fractures or in cases of tendon retraction. Delayed primary repair can be undertaken from 7-10 days. Assessment of the injured finger has to be very meticulous. Extension of finger is brought about by the interossei and lumbricals which are the short muscles of the hand. They extend the proximal interphalangeal joints and distal interphalangeal joints and flex metacarpophalangeal joint, these intrinsic muscles are innervated by the ulnar and median nerves. The long extensors are innervated by the radial nerve, they primarily extend the metacarpophalangeal joints and also interphalangeal joints. In cases of injury the intrinsic system may compensate for an extensor deficit. Closed injuries of zone I may be managed by splinting of the distal interphalangeal joints and open injuries in the zone I and II can be treated with tenodermodesis. Proximal interphalangeal joints and distal interphalangeal joints are immobilized in zone 3 and 4. Metacarpophalangeal joint is immobilized in full extension and the wrist in 10o extension.

  12. 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.

  13. Achilles tendon rupture; assessment of nonoperative treatment

    DEFF Research Database (Denmark)

    Barfod, Kristoffer Weisskirchner

    2014-01-01

    BACKGROUND: Acute Achilles tendon rupture is a frequent and potentially disabling injury. Over the past decade a change in treatment of acute Achilles tendon rupture away from operative towards non-operative treatment has taken place. However, the optimal non-operative treatment protocol remains...... and Sweden. Immediate weight-bearing was found to be safe and recommendable in non-operative treatment of acute Achilles tendon rupture. The novel ultrasound measurement showed excellent reliability and acceptable validity and agreement....

  14. Achilles tendon rupture; assessment of nonoperative treatment

    DEFF Research Database (Denmark)

    Barfod, Kristoffer Weisskirchner; Troelsen, Anders

    2014-01-01

    BACKGROUND: Acute Achilles tendon rupture is a frequent and potentially disabling injury. Over the past decade a change in treatment ofacute Achilles tendon rupture away from operative towards non-operative treatment has taken place. However, the optimal non-operative treatment protocol remains...... and Sweden. Immediate weight-bearing was found to be safe and recommendable in non-operative treatment of acute Achilles tendon rupture. The novel ultrasound measurement showed excellent reliability and acceptable validity and agreement....

  15. 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

    OpenAIRE

    RI Barbosa; GOES, R; Mazzer,N; MCR Fonseca

    2008-01-01

    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 musc...

  16. sEMG Signal Changes During Isometric Contraction of the Biceps Brachii to Fatigue%等长负荷诱发肱二头肌疲劳过程中sEMG信号变化

    Institute of Scientific and Technical Information of China (English)

    扬丹

    2000-01-01

    本研究比较了等长负荷诱发肱二头肌疲劳过程中sEMG信号时域和频域指标变化的特异性、有效性和可靠性.研究发现:(1) 频域指标在肌肉疲劳过程中均呈明显的直线递减型变化,而时域指标的变化则有较大的变异;(2) 频域指标时间序列曲线的斜率不受受试者皮下脂肪厚度和肢体围度的影响,而时域指标则易受影响;(3) 频域指标时间序列曲线的斜率与负荷持续时间明显相关,而时域指标的相关不明显.研究结果表明sEMG频域指标反映肌肉疲劳的效果优于时域指标.

  17. Lubricin Surface Modification Improves Tendon Gliding After Tendon Repair in a Canine Model in Vitro

    Science.gov (United States)

    Taguchi, Manabu; Sun, Yu-Long; Zhao, Chunfeng; Zobitz, Mark E.; Cha, Chung-Ja; Jay, Gregory D.; An, Kai-Nan; Amadio, Peter C.

    2011-01-01

    This study investigated the effects of lubricin on the gliding of repaired flexor digitorum profundus (FDP) tendons in vitro. Canine FDP tendons were completely lacerated, repaired with a modified Pennington technique, and treated with one of the following solutions: saline, carbodiimide derivatized gelatin/hyaluronic acid (cd-HA-gelatin), carbodiimide derivatized gelatin to which lubricin was added in a second step (cd-gelatin + lubricin), or carbodiimide derivatized gelatin/HA + lubricin (cd-HA-gelatin + lubricin). After treatment, gliding resistance was measured up to 1,000 cycles of simulated flexion/extension motion. The increase in average and peak gliding resistance in cd-HA-gelatin, cd-gelatin + lubricin, and cd-HA-gelatin + lubricin tendons was less than the control tendons after 1,000 cycles (p < 0.05). The increase in average gliding resistance of cd-HA-gelatin + lubricin treated tendons was also less than that of the cd-HA-gelatin treated tendons (p < 0.05). The surfaces of the repaired tendons and associated pulleys were assessed qualitatively with scanning electron microscopy and appeared smooth after 1,000 cycles of tendon motion for the cd-HA-gelatin, cd-gelatin + lubricin, and cd-HA-gelatin + lubricin treated tendons, while that of the saline control appeared roughened. These results suggest that tendon surface modification can improve tendon gliding ability, with a trend suggesting that lubricin fixed on the repaired tendon may provide additional improvement over that provided by HA and gelatin alone. PMID:18683890

  18. Quadriceps tendon rupture - treatment results

    Directory of Open Access Journals (Sweden)

    Popov Iva

    2013-01-01

    Full Text Available Introduction. Quadriceps tendon rupture is a rare but rather serious injury. If this injury is not promptly recognized and early operated, it may lead to disability. This research was aimed at pointing out the results and complications of the quadriceps tendon rupture surgical treatment. Material and Methods. This retrospective multicentric study was conducted in a group of 29 patients (mostly elderly men. Lysholm knee scoring scale was used to evaluate the surgical results. The post-operative results were compared in relation to the type of tendon rupture reconstructions (acute or chronic, various surgical techniques, type of injuries (unilateral or bilateral as well as the presence or absence of comorbid risk factors in the patients. Results. The average value of a Lysholm score was 87.6. Excellent and satisfactory Lysholm score results dominated in our sample of patients. Better post-operative results were recorded in the group of patients without risk factors, in case of a bilateral injury, and in case of an acute injury. The best result was obtained after performing the reconstruction using anchors, and the worst result came after using Codivilla technique. Discussion and Conclusion. Early diagnosis and surgical treatment are an absolute imperative in management of this injury. We have not proven that a certain surgical technique has an advantage over the others. A comorbid risk factor is related to a lower Lysholm score. Despite a few cases of complications, we can conclude that the surgical treatment yields satisfactory results.

  19. Quadriceps and patellar tendon ruptures.

    Science.gov (United States)

    Lee, Dennis; Stinner, Daniel; Mir, Hassan

    2013-10-01

    The diagnosis of quadriceps and patellar tendon ruptures requires a high index of suspicion and thorough history-taking to assess for medical comorbidities that may predispose patients to tendon degeneration. Radiographic assessment with plain films supplemented by ultrasound and magnetic resonance imaging when the work-up is equivocal further aids diagnosis; however, advanced imaging is often unnecessary in patients with functional extensor mechanism deficits. Acute repair is preferred, and transpatellar bone tunnels serve as the primary form of fixation when the tendon rupture occurs at the patellar insertion, with or without augmentation depending on surgeon preference. Chronic tears and disruptions following total knee arthroplasty are special cases requiring reconstructions with allograft, synthetic mesh, or autograft. Rehabilitation protocols generally allow immediate weight-bearing with the knee locked in extension and crutch support. Limited arc motion is started early with active flexion and passive extension and then advanced progressively, followed by full active range of motion and strengthening. Complications are few but include quadriceps atrophy, knee stiffness, and rerupture. Outcomes are excellent if repair is done acutely, with poorer outcomes associated with delayed repair.

  20. Outcome of quadriceps tendon repair.

    Science.gov (United States)

    Puranik, Gururaj S; Faraj, Adnan

    2006-04-01

    Complete rupture of the quadriceps tendon is a well-described injury. There is a scarcity of literature relating to the outcome of patients with this injury after surgery. We undertook a retrospective analysis of patients who had surgical repair of their quadriceps tendon at our institution over a 13-year period, totalling 21 patients. Males were more commonly affected, with a male/female ratio of 4:1. The peak incidence was in the sixth decade of life. Assessment consisted of the completion of a functional knee questionnaire and a clinical examination. Symptomatic outcome following surgical repair was good with a mean symptom score generated of 19.16 out of a maximum of 25 using the Rougraff et al scoring system. Most of the patients returned to their pre-injury level of activity. Five degrees deficit and extension lag was present in three patients; these patients had the quadriceps repaired using transosseous sutures. Patients who had direct repair of the tendon using the Bunnell technique had lower Rougraff scores than the rest.

  1. Technique for and an anatomic guide to forearm tendon repair.

    Science.gov (United States)

    Burnham, Jeremy M; Hollister, Anne M; Rush, David A; Avallone, Thomas J; Shi, Runhua; Jordan, Jenee' C

    2011-06-01

    Forearm lacerations involving muscle bellies are usually treated by repairing muscle fascia. Repair of tendons themselves is stronger and restores normal muscle anatomy better. Tendon repair requires good knowledge of forearm muscle and tendon anatomy. We have made cadaver measurements to produce graphical maps of locations of individual muscles tendons of origin and insertion, some practical guides for finding tendon ends and a simple grasping stitch for intramuscular tendons.

  2. Early diagnosis of tendon pathologies with sonoelastography

    Directory of Open Access Journals (Sweden)

    Zeynep ilerisoy Yakut

    2015-04-01

    RESULTS: Achilles tendon thicknesses measured at three segments (proximal, middle ,distal. did not show any statistically significant difference in both painless and symptomatic side. Proximal part of achilles tendon's elasticity did not show any difference in both side (p=0.31. In middle and distal segment , the elasticity was statistically different in symptomatic side than normal side p=0.005 and p=0.001 respectively. CONCLUSION: Sonoelastographic examination of Achilles tendons in patients with FMF suffering from talalgia may be useful for determining early dejenerative changes in tendons either in the absence of B-mode ultrasound findings. [TAF Prev Med Bull 2015; 14(2.000: 75-80

  3. 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 simulation...... system is based on inverse dynamics, where the redundancy problem is solved by a minimum fatigue criterion guaranteeing maximuminter-muscular collaboration. The tendons are assumed to be linearly elastic. It is concluded that tendon elasticity is responsible for metabolic power loss...

  4. Ultrasonography in traumatic rupture of Schilles tendon

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Kil Ho; Byun, Woo Mok; Lee, Dong Chul; Kim, Se Dong; Park, Bok Hwan [Yeungnam University College of Medicine, Gyeongsan (Korea, Republic of)

    1993-12-15

    Ultrasonography was performed prospectively in 16 patients with suspected rupture of Achilles tendon from March to October 1992 to evaluate the diagnostic value of ultrasonography. Ultrasonography examinations were done according to standard techniques, and then dynamic evaluations were performed during passive plantar flexion of the ankle. We reviewed 10 confirmed cases of ruptured tendons, among which 9 cases were confirmed by operation,and one by ultrasonography and MRI. ultrasonic results were compared with the findings at physical examination and surgery. The normal thickness of the Achilles tendons in healthy sides on ultrasonography ranged from 3 to 5mm.The ruptured tendons were 6-10mm thick at 1-2cm superior to the upper margin of Os Calcis. Rupture sites on ultrasonography were exactly predicted in 7 among the 9 operative cases. In on non-operative case, the rupture site on ultrasonography corresponded to that seen on MRI. Tendon bucking on dynamic ultrasonography was positive in all 4 complete ruptures. In 2 of the 6 partial ruptures which were near complete tears, tendon buckling was also observed. In conclusion, ultrasonography is a valuable diagnostic modality in the diagnosis of Achilles tendon rupture, the differentiation between total and partial rupture, and in determining the rupture site. We consider ultrasonography of tendon as an important diagnostic toot that may guide the treatment plan in the traumatic rupture of the Achilles tendon

  5. 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.

  6. BICEP2 / Keck Array VII: Matrix based E/B Separation applied to BICEP2 and the Keck Array

    CERN Document Server

    Array, Keck; Ade, P; Ahmed, Z; Aikin, R W; Alexander, K D; Barkats, D; Benton, S J; Bischoff, C A; Bock, J J; Bowens-Rubin, R; Brevik, J A; Buder, I; Bullock, E; Buza, V; Connors, J; Crill, B P; Duband, L; Dvorkin, C; Filippini, J P; Fliescher, S; Grayson, J; Halpern, M; Harrison, S; Hildebrandt, S R; Hilton, G C; Hui, H; Irwin, K D; Kang, J; Karkare, K S; Karpel, E; Kaufman, J P; Keating, B G; Kefeli, S; Kernasovskiy, S A; Kovac, J; Kuo, C L; Leitch, E M; Lueker, M; Megerian, K G; Namikawa, T; Netterfield, C B; Nguyen, H T; O'Brient, R; W., R; Orlando, A; Pryke, C; Richter, S; Schwarz, R; Sheehy, C D; Staniszewski, Z K; Steinbach, B; Sudiwala, R V; Teply, G P; Thompson, K L; Tolan, J E; Tucker, C; Turner, A D; Vieregg, A G; Weber, A C; Wiebe, D V; Willmert, J; Wong, C L; Wu, W L; Yoon, K W

    2016-01-01

    A linear polarization field on the sphere can be uniquely decomposed into an E-mode and a B-mode component. These two components are analytically defined in terms of spin-2 spherical harmonics. Maps that contain filtered modes on a partial sky can also be decomposed into E-mode and B-mode components. However, the lack of full sky information prevents orthogonally separating these components using spherical harmonics. In this paper, we present a technique for decomposing an incomplete map into E and B-mode components using E and B eigenmodes of the pixel covariance in the observed map. This method is found to orthogonally define E and B in the presence of both partial sky coverage and spatial filtering. This method has been applied to the BICEP2 and the Keck Array maps and results in reducing E to B leakage from LCDM E-modes to a level corresponding to a tensor-to-scalar ratio of $r<1\\times10^{-4}$.

  7. Foam Rolling of Quadriceps Decreases Biceps Femoris Activation.

    Science.gov (United States)

    Cavanaugh, Mark Tyler; Aboodarda, Saied Jalal; Hodgson, Daniel; Behm, David George

    2016-09-06

    Foam rolling has been shown to increase range of motion without subsequent performance impairments of the rolled muscle, however, there are no studies examining rolling effects on antagonist muscles. The objective of this study was to determine whether foam rolling the hamstrings and/or quadriceps would affect hamstrings and quadriceps activation in men and women. Recreationally active men (n=10, 25 ± 4.6 years, 180.1 ± 4.4 cm, 86.5 ± 15.7 kg) and women (n=8, 21.75 ± 3.2 years, 166.4 ± 8.8 cm, 58.9 ± 7.9 kg) had surface electromyographic activity analyzed in the dominant vastus lateralis (VL), vastus medialis (VM), and biceps femoris (BF) muscles upon a single leg landing from a hurdle jump under four conditions. Conditions included rolling of the hamstrings, quadriceps, both muscle groups and a control session. BF activation significantly decreased following quadriceps foam rolling (F(1,16) = 7.45, p = 0.015, -8.9%). There were no significant changes in quadriceps activation following hamstrings foam rolling. This might be attributed to the significantly greater levels of perceived pain with quadriceps rolling applications (F(1,18) = 39.067, p foam rolling for VL (F(6,30) = 1.31, p = 0.283) VM (F(6,30) = 1.203, p = 0.332) or BF (F(6,36) = 1.703, p = 0.199). Antagonist muscle activation may be altered following agonist foam rolling, however, it can be suggested that any changes in activation are likely a result of reciprocal inhibition due to increased agonist pain perception.

  8. Tendon mineralization is accelerated bilaterally and creep of contralateral tendons is increased after unilateral needle injury of murine achilles tendons.

    Science.gov (United States)

    O'Brien, Etienne John Ogilvy; Shrive, Nigel G; Rosvold, Joshua M; Thornton, Gail M; Frank, Cyril B; Hart, David A

    2013-10-01

    Heterotopic mineralization may result in tendon weakness, but effects on other biomechanical responses have not been reported. We used a needle injury, which accelerates spontaneous mineralization of murine Achilles tendons, to test two hypotheses: that injured tendons would demonstrate altered biomechanical responses; and that unilateral injury would accelerate mineralization bilaterally. Mice underwent left hind (LH) injury (I; n = 11) and were euthanized after 20 weeks along with non-injured controls (C; n = 9). All hind limbs were examined by micro computed tomography followed by biomechanical testing (I = 7 and C = 6). No differences were found in the biomechanical responses of injured tendons compared with controls. However, the right hind (RH) tendons contralateral to the LH injury exhibited greater static creep strain and total creep strain compared with those LH tendons (p ≤ 0.045) and RH tendons from controls (p ≤ 0.043). RH limb lesions of injured mice were three times larger compared with controls (p = 0.030). Therefore, despite extensive mineralization, changes to the responses we measured were limited or absent 20 weeks postinjury. These results also suggest that bilateral occurrence should be considered where tendon mineralization is identified clinically. This experimental system may be useful to study the mechanisms of bilateral new bone formation in tendinopathy and other conditions. Copyright © 2013 Orthopaedic Research Society.

  9. BICEP3: a 95 GHz refracting telescope for degree-scale CMB polarization

    CERN Document Server

    Ahmed, Z; Benton, S J; Bock, J J; Bowens-Rubin, R; Buder, I; Bullock, E; Connors, J; Filippini, J P; Grayson, J A; Halpern, M; Hilton, G C; Hristov, V V; Hui, H; Irwin, K D; Kang, J; Karkare, K S; Karpel, E; Kovac, J M; Kuo, C L; Netterfield, C B; Nguyen, H T; O'Brient, R; Ogburn, R W; Pryke, C; Reintsema, C D; Richter, S; Thompson, K L; Turner, A D; Vieregg, A G; Wu, W L K; Yoon, K W

    2014-01-01

    BICEP3 is a 550 mm-aperture refracting telescope for polarimetry of radiation in the cosmic microwave background at 95 GHz. It adopts the methodology of BICEP1, BICEP2 and the Keck Array experiments - it possesses sufficient resolution to search for signatures of the inflation-induced cosmic gravitational-wave background while utilizing a compact design for ease of construction and to facilitate the characterization and mitigation of systematics. However, BICEP3 represents a significant breakthrough in per-receiver sensitivity, with a focal plane area 5$\\times$ larger than a BICEP2/Keck Array receiver and faster optics ($f/1.6$ vs. $f/2.4$). Large-aperture infrared-reflective metal-mesh filters and infrared-absorptive cold alumina filters and lenses were developed and implemented for its optics. The camera consists of 1280 dual-polarization pixels; each is a pair of orthogonal antenna arrays coupled to transition-edge sensor bolometers and read out by multiplexed SQUIDs. Upon deployment at the South Pole duri...

  10. Masticatory muscle tendon-aponeurosis hyperplasia exhibits heterotopic calcification in tendons.

    Science.gov (United States)

    Sato, T; Hori, N; Nakamoto, N; Akita, M; Yoda, T

    2014-05-01

    Masticatory muscle tendon-aponeurosis hyperplasia is a new disease entity associated with limited mouth opening. In this study, we analyzed the microstructural characteristics of muscles and tendons in masticatory muscle tendon-aponeurosis hyperplasia by electron microscopy and energy-dispersive X-ray analysis to determine the elemental composition. Histological analysis was performed to detect the calcification. Transmission electron microscopy and scanning electron microscopy were conducted to clarify the microstructural characteristics of muscles and tendons. Energy-dispersive X-ray microanalysis was performed to identify the distribution of elements. Mineralized nodules were observed in tendon tissues of masticatory muscle tendon-aponeurosis hyperplasia as compared with facial deformity. Electron microscopy revealed that the muscle and tendon tissues in masticatory muscle tendon-aponeurosis hyperplasia showed degenerative changes and distinctive histological findings as compared with tissues in facial deformity. We found that Ca, P, and Si were detected only in masticatory muscle tendon-aponeurosis hyperplasia. We demonstrated that masticatory muscle tendon-aponeurosis hyperplasia exhibits heterotopic calcification in tendon tissues. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Tensile strength of a weave tendon suture using tendons of different sizes.

    Science.gov (United States)

    Mazurek, Tomasz; Strankowski, Michał; Ceynowa, Marcin; Rocławski, Marek

    2011-05-01

    This study compared the maximum load, stress, elongation at failure and the mode of failure of three kinds of tendons most frequently used for tendon grafting and tendon transfers, using the Pulvertaft weave suture. Sixty tendons were used from fresh human cadaver upper and lower extremities. The performed repairs included: 9 specimens of flexor digitorum superficialis or profundus tendon with flexor digitorum superficialis or profundus tendon (thick-thick suture), 10 specimens of flexor digitorum superficialis or profundus tendon with palmaris longus tendon (thick-medium thin suture), and 10 specimens of flexor digitorum superficialis or profundus tendon with plantaris tendon (thick-thin suture). Material testing machine was used to test repairs to failure. The mean maximum load at failure increased with the thickness of donor tendon. For the thick-thick specimen, the maximum load at failure was 125 newtons (N), for the thick-medium thin specimen it was 86,8N, and for the thick-thin it was 65,2N. These differences were all statistically significant. The active rehabilitation protocol is possible only with thick-thick connections used, the strength of the thick-medium thin connection is on the border of indications for the active rehabilitation protocol, and the thick-thin connection strength is sufficient only for the passive rehabilitation protocol. Copyright © 2010. Published by Elsevier Ltd.

  12. Single-stage reconstruction of flexor tendons with vascularized tendon transfers.

    Science.gov (United States)

    Cavadas, P C; Pérez-García, A; Thione, A; Lorca-García, C

    2015-03-01

    The reconstruction of finger flexor tendons with vascularized flexor digitorum superficialis (FDS) tendon grafts (flaps) based on the ulnar vessels as a single stage is not a popular technique. We reviewed 40 flexor tendon reconstructions (four flexor pollicis longus and 36 finger flexors) with vascularized FDS tendon grafts in 38 consecutive patients. The donor tendons were transferred based on the ulnar vessels as a single-stage procedure (37 pedicled flaps, three free flaps). Four patients required composite tendon and skin island transfer. Minimum follow-up was 12 months, and functional results were evaluated using a total active range of motion score. Multiple linear regression analysis was performed to evaluate the factors that could be associated with the postoperative total active range of motion. The average postoperative total active range of motion (excluding the thumbs) was 178.05° (SD 50°). The total active range of motion was significantly lower for patients who were reconstructed with free flaps and for those who required composite tendon and skin island flap. Age, right or left hand, donor/motor tendon and pulley reconstruction had no linear effect on total active range of motion. Overall results were comparable with a published series on staged tendon grafting but with a lower complication rate. Vascularized pedicled tendon grafts/flaps are useful in the reconstruction of defects of finger flexor tendons in a single stage, although its role in the reconstructive armamentarium remains to be clearly established. © The Author(s) 2014.

  13. 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.

  14. Structure-mechanics relationships in mineralized tendons.

    Science.gov (United States)

    Spiesz, Ewa M; Zysset, Philippe K

    2015-12-01

    In this paper, we review the hierarchical structure and the resulting elastic properties of mineralized tendons as obtained by various multiscale experimental and computational methods spanning from nano- to macroscale. The mechanical properties of mineralized collagen fibres are important to understand the mechanics of hard tissues constituted by complex arrangements of these fibres, like in human lamellar bone. The uniaxial mineralized collagen fibre array naturally occurring in avian tendons is a well studied model tissue for investigating various stages of tissue mineralization and the corresponding elastic properties. Some avian tendons mineralize with maturation, which results in a graded structure containing two zones of distinct morphology, circumferential and interstitial. These zones exhibit different amounts of mineral, collagen, pores and a different mineral distribution between collagen fibrillar and extrafibrillar space that lead to distinct elastic properties. Mineralized tendon cells have two phenotypes: elongated tenocytes placed between fibres in the circumferential zone and cuboidal cells with lower aspect ratios in the interstitial zone. Interestingly some regions of avian tendons seem to be predestined to mineralization, which is exhibited as specific collagen cross-linking patterns as well as distribution of minor tendon constituents (like proteoglycans) and loss of collagen crimp. Results of investigations in naturally mineralizing avian tendons may be useful in understanding the pathological mineralization occurring in some human tendons. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Recent advances in flexor tendon repair

    NARCIS (Netherlands)

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

    1971-01-01

    markdownabstractThe prognosis for restoration of good function after the treatment of a tendon lesion in 'no-man's land' is influenced by a number of factors which may be summarized as follows: - The nature of the injury. - The amplitude of the tendon excursion. - The motility of the

  16. Recent advances in flexor tendon repair

    NARCIS (Netherlands)

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

    1971-01-01

    markdownabstractThe prognosis for restoration of good function after the treatment of a tendon lesion in 'no-man's land' is influenced by a number of factors which may be summarized as follows: - The nature of the injury. - The amplitude of the tendon excursion. - The motility of the hand. -

  17. Rupture of Achilles Tendon : Usefulness of Ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Nam Hyeon; Ki, Won Woo; Yoon, Kwon Ha; Kim, Song Mun; Shin, Myeong Jin [Ulsan Medical College, Ulsan (Korea, Republic of); Kwon, Soon Tae [Chungnam University College of Medicine, Daejeon (Korea, Republic of)

    1996-06-15

    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

  18. Simultaneous and spontaneous bilateral quadriceps tendons rupture.

    Science.gov (United States)

    Celik, Evrim Coşkun; Ozbaydar, Mehmet; Ofluoglu, Demet; Demircay, Emre

    2012-07-01

    Simultaneous and spontaneous bilateral quadriceps tendon rupture is an uncommon injury that is usually seen in association with multiple medical conditions and some medications. We report a case of simultaneous and spontaneous bilateral quadriceps tendon rupture that may be related to the long-term use of a statin.

  19. 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.

  20. Instructive materials for tendon and ligament augmentation

    NARCIS (Netherlands)

    Ribeiro Pereira Simões Crispim, João Francisco

    2016-01-01

    Tendons and ligaments (T/L) are the connective tissue that connect muscles to bone and bone to bone, respectively. The main function of tendons is to translate muscle contractions into join motion and consequently generate movement. Ligaments function to stabilize joints and guide them during their

  1. Duplication of the extensor carpi ulnaris tendon.

    Science.gov (United States)

    Barfred, T; Adamsen, S

    1986-05-01

    Three cases are presented, in which an anomalous tendon slip between the extensor carpi ulnaris tendon and the extensor apparatus of the fifth finger was found. One of the patients was a violinist, who had serious impairment of the left wrist joint and the small finger due to the anomaly. The symptoms disappeared after excision.

  2. 高频超声在肌肉、肌腱损伤中的应用%High Frequency Ultrasound in Muscle,Tendon Injury

    Institute of Scientific and Technical Information of China (English)

    庄艳芳; 庄慧芳

    2015-01-01

    目的:探讨超声在肌肉、肌腱损伤诊疗中的应用价值。方法回顾性分析30例外伤性和运动性所致的四肢肌肉、肌腱损伤患者的超声检查结果。结果10例诊断为单纯性肌腱损伤,3例为股四头肌-腱连接损伤,3例为腓肠肌撕裂,6例为股四头肌撕裂,余下8例为肱二头肌肌肉挫伤。结论超声在四肢肌肉、肌腱损伤的诊断中具有较大的优势,可作为临床诊断肌肉、肌腱损伤和愈合情况检查的首选辅助性检查手段之一。%Objective To investigate the value of ultrasonography in the muscle,tendon injury diagnosis and treatment. Methods A retrospective analysis of limbs,muscle,tendon injury ultrasound results of 30 patients with traumatic and movement caused. Results 10 cases diagnosed as simple tendon injury,three cases of the quadriceps - connecting tendon injury,three cases of gastrocnemius tear,six cases of quadriceps tear,and the remaining eight cases of biceps muscle contusion . Conclusion Ultrasound has a large advantage in the muscle,tendon injury in the diagnosis of the limbs can be used as one of the clinical muscle,tendon damage and healing supplementary examination to check the preferred means of diagnosis.

  3. A CMB B-mode Search with Three Years of BICEP Observations

    Science.gov (United States)

    Bischoff, Colin; BICEP Collaboration

    2013-01-01

    The search for B-mode, or curl-type, polarization in the Cosmic Microwave Background is the most promising technique to constrain or detect primordial gravitational waves predicted by the theory of inflation. The Bicep telescope, which observed from the South Pole for three years from 2006 through 2008, is the first experiment specifically designed to target this signal. We review the observational motivations for inflation, the advantages of B-mode observations as a technique for detecting the gravitational wave background, and the design features of Bicep that optimize it for this search. The final analysis of all three seasons of Bicep data is in progress, representing a 50% increase in integration time compared to the result from Chiang et al. (2010). A preview of the three year result includes E-mode and B-mode maps, as well as the projected constraint on r, the tensor-to-scalar ratio.

  4. Tendon vasculature in health and disease.

    Directory of Open Access Journals (Sweden)

    Herbert eTempfer

    2015-11-01

    Full Text Available Tendons represent a bradytrophic tissue which is poorly vascularized and, compared to bone or skin, heal poorly. Usually, a vascularized connective scar tissue with inferior functional properties forms at the injury site. Whether the increased vascularization is the root cause of tissue impairments such as loss of collagen fibre orientation, ectopic formation of bone, fat or cartilage, or is a consequence of these pathological changes remains unclear. This review provides an overview of the role of tendon vasculature in healthy and chronically diseased tendon tissue as well as its relevance for tendon repair. Further, the nature and the role of perivascular tendon stem/progenitor cells residing in the vascular niche will be discussed and compared to multipotent stromal cells in other tissues.

  5. Simultaneous bilateral patellar tendon rupture without

    Directory of Open Access Journals (Sweden)

    LU Hua-ding

    2012-04-01

    Full Text Available 【Abstract】There is a dearth of case reports de-scribing simultaneous bilateral patellar tendon ruptures in the medical literature. These ruptures are often associated with systemic disorders such as lupus erythematosus or chronic steroid use. The author describes a case of a 24-year-old man who sustained traumatic bilateral patellar ten-don ruptures without any history of systemic disease or steroidal medication. We repaired and reattached the rup-tured tendons to the patella and augmented our procedure with allogeneic tendon followed by wire loop reinforcement. One year after operation, the patient regained a satisfactory range of motion of both knees with good quadriceps strength and no extensor lag. The recurrent microtrauma from a history of intense sports activity and a high body mass index may have played an important role in this trauma event. Key words: Patella; Patellar ligament; Rupture; Ten-don injuries; Knee

  6. Tendon Vasculature in Health and Disease

    Science.gov (United States)

    Tempfer, Herbert; Traweger, Andreas

    2015-01-01

    Tendons represent a bradytrophic tissue which is poorly vascularized and, compared to bone or skin, heal poorly. Usually, a vascularized connective scar tissue with inferior functional properties forms at the injury site. Whether the increased vascularization is the root cause of tissue impairments such as loss of collagen fiber orientation, ectopic formation of bone, fat or cartilage, or is a consequence of these pathological changes remains unclear. This review provides an overview of the role of tendon vasculature in healthy and chronically diseased tendon tissue as well as its relevance for tendon repair. Further, the nature and the role of perivascular tendon stem/progenitor cells residing in the vascular niche will be discussed and compared to multipotent stromal cells in other tissues. PMID:26635616

  7. 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...... 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...... adjacent collagen fascicles in human tendons is small or negligible, suggesting that tendon fascicles largely act as independent structures and that force transmission principally takes place within the individual fascicles....

  8. [Conservative functional treatment of Achilles tendon ruptures].

    Science.gov (United States)

    Hüfner, T; Gaulke, R; Imrecke, J; Krettek, C; Stübig, T

    2010-09-01

    The conservative functional treatment of Achilles tendon ruptures has developed further over the last 20 years and is basically possible for 60-80% of patients. The treatment leads to success if the indications obtained by dynamic sonography are correctly interpreted (adaptation of the tendon ends up to 20 degrees plantar flexion), if the patient presents sufficient compliance and the physiotherapy is increasingly intensified depending on tendon healing. Modern ortheses allow an increased equinus position and therefore improved protection of the healing tendon. If these factors are present a relatively low re-rupture rate of only 7% can be achieved. The decisive advantage of conservative functional therapy is the avoidance of specific operative risks, such as infection and injury to the sural nerve. After removal of the orthesis the tendon should continue to be modeled using shoe insoles and raised heels.

  9. Mactaquac intake tendons removal and replacement

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, I. [NB Power Generation Corp., Mactaquac Generating Station, Keswick Ridge, NB (Canada); Mee, A. [Hatch Energy, Niagara Falls, ON (Canada)

    2007-07-01

    In 1988 and 1989, multi-strand tendons were installed in the intake structure of the Mactaquac generating station. In order to control displacements caused by alkali aggregate reaction (AAR), they were installed in preparation for a slot cutting program in the intake structure to guard against the possibility of a sliding failure of a section of the structure along a plane coincident with the bottom of the water passage. Unique problems for the designers were present in the expansion affect of AAR that were compounded by field conditions that resulted in further difficulties. For example, concrete expansion required the installation of a thick shim pack under the upper anchor head and the periodic testing of the tendons. Once tested, shims could be gradually removed to maintain the correct load over the life of the tendon. However, during the first round of testing and de-stressing five years after the original installation, it was found that some of the tendons had already failed. Over half of the tendons have been replaced in the 20 years since the installation. This paper discussed the original design considerations and examined the conditions that contributed to the premature failure of the tendons. It outlined the history of tendon testing procedures, tendon failure modes and tendon replacement methods. Specifically, the paper discussed the remedial techniques that were employed and the iterations that lead to the current repair approach, while considering the unique field conditions. The application of various corrosion protection schemes and installation and testing methodologies were discussed. It was concluded that tendons were successfully installed in numerous concrete dams around the world but have needed replacement for a variety of reasons. 1 ref., 10 figs.

  10. The Role of Detraining in Tendon Mechanobiology.

    Science.gov (United States)

    Frizziero, Antonio; Salamanna, Francesca; Della Bella, Elena; Vittadini, Filippo; Gasparre, Giuseppe; Nicoli Aldini, Nicolò; Masiero, Stefano; Fini, Milena

    2016-01-01

    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, few data evaluated the importance that cessation of training might have on tendon. Basically, we do not fully understand how tendons react to a phase of training followed by sudden detraining. Therefore, within this review, we summarize the studies where tendon detraining was examined. A descriptive systematic literature review was carried out 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 adopted to remove duplicate articles. An initial literature search yielded 134 references (www.pubmed.org: 53; www.scopus.com: 11; www.webofknowledge.com: 70). Fifteen publications were extracted based on the title for further analysis by two independent reviewers. Abstracts and complete articles were after that reviewed to evaluate if they met inclusion criteria. The revised literature comprised four 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 should be taken with caution, following a targeted rehabilitation

  11. Arthroscopic biceps tenodesis compared with repair of isolated type II SLAP lesions in patients older than 35 years.

    Science.gov (United States)

    Denard, Patrick J; Lädermann, Alexandre; Parsley, B K; Burkhart, Stephen S

    2014-03-01

    This study compared arthroscopic biceps tenodesis with biceps repair for isolated type II superior labrum anterior and posterior (SLAP) lesions in patients older than 35 years. The authors identified isolated type II SLAP lesions that were surgically managed over a 5-year period. Minimum 2-year follow-up data were available for 22 patients who underwent biceps repair (repair group) and for 15 patients who underwent a primary biceps tenodesis (tenodesis group). Mean age at surgery was 45.2±5.5 years in the repair group and 52.0±8.0 years in the tenodesis group. In the repair group, functional outcome improved from baseline to final follow-up using the American Shoulder and Elbow Surgeons (ASES) (47.5 to 87.4, respectively; PSLAP lesion had a shorter postoperative recovery, a more predictable functional outcome, and a higher rate of satisfaction and return to activity with a biceps tenodesis compared with a biceps repair. Based on these observations, biceps tenodesis is preferable to biceps repair for isolated type II SLAP lesions in nonoverhead athletes older than 35 years.

  12. Calcific tendinitis of the biceps-labral complex: a rare cause of acute shoulder pain.

    Science.gov (United States)

    Ji, Jong-Hun; Shafi, Mohamed; Kim, Weon-Yoo

    2008-06-01

    Calcific tendinitis most commonly affects the rotator cuff and has not been previously reported affecting the biceps-labral complex. We report a case of calcific tendinitis of the biceps-labral complex attachment, a rare cause of acute, severe shoulder pain. Clinically, it can be misdiagnosed as supraspinatus tendinitis or septic arthritis of the shoulder joint. Non-operative treatment failed to resolve the symptoms. Arthroscopic debridement of the calcific deposit resulted in resolution of symptoms. Knowledge of this clinical condition and its imaging features is crucial for a correct diagnosis of this uncommon cause of shoulder pain.

  13. Elastographic characteristics of the metacarpal tendons in horses without clinical evidence of tendon injury.

    Science.gov (United States)

    Lustgarten, Meghann; Redding, W Rich; Labens, Raphael; Morgan, Michel; Davis, Weston; Seiler, Gabriela S

    2014-01-01

    Tendon and ligament injuries are common causes of impaired performance in equine athletes. Gray-scale ultrasonography is the current standard method for diagnosing and monitoring these injuries, however this modality only provides morphologic information. Elastography is an ultrasound technique that allows detection and measurement of tissue strain, and may provide valuable mechanical information about equine tendon and ligament injuries. The purpose of this study was to determine the feasibility, reproducibility, and repeatability of elastography; and to describe elastographic characteristics of metacarpal tendons in sound horses. Nineteen legs for 17 clinically sound horses without evidence of musculoskeletal pathology were included. Elastographic images of the superficial and deep digital flexor tendons and the branches of the suspensory ligament (tendon of the interosseous muscle) were described quantitatively and qualitatively. There was no statistically significant difference between operators (P = 0.86) nor within operators (P = 0.93). For qualitative assessments, reproducibility (0.46) was moderate and repeatability (0.78) was good. Similar to human Achilles tendons, equine tendons were classified as predominantly hard using elastography. There was no statistically significant difference in stiffness of the flexor tendons (P = 0.96). No significant difference in stiffness was found with altered leg position during standing (P = 0.84) and while nonweight bearing (P = 0.61). The flexor tendons were softer when imaged in longitudinal versus transverse planes (P tendons and ligaments of the distal forelimb in horses. © 2013 American College of Veterinary Radiology.

  14. Is higher serum cholesterol associated with altered tendon structure or tendon pain? A systematic review

    Science.gov (United States)

    Tilley, Benjamin J; Cook, Jill L; Docking, Sean I; Gaida, James E

    2015-01-01

    Background Tendon pain occurs in individuals with extreme cholesterol levels (familial hypercholesterolaemia). It is unclear whether the association with tendon pain is strong with less extreme elevations of cholesterol. Objective To determine whether lipid levels are associated with abnormal tendon structure or the presence of tendon pain. Methods We conducted a systematic review and meta-analysis. Relevant articles were found through an electronic search of 6 medical databases—MEDLINE, Cochrane, AMED, EMBASE, Web of Science and Scopus. We included all case–control or cross-sectional studies with data describing (1) lipid levels or use of lipid-lowering drugs and (2) tendon structure or tendon pain. Results 17 studies (2612 participants) were eligible for inclusion in the review. People with altered tendon structure or tendon pain had significantly higher total cholesterol, low-density lipoprotein cholesterol and triglycerides, as well as lower high-density lipoprotein cholesterol; with mean difference values of 0.66, 1.00, 0.33, and −0.19 mmol/L, respectively. Conclusions The results of this review indicate that a relationship exists between an individual’s lipid profile and tendon health. However, further longitudinal studies are required to determine whether a cause and effect relationship exists between tendon structure and lipid levels. This could lead to advancement in the understanding of the pathoaetiology and thus treatment of tendinopathy. PMID:26474596

  15. ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: CLINICAL OUTCOMES OF PATELLA TENDON AND HAMSTRING TENDON GRAFTS

    Directory of Open Access Journals (Sweden)

    Dawn T. Gulick

    2002-09-01

    Full Text Available An injury to the ACL can result in significant functional impairment. It has been estimated that more than 100,000 new ACL injuries occur each year. Surgeons employ numerous techniques for reconstruction of the ACL. Of critical importance is the source of the graft to replace the damaged ACL. The graft choices include autografts (the patient's own tissue, allografts (donor tendon, and synthetic/prosthetic ligaments. Tissue harvest sites for autografting include the middle third of the patella tendon, the quadriceps tendon, semitendinosus tendon, gracilis tendon, iliotibial band, tensor fascia lata, and the Achilles tendon. Selection of the type of graft material is predicated upon the tissue's ability to tolerate high levels of stress. Likewise, the clinical presentation and functional outcome is related to the graft material selected. This manuscript specifically examined the patella tendon and hamstring tendon grafts. Numerous manuscripts that studied the outcomes of these graft materials were compiled to help the clinician appreciate the advantages and disadvantages of each of the graft materials. Outcome measures such as thigh circumference, knee range of motion, isokinetic strength, knee stability, pain, and vertical jump/1-leg hop were incorporated. The purpose of this manuscript was to compare and contrast the clinical presentation of patients who underwent an ACL reconstruction using the patella tendon versus the hamstring tendons. This information can be valuable to the clinician when considering the rehabilitation protocol after ACL reconstruction

  16. 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....

  17. 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.

  18. 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

  19. PRP and Metaplasia in repaired tendon

    Institute of Scientific and Technical Information of China (English)

    Kamal Seyed-Forootan; Hamid Karimi; Ahmad-Reza Dayani

    2014-01-01

    Objective:To evaluate effects ofPRP injection in strengthening of repaired tendon.Methods:This study was conducted in animal lab of our hospital on20 rats.The animals were divided into two groups randomly and distal third of leftAchillis tendons were cut and then repaired with Vicryl2/0.The first group was control group and in the second group0.5 cc ofPRP was injected into the repair site.After4 weeks all of the rats were executed and70% of tendons were sent randomly for tensilometry and the force that required to rupture the tendons were measured.In next stage the tendons were sent for pathological exam.Results:The force that was needed to rupture the tendon were not significantly different in the two groups.Neovascularization were more prevalent inPRP group but not statistically significant.There were two cases ofCartilage Metaplasia inPRP group.Conclusion:It seems that usingPRP has no effect on strengthening the tendons repair and may have some adverse effects.It usage needs further studies to evaluate their probable adverse side effects.

  20. Hamstring tendons insertion - an anatomical study

    Directory of Open Access Journals (Sweden)

    Cristiano Antonio Grassi

    2013-09-01

    Full Text Available OBJECTIVE: To study the anatomy of the hamstring tendons insertion and anatomical rela-tionships. METHODS: Ten cadaver knees with medial and anterior intact structures were selected. The dissection was performed from anteromedial access to exposure of the insertion of the flexor tendons (FT, tibial plateau (TP and tibial tuberosity (TT. A needle of 40 × 12 and a caliper were used to measure the distance of the tibial plateau of the knee flexor tendons insertion at 15 mm from the medial border of the patellar tendon and tibial tuberosity to the insertion of the flexor tendons of the knee. The angle between tibial plateau and the insertion of the flexor tendons of the knee (A-TP-FT was calculated using Image Pro Plus software. RESULTS: The mean distance TP-FT was 41 ± 4.6 mm. The distance between the TT-FT was 6.88 ± 1 mm. The (A-TP-FT was 20.3 ± 4.9°. CONCLUSION: In the anterior tibial flexor tendons are about 40 mm from the plateau with an average of 20°.

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

    DEFF Research Database (Denmark)

    Hansen, M.; Kongsgaard, M; Holm, Lars

    2009-01-01

    The knowledge about the effect of estradiol on tendon connective tissue is limited. Therefore, we studied the influence of estradiol on tendon synthesis, structure, and biomechanical properties in postmenopausal women. Nonusers (control, n = 10) or habitual users of oral estradiol replacement...... therapy (ERT, n = 10) were studied at rest and in response to one-legged resistance exercise. Synthesis of tendon collagen was determined by stable isotope incorporation [fractional synthesis rate (FSR)] and microdialysis technique (NH(2)-terminal propeptide of type I collagen synthesis). Tendon area...... 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

  2. Mechanical properties of human patellar tendon at the hierarchical levels of tendon and fibril

    DEFF Research Database (Denmark)

    Svensson, René B; 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......'s modulus was 2.0 ± 0.5 GPa, and the toe region reached 3.3 ± 1.9% strain in whole patellar tendons. Based on dry cross-sectional area, the Young's modulus of isolated collagen fibrils was 2.8 ± 0.3 GPa, and the toe region reached 0.86 ± 0.08% strain. The measured fibril modulus was insufficient to account...

  3. 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......-generating study, a trauma-induced tendon cell activity (increased total RNA and collagen I mRNA) was observed after repeated patellar tendon biopsies in young men. In a subsequent controlled study, 25 young men were treated with two 0.8 mm diameter needle penetrations (n=13, needle-group (NG)) or one 2.1 mm...... diameter needle biopsy (n=12, biopsy-group (BG)) in one patellar tendon. Four weeks later biopsies were taken from treated (5 mm lateral from trauma site) and contralateral tendons for analyses of RNA content (ribogreen assay), DNA content (PCR based), and gene expression for relevant target genes (Real...

  4. Molecular Biology of Flexor Tendon Healing in Relation to Reduction of Tendon Adhesions.

    Science.gov (United States)

    Legrand, Anais; Kaufman, Yoav; Long, Chao; Fox, Paige M

    2017-09-01

    Tendon injuries are encountered after major and minor hand trauma. Despite meticulous repair technique, adhesion formation can occur, limiting recovery. Although a great deal of progress has been made toward understanding the mechanism of tendon healing and adhesions, clinically applicable solutions to prevent adhesions remain elusive. The goal of this paper is to review the most recent literature relating to the tendon healing and adhesion prevention. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  5. [Rotator cuff repair with decellularized tendon slices for enhancing tendon-bone healing in rabbits].

    Science.gov (United States)

    Pan, Juan; Liu, Guoming; Ning, Liangju; Luo, Jingcong; Huang, Fuguo; Qin, Tingwu

    2013-09-01

    To investigate the effect of canine decellularized tendon slices (DTSs) on tendon-bone healing in repairing rotator cuff injury of rabbit. Canine DTSs were prepared by repetitive freeze/thaw 5 times combined with nuclease processing for 12 hours from the adult Beagles Achilles tendons. Histological observation and cytocompatibility evaluation for the canine DTSs were performed in vitro. Twenty-four mature male New Zealand white rabbits, weighing 2.5-3.0 kg, were randomly selected. U-shaped defect of more than 50% of normal tendon in width and 8 mm in length was made in infraspinatus tendons of unilateral limb as the experimental group; the canine DTSs were used to repair defect, and the insertion of infraspinatus tendon on greater tuberosity of humerus was reconstructed in the experimental group. No treatment was done on the contralateral limb as the control group. At 4, 8, and 12 weeks after operation, the specimens were harvested for histological observation and biomechanical test. Histological examination showed that collagen fibers of canine DTSs were well preserved, without residual cells. The cytocompatibility examination showed that fibroblasts attached well to canine DTSs. Biomechanical test showed that the maximum load and stiffness increased significantly with time, and the maximum load and stiffness at 12 weeks were significantly higher than those at 4 and 8 weeks (P tendon-bone insertion. In the experimental group at 4 weeks, the tendon-bone interface was filled with granulation tissue, and a small amount of Sharpey's fibers-like connected the tendon to bone; granulation tissue disappeared, and fibroblasts, Sharpey's fiber, new cartilage, and chondrocytes significantly increased with time; tendon-bone interface became mature, but the tide line was not observed between the unmineralized fibrocartilage and mineralized fibrocartilage. Canine DTSs prepared by repetitive freeze/thaw 5 times combined with nuclease processing for 12 hours, can enhance the

  6. Interference Screw vs. Suture Anchor Fixation for Open Subpectoral Biceps Tenodesis: Does it Matter?

    Directory of Open Access Journals (Sweden)

    Gobezie Reuben

    2008-09-01

    Full Text Available Abstract Background Bioabsorbable interference screw fixation has superior biomechanical properties compared to suture anchor fixation for biceps tenodesis. However, it is unknown whether fixation technique influences clinical results. Hypothesis We hypothesize that subpectoral interference screw fixation offers relevant clinical advantages over suture anchor fixation for biceps tenodesis. Study Design Case Series. Methods We performed a retrospective review of a consecutive series of 88 patients receiving open subpectoral biceps tenodesis with either interference screw fixation (34 patients or suture anchor fixation (54 patients. Average follow up was 13 months. Outcomes included Visual Analogue Pain Scale (0–10, ASES score, modified Constant score, pain at the tenodesis site, failure of fixation, cosmesis, deformity (popeye and complications. Results There were no failures of fixation in this study. All patients showed significant improvement between their preoperative and postoperative status with regard to pain, ASES score, and abbreviated modified Constant scores. When comparing IF screw versus anchor outcomes, there was no statistical significance difference for VAS (p = 0.4, ASES score (p = 0.2, and modified Constant score (P = 0.09. One patient (3% treated with IF screw complained of persistent bicipital groove tenderness, versus four patients (7% in the SA group (nonsignificant. Conclusion Subpectoral biceps tenodesis reliably relieves pain and improves function. There was no statistically significant difference in the outcomes studied between the two fixation techniques. Residual pain at the site of tenodesis may be an issue when suture anchors are used in the subpectoral location.

  7. 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…

  8. BRAIN-STEM INFLUENCES ON BICEPS REFLEX ACTIVITY AND MUSCLE TONE IN THE ANESTHETIZED RAT

    NARCIS (Netherlands)

    JUCH, PJW; SCHAAFSMA, A; VANWILLIGEN, JD

    1992-01-01

    This study analyzes the effect of electrical stimulation of the locus coeruleus (LC) and adjacent brainstem structures on the tonic reflex (TVR), the tonic stretch reflex (TSR) and on muscle tone (MT) in anaesthetized rat. Increases in TVR. TSR and MT of the m. biceps were evoked from regions

  9. Short-latency crossed responses in the human biceps femoris muscle

    DEFF Research Database (Denmark)

    Stevenson, Andrew James Thomas; Kamavuako, Ernest Nlandu; Geertsen, Svend S.

    2015-01-01

    , 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...

  10. 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

    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...

  11. Functionality of the contralateral biceps femoris reflex response during human walking

    DEFF Research Database (Denmark)

    Stevenson, Andrew James Thomas; Geertsen, Svend S.; Sinkjær, Thomas

    2014-01-01

    In this study we examined the functionality of the contralateral biceps femoris (cBF) reflex response following ipsilateral knee extension joint rotations during the late stance phase of the gait cycle [1]. Stevenson et al. [1] proposed that the cBF reflex acts to slow the forward progression...

  12. 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…

  13. Clinical and Sonographic Evaluation of Bicortical Button for Proximal Biceps Tenodesis.

    Science.gov (United States)

    Meadows, James R; Diesselhorst, Matthew M; Finnoff, Jonathan T; Swanson, Britta L; Swanson, Kyle E

    2016-01-01

    Use of a cortical button for proximal biceps tenodesis has demonstrated strength comparable to that of other types of fixation in biomechanical models, but few studies have evaluated the clinical outcome of such fixation. In the study reported here, 18 patients who underwent open subpectoral biceps tenodesis with a bicortical button were assessed, at minimum 12-month follow-up, with the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, a pain scale, physical examination, biceps supination strength testing, and ultrasonographic evaluation (to determine tenodesis integrity and proximity of the button to the axillary nerve). No patient had symptoms of axillary nerve damage, clinical deformity, or tenodesis failure. Mean DASH score was 15.15 (scale range: 0, none to 100, extreme difficulty), and mean pain score was 12.6 (scale range: 0, none to 100, worst pain). Seventy-eight percent of patients had no bicipital groove tenderness, 89% had full elbow range of motion, and 94% had full shoulder range of motion. Mean forearm supination strength of the operated arm (125.04 lb) was significantly (P = .01) less than that of the nonoperated arm (134.39 lb). Mean (SD) distance from button to posterior circumflex humeral artery was 18.17 (9.0) mm. The study results suggest that subpectoral biceps tenodesis with a bicortical button is a safe, stable procedure that results in excellent functional outcomes.

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

    CERN Document Server

    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...

  15. Acute compartment syndrome of the forearm caused by calcific tendinitis of the distal biceps.

    Science.gov (United States)

    Garayoa, Santiago Amillo; Romero-Muñoz, Luis M; Pons-Villanueva, Juan

    2010-12-01

    Acute compartment syndrome of the forearm requires immediate treatment to avoid damage of the soft tissues and a poor functional outcome for the forearm. Muscular and bone lesions are the main causes of acute compartment syndromes. We report a case of acute compartment syndrome of the forearm caused by a calcific tendinitis of the distal biceps.

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

    Energy Technology Data Exchange (ETDEWEB)

    Bamba, Kazuharu [Leading Graduate School Promotion Center, Ochanomizu University, 2-1-1 Ohtsuka, Bunkyo-ku, Tokyo 112-8610 (Japan); Department of Physics, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo 112-8610 (Japan); Nojiri, Shin' ichi [Kobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya University, Nagoya 464-8602 (Japan); Department of Physics, Nagoya University, Nagoya 464-8602 (Japan); Odintsov, Sergei D. [Consejo Superior de Investigaciones Científicas, ICE/CSIC-IEEC, Campus UAB, Facultat de Ciències, Torre C5-Parell-2a pl, E-08193 Bellaterra (Barcelona) (Spain); Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona (Spain); Tomsk State Pedagogical University, 634061 Tomsk (Russian Federation); National Research Tomsk State University, 634050 Tomsk (Russian Federation); King Abdulaziz University, Jeddah (Saudi Arabia)

    2014-10-07

    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.

  17. Traumatic tibialis anterior tendon rupture: treatment with a two-stage silicone tube and an interposition hamstring tendons graft protocol.

    Science.gov (United States)

    Kontogeorgakos, Vasileios; Koutalos, Antonios; Hantes, Michael; Manoudis, Gregory; Badras, Leonidas; Malizos, Konstantinos

    2015-03-01

    A novel technique for managing ruptured tibialis anterior tendon complicated by infection and tendon substance loss in a young adult is described. A two-stage reconstruction technique with a silicon tube and tendon autograft was performed. At first, after local control of the infection, scar excision and placement of a silicone tube was performed. Ten weeks later, ipsilateral hamstrings tendons were harvested and bridged the 7 cm tendon gap. Eighteen months later, the patient has excellent clinical and functional outcome.

  18. Famotidine suppresses osteogenic differentiation of tendon cells in vitro and pathological calcification of tendon in vivo.

    Science.gov (United States)

    Yamamoto, Kenichi; Hojo, Hironori; Koshima, Isao; Chung, Ung-il; Ohba, Shinsuke

    2012-12-01

    Heterotopic ossification or calcification follows any type of musculoskeletal trauma and is known to occur after arthroplasties of hip, knee, shoulder, or elbow; fractures; joint dislocations; or tendon ruptures. Histamine receptor H2 (Hrh2) has been shown to be effective for reducing pain and decreasing calcification in patients with calcifying tendinitis, which suggested that H2 blockers were effective for the treatment of tendon ossification or calcification. However, the detailed mechanisms of its action on tendon remain to be clarified. We investigated the mechanisms underlying H2 blocker-mediated suppression of tendon calcification, with a focus on the direct action of the drug on tendon cells. Famotidine treatment suppressed the mRNA expressions of Col10a1 and osteocalcin, ossification markers, in a tendon-derived cell line TT-D6, as well as a preosteoblastic one MC3T3-E1. Both of the cell lines expressed Hrh2; histamine treatment induced osteocalcin expression in these cells. Famotidine administration suppressed calcification in the Achilles tendon of ttw mice, a mouse model of ectopic ossification. These data suggest that famotidine inhibits osteogenic differentiation of tendon cells in vitro, and this inhibition may underlie the anti-calcification effects of the drug in vivo. This study points to the use of H2 blockers as a promising strategy for treating heterotopic ossification or calcification in tendon, and provides evidence in support of the clinical use of famotidine. Copyright © 2012 Orthopaedic Research Society.

  19. Multi-Layer Electrospun Membrane Mimicking Tendon Sheath for Prevention of Tendon Adhesions

    Directory of Open Access Journals (Sweden)

    Shichao Jiang

    2015-03-01

    Full Text Available Defect of the tendon sheath after tendon injury is a main reason for tendon adhesions, but it is a daunting challenge for the biomimetic substitute of the tendon sheath after injury due to its multi-layer membrane-like structure and complex biologic functions. In this study, a multi-layer membrane with celecoxib-loaded poly(l-lactic acid-polyethylene glycol (PELA electrospun fibrous membrane as the outer layer, hyaluronic acid (HA gel as middle layer, and PELA electrospun fibrous membrane as the inner layer was designed. The anti-adhesion efficacy of this multi-layer membrane was compared with a single-layer use in rabbit flexor digitorum profundus tendon model. The surface morphology showed that both PELA fibers and celecoxib-loaded PELA fibers in multi-layer membrane were uniform in size, randomly arrayed, very porous, and smooth without beads. Multi-layer membrane group had fewer peritendinous adhesions and better gliding than the PELA membrane group and control group in gross and histological observation. The similar mechanical characteristic and collagen expression of tendon repair site in the three groups indicated that the multi-layer membrane did not impair tendon healing. Taken together, our results demonstrated that such a biomimetic multi-layer sheath could be used as a potential strategy in clinics for promoting tendon gliding and preventing adhesion without poor tendon healing.

  20. Transcription factor EGR1 directs tendon differentiation and promotes tendon repair

    National Research Council Canada - National Science Library

    Guerquin, Marie-Justine; Charvet, Benjamin; Nourissat, Geoffroy; Havis, Emmanuelle; Ronsin, Olivier; Bonnin, Marie-Ange; Ruggiu, Mathilde; Olivera-Martinez, Isabel; Robert, Nicolas; Lu, Yinhui; Kadler, Karl E; Baumberger, Tristan; Doursounian, Levon; Berenbaum, Francis; Duprez, Delphine

    2013-01-01

    Tendon formation and repair rely on specific combinations of transcription factors, growth factors, and mechanical parameters that regulate the production and spatial organization of type I collagen...

  1. Assessment of Postoperative Tendon Quality in Patients With Achilles Tendon Rupture Using Diffusion Tensor Imaging and Tendon Fiber Tracking.

    Science.gov (United States)

    Sarman, Hakan; Atmaca, Halil; Cakir, Ozgur; Muezzinoglu, Umit Sefa; Anik, Yonca; Memisoglu, Kaya; Baran, Tuncay; Isik, Cengiz

    2015-01-01

    Although pre- and postoperative imaging of Achilles tendon rupture (ATR) has been well documented, radiographic evaluations of postoperative intratendinous healing and microstructure are still lacking. Diffusion tensor imaging (DTI) is an innovative technique that offers a noninvasive method for describing the microstructure characteristics and organization of tissues. DTI was used in the present study for quantitative assessment of fiber continuity postoperatively in patients with acute ATR. The data from 16 patients with ATR from 2005 to 2012 were retrospectively analyzed. The microstructure of ART was evaluated using tendon fiber tracking, tendon continuity, fractional anisotropy, and apparent diffusion coefficient values by way of DTI. The distal and proximal portions were measured separately in both the ruptured and the healthy extremities of each patient. The mean patient age was 41.56 ± 8.49 (range 26 to 56) years. The median duration of follow-up was 21 (range 6 to 80) months. The tendon fractional anisotropy values of the ruptured Achilles tendon were significantly lower statistically than those of the normal side (p = .001). However, none of the differences between the 2 groups with respect to the distal and proximal apparent diffusion coefficient were statistically significant (p = .358 and p = .899, respectively). In addition, the fractional anisotropy and apparent diffusion coefficient measurements were not significantly different in the proximal and distal regions of the ruptured tendons compared with the healthy tendons. The present study used DTI and fiber tracking to demonstrate the radiologic properties of postoperative Achilles tendons with respect to trajectory and tendinous fiber continuity. Quantifying DTI and fiber tractography offers an innovative and effective tool that might be able to detect microstructural abnormalities not appreciable using conventional radiologic techniques. Copyright © 2015 American College of Foot and Ankle

  2. Converting round tendons to flat tendon constructs: Does the preparation process have an influence on the structural properties?

    Science.gov (United States)

    Domnick, C; Herbort, M; Raschke, M J; Schliemann, B; Siebold, R; Śmigielski, R; Fink, C

    2017-05-01

    The structural properties of hamstring tendon grafts were evaluated in a porcine model, after processing it to a flat shape, to better replace or augment anatomic flat structures (e.g. ACL, MPFL or MCL). In this biomechanical study, porcine flexor tendons were used which have a comparable shape to semitendinosus and gracilis tendons. One part of the tendon was prepared to a flat tendon construct by splitting the tendon longitudinally with a knife to half of the diameter of the tendon. The semi-split tendon was scratched out to a flat shape. The other matched part was tested in its original round shape. The tendons (n = 40) have been fixed in a uniaxial testing machine (Zwick/Roell) by cryo-clamps after preparing the fixed ends by 2-0 polyester sutures (2-0 Ethibond(®) EXCEL, Ethicon, Somerville, NJ). In every specimen, there was a free 60-mm tendon part between both clamps. The tendons have been loaded to failure to evaluate typical biomechanical parameters such as stiffness, yield load and maximum load. No statistically significant differences (n.s.) regarding stiffness, yield load and maximum load between natively round and processed flat tendons could be detected. A prepared flat-shaped tendon does not show any different structural properties compared with an original round tendon. Therefore, a flat tendon seems to be a biomechanical stable graft option for anatomic reconstruction or augmentation of injured natively flat-shaped structures such as MCL, MPFL or ACL.

  3. PRP and Metaplasia in repaired tendon

    Directory of Open Access Journals (Sweden)

    Kamal Seyed-Forootan

    2014-01-01

    Conclusion: It seems that using PRP has no effect on strengthening the tendons repair and may have some adverse effects. It usage needs further studies to evaluate their probable adverse side effects.

  4. Position Control of Tendon-Driven Fingers

    Science.gov (United States)

    Abdallah, Muhammad E.; Platt, Robert, Jr.; Hargrave, B.; Pementer, Frank

    2011-01-01

    Conventionally, tendon-driven manipulators implement some force control scheme based on tension feedback. This feedback allows the system to ensure that the tendons are maintained taut with proper levels of tensioning at all times. Occasionally, whether it is due to the lack of tension feedback or the inability to implement sufficiently high stiffnesses, a position control scheme is needed. This work compares three position controllers for tendon-driven manipulators. A new controller is introduced that achieves the best overall performance with regards to speed, accuracy, and transient behavior. To compensate for the lack of tension feedback, the controller nominally maintains the internal tension on the tendons by implementing a two-tier architecture with a range-space constraint. These control laws are validated experimentally on the Robonaut-2 humanoid hand. I

  5. 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...... before, during and after either experimental Achilles tendon pain or a non-painful control condition. Pain was induced by intratendinous injections of hypertonic saline with isotonic saline injections as control. Joint kinematics, ground reaction force frequency contents and average EMG amplitudes were...... calculated. Results Compared with the control condition experimental Achilles tendon pain reduced the EMG activity in agonistic, synergistic and antagonistic muscles, and increased the ground reaction force frequency content around 10 Hz, during both eccentric and concentric movement phases. Conclusions...

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

    Science.gov (United States)

    ... Preventing Jumper's Knee en español Rodilla de saltador (tendinitis rotuliana) Jumper's knee — also known as patellar tendonitis or patellar tendinopathy — is an inflammation or injury of the patellar ...

  7. Delayed reconstruction of a quadriceps tendon.

    Science.gov (United States)

    Pocock, C A J; Trikha, S P; Bell, J S P

    2008-01-01

    Rupture of the quadriceps tendon is an uncommon injury and rapid diagnosis is important because delay in surgical repair generally is believed to adversely affect outcome. One study of 20 patients suggests repair should be done during the first 48 to 72 hours postinjury to achieve a successful outcome and late repair led to unsatisfactory recovery. Cases of delayed tendon repair have been reported, the longest to our knowledge being 11 months before surgical intervention. We present a case of successful outcome of a quadriceps tendon rupture reconstructed at least 8 years after occurrence and a review of the literature of delayed reconstructions. We show that successful restoration of extensor mechanism function can be achieved several years after tendon rupture.

  8. 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.

  9. Biological Augmentation of Rotator Cuff Tendon Repair

    National Research Council Canada - National Science Library

    Kovacevic, David; Rodeo, Scott A

    2008-01-01

    A histologically normal insertion site does not regenerate following rotator cuff tendon-to-bone repair, which is likely due to abnormal or insufficient gene expression and/or cell differentiation at the repair site...

  10. Achilles tendon rupture; assessment of nonoperative treatment.

    Science.gov (United States)

    Barfod, Kristoffer Weisskirchner

    2014-04-01

    Acute Achilles tendon rupture is a frequent and potentially disabling injury. Over the past decade a change in treatment of acute Achilles tendon rupture away from operative towards non-operative treatment has taken place. However, the optimal non-operative treatment protocol remains to be clarified, particularly the role of weight-bearing during early rehabilitation. Also, there is a need for a clinically applicable and accurate measurement to detect patients in risk of developing Achilles tendon elongation. The aim of this PhD thesis was to evaluate non-operative treatment of acute Achilles tendon rupture. In study I, a cross-sectional survey was performed investigating the chosen treatment protocols across Scandinavia. In study II, the effect of immediate weight-bearing on patient reported and functional outcomes was investigated in a randomized controlled trial (RCT). In study III, the effect of immediate weight-bearing on the biomechanical properties of the plantar flexor muscle-tendon complex was investigated in an RCT. In study IV, validity, reliability and agreement of a novel ultrasound measurement of Achilles tendon length and elongation was tested. Study I found surgery to be the preferred treatment in 83% of departments in Denmark, 92% in Norway, 65% in Sweden, and 30% in Finland (p tendon complex. Study IV showed excellent intra-rater reliability (ICC 0.96, SEM 3.7 mm and MDC 10.3 mm), inter-rater reliability (ICC 0.97, SEM 3.3 mm and MDC 9.3 mm) and validity (measurement error 2%). Treatment algorithms across Scandinavia showed considerable variation, though operative treatment and controlled early weight-bearing was the preferred treatment in Denmark, Norway and Sweden. Immediate weight-bearing was found to be safe and recommendable in non-operative treatment of acute Achilles tendon rupture. The novel ultrasound measurement showed excellent reliability and acceptable validity and agreement.

  11. 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.

  12. Tension Distribution in a Tendon-Driven Robotic Finger

    Science.gov (United States)

    Abdallah, Muhammad E. (Inventor); Platt, Robert (Inventor); Wampler, II, Charles W. (Inventor)

    2013-01-01

    A method is provided for distributing tension among tendons of a tendon-driven finger in a robotic system, wherein the finger characterized by n degrees of freedom and n+1 tendons. The method includes determining a maximum functional tension and a minimum functional tension of each tendon of the finger, and then using a controller to distribute tension among the tendons, such that each tendon is assigned a tension value less than the maximum functional tension and greater than or equal to the minimum functional tension. The method satisfies the minimum functional tension while minimizing the internal tension in the robotic system, and satisfies the maximum functional tension without introducing a coupled disturbance to the joint torques. A robotic system includes a robot having at least one tendon-driven finger characterized by n degrees of freedom and n+1 tendons, and a controller having an algorithm for controlling the tendons as set forth above.

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

    Science.gov (United States)

    Hansen, Mette; Kongsgaard, Mads; Holm, Lars; Skovgaard, Dorthe; Magnusson, S Peter; Qvortrup, Klaus; Larsen, Jytte O; Aagaard, Per; Dahl, Morten; Serup, Annette; Frystyk, Jan; Flyvbjerg, Allan; Langberg, Henning; Kjaer, Michael

    2009-04-01

    The knowledge about the effect of estradiol on tendon connective tissue is limited. Therefore, we studied the influence of estradiol on tendon synthesis, structure, and biomechanical properties in postmenopausal women. Nonusers (control, n = 10) or habitual users of oral estradiol replacement therapy (ERT, n = 10) were studied at rest and in response to one-legged resistance exercise. Synthesis of tendon collagen was determined by stable isotope incorporation [fractional synthesis rate (FSR)] and microdialysis technique (NH(2)-terminal propeptide of type I collagen synthesis). Tendon area 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 < 0.001), whereas no group difference was seen in tendon NH(2)-terminal propeptide of type I collagen synthesis (P = 0.32). In ERT users, positive correlations between serum estradiol (s-estradiol) and tendon synthesis were observed, whereas change in tendon synthesis from rest to exercise was negatively correlated to s-estradiol. Tendon area, fibril density, fibril volume fraction, and fibril mean area did not differ between groups. However, the percentage of medium-sized fibrils was higher in ERT users (P < 0.05), whereas the percentage of large fibrils tended to be greater in control (P = 0.10). A lower Young's modulus (GPa/%) was found in ERT users (P < 0.05). In conclusion, estradiol administration was associated with higher tendon FSR and a higher relative number of smaller fibrils. Whereas this indicates stimulated collagen turnover in the resting state, collagen responses to exercise were negatively associated with s-estradiol. These results indicate a pivotal role for estradiol in maintaining homeostasis of female connective tissue.

  14. Erythropoietin stimulates patellar tendon healing in rats.

    Science.gov (United States)

    Uslu, Mustafa; Kaya, Ertuğrul; Yaykaşlı, Kürşat Oğuz; Oktay, Murat; Inanmaz, Mustafa Erkan; Işık, Cengiz; Erdem, Havva; Erkan, Melih Engin; Kandiş, Hayati

    2015-12-01

    Erythropoietin (EPO), regulating erythropoiesis, is used to provide protective and regenerative activity in non-haematopoietic tissues. There is insufficient knowledge about the role of EPO activity in tendon healing. Therefore, we investigated the effect of EPO treatment on healing in rat patellar tendons. One hundred and twenty-six, four-month-old male Sprague-Dawley rats were randomly assigned to three experimental groups: 1, no treatment; 2, treatment with isotonic saline (NaCl) and 3, treatment with EPO. Each group was randomly subdivided into two groups for sacrifice at three (1a, 2a, 3a) or six weeks (1b, 2b, 3b). Complete incision of the left patellar tendon from the distal patellar pole was performed. We applied body casts for 20 days after the incised edges of the patellar tendon were brought together with a surgical technique. Both legs were harvested and specimens from each group underwent histological, biomechanical, and protein mRNA expression analyses. There were statistically significant differences in the ultimate breaking force between the EPO group and others at both weeks three and six (prats compared to the control groups biomechanically, histopathologically and with tissue protein mRNA expression. This is the first experimental study to analyze the relationship between EPO treatment and the patellar tendon repair process by biomechanical, histopathological, and tendon tissue mRNA expression methodologies. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. TREATMENT OF OLD ACHILLES TENDON RUPTURES

    Directory of Open Access Journals (Sweden)

    N. A. Koryshkov

    2012-01-01

    Full Text Available From 1998 to 2010 32 patients (14 men, 18 women, aged 15-65 years, underwent surgical treatment for old Achilles tendon rupture. In all cases correct diagnosis was made not earlier than 1 month after injury. The importance of clinical Thompson test and sonographic examination for diagnosis of Achilles tendon rupture is underlined. For the restoration of Achilles tendon V-Y plasty was used. Surgery was performed in a period of 1 to 13 months in patients with subcutaneous Achilles tendon ruptures. Follow-up results of patients in the postoperative period ranged from 6 months to 10 years (mean follow-up 1 year 7 months. Date of observation in the postoperative period ranged from 6 months to 19 years. Marginal necrosis wound occurred in 3 (10% patients, re-rupture of the Achilles tendon to tendon suture zone - in one patient, even in one patient on day 14 became infected. Violations of the foot innervation were no detected.

  16. Arthroscopic Quadriceps Tendon Repair: Two Case Reports

    Directory of Open Access Journals (Sweden)

    Hidetomo Saito

    2015-01-01

    Full Text Available Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation. Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury.

  17. Arthroscopic quadriceps tendon repair: two case reports.

    Science.gov (United States)

    Saito, Hidetomo; Shimada, Yoichi; Yamamura, Toshiaki; Yamada, Shin; Sato, Takahiro; Nozaka, Koji; Kijima, Hiroaki; Saito, Kimio

    2015-01-01

    Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation). Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA) Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight t