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Sample records for muscles tendons bones

  1. The Masticatory Contractile Load Induced Expression and Activation of Akt1/PKBα in Muscle Fibers at the Myotendinous Junction within Muscle-Tendon-Bone Unit

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    Yüksel Korkmaz

    2010-01-01

    Full Text Available The cell specific detection of enzyme activation in response to the physiological contractile load within muscle-tendon-bone unit is essential for understanding of the mechanical forces transmission from muscle cells via tendon to the bone. The hypothesis that the physiological mechanical loading regulates activation of Akt1/PKBα at Thr308 and at Ser473 in muscle fibers within muscle-tendon-bone unit was tested using quantitative immunohistochemistry, confocal double fluorescence analysis, and immunoblot analysis. In comparison to the staining intensities in peripheral regions of the muscle fibers, Akt1/PKBα was detected with a higher staining intensity in muscle fibers at the myotendinous junction (MTJ areas. In muscle fibers at the MTJ areas, Akt1/PKBα is dually phosphorylated at Thr308 and Ser473. The immunohistochemical results were confirmed by immunoblot analysis. We conclude that contractile load generated by masticatory muscles induces local domain-dependent expression of Akt1/PKBα as well as activation by dually phosphorylation at Thr308 and Ser473 in muscle fibers at the MTJ areas within muscle-tendon-bone unit.

  2. Reversibility of Supraspinatus Muscle Atrophy in Tendon-Bone Healing After Arthroscopic Rotator Cuff Repair.

    Science.gov (United States)

    Park, Yong Bok; Ryu, Ho Young; Hong, Jin Ho; Ko, Young Hoo; Yoo, Jae Chul

    2016-04-01

    To date, there are few reports of the definite reversibility of rotator cuff muscle atrophy after repair. To evaluate the reversibility of rotator cuff muscle atrophy after successful arthroscopic repair. Case series; Level of evidence, 4. Included in this study were 47 patients (mean age, 61.2 ± 7.3 years; range, 49-73 years) who underwent arthroscopic rotator cuff repair as well as magnetic resonance imaging (MRI) preoperatively and at 6-month and last follow-up. Patients who had confirmed rotator cuff healing (grades 1-3 according to the Sugaya classification) on both series of postoperative MRI were enrolled in the study. The mean time from the onset of symptoms to surgery was 24.7 ± 25.6 months (range, 3-120 months). The minimum follow-up was 2 years, and the mean follow-up duration was 41.8 ± 14.4 months. Serial changes in the supraspinatus muscle area on the most matching MRI scans (sagittal-oblique view) were evaluated. The area was measured by 2 independent observers. Both independent observers reported no significant difference in the area of the supraspinatus muscle between the preoperative time point and 6-month follow-up (observer 1: P = .135; observer 2: P = .189). However, there was a significant difference between the 6-month and last follow-up (mean, 41.8 months; observers 1 and 2: P .999) or from 6-month to final follow-up (P = .077). After successful arthroscopic rotator cuff repair, there was a slight (11.3%-13.9%) increase in muscle volume from preoperatively to final follow-up, as seen on serial MRI. Fatty infiltration according to the Goutallier grade was not reversed (P = .077). Some reversibility of supraspinatus muscle atrophy may exist in tendon-bone healing after arthroscopic rotator cuff repair; further follow-up is needed to better elucidate this result. © 2016 The Author(s).

  3. An artificial tendon with durable muscle interface.

    Science.gov (United States)

    Melvin, Alan; Litsky, Alan; Mayerson, Joel; Witte, David; Melvin, David; Juncosa-Melvin, Natalia

    2010-02-01

    A coupling mechanism that can permanently fix a forcefully contracting muscle to a bone anchor or any totally inert prosthesis would meet a serious need in orthopaedics. Our group developed the OrthoCoupler device to satisfy these demands. The objective of this study was to test OrthoCoupler's performance in vitro and in vivo in the goat semitendinosus tendon model. For in vitro evaluation, 40 samples were fatigue-tested, cycling at 10 load levels, n = 4 each. For in vivo evaluation, the semitendinosus tendon was removed bilaterally in eight goats. Left sides were reattached with an OrthoCoupler, and right sides were reattached using the Krackow stitch with #5 braided polyester sutures. Specimens were harvested 60 days postsurgery and assigned for biomechanics and histology. Fatigue strength of the devices in vitro was several times the contractile force of the semitendinosus muscle. The in vivo devices were built equivalent to two of the in vitro devices, providing an additional safety factor. In strength testing at necropsy, suture controls pulled out at 120.5 +/- 68.3 N, whereas each OrthoCoupler was still holding after the muscle tore, remotely, at 298 +/- 111.3 N (mean +/- SD) (p < 0.0003). Muscle tear strength was reached with the fiber-muscle composite produced in healing still soundly intact. This technology may be of value for orthopaedic challenges in oncology, revision arthroplasty, tendon transfer, and sports-injury reconstruction. (c) 2009 Orthopaedic Research Society.

  4. An Artificial Tendon with Durable Muscle Interface

    OpenAIRE

    Melvin, Alan; Litsky, Alan; Mayerson, Joel; Witte, David; Melvin, David; Juncosa-Melvin, Natalia

    2010-01-01

    A coupling mechanism that can permanently fix a forcefully contracting muscle to a bone anchor or any totally inert prosthesis would meet a serious need in orthopaedics. Our group developed the OrthoCoupler™ device to satisfy these demands. The objective of this study was to test OrthoCoupler’s performance in vitro and in vivo in the goat semitendinosus tendon model. For in vitro evaluation, 40 samples were fatigue-tested, cycling at 10 load levels, n=4 each. For in vivo evaluation, the semit...

  5. Biology and augmentation of tendon-bone insertion repair

    OpenAIRE

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

    2010-01-01

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

  6. Extracellular matrix adaptation of tendon and skeletal muscle to exercise

    DEFF Research Database (Denmark)

    Kjaer, Michael; Magnusson, Peter; Krogsgaard, Michael

    2006-01-01

    The extracellular matrix (ECM) of connective tissues enables linking to other tissues, and plays a key role in force transmission and tissue structure maintenance in tendons, ligaments, bone and muscle. ECM turnover is influenced by physical activity, and both collagen synthesis and metalloprotease......-beta and IL-6 is enhanced following exercise. For tendons, metabolic activity (e.g. detected by positron emission tomography scanning), circulatory responses (e.g. as measured by near-infrared spectroscopy and dye dilution) and collagen turnover are markedly increased after exercise. Tendon blood flow...... is regulated by cyclooxygenase-2 (COX-2)-mediated pathways, and glucose uptake is regulated by specific pathways in tendons that differ from those in skeletal muscle. Chronic loading in the form of physical training leads both to increased collagen turnover as well as to some degree of net collagen synthesis...

  7. Fetal development of the pulley for muscle insertion tendons: A review and new findings related to the tensor tympani tendon.

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    Rodríguez-Vázquez, Jose Francisco; Honkura, Yohei; Katori, Yukio; Murakami, Gen; Abe, Hiroshi

    2017-01-01

    The existence of hard tissue pulleys that act to change the direction of a muscle insertion tendon is well known in the human body. These include (1) the trochlea for the extraocular obliquus superior muscle, (2) the pterygoid hamulus for the tensor veli palatini muscle, (3) the deep sulcus on the plantar aspect of the cuboid bone for the peroneus longus tendon, (4) the lesser sciatic notch for the obturator internus muscle, and (5) the bony trochleariformis process for the tensor tympani muscle tendon. In addition, (6) the stapedius muscle tendon shows a lesser or greater angulation at the pyramidal eminence of the temporal bone. Our recent studies have shown that the development of pulleys Nos. 1 and 2 can be explained by a change in the topographical relationship between the pulley and the tendon, that of pulley No. 3 by the rapidly growing calcaneus pushing the tendon, and that of pulley No. 4 by migration of the insertion along the sciatic nerve and gluteus medius tendon. Therefore, in Nos. 1-4, an initially direct tendon curves secondarily and obtains an attachment to the pulley. In case No. 6, the terminal part of the stapedius tendon originates secondarily from the interzone mesenchymal tissue of the incudostapedial joint. In the case of pulley No. 5, we newly demonstrated that its initial phase of development was similar to No. 6, but the tensor tympani tendon achieved a right-angled turn under guidance by a specific fibrous tissue and it migrated along the growing malleus manubrium. Copyright © 2016 Elsevier GmbH. All rights reserved.

  8. Ultrasound diagnostics of muscle and tendon injuries

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    Stević Ruža

    2009-01-01

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

  9. Mechanical Coupling between Muscle-Tendon Units Reduces Peak Stresses

    NARCIS (Netherlands)

    Maas, Huub; Finni, Taija

    2018-01-01

    The presence of mechanical linkages between synergistic muscles and their common tendons may distribute forces among the involved structures. We review studies, using humans and other animals, examining muscle and tendon interactions and discuss the hypothesis that connections between muscle bellies

  10. Tendon Transfer Surgery

    Science.gov (United States)

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

  11. Corticospinal excitability changes following prolonged muscle tendon vibration

    NARCIS (Netherlands)

    Steyvers, M.; Levin, O.; Baelen, M.G.M. van; Swinnen, S.P.

    2003-01-01

    The present experiment addressed the time course of corticospinal excitability changes following interventional muscle tendon vibration. Using transcranial magnetic stimulation, motor evoked potentials of the flexor carpi radialis and extensor carpi radialis brevis muscle were recorded for a period

  12. Biology and augmentation of tendon-bone insertion repair

    Directory of Open Access Journals (Sweden)

    Lui PPY

    2010-08-01

    Full Text Available Abstract Surgical reattachment of tendon and bone such as in rotator cuff repair, patellar-patella tendon repair and anterior cruciate ligament (ACL reconstruction often fails due to the failure of regeneration of the specialized tissue ("enthesis" which connects tendon to bone. Tendon-to-bone healing taking place between inhomogenous tissues is a slow process compared to healing within homogenous tissue, such as tendon to tendon or bone to bone healing. Therefore special attention must be paid to augment tendon to bone insertion (TBI healing. Apart from surgical fixation, biological and biophysical interventions have been studied aiming at regeneration of TBI healing complex, especially the regeneration of interpositioned fibrocartilage and new bone at the healing junction. This paper described the biology and the factors influencing TBI healing using patella-patellar tendon (PPT healing and tendon graft to bone tunnel healing in ACL reconstruction as examples. Recent development in the improvement of TBI healing and directions for future studies were also reviewed and discussed.

  13. Structural and Ultrastructural Characteristics of Bone-Tendon Junction of the Calcaneal Tendon of Adult and Elderly Wistar Rats

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    Cury, Diego Pulzatto; Dias, Fernando José; Miglino, Maria Angélica; Watanabe, Ii-sei

    2016-01-01

    Tendons are transition tissues that transfer the contractile forces generated by the muscles to the bones, allowing movement. The region where the tendon attaches to the bone is called bone-tendon junction or enthesis and may be classified as fibrous or fibrocartilaginous. This study aims to analyze the collagen fibers and the cells present in the bone-tendon junction using light microscopy and ultrastructural techniques as scanning electron microscopy and transmission electron microscopy. Forty male Wistar rats were used in the experiment, being 20 adult rats at 4 months-old and 20 elderly rats at 20 months-old. The hind limbs of the rats were removed, dissected and prepared to light microscopy, transmission electron microscopy and scanning electron microscopy. The aging process showed changes in the collagen fibrils, with a predominance of type III fibers in the elderly group, in addition to a decrease in the amount of the fibrocartilage cells, fewer and shorter cytoplasmic processes and a decreased synthetic capacity due to degradation of the organelles involved in synthesis. PMID:27078690

  14. Structural and Ultrastructural Characteristics of Bone-Tendon Junction of the Calcaneal Tendon of Adult and Elderly Wistar Rats.

    Directory of Open Access Journals (Sweden)

    Diego Pulzatto Cury

    Full Text Available Tendons are transition tissues that transfer the contractile forces generated by the muscles to the bones, allowing movement. The region where the tendon attaches to the bone is called bone-tendon junction or enthesis and may be classified as fibrous or fibrocartilaginous. This study aims to analyze the collagen fibers and the cells present in the bone-tendon junction using light microscopy and ultrastructural techniques as scanning electron microscopy and transmission electron microscopy. Forty male Wistar rats were used in the experiment, being 20 adult rats at 4 months-old and 20 elderly rats at 20 months-old. The hind limbs of the rats were removed, dissected and prepared to light microscopy, transmission electron microscopy and scanning electron microscopy. The aging process showed changes in the collagen fibrils, with a predominance of type III fibers in the elderly group, in addition to a decrease in the amount of the fibrocartilage cells, fewer and shorter cytoplasmic processes and a decreased synthetic capacity due to degradation of the organelles involved in synthesis.

  15. Comparison of a novel bone-tendon allograft with a human dermis-derived patch for repair of chronic large rotator cuff tears using a canine model.

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    Smith, Matthew J; Cook, James L; Kuroki, Keiichi; Jayabalan, Prakash S; Cook, Cristi R; Pfeiffer, Ferris M; Waters, Nicole P

    2012-02-01

    This study tested a bone-tendon allograft versus human dermis patch for reconstructing chronic rotator cuff repair by use of a canine model. Mature research dogs (N = 15) were used. Radiopaque wire was placed in the infraspinatus tendon (IST) before its transection. Three weeks later, radiographs showed IST retraction. Each dog then underwent 1 IST treatment: debridement (D), direct repair of IST to bone with a suture bridge and human dermis patch augmentation (GJ), or bone-tendon allograft (BT) reconstruction. Outcome measures included lameness grading, radiographs, and ultrasonographic assessment. Dogs were killed 6 months after surgery and both shoulders assessed biomechanically and histologically. BT dogs were significantly (P = .01) less lame than the other groups. BT dogs had superior bone-tendon, tendon, and tendon-muscle integrity compared with D and GJ dogs. Biomechanical testing showed that the D group had significantly (P = .05) more elongation than the other groups whereas BT had stiffness and elongation characteristics that most closely matched normal controls. Radiographically, D and GJ dogs showed significantly more retraction than BT dogs (P = .003 and P = .045, respectively) Histologically, GJ dogs had lymphoplasmacytic infiltrates, tendon degeneration and hypocellularity, and poor tendon-bone integration. BT dogs showed complete incorporation of allograft bone into host bone, normal bone-tendon junctions, and well-integrated allograft tendon. The bone-tendon allograft technique re-establishes a functional IST bone-tendon-muscle unit and maintains integrity of repair in this model. Clinical trials using this bone-tendon allograft technique are warranted. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  16. Vibration sensitivity of human muscle spindles and Golgi tendon organs.

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    Fallon, James B; Macefield, Vaughan G

    2007-07-01

    The responses of the various muscle receptors to vibration are more complicated than a naïve categorization into stretch (muscle spindle primary ending), length (muscle spindle secondary endings), and tension (Golgi tendon organs) receptors. To emphasize the similarity of responses to small length changes, we recorded from 58 individual muscle afferents subserving receptors in the ankle or toe dorsiflexors of awake human subjects (32 primary endings, 20 secondary endings, and six Golgi tendon organs). Transverse sinusoidal vibration was applied to the distal tendon of the receptor-bearing muscle, while subjects either remained completely relaxed or maintained a weak isometric contraction of the appropriate muscle. In relaxed muscle, few units responded in a 1:1 manner to vibration, and there was no evidence of a preferred frequency of activation. In active muscle the response profiles of all three receptor types overlapped, with no significant difference in threshold between receptor types. These results emphasize that when intramuscular tension increases during a voluntary contraction, Golgi tendon organs and muscle spindle secondary endings, not just muscle spindle primary endings, can effectively encode small imposed length changes.

  17. A Tendon Cell Specific RNAi Screen Reveals Novel Candidates Essential for Muscle Tendon Interaction.

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    Prabhat Tiwari

    Full Text Available Tendons are fibrous connective tissue which connect muscles to the skeletal elements thus acting as passive transmitters of force during locomotion and provide appropriate body posture. Tendon-derived cues, albeit poorly understood, are necessary for proper muscle guidance and attachment during development. In the present study, we used dorsal longitudinal muscles of Drosophila and their tendon attachment sites to unravel the molecular nature of interactions between muscles and tendons. We performed a genetic screen using RNAi-mediated knockdown in tendon cells to find out molecular players involved in the formation and maintenance of myotendinous junction and found 21 candidates out of 2507 RNAi lines screened. Of these, 19 were novel molecules in context of myotendinous system. Integrin-βPS and Talin, picked as candidates in this screen, are known to play important role in the cell-cell interaction and myotendinous junction formation validating our screen. We have found candidates with enzymatic function, transcription activity, cell adhesion, protein folding and intracellular transport function. Tango1, an ER exit protein involved in collagen secretion was identified as a candidate molecule involved in the formation of myotendinous junction. Tango1 knockdown was found to affect development of muscle attachment sites and formation of myotendinous junction. Tango1 was also found to be involved in secretion of Viking (Collagen type IV and BM-40 from hemocytes and fat cells.

  18. Press-fit Femoral Fixation in ACL Reconstruction using Bone-Patellar Tendon-Bone Graft

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    Kaseb Mohammad Hasan

    2009-05-01

    Full Text Available Bone-patellar tendon auto graft is probably the most widely used graft for ACL reconstruction. Several methods for graft fixation have been described. To avoid intra-articular hardware we adopt biological fixation with a femoral trapezoidal press-fit fixation. A prospective study was performed on 30 consecutive active people who underwent ACL reconstruction with this technique by two surgeons between september2004 and march2007 (mean follow-up 15.2 months. Results were evaluated by an independent examiner using radiography, subjective and objective evaluation. Assessment using the IKDC knee scoring revealed 92% of the patients with a normal or nearly normal knee joint. Lysholm's score was 63.6(40- 86 preoperatively and 91.88(73-100 at the latest follow up (P < 0.005. No patient complained of instability at latest follow up. The quadriceps muscle showed mild atrophy at 3 and 6 months and at final follow-up. Five Patients complained of anterior knee pain and had a positive kneeling test. We found no graft displacement on follow up radiographs. All cases showed radiological evidence of graft osteointegration at last follow up. Our results show that press-fit fixation of trapezoidal bone graft in femoral tunnel is a simple, reliable, and cost-effective alternative for ACL recon-struction using bone-patellar tendon-bone graft.

  19. Avulsion of subscapularis muscle tendon leading to recurrent ...

    African Journals Online (AJOL)

    The dislocation was found to be due to a complete tear of the subscapularis tendon (12 patients) and partial tears in three patients, without fracture of the lesser tuberosity in any of the patients. The repair consisted of mobilisation of the subscapularis muscle and its reinsertion into an osseous trough created in the humerus.

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

    Science.gov (United States)

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

    2011-09-01

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

  1. The development and morphogenesis of the tendon-to-bone insertion What development can teach us about healing

    Science.gov (United States)

    Thomopoulos, Stavros; Genin, Guy M.; Galatz, Leesa M.

    2013-01-01

    The attachment of dissimilar materials is a major challenge because of the high levels of stress that develop at such interfaces. An effective solution to this problem develops at the attachment of tendon (a compliant “soft tissue”) to bone (a stiff “hard tissue”). This tissue, the “enthesis”, transitions from tendon to bone through gradations in structure, composition, and mechanical properties. These gradations are not regenerated during tendon-to-bone healing, leading to a high incidence of failure after surgical repair. Understanding the development of the enthesis may allow scientists to develop treatments that regenerate the natural tendon-to-bone insertion. Recent work has demonstrated that both biologic and mechanical factors drive the development and morphogenesis of the enthesis. A cascade of biologic signals similar to those seen in the growth plate promotes mineralization of cartilage on the bony end of the enthesis and the formation of fibrocartilage on the tendon end of the enthesis. Mechanical loading is also necessary for the development of the enthesis. Removal of muscle load impairs the formation of bone, fibrocartilage, and tendon at the developing enthesis. This paper reviews recent work on the development of the enthesis, with an emphasis on the roles of biologic and mechanical factors. PMID:20190378

  2. Tendon Reattachment to Bone in an Ovine Tendon Defect Model of Retraction Using Allogenic and Xenogenic Demineralised Bone Matrix Incorporated with Mesenchymal Stem Cells.

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    Tanujan Thangarajah

    Full Text Available Tendon-bone healing following rotator cuff repairs is mainly impaired by poor tissue quality. Demineralised bone matrix promotes healing of the tendon-bone interface but its role in the treatment of tendon tears with retraction has not been investigated. We hypothesized that cortical demineralised bone matrix used with minimally manipulated mesenchymal stem cells will result in improved function and restoration of the tendon-bone interface with no difference between xenogenic and allogenic scaffolds.In an ovine model, the patellar tendon was detached from the tibial tuberosity and a complete distal tendon transverse defect measuring 1 cm was created. Suture anchors were used to reattach the tendon and xenogenic demineralised bone matrix + minimally manipulated mesenchymal stem cells (n = 5, or allogenic demineralised bone matrix + minimally manipulated mesenchymal stem cells (n = 5 were used to bridge the defect. Graft incorporation into the tendon and its effect on regeneration of the enthesis was assessed using histomorphometry. Force plate analysis was used to assess functional recovery.Compared to the xenograft, the allograft was associated with significantly higher functional weight bearing at 6 (P = 0.047, 9 (P = 0.028, and 12 weeks (P = 0.009. In the allogenic group this was accompanied by greater remodeling of the demineralised bone matrix into tendon-like tissue in the region of the defect (p = 0.015, and a more direct type of enthesis characterized by significantly more fibrocartilage (p = 0.039. No failures of tendon-bone healing were noted in either group.Demineralised bone matrix used with minimally manipulated mesenchymal stem cells promotes healing of the tendon-bone interface in an ovine model of acute tendon retraction, with superior mechanical and histological results associated with use of an allograft.

  3. The arrangement of muscle fibers and tendons in two muscles used for growth studies.

    OpenAIRE

    Stickland, N C

    1983-01-01

    The arrangement of muscle fibres and tendons was examined in the soleus muscle of rats from 6 to 175 days post partum. The muscle was seen to change from a simple structure, with mean fibre length of approximately 90% of complete muscle length, to a unipennate structure, with mean fibre length of only about 60% of muscle length. The dog pectineus muscle was also investigated and found to have a bipennate structure throughout postnatal growth. The arrangement of muscle fibres in both these mus...

  4. Rat rotator cuff muscle responds differently from hindlimb muscle to a combined tendon-nerve injury.

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    Davies, Michael R; Ravishankar, Bharat; Laron, Dominique; Kim, Hubert T; Liu, Xuhui; Feeley, Brian T

    2015-07-01

    Rotator cuff tears (RCTs) are among the most common musculoskeletal injuries seen by orthopaedic surgeons. Clinically, massive cuff tears lead to unique pathophysiological changes in rotator cuff muscle, including atrophy, and massive fatty infiltration, which are rarely seen in other skeletal muscles. Studies in a rodent model for RCT have demonstrated that these histologic findings are accompanied by activation of the Akt/mammalian target of rapamycin (mTOR) and transforming growth factor-β (TGF-β) pathways following combined tendon-nerve injury. The purpose of this study was to compare the histologic and molecular features of rotator cuff muscle and gastrocnemius muscle--a major hindlimb muscle, following combined tendon-nerve injury. Six weeks after injury, the rat gastrocnemius did not exhibit notable fatty infiltration compared to the rotator cuff. Likewise, the adipogenic markers SREBP-1 and PPARγ as well as the TGF-β canonical pathway were upregulated in the rotator cuff, but not the gastrocnemius. Our study suggests that the rat rotator cuff and hindlimb muscles differ significantly in their response to a combined tendon-nerve injury. Clinically, these findings highlight the unique response of the rotator cuff to injury, and may begin to explain the poor outcomes of massive RCTs compared to other muscle-tendon injuries. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  5. The arrangement of muscle fibers and tendons in two muscles used for growth studies.

    Science.gov (United States)

    Stickland, N C

    1983-01-01

    The arrangement of muscle fibres and tendons was examined in the soleus muscle of rats from 6 to 175 days post partum. The muscle was seen to change from a simple structure, with mean fibre length of approximately 90% of complete muscle length, to a unipennate structure, with mean fibre length of only about 60% of muscle length. The dog pectineus muscle was also investigated and found to have a bipennate structure throughout postnatal growth. The arrangement of muscle fibres in both these muscles is such that it might be difficult (particularly in the older animals) to cut a transverse section through all the fibres contained in the muscle; some fibres might not enter the plane of section. Results on muscle fibre number in these muscles at different ages may therefore be misleading.

  6. Piezoelectricity and absorption of water in biomaterials: bone and tendon

    International Nuclear Information System (INIS)

    Ghilardi Netto, T.

    1973-01-01

    A new application of the Fabry-Perot interferometer has been developed, capable of measuring variations in length with a precision of the order of one angstrom. The method has been applied to the determination of some of the inverse piezoelectric coefficients of bovine bone and tendon. The effect of water in these materials was carefully measured and shown to decrease the piezoelectricity. Correlations between the piezoelectricity and length, weight, and volume and surface resistivity were made during the absorption of water [pt

  7. Achilles Tendon Rupture

    Science.gov (United States)

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

  8. Muscle-tendon-related abnormalities detected by ultrasonography are common in symptomatic hip dysplasia

    DEFF Research Database (Denmark)

    Jacobsen, Julie Sandell; Bolvig, Lars; Hölmich, Per

    2018-01-01

    INTRODUCTION: Hip dysplasia is characterized by reduced acetabular coverage of the femoral head leading to an increased mechanical load on the hip joint and the acting hip muscles. Potentially, the muscles and tendons functioning close to the hip joint may present with overuse......-related ultrasonography findings. The primary aim was to report the prevalence of muscle-tendon-related abnormalities detected by ultrasonography in 100 patients with symptomatic hip dysplasia. The secondary aim was to investigate correlations between muscle-tendon-related abnormalities detected by ultrasonography......-tendon-related abnormalities detected by ultrasonography in the hip and groin region are common in patients with symptomatic hip dysplasia, and the ultrasonography findings of the iliopsoas and gluteus medius/minimus tendons are weakly to moderately correlated to pain related to muscles and tendons in these structures. Both...

  9. Effect of administration of oral contraceptives in vivo on collagen synthesis in tendon and muscle connective tissue in young women

    DEFF Research Database (Denmark)

    Hansen, M; Miller, B F; Holm, L

    2009-01-01

    concentrations of estradiol and progesterone (control, n = 12). Subjects performed 1 h of one-legged kicking exercise. The next day collagen fractional synthesis rates (FSR) in tendon and muscle connective tissue were measured after a flooding dose of [(13)C]proline followed by biopsies from the patellar tendon......, body composition, and exercise-training status were included. The two groups were either habitual users of oral contraceptives exposed to a high concentration of synthetic estradiol and progestogens (OC, n = 11), or non-OC-users tested in the follicular phase of the menstrual cycle characterized by low...... bioavailability of IGF-I in OC. In conclusion, synthetic female sex hormones administered as OC had an inhibiting effect on collagen synthesis in tendon, bone, and muscle connective tissue, which may be related to a lower bioavailability of IGF-I....

  10. TGIF1 Gene Silencing in Tendon-Derived Stem Cells Improves the Tendon-to-Bone Insertion Site Regeneration

    Directory of Open Access Journals (Sweden)

    Liyang Chen

    2015-11-01

    Full Text Available Background/Aims: The slow healing process of tendon-to-bone junctions can be accelerated via implanted tendon-derived stem cells (TDSCs with silenced transforming growth interacting factor 1 (TGIF1 gene. Tendon-to-bone insertion site is the special form of connective tissues derivatives of common connective progenitors, where TGF-β plays bidirectional effects (chondrogenic or fibrogenic through different signaling pathways at different stages. A recent study revealed that TGF-β directly induces the chondrogenic gene Sox9. However, TGIF1 represses the expression of the cartilage master Sox9 gene and changes its expression rate against the fibrogenesis gene Scleraxis (Scx. Methods: TGIF1 siRNA was transduced or TGIF1 was over-expressed in tendon-derived stem cells. Following suprapinatus tendon repair, rats were either treated with transduced TDSCs or nontransduced TDSCs. Histologic examination and Western blot were performed in both groups. Results: In this study, the silencing of TGIF1 significantly upregulated the chondrogenic genes and markers. Similarly, TGIF1 inhibited TDSC differentiation into cartilage via interactions with TGF-β-activated Smad2 and suppressed the phosphorylation of Smad2. The area of fibrocartilage at the tendon-bone interface was significantly increased in the TGIF1 (- group compared with the control and TGIF1-overexpressing groups in the early stages of the animal model. The interface between the tendon and bone showed a increase of new bone and fibrocartilage in the TGIF1 (- group at 4 weeks. Fibrovascular scar tissue was observed in the TGIF1-overexpressing group and the fibrin glue only group. Low levels of fibrocartilage and fibrovascular scar tissue were found in the TDSCs group. Conclusion: Collectively, this study shows that the tendon-derived stem cell modified with TGIF1 gene silencing has promising effects on tendon-to-bone healing which can be further explored as a therapeutic tool in regenerative medicine.

  11. Anterior Cruciate Ligament Reconstruction using Bone Patellar Tendon Bone autograft in ACL deficient Knee

    Directory of Open Access Journals (Sweden)

    Navin Kumar Karn

    2015-12-01

    Full Text Available Background & Objectives: Injury to Anterior Cruciate Ligament (ACL reconstruction has increased because of increased interest in sports. There are various grafts used for reconstruction of ACL, for example, Bone Patellar Tendon Bone, Hamstring etc. The study was conducted to evaluate the results of Bone Patellar Tendon Bone graft used for reconstruction of Anterior Cruciate Ligament.Materials & Methods: 40 patients with chronic ACL deficient knee presenting to Neuro Hospital from July 2011 to June 2013 were included in the study. The patients with intraarticular fracture of knee, severe OA knee, local active or suspected infection and systemic disease that might influence the study results were excluded from the study. Bone patellar tendon bone graft was harvested from ipsilateral knee in all the cases. The patient was followed till 2 year with specified programme of rehabilitation. The pain was assessed using VAS and the function of the knee was assessed using Modified WOMAC knee index.Results: The long term satisfactory results in terms of functional stability, symptom relief and return to preinjury level of activity was seen in 32 cases (80%. Two knees got infected out of which one required arthroscopic debridement. Mean visual analogue scale was 8 and modified WOMAC knee score was 3 at 2 year follow up.Conclusion: Bone patellar tendon bone graft is useful in high demand patients and cost effective option with high patient satisfaction rate for reconstruction of ACL.JCMS Nepal. 2015;11(3:12-15.

  12. Tendon material properties vary and are interdependent among turkey hindlimb muscles.

    Science.gov (United States)

    Matson, Andrew; Konow, Nicolai; Miller, Samuel; Konow, Pernille P; Roberts, Thomas J

    2012-10-15

    The material properties of a tendon affect its ability to store and return elastic energy, resist damage, provide mechanical feedback and amplify or attenuate muscle power. While the structural properties of a tendon are known to respond to a variety of stimuli, the extent to which material properties vary among individual muscles remains unclear. We studied the tendons of six different muscles in the hindlimb of Eastern wild turkeys to determine whether there was variation in elastic modulus, ultimate tensile strength and resilience. A hydraulic testing machine was used to measure tendon force during quasi-static lengthening, and a stress-strain curve was constructed. There was substantial variation in tendon material properties among different muscles. Average elastic modulus differed significantly between some tendons, and values for the six different tendons varied nearly twofold, from 829±140 to 1479±106 MPa. Tendons were stretched to failure, and the stress at failure, or ultimate tensile stress, was taken as a lower-limit estimate of tendon strength. Breaking tests for four of the tendons revealed significant variation in ultimate tensile stress, ranging from 66.83±14.34 to 112.37±9.39 MPa. Resilience, or the fraction of energy returned in cyclic length changes was generally high, and one of the four tendons tested was significantly different in resilience from the other tendons (range: 90.65±0.83 to 94.02±0.71%). An analysis of correlation between material properties revealed a positive relationship between ultimate tensile strength and elastic modulus (r(2)=0.79). Specifically, stiffer tendons were stronger, and we suggest that this correlation results from a constrained value of breaking strain, which did not vary significantly among tendons. This finding suggests an interdependence of material properties that may have a structural basis and may explain some adaptive responses observed in studies of tendon plasticity.

  13. Bone marrow-derived mesenchymal stem cells influence early tendon-healing in a rabbit achilles tendon model.

    Science.gov (United States)

    Chong, Alphonsus K S; Ang, Abel D; Goh, James C H; Hui, James H P; Lim, Aymeric Y T; Lee, Eng Hin; Lim, Beng Hai

    2007-01-01

    A repaired tendon needs to be protected for weeks until it has accrued enough strength to handle physiological loads. Tissue-engineering techniques have shown promise in the treatment of tendon and ligament defects. The present study tested the hypothesis that bone marrow-derived mesenchymal stem cells can accelerate tendon-healing after primary repair of a tendon injury in a rabbit model. Fifty-seven New Zealand White rabbits were used as the experimental animals, and seven others were used as the source of bone marrow-derived mesenchymal stem cells. The injury model was a sharp complete transection through the midsubstance of the Achilles tendon. The transected tendon was immediately repaired with use of a modified Kessler suture and a running epitendinous suture. Both limbs were used, and each side was randomized to receive either bone marrow-derived mesenchymal stem cells in a fibrin carrier or fibrin carrier alone (control). Postoperatively, the rabbits were not immobilized. Specimens were harvested at one, three, six, and twelve weeks for analysis, which included evaluation of gross morphology (sixty-two specimens), cell tracing (twelve specimens), histological assessment (forty specimens), immunohistochemistry studies (thirty specimens), morphometric analysis (forty specimens), and mechanical testing (sixty-two specimens). There were no differences between the two groups with regard to the gross morphology of the tendons. The fibrin had degraded by three weeks. Cell tracing showed that labeled bone marrow-derived mesenchymal stem cells remained viable and present in the intratendinous region for at least six weeks, becoming more diffuse at later time-periods. At three weeks, collagen fibers appeared more organized and there were better morphometric nuclear parameters in the treatment group (p tendon repair can improve histological and biomechanical parameters in the early stages of tendon-healing.

  14. Coordinated collagen and muscle protein synthesis in human patella tendon and quadriceps muscle after exercise

    DEFF Research Database (Denmark)

    Miller, Benjamin F; Olesen, Jens L; Hansen, Mette

    2005-01-01

    We hypothesized that an acute bout of strenuous, non-damaging exercise would increase rates of protein synthesis of collagen in tendon and skeletal muscle but these would be less than those of muscle myofibrillar and sarcoplasmic proteins. Two groups (n = 8 and 6) of healthy young men were studied...... collagen (0.077% h(-1)), muscle collagen (0.054% h(-1)), myofibrillar protein (0.121% h(-1)), and sarcoplasmic protein (0.134% h(-1))). The rates decreased toward basal values by 72 h although rates of tendon collagen and myofibrillar protein synthesis remained elevated. There was no tissue damage...... of muscle visible on histological evaluation. Neither tissue microdialysate nor serum concentrations of IGF-I and IGF binding proteins (IGFBP-3 and IGFBP-4) or procollagen type I N-terminal propeptide changed from resting values. Thus, there is a rapid increase in collagen synthesis after strenuous exercise...

  15. Dynamic adaptation of tendon and muscle connective tissue to mechanical loading

    DEFF Research Database (Denmark)

    Mackey, Abigail; Heinemeier, Katja Maria; Koskinen, Satu Osmi Anneli

    2008-01-01

    The connective tissue of tendon and skeletal muscle is a crucial structure for force transmission. A dynamic adaptive capacity of these tissues in healthy individuals is evident from reports of altered gene expression and protein levels of the fibrillar and network-forming collagens, when subjected...... in this article provide strong evidence for the highly adaptable nature of connective tissue in muscle and tendon....

  16. Extensor Tendon Injuries

    Science.gov (United States)

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

  17. The energetic benefits of tendon springs in running: is the reduction of muscle work important?

    Science.gov (United States)

    Holt, Natalie C; Roberts, Thomas J; Askew, Graham N

    2014-12-15

    The distal muscle-tendon units of cursorial species are commonly composed of short muscle fibres and long, compliant tendons. It is assumed that the ability of these tendons to store and return mechanical energy over the course of a stride, thus avoiding the cyclic absorption and regeneration of mechanical energy by active muscle, offers some metabolic energy savings during running. However, this assumption has not been tested directly. We used muscle ergometry and myothermic measurements to determine the cost of force production in muscles acting isometrically, as they could if mechanical energy was stored and returned by tendon, and undergoing active stretch-shorten cycles, as they would if mechanical energy was absorbed and regenerated by muscle. We found no detectable difference in the cost of force production in isometric cycles compared with stretch-shorten cycles. This result suggests that replacing muscle stretch-shorten work with tendon elastic energy storage and recovery does not reduce the cost of force production. This calls into question the assumption that reduction of muscle work drove the evolution of long distal tendons. We propose that the energetic benefits of tendons are derived primarily from their effect on muscle and limb architecture rather than their ability to reduce the cyclic work of muscle. © 2014. Published by The Company of Biologists Ltd.

  18. Free Bone Plug Quadriceps Tendon Harvest and Suspensory Button Attachment for Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Todor, Adrian; Caterev, Sergiu; Nistor, Dan Viorel; Khallouki, Youssef

    2016-06-01

    The most commonly used autografts for anterior cruciate ligament reconstruction are the bone-patellar tendon-bone and hamstring tendons. Each has its advantages and limitations. The bone-patellar tendon-bone autograft can lead to more donor-site morbidity, and the hamstring autograft can be unpredictable in size. The quadriceps tendon, with or without a bone block, has been described as an alternative graft source and has been used especially in revision cases, but in recent years, it has attracted attention even for primary cases. We report a technique for harvesting a free bone quadriceps tendon graft and attaching an extracortical button for femoral fixation for anterior cruciate ligament reconstruction.

  19. Magnetic resonance imaging appearance of partial latissimus dorsi muscle tendon tear

    International Nuclear Information System (INIS)

    Le, Huy B.Q.; Lee, Steven T.; Lane, Michael D.; Munk, Peter L.; Malfair, David; Blachut, Piotr A.

    2009-01-01

    There is still a paucity of information about the clinical presentation, treatment and imaging findings of latissimus muscle tears. Only one study has specifically described the magnetic resonance imaging (MRI) features of latissimus tendon tears. We describe a case of a high-grade tear in the latissimus muscle tendon in an active water skier with no significant prior medical history. MRI demonstrated at least a 50% tear of the latissimus tendon, manifesting as increased signal intensity on T2-weighted sequences and surrounding edema, as well as a diminutive tendon at the humeral insertion. (orig.)

  20. Coordinated development of muscles and tendon-like structures: early interactions in the Drosophila leg

    Directory of Open Access Journals (Sweden)

    cedric esoler

    2016-02-01

    Full Text Available The formation of the musculoskeletal system is a remarkable example of tissue assembly. In both vertebrates and invertebrates, precise connectivity between muscles and skeleton (or exoskeleton via tendons or equivalent structures is fundamental for movement and stability of the body. The molecular and cellular processes underpinning muscle formation are well established and significant advances have been made in understanding tendon development. However, the mechanisms contributing to proper connection between these two tissues have received less attention. Observations of coordinated development of tendons and muscles suggest these tissues may interact during the different steps in their development. There is growing evidence that, depending on animal model and muscle type, these interactions can take place from progenitor induction to the final step of the formation of the musculoskeletal system. Here we briefly review and compare the mechanisms behind muscle and tendon interaction throughout the development of vertebrates and Drosophila before going on to discuss our recent findings on the coordinated development of muscles and tendon-like structures in Drosophila leg. By altering apodeme formation (the functional Drosophila equivalent of tendons in vertebrates during the early steps of leg development, we affect the spatial localisation of subsequent myoblasts. These findings provide the first evidence of the developmental impact of early interactions between muscle and tendon-like precursors, and confirm the appendicular Drosophila muscle system as a valuable model for studying these processes.

  1. Mechanical properties of human bone-tendon-bone grafts preserved by different methods and radiation sterilised

    International Nuclear Information System (INIS)

    Kaminski, A.; Gut, G.

    2008-01-01

    Full text: Patellar tendon auto and allografts are commonly used in orthopaedic surgery for reconstruction of the anterior crucial ligaments (ACL). Autografts are mainly used for primary reconstruction, while allografts are useful for revision surgery. To avoid the risk of infection diseases transmission allografts should be radiation-sterilised. As radiation-sterilisation is supposed to decrease the mechanical strength of tendon tissue, it is important to establish methods of allografts preservation and sterilisation resulting in their best quality and safety. Therefore, the purpose of the study was to compare the tensile strength of the central one third of human patellar tendon (as used for ACL reconstruction), preserved by different methods (deep fresh freezing, lyophilisation) and subsequently radiation-sterilised with doses of 0 (control), 25, 50 or 100 kGy. Bone-tendon-bone grafts were prepared from cadaveric human patella tendon with both patellar and tibial attachments. BTB grafts were preserved by deep freezing, glicerolisation or lyophilisation and radiation-sterilised with doses of 0 (control), 25, 50 or 100 kGy. To estimate mechanical properties all samples were subjected to tensile tests to failure using Instron system. Before these tests all lyophilised grafts were rehydrated. We found decrease of tensile strength of irradiated grafts compared to non-irradiated controls. Obtained results of the mechanical testing of studied grafts indicate their potential usefulness for clinical applications.(Author)

  2. Spring or string: does tendon elastic action influence wing muscle mechanics in bat flight?

    Science.gov (United States)

    Konow, Nicolai; Cheney, Jorn A; Roberts, Thomas J; Waldman, J Rhea S; Swartz, Sharon M

    2015-10-07

    Tendon springs influence locomotor movements in many terrestrial animals, but their roles in locomotion through fluids as well as in small-bodied mammals are less clear. We measured muscle, tendon and joint mechanics in an elbow extensor of a small fruit bat during ascending flight. At the end of downstroke, the tendon was stretched by elbow flexion as the wing was folded. At the end of upstroke, elastic energy was recovered via tendon recoil and extended the elbow, contributing to unfurling the wing for downstroke. Compared with a hypothetical 'string-like' system lacking series elastic compliance, the tendon spring conferred a 22.5% decrease in muscle fascicle strain magnitude. Our findings demonstrate tendon elastic action in a small flying mammal and expand our understanding of the occurrence and action of series elastic actuator mechanisms in fluid-based locomotion. © 2015 The Author(s).

  3. Extrusion of bone anchor suture following flexor digitorum profundus tendon avulsion injury repair.

    LENUS (Irish Health Repository)

    Tiong, William H C

    2011-09-01

    Flexor digitorum profundus (FDP) zone I tendon avulsion injury is traditionally repaired with a pullout suture technique. More recently, bone anchor sutures have been used as a viable alternative and have largely replaced areas in hand surgery where pullout suture technique was once required. To date, there have been very few complications reported related to bone anchor suture use in FDP tendon reattachment to the bone. We report a very unusual case of extrusion of bone anchor through the nailbed, 6 years after zone I FDP tendon avulsion injury repair and a brief review of literature.

  4. Effects of plyometric and isometric training on muscle and tendon stiffness in vivo.

    Science.gov (United States)

    Kubo, Keitaro; Ishigaki, Tomonobu; Ikebukuro, Toshihiro

    2017-08-01

    The purpose of this study was to compare the effects of plyometric and isometric training on tendon properties during ramp and ballistic contractions and muscle stiffness under passive and active conditions. Eleven subjects completed 12 weeks (3 days/week) of a unilateral training program for the plantar flexors. They performed plyometric training on one side (PLY) and isometric training on the other side (ISO). Active muscle stiffness in the medial gastrocnemius muscle was calculated according to changes in estimated muscle force and fascicle length during fast stretching after submaximal isometric contractions. Passive muscle stiffness was also calculated from estimated passive muscle force and fascicle length during slow passive stretching. Stiffness and hysteresis of tendon structures were measured using ultrasonography during ramp and ballistic contractions. Passive muscle stiffness and tendon hysteresis did not change for PLY or ISO Active muscle stiffness significantly increased for PLY, but not for ISO Tendon stiffness during ramp and ballistic contractions increased significantly for ISO, but not for PLY In addition, tendon elongation values at force production levels beyond 100 N during ballistic contractions increased for PLY These results suggest that plyometric training (but not isometric training) enhances the extensibility of tendon structures during ballistic contractions and active muscle stiffness during fast stretching, and these changes may be related to improved performances during stretch-shortening cycle exercises. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  5. Clinical evaluation of bone- patellar tendon- bone grafts for anterior cruciate ligament injury

    International Nuclear Information System (INIS)

    Nakamura, Yasuhiro

    2011-01-01

    One thousand and thirty-eight cases of Anterior Cruciate Ligament (ACL) rupture were treated between January 2002 and November 2010. Eight hundred sixty-six cases (83.9%) were observed for at least six months. All cases were reconstructed with a bone to tendon to bone (BTB) graft from the patella. Much effort was made to return the patient to a competitive sports activity level within one year. The age at suffering from the initial injury ranged from 9 to 74 years old with a mean of 24.7 years old. There were 493 female (50.7%) and 427 male (49.3%) cases. The injured side was right in 408 cases and left in 458 cases. The mean postoperative observation period was 449.2 days. The number of patients who felt 80% or more certain that they could return to competitive sports activities was 538 (61.9%). From the MRI findings, continuity of the reconstructed graft was observed in 793 cases (98.5%). Arthroscopy after reconstruction was performed in 775 cases (89.5%). The reconstructed ACL was observed to be covered with an adequate synovium in 629 cases (81.2%). The medial meniscus and lateral meniscus showed no changes in 657 cases (84.8%) and 666 cases (85.9%) respectively. Reconstructions performed less than two weeks after injury showed no significant differences in terms of Range Of Motion (ROM), arthroscopic findings, or the number of patients who could return to competitive sports activities. Statistically significantly more patients who underwent their reconstruction at an age over forty experienced a loss motion of five degree in extension or ten degree in flexion and resumed a lower level of sports activities. Patients who underwent the reconstruction could return to exercises for muscle strengthening and ROMs within 2 weeks. Patients over forty years old who underwent their reconstruction could prevent their menisci from fraying, tearing, or undergoing osteoarthritic changes. (author)

  6. The series elastic shock absorber: tendon elasticity modulates energy dissipation by muscle during burst deceleration.

    Science.gov (United States)

    Konow, Nicolai; Roberts, Thomas J

    2015-04-07

    During downhill running, manoeuvring, negotiation of obstacles and landings from a jump, mechanical energy is dissipated via active lengthening of limb muscles. Tendon compliance provides a 'shock-absorber' mechanism that rapidly absorbs mechanical energy and releases it more slowly as the recoil of the tendon does work to stretch muscle fascicles. By lowering the rate of muscular energy dissipation, tendon compliance likely reduces the risk of muscle injury that can result from rapid and forceful muscle lengthening. Here, we examine how muscle-tendon mechanics are modulated in response to changes in demand for energy dissipation. We measured lateral gastrocnemius (LG) muscle activity, force and fascicle length, as well as leg joint kinematics and ground-reaction force, as turkeys performed drop-landings from three heights (0.5-1.5 m centre-of-mass elevation). Negative work by the LG muscle-tendon unit during landing increased with drop height, mainly owing to greater muscle recruitment and force as drop height increased. Although muscle strain did not increase with landing height, ankle flexion increased owing to increased tendon strain at higher muscle forces. Measurements of the length-tension relationship of the muscle indicated that the muscle reached peak force at shorter and likely safer operating lengths as drop height increased. Our results indicate that tendon compliance is important to the modulation of energy dissipation by active muscle with changes in demand and may provide a mechanism for rapid adjustment of function during deceleration tasks of unpredictable intensity. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  7. Is passive stiffness in human muscles related to the elasticity of tendon structures?

    Science.gov (United States)

    Kubo, K; Kanehisa, H; Fukunaga, T

    2001-08-01

    The purpose of this study was to examine in vivo whether passive stiffness in human muscles was related to the elasticity of tendon structures and to performance during stretch-shortening cycle exercise. Passive torque of plantar flexor muscles was measured during passive stretch from 90 degrees (anatomical position) to 65 degrees of dorsiflexion at a constant velocity of 5 degrees.s-1. The slope of the linear portion of the passive torque-angle curve during stretching was defined as the passive stiffness of the muscle. The elongation of the tendon and aponeurosis of the medial gastrocnemius muscle (MG) was directly measured using ultrasonography during ramp isometric plantar flexion up to the voluntary maximum. The relationship between the estimated muscle force of MG and tendon elongation was fitted to a linear regression, the slope of which was defined as the stiffness of the tendon. In addition, the dynamic torques during maximal voluntary concentric plantar flexion with and without prior eccentric contraction were determined at a constant velocity of 120 degrees.s-1. There were no significant correlations between passive stiffness and either the tendon stiffness (r = 0.19, P > 0.05) or the relative increase in torque with prior eccentric contraction (r = -0.19, P > 0.05). However, tendon stiffness was negatively correlated to the relative increase in torque output (r = -0.42, P tendon structures, and had no favourable effect on the muscle performance during stretch-shortening cycle exercise.

  8. The Prevalence and Role of Low Lying Peroneus Brevis Muscle Belly in Patients with Peroneal Tendon Pathologies: A Potential Source for Tendon Subluxation

    OpenAIRE

    Mirmiran, Roya; Squire, Chad; Wassell, Daniel

    2015-01-01

    A low lying peroneus brevis muscle belly is a rare anomaly. There are few published studies that support presence of this anomaly as an etiology for peroneal tendon tear. However, the association between a low lying peroneus muscle belly (LLMB) and tendon subluxation is not well explored. In this retrospective study, the magnetic resonance imaging (MRI) and intraoperative findings of 50 consecutive patients undergoing a primary peroneal tendon surgery, in a five year period, were assessed. Th...

  9. Muscle-tendon mechanics explain unexpected effects of exoskeleton assistance on metabolic rate during walking.

    Science.gov (United States)

    Jackson, Rachel W; Dembia, Christopher L; Delp, Scott L; Collins, Steven H

    2017-06-01

    The goal of this study was to gain insight into how ankle exoskeletons affect the behavior of the plantarflexor muscles during walking. Using data from previous experiments, we performed electromyography-driven simulations of musculoskeletal dynamics to explore how changes in exoskeleton assistance affected plantarflexor muscle-tendon mechanics, particularly for the soleus. We used a model of muscle energy consumption to estimate individual muscle metabolic rate. As average exoskeleton torque was increased, while no net exoskeleton work was provided, a reduction in tendon recoil led to an increase in positive mechanical work performed by the soleus muscle fibers. As net exoskeleton work was increased, both soleus muscle fiber force and positive mechanical work decreased. Trends in the sum of the metabolic rates of the simulated muscles correlated well with trends in experimentally observed whole-body metabolic rate ( R 2 =0.9), providing confidence in our model estimates. Our simulation results suggest that different exoskeleton behaviors can alter the functioning of the muscles and tendons acting at the assisted joint. Furthermore, our results support the idea that the series tendon helps reduce positive work done by the muscle fibers by storing and returning energy elastically. We expect the results from this study to promote the use of electromyography-driven simulations to gain insight into the operation of muscle-tendon units and to guide the design and control of assistive devices. © 2017. Published by The Company of Biologists Ltd.

  10. Elastic modulus of muscle and tendon with shear wave ultrasound elastography: variations with different technical settings.

    Directory of Open Access Journals (Sweden)

    Brian Chin Wing Kot

    Full Text Available Standardization on Shear wave ultrasound elastography (SWUE technical settings will not only ensure that the results are accurate, but also detect any differences over time that may be attributed to true physiological changes. The present study evaluated the variations of elastic modulus of muscle and tendon using SWUE when different technical aspects were altered. The results of this study indicated that variations of elastic modulus of muscle and tendon were found when different transducer's pressure and region of interest (ROI's size were applied. No significant differences in elastic modulus of the rectus femoris muscle and patellar tendon were found with different acquisition times of the SWUE sonogram. The SWUE on the muscle and tendon should be performed with the lightest transducer's pressure, a shorter acquisition time for the SWUE sonogram, while measuring the mean elastic modulus regardless the ROI's size.

  11. Passive Muscle-Tendon Unit Gearing is Joint Dependent in Human Medial Gastrocnemius

    Directory of Open Access Journals (Sweden)

    Emma F Hodson-Tole

    2016-03-01

    Full Text Available Skeletal muscles change length and develop force both passively and actively. Gearing allows muscle fibre length changes to be uncoupled from those of the whole muscle-tendon unit. During active contractions this process allows muscles to operate at mechanically favorable conditions for power or economical force production. Here we ask whether gearing is constant in passive muscle; determining the relationship between fascicle and muscle-tendon unit length change in the bi-articular medial gastrocnemius and investigating the influence of whether motion occurs at the knee or ankle joint. Specifically, the same muscle-tendon unit length changes were elicited by rotating either the ankle or knee joint whilst simultaneously measuring fascicle lengths in proximal and distal muscle regions using B-mode ultrasound. In both the proximal and distal muscle region, passive gearing values differed depending on whether ankle or knee motion occurred. Fascicle length changes were greater with ankle motion, likely reflecting anatomical differences in proximal and distal passive tendinous tissues, as well as shape changes of the adjacent mono-articular soleus. This suggests that there is joint-dependent dissociation between the mechanical behaviour of muscle fibres and the muscle-tendon unit during passive joint motions that may be important to consider when developing accurate models of bi-articular muscles.

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

    Science.gov (United States)

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

    2018-02-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  14. GH receptor blocker administration and muscle-tendon collagen synthesis in humans

    DEFF Research Database (Denmark)

    Nielsen, Rie Harboe; Doessing, Simon; Goto, Kazushige

    2011-01-01

    The growth hormone (GH)/insulin-like growth factor-I (IGF-I) axis stimulates collagen synthesis in tendon and skeletal muscle, but no studies have investigated the effect of reducing IGF-I on collagen synthesis in healthy humans.......The growth hormone (GH)/insulin-like growth factor-I (IGF-I) axis stimulates collagen synthesis in tendon and skeletal muscle, but no studies have investigated the effect of reducing IGF-I on collagen synthesis in healthy humans....

  15. Muscle-tendon-related pain in 100 patients with hip dysplasia: prevalence and associations with self-reported hip disability and muscle strength

    DEFF Research Database (Denmark)

    Jacobsen, Julie Sandell; Hølmich, Per; Thorborg, Kristian

    2018-01-01

    The primary aim was to identify muscle-tendon-related pain in 100 patients with hip dysplasia. The secondary aim was to test whether muscle-tendon-related pain is associated with self-reported hip disability and muscle strength in patient with hip dysplasia. One hundred patients (17 men......-tendon-related pain and hip extension a significant inverse linear association between muscle-tendon-related pain and muscle strength was found ranging from -0.11 to - 0.12 Nm/kg in the adjusted analysis (P hip dysplasia with a high prevalence......) with a mean age of 29 years (SD 9) were included. Clinical entity approach was carried out to identify muscle-tendon-related pain. Associations between muscle-tendon-related pain and self-reported hip disability and muscle strength were tested with multiple regression analysis, including adjustments for age...

  16. The Influence of External Load on Quadriceps Muscle and Tendon Dynamics during Jumping.

    Science.gov (United States)

    Earp, Jacob E; Newton, Robert U; Cormie, Prue; Blazevich, Anthony J

    2017-11-01

    Tendons possess both viscous (rate-dependent) and elastic (rate-independent) properties that determine tendon function. During high-speed movements external loading increases both the magnitude (FT) and rate (RFDT) of tendon loading. The influence of external loading on muscle and tendon dynamics during maximal vertical jumping was explored. Ten resistance-trained men performed parallel-depth, countermovement vertical jumps with and without additional load (0%, 30%, 60%, and 90% of maximum squat lift strength), while joint kinetics and kinematics, quadriceps tendon length (LT) and patellar tendon FT and RFDT were estimated using integrated ultrasound, motion analysis and force platform data and muscle tendon modelling. Estimated FT and RFDT, but not peak LT, increased with external loading. Temporal comparisons between 0% and 90% loads revealed that FT was greater with 90% loading throughout the majority of the movement (11%-81% and 87%-95% movement duration). However, RFDT was greater with 90% load only during the early movement initiation phase (8%-15% movement duration) but was greater in the 0% load condition later in the eccentric phase (27%-38% movement duration). LT was longer during the early movement (12%-23% movement duration) but shorter in the late eccentric and early concentric phases (48%-55% movement duration) with 90% load. External loading positively influenced peak FT and RFDT but tendon strain appeared unaffected, suggesting no additive effect of external loading on patellar tendon lengthening during human jumping. Temporal analysis revealed that external loading resulted in a large initial RFDT that may have caused dynamic stiffening of the tendon and attenuated tendon strain throughout the movement. These results suggest that external loading influences tendon lengthening in both a load- and movement-dependent manner.

  17. Rotator cuff repair with a tendon-fibrocartilage-bone composite bridging patch.

    Science.gov (United States)

    Ji, Xiaoxi; Chen, Qingshan; Thoreson, Andrew R; Qu, Jin; An, Kai-Nan; Amadio, Peter C; Steinmann, Scott P; Zhao, Chunfeng

    2015-11-01

    To compare the mechanical performance of a rotator cuff repaired with a novel tendon-fibrocartilage-bone composite bridging patch vs the traditional Mason-Allen repair in an in vitro canine model. Twenty shoulders and 10 bridging patches from patellar tendon were harvested. The patches were trimmed and sliced into 2 layers. An infraspinatus tendon tear was created in each shoulder. Modified Mason-Allen sutures were used to repair the infraspinatus tendon to the greater tuberosity, with or without the bridging patch (bridging patch group and controls, respectively). Shoulders were loaded to failure under displacement control at a rate of 0.5mm/s. The ultimate tensile load was significantly higher in the bridging patch group than control (mean [SD], 365.46 [36.45] vs 272.79 [48.88] N; Pfibrocartilage-bone composite bridging patch achieved higher ultimate tensile load and stiffness at the patch-greater tuberosity repair site compared with traditional repair in a canine model. This composite tissue transforms the traditional tendon-to-bone healing interface (with dissimilar tissues) into a pair of bone-to-bone and tendon-to-tendon interfaces, which may improve healing quality and reduce retear rate. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. * Fabrication and Characterization of Biphasic Silk Fibroin Scaffolds for Tendon/Ligament-to-Bone Tissue Engineering.

    Science.gov (United States)

    Font Tellado, Sònia; Bonani, Walter; Balmayor, Elizabeth R; Foehr, Peter; Motta, Antonella; Migliaresi, Claudio; van Griensven, Martijn

    2017-08-01

    Tissue engineering is an attractive strategy for tendon/ligament-to-bone interface repair. The structure and extracellular matrix composition of the interface are complex and allow for a gradual mechanical stress transfer between tendons/ligaments and bone. Thus, scaffolds mimicking the structural features of the native interface may be able to better support functional tissue regeneration. In this study, we fabricated biphasic silk fibroin scaffolds designed to mimic the gradient in collagen molecule alignment present at the interface. The scaffolds had two different pore alignments: anisotropic at the tendon/ligament side and isotropic at the bone side. Total porosity ranged from 50% to 80% and the majority of pores (80-90%) were ligament, enthesis, and cartilage markers significantly changed depending on pore alignment in each region of the scaffolds. In conclusion, the biphasic scaffolds fabricated in this study show promising features for tendon/ligament-to-bone tissue engineering.

  19. Flexor Tendon Injuries

    Science.gov (United States)

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

  20. Functional grading of mineral and collagen in the attachment of tendon to bone.

    Science.gov (United States)

    Genin, Guy M; Kent, Alistair; Birman, Victor; Wopenka, Brigitte; Pasteris, Jill D; Marquez, Pablo J; Thomopoulos, Stavros

    2009-08-19

    Attachment of dissimilar materials is a major challenge because high levels of localized stress may develop at their interfaces. An effective biologic solution to this problem exists at one of nature's most extreme interfaces: the attachment of tendon (a compliant, structural "soft tissue") to bone (a stiff, structural "hard tissue"). The goal of our study was to develop biomechanical models to describe how the tendon-to-bone insertion derives its mechanical properties. We examined the tendon-to-bone insertion and found two factors that give the tendon-to-bone transition a unique grading in mechanical properties: 1), a gradation in mineral concentration, measured by Raman spectroscopy; and 2), a gradation in collagen fiber orientation, measured by polarized light microscopy. Our measurements motivate a new physiological picture of the tissue that achieves this transition, the tendon-to-bone insertion, as a continuous, functionally graded material. Our biomechanical model suggests that the experimentally observed increase in mineral accumulation within collagen fibers can provide significant stiffening of the partially mineralized fibers, but only for concentrations of mineral above a "percolation threshold" corresponding to formation of a mechanically continuous mineral network within each collagen fiber (e.g., the case of mineral connectivity extending from one end of the fiber to the other). Increasing dispersion in the orientation distribution of collagen fibers from tendon to bone is a second major determinant of tissue stiffness. The combination of these two factors may explain the nonmonotonic variation of stiffness over the length of the tendon-to-bone insertion reported previously. Our models explain how tendon-to-bone attachment is achieved through a functionally graded material composition, and provide targets for tissue engineered surgical interventions and biomimetic material interfaces.

  1. Ultrasound elastography for imaging tendons and muscles

    Directory of Open Access Journals (Sweden)

    Elena Drakonaki

    2012-06-01

    Full Text Available Ultrasound elastography is a recently developed ultrasound-based method which allows the qualitative or quantitative evaluation of the mechanical properties of tissue. Strain (compression ultrasound elastography is the commonest technique performed by ap‑ plying mild compression with the hand-held transducer to create real-time strain dis‑ tribution maps, which are color-coded and superimposed on the B-mode images. There is increasing evidence that ultrasound elastography can be used in the investigation of muscle, tendon and soft tissue disease in the clinical practice, as a supplementary tool to conventional ultrasound examination. Based on preliminary data, potential clinical appli‑ cations include early diagnosis, staging, and guiding interventions musculotendinous and neuromuscular disease as well as monitoring disease during rehabilitation. Ultrasound elastography could also be used for research into the biomechanics and pathophysiology of musculotendinous disease. Despite the great interest in the technique, there is still limited evidence in the literature and there are several technical issues which limit the reproducibility of the method, including differences in quantification methods, artefacts, limitations and variation in the application of the technique by different users. This re‑ view presents the published evidence on musculoskeletal applications of strain elastogra‑ phy, discusses the technical issues and future perspectives of this method and emphasizes the need for standardization and further research.

  2. Tissue-engineering strategies for the tendon/ligament-to-bone insertion.

    Science.gov (United States)

    Smith, Lester; Xia, Younan; Galatz, Leesa M; Genin, Guy M; Thomopoulos, Stavros

    2012-01-01

    Injuries to connective tissues are painful and disabling and result in costly medical expenses. These injuries often require reattachment of an unmineralized connective tissue to bone. The uninjured tendon/ligament-to-bone insertion (enthesis) is a functionally graded material that exhibits a gradual transition from soft tissue (i.e., tendon or ligament) to hard tissue (i.e., mineralized bone) through a fibrocartilaginous transition region. This transition is believed to facilitate force transmission between the two dissimilar tissues by ameliorating potentially damaging interfacial stress concentrations. The transition region is impaired or lost upon tendon/ligament injury and is not regenerated following surgical repair or natural healing, exposing the tissue to risk of reinjury. The need to regenerate a robust tendon-to-bone insertion has led a number of tissue engineering repair strategies. This review treats the tendon-to-bone insertion site as a tissue structure whose primary role is mechanical and discusses current and emerging strategies for engineering the tendon/ligament-to-bone insertion in this context. The focus lies on strategies for producing mechanical structures that can guide and subsequently sustain a graded tissue structure and the associated cell populations.

  3. The series-elastic shock absorber: tendons attenuate muscle power during eccentric actions.

    Science.gov (United States)

    Roberts, Thomas J; Azizi, Emanuel

    2010-08-01

    Elastic tendons can act as muscle power amplifiers or energy-conserving springs during locomotion. We used an in situ muscle-tendon preparation to examine the mechanical function of tendons during lengthening contractions, when muscles absorb energy. Force, length, and power were measured in the lateral gastrocnemius muscle of wild turkeys. Sonomicrometry was used to measure muscle fascicle length independently from muscle-tendon unit (MTU) length, as measured by a muscle lever system (servomotor). A series of ramp stretches of varying velocities was applied to the MTU in fully activated muscles. Fascicle length changes were decoupled from length changes imposed on the MTU by the servomotor. Under most conditions, muscle fascicles shortened on average, while the MTU lengthened. Energy input to the MTU during the fastest lengthenings was -54.4 J/kg, while estimated work input to the muscle fascicles during this period was only -11.24 J/kg. This discrepancy indicates that energy was first absorbed by elastic elements, then released to do work on muscle fascicles after the lengthening phase of the contraction. The temporary storage of energy by elastic elements also resulted in a significant attenuation of power input to the muscle fascicles. At the fastest lengthening rates, peak instantaneous power input to the MTU reached -2,143.9 W/kg, while peak power input to the fascicles was only -557.6 W/kg. These results demonstrate that tendons may act as mechanical buffers by limiting peak muscle forces, lengthening rates, and power inputs during energy-absorbing contractions.

  4. Reconstruction of long digital extensor tendon by cranial tibial muscle fascia graft in a dog.

    Science.gov (United States)

    Sabiza, Soroush; Khajeh, Ahmad; Naddaf, Hadi

    2016-01-01

    Tendon rupture in dogs is generally the result of a direct trauma. This report described the use of adjacent muscle autogenic fascial graft for reconstruction of distal rupture of long digital extensor tendon in a dog. A two-year-old male mix breed dog, was presented with a non-weight bearing lameness of the right hind limb and a deep rupture of lateral side of right tarsus. History taking revealed that this rupture appeared without any apparent cause, when walking around the farm, three days before. Radiography was done and no fracture was observed. Hyperextension of right tarsal joint compared to left limb was observed. Under general anesthesia, after dissections of the ruptured area, complete rupture of long digital extensor tendon was revealed. Then, we attempted to locate the edge of the tendon, however, the tendon length was shortened approximately 1 cm. Hence, a strip of 1 cm length from fascia of cranial tibial muscle was harvested to fill the defect. The graft was sutured to the two ends of tendon using locking loop pattern. Subcutaneous layers and the skin were sutured routinely. Ehmer sling bandage was applied to prevent weight bearing on the surgical region. Re-examination and phone contact with the owner eight weeks and six months postoperatively revealed a poor lameness and excellent function of the dog, respectively. It could be concluded that the fascia of adjacent muscles can be used as an autogenic graft for reconstruction of some tendon ruptures.

  5. Mechanical Loading Improves Tendon-Bone Healing in a Rabbit Anterior Cruciate Ligament Reconstruction Model by Promoting Proliferation and Matrix Formation of Mesenchymal Stem Cells and Tendon Cells

    Directory of Open Access Journals (Sweden)

    Fanglong Song

    2017-02-01

    Full Text Available Background/Aims: This study investigated the effect of mechanical stress on tendon-bone healing in a rabbit anterior cruciate ligament (ACL reconstruction model as well as cell proliferation and matrix formation in co-culture of bone-marrow mesenchymal stem cells (BMSCs and tendon cells (TCs. Methods: The effect of continuous passive motion (CPM therapy on tendon-bone healing in a rabbit ACL reconstruction model was evaluated by histological analysis, biomechanical testing and gene expressions at the tendon-bone interface. Furthermore, the effect of mechanical stretch on cell proliferation and matrix synthesis in BMSC/TC co-culture was also examined. Results: Postoperative CPM therapy significantly enhanced tendon-bone healing, as evidenced by increased amount of fibrocartilage, elevated ultimate load to failure levels, and up-regulated gene expressions of Collagen I, alkaline phosphatase, osteopontin, Tenascin C and tenomodulin at the tendon-bone junction. In addition, BMSC/TC co-culture treated with mechanical stretch showed a higher rate of cell proliferation and enhanced expressions of Collagen I, Collagen III, alkaline phosphatase, osteopontin, Tenascin C and tenomodulin than that of controls. Conclusion: These results demonstrated that proliferation and differentiation of local precursor cells could be enhanced by mechanical stimulation, which results in enhanced regenerative potential of BMSCs and TCs in tendon-bone healing.

  6. The effect of platelet rich plasma from bone marrow aspirate with added bone morphogenetic protein-2 on the Achilles tendon-bone junction in rabbits.

    Science.gov (United States)

    Kim, Hak Jun; Nam, Hyok-Woo; Hur, Chang-Yong; Park, Misu; Yang, Hee Seok; Kim, Byung-Soo; Park, Jung-Ho

    2011-12-01

    To determine if exogenously injected bone marrow derived platelet-rich plasma (PRP) plus bone morphogenetic protein (BMP)-2 could accelerate the healing of bone-tendon junction injuries and increase the junction holding strength during the early regeneration period. A direct injury model of the bone-tendon junction was made using an Achilles tendon-calcaneus bone junction in a rabbit. In the PRP/BMP-2/fibrin group, 0.05 mL of bone marrow derived PRP and 100 ng/mL of BMP-2 both incorporated into 0.1 mL of fibrin glue were injected into Achilles tendon-calcaneus bone junctions. The effect of the intervention was tested by comparing the results of an intervention group to a control group. The results of biomechanical testing, and histological and gross analyses were compared between the 2 groups at the following time points after surgery: 2 weeks, 4 weeks, and 8 weeks. Histologic examinations showed that woven bone developed in tendon-bone junctions at 2 weeks after surgery in the PRP/BMP-2/fibrin group. Mechanical test results showed no significant difference between the PRP/BMP-2/fibrin and control groups at 2 and 4 weeks after surgery, but the mean maximal load in the PRP/BMP-2/fibrin group was significantly higher than in the control group (p rabbit model of tendon-bone junction injury.

  7. Rectus abdominis muscle flap for repair of prepubic tendon rupture in 8 dogs.

    Science.gov (United States)

    Archipow, Wendy; Lanz, Otto I

    2011-11-01

    The clinical use and outcome of the rectus abdominis muscle flap to repair prepubic hernias were evaluated retrospectively. Medical records (2002-2007) of 8 dogs that had a rectus abdominis muscle flap to repair traumatic prepubic tendon rupture were reviewed. Only minor donor site complications were noted, including self-limiting ventral and hind-limb swelling. No long-term complications including recurrence of hernia were noted. The results of this study indicate that the rectus abdominis muscle flap is a clinically useful option for repairing prepubic tendon rupture in dogs.

  8. Knee extension and flexion muscle power after anterior cruciate ligament reconstruction with patellar tendon graft or hamstring tendons graft: a cross-sectional comparison 3 years post surgery

    DEFF Research Database (Denmark)

    Ageberg, Eva; Roos, Harald; Silbernagel, Karin

    2008-01-01

    Hamstring muscles play a major role in knee-joint stabilization after anterior cruciate ligament (ACL) injury. Weakness of the knee extensors after ACL reconstruction with patellar tendon (PT) graft, and in the knee flexors after reconstruction with hamstring tendons (HT) graft has been observed ...

  9. Effects of 12-wk eccentric calf muscle training on muscle-tendon glucose uptake and SEMG in patients with chronic Achilles tendon pain

    DEFF Research Database (Denmark)

    Masood, Tahir; Kalliokoski, Kari; Magnusson, S Peter

    2014-01-01

    High-load eccentric exercises have been a key component in the conservative management of chronic Achilles tendinopathy. This study investigated the effects of a 12-wk progressive, home-based eccentric rehabilitation program on ankle plantar flexors' glucose uptake (GU) and myoelectric activity......, while the asymptomatic leg displayed higher uptake for medial gastrocnemius and flexor hallucis longus (P tendon GU than the controls (P effect on the tendon GU. Concerning SEMG, at baseline, soleus showed more relative...... within- or between-group differences. Eccentric rehabilitation was effective in decreasing subjective severity of Achilles tendinopathy. It also resulted in redistribution of relative electrical activity, but not metabolic activity, within the triceps surae muscle....

  10. Kartogenin with PRP promotes the formation of fibrocartilage zone in the tendon-bone interface.

    Science.gov (United States)

    Zhou, Yiqin; Zhang, Jianying; Yang, Jinsong; Narava, Manoj; Zhao, Guangyi; Yuan, Ting; Wu, Haishan; Zheng, Nigel; Hogan, MaCalus V; Wang, James H-C

    2017-12-01

    Treatment of tendon-bone junction injuries is a challenge because tendon-bone interface often heals poorly and the fibrocartilage zone, which reduces stress concentration, at the interface is not formed. In this study, we used a compound called kartogenin (KGN) with platelet-rich plasma (PRP) to induce the formation of fibrocartilage zone in a rat tendon graft-bone tunnel model. The experimental rats received KGN-PRP or PRP injections in the tendon graft-bone tunnel interface. The control group received saline. After 4, 8 and 12 weeks, Safranin O staining of the tendon graft-bone tunnels revealed abundant proteoglycans in the KGN-PRP group indicating the formation of cartilage-like transition zone. Immunohistochemical and immuno-fluorescence staining revealed collagen types I (Col-I) and II (Col-II) in the newly formed fibrocartilage zone. Both fibrocartilage zone formation and maturation were healing time dependent. In contrast, the PRP and saline control groups had no cartilage-like tissues and minimal Col-I and Col-II staining. Some gaps were also present in the saline control group. Finally, pull-out strength in the KGN-PRP-treated group at 8 weeks was 1.4-fold higher than the PRP-treated group and 1.6-fold higher than the saline control group. These findings indicate that KGN, with PRP as a carrier, promotes the formation of fibrocartilage zone between the tendon graft and bone interface. Thus, KGN-PRP may be used as a convenient cell-free therapy in clinics to promote fibrocartilage zone formation in rotator calf repair and anterior cruciate ligament reconstruction, thereby enhancing the mechanical strength of the tendon-bone interface and hence the clinical outcome of these procedures. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  11. Muscle-tendon-related pain in 100 patients with hip dysplasia: prevalence and associations with self-reported hip disability and muscle strength

    DEFF Research Database (Denmark)

    Jacobsen, Julie Sandell; Hölmich, Per; Thorborg, Kristian

    2017-01-01

    The primary aim was to identify muscle-tendon-related pain in 100 patients with hip dysplasia. The secondary aim was to test whether muscle-tendon-related pain is associated with self-reported hip disability and muscle strength in patient with hip dysplasia. One hundred patients (17 men......-tendon-related pain and hip extension a significant inverse linear association between muscletendon- related pain and muscle strength was found ranging from 0.11 to0.12 Nm/kg in the adjusted analysis (Phip dysplasia with a high prevalence......) with a mean age of 29 years (SD 9) were included. Clinical entity approach was carried out to identify muscle-tendon-related pain. Associations between muscle-tendon-related pain and self-reported hip disability and muscle strength were tested with multiple regression analysis, including adjustments for age...

  12. Neuromuscular and muscle-tendon system adaptations to isotonic and isokinetic eccentric exercise.

    Science.gov (United States)

    Guilhem, G; Cornu, C; Guével, A

    2010-06-01

    To present the properties of an eccentric contraction and compare neuromuscular and muscle-tendon system adaptations induced by isotonic and isokinetic eccentric trainings. An eccentric muscle contraction is characterized by the production of muscle force associated to a lengthening of the muscle-tendon system. This muscle solicitation can cause micro lesions followed by a regeneration process of the muscle-tendon system. Eccentric exercise is commonly used in functional rehabilitation for its positive effect on collagen synthesis but also for resistance training to increase muscle strength and muscle mass in athletes. Indeed, eccentric training stimulates muscle hypertrophy, increases the fascicle pennation angle, fascicles length and neural activation, thus inducing greater strength gains than concentric or isometric training programs. Eccentric exercise is commonly performed either against a constant external load (isotonic) or at constant velocity (isokinetic), inducing different mechanical constraints. These different mechanical constraints could induce structural and neural adaptive strategies specific to each type of exercise. The literature tends to show that isotonic mode leads to a greater strength gain than isokinetic mode. This observation could be explained by a greater neuromuscular activation after IT training. However, the specific muscle adaptations induced by each mode remain difficult to determine due to the lack of standardized, comparative studies. 2010 Elsevier Masson SAS. All rights reserved.

  13. Development and evaluation of a removable tissue-engineered muscle with artificial tendons.

    Science.gov (United States)

    Nakamura, Tomohiro; Takagi, Shunya; Kamon, Takafumi; Yamasaki, Ken-Ichi; Fujisato, Toshia

    2017-02-01

    Tissue-engineered skeletal muscles were potentially useful as physiological and biochemical in vitro models. Currently, most of the similar models were constructed without tendons. In this study, we aimed to develop a simple, highly versatile tissue-engineered muscle with artificial tendons, and to evaluate the contractile, histological and molecular dynamics during differentiation. C2C12 cells were embedded in a cold type-І collagen gel and placed between two artificial tendons on a silicone sheet. The construct shrank and tightly attached to the artificial tendons with differentiation, finally detaching from the silicone sheet within 1 week of culture onset. We successfully developed a tissue-engineered skeletal muscle with two artificial tendons from C2C12 myoblasts embedded in type-І collagen gel. The isometric twitch contractile force (TCF) significantly increased during differentiation. Time to Peak Tension (TPT) and Half-Relaxation Time (1/2RT) were significantly shortened during differentiation. Myogenic regulatory factors were maximally expressed at 2 weeks, and subsequently decreased at 3 weeks of culture. Histological analysis indicated that myotube formation increased markedly from 2 weeks and well-ordered sarcomere structures were observed on the surface of the 3D engineered muscle at 3 weeks of culture. These results suggested that robust muscle structure occurred by 3 weeks in the tissue-engineered skeletal muscle. Moreover, during the developmental process, the artificial tendons might contribute to well-ordered sarcomere formation. Our results indicated that this simple culture system could be used to evaluate the effects of various pharmacological and mechanical cues on muscle contractility in a variety of research areas. Copyright © 2016 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

  14. Abductor tendon tears are associated with hypertrophy of the tensor fasciae latae muscle.

    Science.gov (United States)

    Sutter, Reto; Kalberer, Fabian; Binkert, Christoph A; Graf, Nicole; Pfirrmann, Christian W A; Gutzeit, Andreas

    2013-05-01

    To evaluate the association between hypertrophy of the tensor fasciae latae muscle and abductor tendon tears. Thirty-five patients who underwent MRI of the abductor tendons of the hip were included in this retrospective study. A subgroup of 18 patients was examined bilaterally. The area of the tensor fasciae latae muscle and the area of the sartorius muscle (size reference) were quantified at the level of the femoral head, and a ratio was calculated. Two radiologists assessed the integrity of the gluteus medius and minimus tendon in consensus. Data were analyzed with a Mann-Whitney U test. Sixteen out of 35 patients (46 %) had a tear of the gluteus medius or minimus tendon. The ratio of the area of the tensor fasciae latae to the sartorius muscle was significantly higher (p = .028) in the group with an abductor tendon tear (median 2.25; Interquartile Range [IQR] = 1.97-3.21) compared to the group without any tears (median 1.91; IQR = 1.52-2.26). The bilateral subanalysis showed that in patients without a tear, the ratio of the two areas did not differ between each side (p = .966), with a median of 1.54 (primary side) and 1.76 (contralateral side). In patients with an abductor tendon tear the ratio was significantly higher (p = .031) on the side with a tear (median 2.81) compared to the contralateral healthy side (1.67). Patients with abductor tendon tears showed hypertrophy of the tensor fasciae latae muscle when compared to the contralateral healthy side and to patients without a tear.

  15. Repeated freeze-thaw cycles reduce the survival rate of osteocytes in bone-tendon constructs without affecting the mechanical properties of tendons.

    Science.gov (United States)

    Suto, Kaori; Urabe, Ken; Naruse, Kouji; Uchida, Kentaro; Matsuura, Terumasa; Mikuni-Takagaki, Yuko; Suto, Mitsutoshi; Nemoto, Noriko; Kamiya, Kentaro; Itoman, Moritoshi

    2012-03-01

    Frozen bone-patellar tendon bone allografts are useful in anterior cruciate ligament reconstruction as the freezing procedure kills tissue cells, thereby reducing immunogenicity of the grafts. However, a small portion of cells in human femoral heads treated by standard bone-bank freezing procedures survive, thus limiting the effectiveness of allografts. Here, we characterized the survival rates and mechanisms of cells isolated from rat bones and tendons that were subjected to freeze-thaw treatments, and evaluated the influence of these treatments on the mechanical properties of tendons. After a single freeze-thaw cycle, most cells isolated from frozen bone appeared morphologically as osteocytes and expressed both osteoblast- and osteocyte-related genes. Transmission electron microscopic observation of frozen cells using freeze-substitution revealed that a small number of osteocytes maintained large nuclei with intact double membranes, indicating that these osteocytes in bone matrix were resistant to ice crystal formation. We found that tendon cells were completely killed by a single freeze-thaw cycle, whereas bone cells exhibited a relatively high survival rate, although survival was significantly reduced after three freeze-thaw cycles. In patella tendons, the ultimate stress, Young's modulus, and strain at failure showed no significant differences between untreated tendons and those subjected to five freeze-thaw cycles. In conclusion, we identified that cells surviving after freeze-thaw treatment of rat bones were predominantly osteocytes. We propose that repeated freeze-thaw cycles could be applied for processing bone-tendon constructs prior to grafting as the treatment did not affect the mechanical property of tendons and drastically reduced surviving osteocytes, thereby potentially decreasing allograft immunogenecity.

  16. Whey protein hydrolysate augments tendon and muscle hypertrophy independent of resistance exercise contraction mode

    DEFF Research Database (Denmark)

    Farup, Jean; Rahbek, S K; Vendelbo, M H

    2014-01-01

    In a comparative study, we investigated the effects of maximal eccentric or concentric resistance training combined with whey protein or placebo on muscle and tendon hypertrophy. 22 subjects were allocated into either a high-leucine whey protein hydrolysate + carbohydrate group (WHD) or a carbohy......In a comparative study, we investigated the effects of maximal eccentric or concentric resistance training combined with whey protein or placebo on muscle and tendon hypertrophy. 22 subjects were allocated into either a high-leucine whey protein hydrolysate + carbohydrate group (WHD...... or contraction mode effects. In conclusion, high-leucine whey protein hydrolysate augments muscle and tendon hypertrophy following 12 weeks of resistance training – irrespective of contraction mode....

  17. Anabolic Steroids Reduce Muscle Degeneration Associated With Rotator Cuff Tendon Release in Sheep.

    Science.gov (United States)

    Gerber, Christian; Meyer, Dominik C; Flück, Martin; Benn, Mario C; von Rechenberg, Brigitte; Wieser, Karl

    2015-10-01

    Chronic rotator cuff tendon tearing is associated with irreversible atrophy, fatty infiltration, and interstitial fibrosis of the corresponding muscle. Anabolic steroids can prevent musculotendinous degeneration during retraction and/or can reverse these changes after operative repair of the retracted musculotendinous unit in sheep. Controlled laboratory study. The infraspinatus tendon was released in 18 alpine sheep. All sheep underwent repair of the retracted musculotendinous unit after 16 weeks and were sacrificed after 22 weeks; 6 sheep served as controls, 6 sheep were treated with weekly intramuscular injection of 150 mg of nandrolone decanoate after infraspinatus (ISP) repair (group N6W), and 6 sheep were treated with 150 mg of nandrolone decanoate immediately after tendon release (group N22W). Muscle biopsy specimens were taken before tendon release and after 16 and 22 weeks. Muscle volume and fatty infiltration (on MRI), myotendinous retraction, and muscle density (on computed tomography) were measured immediately after ISP release, after 6 weeks, and before ISP repair and sacrifice. Muscle volume on MRI decreased to a mean (±SD) of 80% ± 8% of the original volume after 6 weeks, remained stable at 78% ± 11% after 16 weeks, and decreased further to 69% ± 9% after 22 weeks in the control group. These findings were no different from those in group N22W (72% ± 9% at 6 weeks, 73% ± 6% at 16 weeks, and 67% ± 5% at 22 weeks). Conversely, the N6W group did not show a decrease in ISP volume after repair; this finding differed significantly from the response in the control and N22W groups. Fatty infiltration (on MRI) continuously increased in the control group (12% ± 4% at tendon release, 17% ± 4% after 6 weeks, 50% ± 9% after 16 weeks, and 60% ± 8% after 22 weeks) and the N6W group. However, application of anabolic steroids at the time of tendon release (N22W group) significantly reduced fatty infiltration after 16 (16% ± 5%; P anabolic steroids starting

  18. Ibuprofen Differentially Affects Supraspinatus Muscle and Tendon Adaptations to Exercise in a Rat Model.

    Science.gov (United States)

    Rooney, Sarah Ilkhanipour; Baskin, Rachel; Torino, Daniel J; Vafa, Rameen P; Khandekar, Pooja S; Kuntz, Andrew F; Soslowsky, Louis J

    2016-09-01

    Previous studies have shown that ibuprofen is detrimental to tissue healing after acute injury; however, the effects of ibuprofen when combined with noninjurious exercise are debated. Administration of ibuprofen to rats undergoing a noninjurious treadmill exercise protocol will abolish the beneficial adaptations found with exercise but will have no effect on sedentary muscle and tendon properties. Controlled laboratory study. A total of 167 male Sprague-Dawley rats were divided into exercise or cage activity (sedentary) groups and acute (a single bout of exercise followed by 24 hours of rest) and chronic (2 or 8 weeks of repeated exercise) response times. Half of the rats were administered ibuprofen to investigate the effects of this drug over time when combined with different activity levels (exercise and sedentary). Supraspinatus tendons were used for mechanical testing and histologic assessment (organization, cell shape, cellularity), and supraspinatus muscles were used for morphologic (fiber cross-sectional area, centrally nucleated fibers) and fiber type analysis. Chronic intake of ibuprofen did not impair supraspinatus tendon organization or mechanical adaptations (stiffness, modulus, maximum load, maximum stress, dynamic modulus, or viscoelastic properties) to exercise. Tendon mechanical properties were not diminished and in some instances increased with ibuprofen. In contrast, total supraspinatus muscle fiber cross-sectional area decreased with ibuprofen at chronic response times, and some fiber type-specific changes were detected. Chronic administration of ibuprofen does not impair supraspinatus tendon mechanical properties in a rat model of exercise but does decrease supraspinatus muscle fiber cross-sectional area. This fundamental study adds to the growing literature on the effects of ibuprofen on musculoskeletal tissues and provides a solid foundation on which future work can build. The study findings suggest that ibuprofen does not detrimentally affect

  19. Effects of 12-wk eccentric calf muscle training on muscle-tendon glucose uptake and SEMG in patients with chronic Achilles tendon pain.

    Science.gov (United States)

    Masood, Tahir; Kalliokoski, Kari; Magnusson, S Peter; Bojsen-Møller, Jens; Finni, Taija

    2014-07-15

    High-load eccentric exercises have been a key component in the conservative management of chronic Achilles tendinopathy. This study investigated the effects of a 12-wk progressive, home-based eccentric rehabilitation program on ankle plantar flexors' glucose uptake (GU) and myoelectric activity and Achilles tendon GU. A longitudinal study design with control (n = 10) and patient (n = 10) groups was used. Surface electromyography (SEMG) from four ankle plantar flexors and GU from the same muscles and the Achilles tendon were measured during submaximal intermittent isometric plantar flexion task. The results indicated that the symptomatic leg was weaker (P eccentric rehabilitation. Additionally, the rehabilitation resulted in greater GU in both soleus (P tendon GU than the controls (P effect on the tendon GU. Concerning SEMG, at baseline, soleus showed more relative activity in the symptomatic leg compared with both the asymptomatic and control legs (P Eccentric rehabilitation was effective in decreasing subjective severity of Achilles tendinopathy. It also resulted in redistribution of relative electrical activity, but not metabolic activity, within the triceps surae muscle. Copyright © 2014 the American Physiological Society.

  20. Deltoid muscle and tendon tears in patients with chronic rotator cuff tears

    International Nuclear Information System (INIS)

    Ilaslan, Hakan; Recht, Michael P.; Iannotti, Joseph P.

    2007-01-01

    To describe the magnetic resonance imaging (MRI) appearances of tears of the deltoid muscle and tendon in patients with rotator cuff tears and without a prior history of shoulder surgery. Deltoid tears diagnosed on MR examinations were prospectively recorded between February 2003 through June 2004. The images of these patients were then retrospectively reviewed to determine the location of the deltoid tear, the presence of rotator cuff tears, tendon retraction, muscle atrophy, degree of humeral head subluxation, bony erosive changes involving the undersurface of the acromion, and the presence of edema or fluid-like signal intensity in the deltoid muscle and overlying subcutaneous tissues. There were 24 (0.3%) patients with deltoid tears; nine men and 15 women. The age range was 54 to 87 (average 73) years. The right side was involved in 20 cases, and the left in four cases. Fifteen patients had full thickness and nine had partial thickness tears of the deltoid. Shoulder pain was the most common presenting symptom. The physical examination revealed a defect in the region of the deltoid in two patients. Nineteen patients had tears in the muscle belly near the musculotendinous junction, and five had avulsion of the tendon from the acromial origin. Full thickness rotator cuff tears were present in all of the patients, and 22 patients had associated muscle atrophy. Subcutaneous edema and fluid-like signal was present in 15 patients. Tears of the deltoid muscle or tendon is an unusual finding, but they can be seen in patients with chronic massive rotator cuff tears. Partial thickness tears tend to involve the undersurface of the deltoid muscle and tendon. Associated findings such as intramuscular cyst or ganglion in the deltoid muscle belly and subcutaneous edema or fluid-like signal overlying the deltoid in a patient with a rotator cuff tear should raise the suspicion of a deltoid tear. (orig.)

  1. Deltoid muscle and tendon tears in patients with chronic rotator cuff tears

    Energy Technology Data Exchange (ETDEWEB)

    Ilaslan, Hakan; Recht, Michael P. [Cleveland Clinic, Musculoskeletal Radiology/A21, Division of Radiology, Cleveland, OH (United States); Iannotti, Joseph P. [Cleveland Clinic, Department of Orthopedic Surgery, Cleveland, OH (United States)

    2007-06-15

    To describe the magnetic resonance imaging (MRI) appearances of tears of the deltoid muscle and tendon in patients with rotator cuff tears and without a prior history of shoulder surgery. Deltoid tears diagnosed on MR examinations were prospectively recorded between February 2003 through June 2004. The images of these patients were then retrospectively reviewed to determine the location of the deltoid tear, the presence of rotator cuff tears, tendon retraction, muscle atrophy, degree of humeral head subluxation, bony erosive changes involving the undersurface of the acromion, and the presence of edema or fluid-like signal intensity in the deltoid muscle and overlying subcutaneous tissues. There were 24 (0.3%) patients with deltoid tears; nine men and 15 women. The age range was 54 to 87 (average 73) years. The right side was involved in 20 cases, and the left in four cases. Fifteen patients had full thickness and nine had partial thickness tears of the deltoid. Shoulder pain was the most common presenting symptom. The physical examination revealed a defect in the region of the deltoid in two patients. Nineteen patients had tears in the muscle belly near the musculotendinous junction, and five had avulsion of the tendon from the acromial origin. Full thickness rotator cuff tears were present in all of the patients, and 22 patients had associated muscle atrophy. Subcutaneous edema and fluid-like signal was present in 15 patients. Tears of the deltoid muscle or tendon is an unusual finding, but they can be seen in patients with chronic massive rotator cuff tears. Partial thickness tears tend to involve the undersurface of the deltoid muscle and tendon. Associated findings such as intramuscular cyst or ganglion in the deltoid muscle belly and subcutaneous edema or fluid-like signal overlying the deltoid in a patient with a rotator cuff tear should raise the suspicion of a deltoid tear. (orig.)

  2. Changes in skeletal muscle and tendon structure and function following genetic inactivation of myostatin in rats

    Science.gov (United States)

    Mendias, Christopher L; Lynch, Evan B; Gumucio, Jonathan P; Flood, Michael D; Rittman, Danielle S; Van Pelt, Douglas W; Roche, Stuart M; Davis, Carol S

    2015-01-01

    Myostatin is a negative regulator of skeletal muscle and tendon mass. Myostatin deficiency has been well studied in mice, but limited data are available on how myostatin regulates the structure and function of muscles and tendons of larger animals. We hypothesized that, in comparison to wild-type (MSTN+/+) rats, rats in which zinc finger nucleases were used to genetically inactivate myostatin (MSTNΔ/Δ) would exhibit an increase in muscle mass and total force production, a reduction in specific force, an accumulation of type II fibres and a decrease and stiffening of connective tissue. Overall, the muscle and tendon phenotype of myostatin-deficient rats was markedly different from that of myostatin-deficient mice, which have impaired contractility and pathological changes to fibres and their extracellular matrix. Extensor digitorum longus and soleus muscles of MSTNΔ/Δ rats demonstrated 20–33% increases in mass, 35–45% increases in fibre number, 20–57% increases in isometric force and no differences in specific force. The insulin-like growth factor-1 pathway was activated to a greater extent in MSTNΔ/Δ muscles, but no substantial differences in atrophy-related genes were observed. Tendons of MSTNΔ/Δ rats had a 20% reduction in peak strain, with no differences in mass, peak stress or stiffness. The general morphology and gene expression patterns were similar between tendons of both genotypes. This large rodent model of myostatin deficiency did not have the negative consequences to muscle fibres and extracellular matrix observed in mouse models, and suggests that the greatest impact of myostatin in the regulation of muscle mass may not be to induce atrophy directly, but rather to block hypertrophy signalling. PMID:25640143

  3. Effects of acute static, ballistic, and PNF stretching exercise on the muscle and tendon tissue properties.

    Science.gov (United States)

    Konrad, A; Stafilidis, S; Tilp, M

    2017-10-01

    The purpose of this study was to investigate the influence of a single static, ballistic, or proprioceptive neuromuscular facilitation (PNF) stretching exercise on the various muscle-tendon parameters of the lower leg and to detect possible differences in the effects between the methods. Volunteers (n = 122) were randomly divided into static, ballistic, and PNF stretching groups and a control group. Before and after the 4 × 30 s stretching intervention, we determined the maximum dorsiflexion range of motion (RoM) with the corresponding fascicle length and pennation angle of the gastrocnemius medialis. Passive resistive torque (PRT) and maximum voluntary contraction (MVC) were measured with a dynamometer. Observation of muscle-tendon junction (MTJ) displacement with ultrasound allowed us to determine the length changes in the tendon and muscle, respectively, and hence to calculate stiffness. Although RoM increased (static: +4.3%, ballistic: +4.5%, PNF: +3.5%), PRT (static: -11.4%, ballistic: -11.5%, PNF: -13,7%), muscle stiffness (static: -13.1%, ballistic: -20.3%, PNF: -20.2%), and muscle-tendon stiffness (static: -11.3%, ballistic: -10.5%, PNF: -13.7%) decreased significantly in all the stretching groups. Only in the PNF stretching group, the pennation angle in the stretched position (-4.2%) and plantar flexor MVC (-4.6%) decreased significantly. Multivariate analysis showed no clinically relevant difference between the stretching groups. The increase in RoM and the decrease in PRT and muscle-tendon stiffness could be explained by more compliant muscle tissue following a single static, ballistic, or PNF stretching exercise. © 2017 The Authors Scandinavian Journal of Medicine & Science In Sports Published by John Wiley & Sons Ltd.

  4. Articular Cartilage Increases Transition Zone Regeneration in Bone-tendon Junction Healing

    Science.gov (United States)

    Qin, Ling; Lee, Kwong Man; Leung, Kwok Sui

    2008-01-01

    The fibrocartilage transition zone in the direct bone-tendon junction reduces stress concentration and protects the junction from failure. Unfortunately, bone-tendon junctions often heal without fibrocartilage transition zone regeneration. We hypothesized articular cartilage grafts could increase fibrocartilage transition zone regeneration. Using a goat partial patellectomy repair model, autologous articular cartilage was harvested from the excised distal third patella and interposed between the residual proximal two-thirds bone fragment and tendon during repair in 36 knees. We evaluated fibrocartilage transition zone regeneration, bone formation, and mechanical strength after repair at 6, 12, and 24 weeks and compared them with direct repair. Autologous articular cartilage interposition resulted in more fibrocartilage transition zone regeneration (69.10% ± 14.11% [mean ± standard deviation] versus 8.67% ± 7.01% at 24 weeks) than direct repair at all times. There was no difference in the amount of bone formation and mechanical strength achieved. Autologous articular cartilage interposition increases fibrocartilage transition zone regeneration in bone-tendon junction healing, but additional research is required to ascertain the mechanism of stimulation and to establish the clinical applicability. PMID:18987921

  5. Noninvasive Cu-64-ATSM and PET/CT Assessment of Hypoxia in Rat Skeletal Muscles and Tendons During Muscle Contractions

    DEFF Research Database (Denmark)

    Skovgaard, D.; Kjaer, M.; Madsen, J.

    2009-01-01

    the first PET/CT scan. Standardized uptake values (SUVs) were calculated for the Achilles tendons and triceps surae muscles and were correlated to gene expression of HIF1 alpha and CAIII using real-time polymerase chain reaction. Results: Immediately after the contractions, uptake of Cu-64-ATSM......The purpose of the present study was to investigate exercise-related changes in oxygenation in rat skeletal muscles and tendons noninvasively with PET/CT and the hypoxia-selective tracer Cu-64-diacetyl bis(N-4-methylthiosemicarbazone) (ATSM) and to quantitatively study concomitant changes in gene...... expression of 2 hypoxia-related genes, hypoxia-inducible factor 1 alpha (HIF1 alpha) and carbonic anhydrase III (CAIII). Methods: Two groups of Wistar rats performed 1-leg contractions of the calf muscle by electrostimulation of the sciatic nerve. After 10 min of muscle contractions, Cu-64-ATSM was injected...

  6. Firm anchoring between a calcium phosphate-hybridized tendon and bone for anterior cruciate ligament reconstruction in a goat model

    Energy Technology Data Exchange (ETDEWEB)

    Mutsuzaki, Hirotaka [Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami Ami-machi, Inashiki-gun, Ibaraki 300-0394 (Japan); Sakane, Masataka; Ochiai, Naoyuki [Department of Orthopaedic Surgery, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 (Japan); Hattori, Shinya; Kobayashi, Hisatoshi, E-mail: sakane-m@md.tsukuba.ac.j [Biomaterial Center, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044 (Japan)

    2009-08-15

    Using an alternative soaking process improved the tendon-bone attachment for a calcium phosphate (CaP)-hybridized tendon graft. We characterized the deposited CaP on and in tendons and analyzed the histology and mechanical properties of the tendon-bone interface in anterior cruciate ligament (ACL) reconstruction in goats. The tendon grafts to be implanted were soaked ten times alternately in a Ca-containing solution and a PO{sub 4}-containing solution for 30 s each. Needlelike CaP nanocrystals including low-crystalline apatite were deposited on and between collagen fibrils from the surface to a depth of 200{mu}m inside the tendon. The structure resembles the extracellular matrix of bone. In animal experiments, the CaP-hybridized tendon directly bonded with newly formed bone at 6 weeks (n = 3), while fibrous bonding was observed in the control (n = 3). The ultimate failure load was not statistically different between the CaP (n = 7) and control (n = 7). However, in the failure mode, all the tendon-bone interfaces were intact in the CaP group, while three of seven specimens were pulled out from bone tunnels in the control. The result suggested that the strength of the tendon-bone interface in the CaP group is superior to that in the control group. Clinically, firm tendon-bone anchoring may lead to good results without the knee instability associated with the loosening of the bone-tendon junction in ACL reconstruction.

  7. Effect of the Interposition of Calcium Phosphate Materials on Tendon-Bone Healing During Repair of Chronic Rotator Cuff Tear.

    Science.gov (United States)

    Zhao, Song; Peng, Lingjie; Xie, Guoming; Li, Dingfeng; Zhao, Jinzhong; Ning, Congqin

    2014-08-01

    The current nature of tendon-bone healing after rotator cuff (RC) repair is still the formation of granulation tissue at the tendon-bone interface rather than the formation of fibrocartilage, which is the crucial structure in native tendon insertion and can be observed after knee ligament reconstruction. The interposition of calcium phosphate materials has been found to be able to enhance tendon-bone healing in knee ligament reconstruction. However, whether the interposition of these kinds of materials can enhance tendon-bone healing or even change the current nature of tendon-bone healing after RC repair still needs to be explored. The interposition of calcium phosphate materials during RC repair would enhance tendon-bone healing or change its current nature of granulation tissue formation into a more favorable process. Controlled laboratory study. A total of 144 male Sprague-Dawley rats underwent unilateral detachment of the supraspinatus tendon, followed by delayed repair after 3 weeks. The animals were allocated into 1 of 3 groups: (1) repair alone, (2) repair with Ca5(PO4)2SiO4 (CPS) bioceramic interposition, or (3) repair with hydroxyapatite (HA) bioceramic interposition at the tendon-bone interface. Animals were sacrificed at 2, 4, or 8 weeks postoperatively, and microcomputed tomography (micro-CT) was used to quantify the new bone formation at the repair site. New fibrocartilage formation and collagen organization at the tendon-bone interface was evaluated by histomorphometric analysis. Biomechanical testing of the supraspinatus tendon-bone complex was performed. Statistical analysis was performed using 1-way analysis of variance. Significance was set at P repair, CPS bioceramic significantly increased the area of fibrocartilage at the tendon-bone interface compared with the control and HA groups. Moreover, CPS and HA bioceramics had significantly improved collagen organization. Biomechanical tests indicated that the CPS and HA groups have greater ultimate

  8. Effects of low-intensity pulsed ultrasound on new trabecular bone during bone-tendon junction healing in a rabbit model: a synchrotron radiation micro-CT study.

    Directory of Open Access Journals (Sweden)

    Hongbin Lu

    Full Text Available This study was designed to evaluate the effects of low-intensity pulsed ultrasound on bone regeneration during the bone-tendon junction healing process and to explore the application of synchrotron radiation micro computed tomography in three dimensional visualization of the bone-tendon junction to evaluate the microarchitecture of new trabecular bone. Twenty four mature New Zealand rabbits underwent partial patellectomy to establish a bone-tendon junction injury model at the patella-patellar tendon complex. Animals were then divided into low-intensity pulsed ultrasound treatment (20 min/day, 7 times/week and placebo control groups, and were euthanized at week 8 and 16 postoperatively (n = 6 for each group and time point. The patella-patellar tendon specimens were harvested for radiographic, histological and synchrotron radiation micro computed tomography detection. The area of the newly formed bone in the ultrasound group was significantly greater than that of control group at postoperative week 8 and 16. The high resolution three dimensional visualization images of the bone-tendon junction were acquired by synchrotron radiation micro computed tomography. Low-intensity pulsed ultrasound treatment promoted dense and irregular woven bone formation at week 8 with greater bone volume fraction, number and thickness of new trabecular bone but with lower separation. At week 16, ultrasound group specimens contained mature lamellar bone with higher bone volume fraction and thicker trabeculae than that of control group; however, there was no significant difference in separation and number of the new trabecular bone. This study confirms that low-intensity pulsed ultrasound treatment is able to promote bone formation and remodeling of new trabecular bone during the bone-tendon junction healing process in a rabbit model, and the synchrotron radiation micro computed tomography could be applied for three dimensional visualization to quantitatively evaluate

  9. Effect of unloading followed by reloading on expression of collagen and related growth factors in rat tendon and muscle

    DEFF Research Database (Denmark)

    Heinemeier, K M; Olesen, J L; Haddad, F

    2009-01-01

    Tendon tissue and the extracellular matrix of skeletal muscle respond to mechanical loading by increased collagen expression and synthesis. This response is likely a secondary effect of a mechanically induced expression of growth factors, including transforming growth factor-beta1 (TGF-beta1......) and insulin-like growth factor-I (IGF-I). It is not known whether unloading of tendon tissue can reduce the expression of collagen and collagen-inducing growth factors. Furthermore, the coordinated response of tendon and muscle tissue to disuse, followed by reloading, is unclear. Female Sprague-Dawley rats...... tissue growth factor (CTGF), myostatin, and IGF-I isoforms were measured by real-time RT-PCR in Achilles tendon and soleus muscle. The tendon mass was unchanged, while the muscle mass was reduced by 50% after HS (P

  10. A model of the human triceps surae muscle-tendon complex applied to jumping

    NARCIS (Netherlands)

    Bobbert, Maarten F.; Huijing, Peter A.; van Ingen Schenau, Gerrit Jan

    1986-01-01

    The purpose of this study was to gain more insight into the behavior of the muscle-tendon complex of human m. triceps surae in jumping. During one-legged vertical jumps of ten subjects ground reaction forces as well as cinematographic data were registered, and electromyograms were recorded from m.

  11. Composition and structure of porcine digital flexor tendon-bone insertion tissues.

    Science.gov (United States)

    Chandrasekaran, Sandhya; Pankow, Mark; Peters, Kara; Huang, Hsiao-Ying Shadow

    2017-11-01

    Tendon-bone insertion is a functionally graded tissue, transitioning from 200 MPa tensile modulus at the tendon end to 20 GPa tensile modulus at the bone, across just a few hundred micrometers. In this study, we examine the porcine digital flexor tendon insertion tissue to provide a quantitative description of its collagen orientation and mineral concentration by using Fast Fourier Transform (FFT) based image analysis and mass spectrometry, respectively. Histological results revealed uniformity in global collagen orientation at all depths, indicative of mechanical anisotropy, although at mid-depth, the highest fiber density, least amount of dispersion, and least cellular circularity were evident. Collagen orientation distribution obtained through 2D FFT of histological imaging data from fluorescent microscopy agreed with past measurements based on polarized light microscopy. Results revealed global fiber orientation across the tendon-bone insertion to be preserved along direction of physiologic tension. Gradation in the fiber distribution orientation index across the insertion was reflective of a decrease in anisotropy from the tendon to the bone. We provided elemental maps across the fibrocartilage for its organic and inorganic constituents through time-of-flight secondary ion mass spectrometry (TOF-SIMS). The apatite intensity distribution from the tendon to bone was shown to follow a linear trend, supporting past results based on Raman microprobe analysis. The merit of this study lies in the image-based simplified approach to fiber distribution quantification and in the high spatial resolution of the compositional analysis. In conjunction with the mechanical properties of the insertion tissue, fiber, and mineral distribution results for the insertion from this may potentially be incorporated into the development of a structural constitutive approach toward computational modeling. Characterizing the properties of the native insertion tissue would provide the

  12. Advanced age diminishes tendon-to-bone healing in a rat model of rotator cuff repair.

    Science.gov (United States)

    Plate, Johannes F; Brown, Philip J; Walters, Jordan; Clark, John A; Smith, Thomas L; Freehill, Michael T; Tuohy, Christopher J; Stitzel, Joel D; Mannava, Sandeep

    2014-04-01

    Advanced patient age is associated with recurrent tearing and failure of rotator cuff repairs clinically; however, basic science studies have not evaluated the influence of aging on tendon-to-bone healing after rotator cuff repair in an animal model. Hypothesis/ This study examined the effect of aging on tendon-to-bone healing in an established rat model of rotator cuff repair using the aged animal colony from the National Institute on Aging of the National Institutes of Health. The authors hypothesized that normal aging decreases biomechanical strength and histologic organization at the tendon-to-bone junction after acute repair. Controlled laboratory study. In 56 F344xBN rats, 28 old and 28 young (24 and 8 months of age, respectively), the supraspinatus tendon was transected and repaired. At 2 or 8 weeks after surgery, shoulder specimens underwent biomechanical testing to compare load-to-failure and load-relaxation response between age groups. Histologic sections of the tendon-to-bone interface were assessed with hematoxylin and eosin staining, and collagen fiber organization was assessed by semiquantitative analysis of picrosirius red birefringence under polarized light. Peak failure load was similar between young and old animals at 2 weeks after repair (31% vs 26% of age-matched uninjured controls, respectively; P > .05) but significantly higher in young animals compared with old animals 8 weeks after repair (86% vs 65% of age-matched uninjured controls, respectively; P repair, fibroblasts appeared more organized and uniformly aligned in young animals on hematoxylin and eosin slides compared with old animals. Collagen birefringence analysis of the tendon-to-bone junction demonstrated that young animals had increased collagen fiber organization and similar histologic structure compared with age-matched controls (53.7 ± 2.4 gray scales; P > .05). In contrast, old animals had decreased collagen fiber organization and altered structure compared with age

  13. Muscle-tendon related pain in 100 patients with hip dysplasia: prevalence and associations with self-reported hip disability and muscle strength

    DEFF Research Database (Denmark)

    Jacobsen, Julie Sandell

    2017-01-01

    Introduction Intra-articular injury has been described as primary cause of pain in hip dysplasia. At this point, it is unknown whether external muscle-tendon related pain coexists with intra-articular pathology. The primary aim was to identify muscle-tendon related pain in 100 patients with hip...... dysplasia. The secondary aim was to test if muscle-tendon related pain is linearly associated to self-reported hip disability and muscle strength in patients with hip dysplasia. Materials and methods One hundred patients (17 men) with a mean age of 29+9 years were included. Clinical entity approach...... (phip dysplasia with a high...

  14. [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.

  15. Hydroxyapatite-doped polycaprolactone nanofiber membrane improves tendon-bone interface healing for anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Han, Fei; Zhang, Peng; Sun, Yaying; Lin, Chao; Zhao, Peng; Chen, Jiwu

    2015-01-01

    Hamstring tendon autograft is a routine graft for anterior cruciate ligament (ACL) reconstruction. However, ways of improving the healing between the tendon and bone is often overlooked in clinical practice. This issue can be addressed by using a biomimetic scaffold. Herein, a biomimetic nanofiber membrane of polycaprolactone/nanohydroxyapatite/collagen (PCL/nHAp/Col) is fabricated that mimics the composition of native bone tissue for promoting tendon-bone healing. This membrane has good cytocompatibility, allowing for osteoblast cell adhesion and growth and bone formation. As a result, MC3T3 cells reveal a higher mineralization level in PCL/nHAp/Col membrane compared with PCL membrane alone. Further in vivo studies in ACL reconstruction in a rabbit model shows that PCL/nHAp/Col-wrapped tendon may afford superior tissue integration to nonwrapped tendon in the interface between the tendon and host bone as well as improved mechanical strength. This study shows that PCL/nHAp/Col nanofiber membrane wrapping of autologous tendon is effective for improving tendon healing with host bone in ACL reconstruction.

  16. Inhibition of 5-LOX, COX-1, and COX-2 increases tendon healing and reduces muscle fibrosis and lipid accumulation after rotator cuff repair.

    Science.gov (United States)

    Oak, Nikhil R; Gumucio, Jonathan P; Flood, Michael D; Saripalli, Anjali L; Davis, Max E; Harning, Julie A; Lynch, Evan B; Roche, Stuart M; Bedi, Asheesh; Mendias, Christopher L

    2014-12-01

    The repair and restoration of function after chronic rotator cuff tears are often complicated by muscle atrophy, fibrosis, and fatty degeneration of the diseased muscle. The inflammatory response has been implicated in the development of fatty degeneration after cuff injuries. Licofelone is a novel anti-inflammatory drug that inhibits 5-lipoxygenase (5-LOX), as well as cyclooxygenase (COX)-1 and COX-2 enzymes, which play important roles in inducing inflammation after injuries. While previous studies have demonstrated that nonsteroidal anti-inflammatory drugs and selective inhibitors of COX-2 (coxibs) may prevent the proper healing of muscles and tendons, studies about bone and cartilage have demonstrated that drugs that inhibit 5-LOX concurrently with COX-1 and COX-2 may enhance tissue regeneration. After the repair of a chronic rotator cuff tear in rats, licofelone would increase the load to failure of repaired tendons and increase the force production of muscle fibers. Controlled laboratory study. Rats underwent supraspinatus release followed by repair 28 days later. After repair, rats began a treatment regimen of either licofelone or a vehicle for 14 days, at which time animals were euthanized. Supraspinatus muscles and tendons were then subjected to contractile, mechanical, histological, and biochemical analyses. Compared with controls, licofelone-treated rats had a grossly apparent decrease in inflammation and increased fibrocartilage formation at the enthesis, along with a 62% increase in the maximum load to failure and a 51% increase in peak stress to failure. Licofelone resulted in a marked reduction in fibrosis and lipid content in supraspinatus muscles as well as reduced expression of several genes involved in fatty infiltration. Despite the decline in fibrosis and fat accumulation, muscle fiber specific force production was reduced by 23%. The postoperative treatment of cuff repair with licofelone may reduce fatty degeneration and enhance the development

  17. Flexible bipolar nanofibrous membranes for improving gradient microstructure in tendon-to-bone healing.

    Science.gov (United States)

    Li, Xiaoxi; Cheng, Ruoyu; Sun, Zhiyong; Su, Wei; Pan, Guoqing; Zhao, Song; Zhao, Jinzhong; Cui, Wenguo

    2017-10-01

    Enthesis is a specialized tissue interface between the tendon and bone. Enthesis structure is very complex because of gradient changes in its composition and structure. There is currently no strategy to create a suitable environment and to regenerate the gradual-changing enthesis because of the modular complexities between two tissue types. Herein, a dual-layer organic/inorganic flexible bipolar fibrous membrane (BFM) was successfully fabricated by electrospinning to generate biomimetic non-mineralized fibrocartilage and mineralized fibrocartilage in tendon-to-bone integration of enthesis. The growth of the in situ apatite nanoparticle layer was induced on the nano hydroxyapatite-poly-l-lactic acid (nHA-PLLA) fibrous layer in simulated body solution, and the poly-l-lactic acid (PLLA) fibrous layer retained its original properties to induce tendon regeneration. The in vivo results showed that BFM significantly increased the area of glycosaminoglycan staining at the tendon-bone interface and improved collagen organization when compared to the simplex fibrous membrane (SFM) of PLLA. Implanting the bipolar membrane also induced bone formation and fibrillogenesis as assessed by micro-CT and histological analysis. Biomechanical testing showed that the BFM group had a greater ultimate load-to-failure and stiffness than the SFM group at 12weeks after surgery. Therefore, this flexible bipolar nanofibrous membrane improves the healing and regeneration process of the enthesis in rotator cuff repair. In this study, we generated a biomimetic dual-layer organic/inorganic flexible bipolar fibrous membrane by sequential electrospinning and in situ biomineralization, producing integrated bipolar fibrous membranes of PLLA fibrous membrane as the upper layer and nHA-PLLA fibrous membrane as the lower layer to mimic non-mineralized fibrocartilage and mineralized fibrocartilage in tendon-to-bone integration of enthesis. Flexible bipolar nanofibrous membranes could be easily fabricated

  18. Medial gastrocnemius and soleus muscle-tendon unit, fascicle, and tendon interaction during walking in children with cerebral palsy.

    Science.gov (United States)

    Barber, Lee; Carty, Chris; Modenese, Luca; Walsh, John; Boyd, Roslyn; Lichtwark, Glen

    2017-08-01

    This study investigates the in vivo function of the medial gastrocnemius and soleus muscle-tendon units (MTU), fascicles, and tendons during walking in children with cerebral palsy (CP) and an equinus gait pattern. Fourteen children with CP (9 males, 5 females; mean age 10y 6mo, standard deviation [SD] 2y 11mo; GMFCS level I=8, II=6), and 10 typically developing (6 males, 4 females; mean age 10y, SD 2y 1mo) undertook full body 3D gait analysis and simultaneous B-mode ultrasound images of the medial gastrocnemius and soleus fascicles during level walking. Fascicle lengths were analysed using a semi-automated tracking algorithm and MTUs using OpenSim. Statistical parametric mapping (two-sample t-test) was used to compare differences between groups (ppower during push-off (p=0.015) and positive work (ppower and positive work in the children with CP may be attributed to reduced active medial gastrocnemius fascicle shortening. These findings suggest a reliance on passive force generation for forward propulsion during equinus gait. © 2017 Mac Keith Press.

  19. Ibuprofen Differentially Affects Supraspinatus Muscle and Tendon Adaptations to Exercise in a Rat Model

    Science.gov (United States)

    Rooney, Sarah Ilkhanipour; Baskin, Rachel; Torino, Daniel J.; Vafa, Rameen P.; Khandekar, Pooja S.; Kuntz, Andrew F.; Soslowsky, Louis J.

    2017-01-01

    Background Previous studies have shown that ibuprofen is detrimental to tissue healing following acute injury; however, the effects of ibuprofen when combined with non-injurious exercise are debated. Hypothesis We hypothesized that administration of ibuprofen to rats undergoing a non-injurious treadmill exercise protocol would abolish the beneficial adaptations found with exercise but have no effect on sedentary muscle and tendon properties. Study Design Controlled laboratory study Methods Rats were divided into exercise or cage activity (sedentary) groups and acute (a single bout of exercise followed by 24 hours of rest) and chronic (2 or 8 weeks of repeated exercise) time points. Half of the rats received ibuprofen to investigate the effects of this drug over time when combined with different activity levels (exercise and sedentary). Supraspinatus tendons were used for mechanical testing and histology (organization, cell shape, cellularity), and supraspinatus muscles were used for morphological (fiber CSA, centrally nucleated fibers) and fiber type analysis. Results Chronic intake of ibuprofen did not impair supraspinatus tendon organization or mechanical adaptations (stiffness, modulus, max load, max stress, dynamic modulus, or viscoelastic properties) to exercise. Tendon mechanical properties were not diminished and in some instances increased with ibuprofen. In contrast, total supraspinatus muscle fiber cross-sectional area decreased with ibuprofen at chronic time points, and some fiber type-specific changes were detected. Conclusions Chronic administration of ibuprofen does not impair supraspinatus tendon mechanical properties in a rat model of exercise but does decrease supraspinatus muscle fiber cross-sectional area. Clinically, these findings suggest that ibuprofen does not detrimentally affect regulation of supraspinatus tendon adaptions to exercise but does decrease muscle growth. Individuals should be advised on the risk of decreased muscle hypertrophy

  20. Enhanced Tendon-to-Bone Healing of Chronic Rotator Cuff Tears by Bone Marrow Aspirate Concentrate in a Rabbit Model

    Science.gov (United States)

    Liu, Xiao Ning; Yang, Cheol-Jung; Kim, Ji Eui; Du, Zhen Wu; Ren, Ming; Zhang, Wei; Zhao, Hong Yu; Kim, Kyung Ok

    2018-01-01

    Background To evaluate the influence of bone marrow aspirate concentrate (BMAC) on tendon-to-bone healing in a rabbit rotator cuff model and to characterize the composition of growth factors in BMAC. Methods In this in vivo study, 40 rabbits were allocated into five groups: control (C), repair + saline (RS), repair + platelet-rich plasma (PRP; RP), repair + BMAC (RB) and repair + PRP + BMAC (RPB). A tear model was created by supraspinatus tendon transection at the footprint. Six weeks after transection, the torn tendon was repaired along with BMAC or PRP administration. Six weeks after repair, shoulder samples were harvested for biomechanical and histological testing. Ten rabbits were used for processing PRP and BMAC, followed by analysis of blood cell composition and the levels of growth factors in vitro. Results The ultimate load-to-failure was significantly higher in RPB group compared to RS group (p = 0.025). BMAC-treated groups showed higher values of biomechanical properties than RS group. The histology of BMAC-treated samples showed better collagen fiber continuity and orientation than RS group. BMAC contained significantly higher levels of the several growth factors than PRP. Conclusions Locally administered BMAC enhanced tendon-to-bone healing and has potential for clinical applications. PMID:29564054

  1. Effect of age on fatty infiltration of supraspinatus muscle after experimental tendon release in rats

    Directory of Open Access Journals (Sweden)

    Farshad Mazda

    2011-12-01

    Full Text Available Abstract Background Rotator cuff tendon tear is a leading cause for atrophy, fibrosis and fatty infiltration of the rotator cuff muscles. The pathophysiology of fatty muscle infiltration is not well understood. An animal model suited to study cellular and molecular mechanisms would therefore be desirable. While a rat model has been established for chronic rotator cuff tendon pathology, sufficient and easily identifiable fatty infiltration of the muscle has not yet been shown in rats. As younger animals regenerate better, we hypothesized that the absence of a sufficient amount of fatty infiltration in previous experiments was due to the selection of young animals and that older animals would exhibit higher amounts of fatty infiltration after tendon tear. Findings The supraspinatus tendon was released using tenotomy in 3 young (6 weeks old and in 3 aged (24 months old Sprague Dawley rats (group I and II. Another 3 aged (24 months old rats underwent sham surgery and served as a control group (group III. In group I and II retraction of the musculotendinous unit was allowed for 6 weeks. All animals were sacrificed 6 weeks after surgery and the supraspinatus muscles were harvested. Each sample was examined for fatty infiltration of the muscle by histological methods and micro-CT. In histology, fat cells were counted with a 10-fold magnification in 6 fields of view twice. An adjusted measurement setup was developed for the use of micro-CT to quantify the absorption coefficient of the muscle as a reciprocal indicator for fatty infiltration, based on the established procedure for quantification of fatty infiltration on CT in humans. Tenotomy resulted in an insignificant increase of fat cells in histological sections in both, aged and young rats. Micro-CT was able to quantify small differences in the absorption coefficients of muscle samples; the absorption coefficient was 8.1% ± 11.3% lower in retracted muscles (group I and II compared with the control

  2. [Foster Modification of Full Tendon Transposition of Vertical Rectus Muscles for Sixth Nerve Palsy].

    Science.gov (United States)

    Heede, Santa

    2018-04-11

    Since 1907 a variety of muscle transposition procedures for the treatment of abducens nerve palsy has been established internationally. Full tendon transposition of the vertical rectus muscle was initially described by O'Connor 1935 and then augmented by Foster 1997 with addition of posterior fixation sutures on the vertical rectus muscle. Full tendon transposition augmented by Foster belongs to the group of the most powerful surgical techniques to improve the abduction. Purpose of this study was to evaluate the results of full tendon vertical rectus transposition augmented with lateral fixation suture for patients with abducens nerve palsy. Full tendon transpositions of vertical rectus muscles augmented with posterior fixation suture was performed in 2014 on five patients with abducens nerve palsy. Two of the patients received Botox injections in the medial rectus muscle: one of them three months after the surgery and another during the surgery. One of the patients had a combined surgery of the horizontal muscles one year before. On three of the patients, who received a pure transposition surgery, the preoperative deviation at the distance (mean: + 56.6 pd; range: + 40 to + 80 pd) was reduced by a mean of 39.6 pd (range 34 to 50 pd), the abduction was improved by a mean of 3 mm (range 2 to 4 mm). The other two patients, who received besides the transposition procedure additional surgeries of the horizontal muscles, the preoperative deviation at the distance (+ 25 and + 126 pd respectively) was reduced by 20 and 81 pd respectively. The abduction was improved by 4 and 8 mm respectively. After surgery two patients developed a vertical deviation with a maximum of 4 pd. None of the patients had complications or signs of anterior segment ischemia. The elevation and/or depression was only marginally affected. There was no diplopia in up- or downgaze. Full tendon transposition of vertical rectus muscles, augmented with lateral posterior fixation suture is

  3. Multifunctional magnetic-responsive hydrogels to engineer tendon-to-bone interface.

    Science.gov (United States)

    Silva, Elsa D; Babo, Pedro S; Costa-Almeida, Raquel; Domingues, Rui M A; Mendes, Bárbara B; Paz, Elvira; Freitas, Paulo; Rodrigues, Márcia T; Granja, Pedro L; Gomes, Manuela E

    2017-06-11

    Photocrosslinkable magnetic hydrogels are attracting great interest for tissue engineering strategies due to their versatility and multifunctionality, including their remote controllability ex vivo, thus enabling engineering complex tissue interfaces. This study reports the development of a photocrosslinkable magnetic responsive hydrogel made of methacrylated chondroitin sulfate (MA-CS) enriched with platelet lysate (PL) with tunable features, envisioning their application in tendon-to-bone interface. MA-CS coated iron-based magnetic nanoparticles were incorporated to provide magnetic responsiveness to the hydrogel. Osteogenically differentiated adipose-derived stem cells and/or tendon-derived cells were encapsulated within the hydrogel, proliferating and expressing bone- and tendon-related markers. External magnetic field (EMF) application modulated the swelling, degradation and release of PL-derived growth factors, and impacted both cell morphology and the expression and synthesis of tendon- and bone-like matrix with a more evident effect in co-cultures. Overall, the developed magnetic responsive hydrogel represents a potential cell carrier system for interfacial tissue engineering with EMF-controlled properties. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Plantarflexor muscle function in healthy and chronic Achilles tendon pain subjects evaluated by the use of EMG and PET imaging

    DEFF Research Database (Denmark)

    Masood, Tahir; Kalliokoski, Kari; Bojsen-Møller, Jens

    2014-01-01

    BACKGROUND: Achilles tendon pathologies may alter the coordinative strategies of synergistic calf muscles. We hypothesized that both surface electromyography and positron emission tomography would reveal differences between symptomatic and asymptomatic legs in Achilles tendinopathy patients and b...

  5. Growth hormone stimulates the collagen synthesis in human tendon and skeletal muscle without affecting myofibrillar protein synthesis

    DEFF Research Database (Denmark)

    Doessing, Simon; Heinemeier, Katja M; Holm, Lars

    2010-01-01

    young individuals. rhGH administration caused an increase in serum GH, serum IGF-I, and IGF-I mRNA expression in tendon and muscle. Tendon collagen I mRNA expression and tendon collagen protein synthesis increased by 3.9-fold and 1.3-fold, respectively (P ...RNA expression and muscle collagen protein synthesis increased by 2.3-fold and 5.8-fold, respectively (P protein synthesis was unaffected by elevation of GH and IGF-I. Moderate exercise did not enhance the effects of GH manipulation. Thus, increased GH availability stimulates...... matrix collagen synthesis in skeletal muscle and tendon, but without any effect upon myofibrillar protein synthesis. The results suggest that GH is more important in strengthening the matrix tissue than for muscle cell hypertrophy in adult human musculotendinous tissue....

  6. Expression of collagen and related growth factors in rat tendon and skeletal muscle in response to specific contraction types

    DEFF Research Database (Denmark)

    Heinemeier, K M; Olesen, J L; Haddad, F

    2007-01-01

    greater than the effect of concentric training on the expression of several transcripts. In conclusion, the study supports an involvement of TGF-beta-1 in loading-induced collagen synthesis in the muscle-tendon unit and importantly, it indicates that muscle tissue is more sensitive than tendon......Acute exercise induces collagen synthesis in both tendon and muscle, indicating an adaptive response in the connective tissue of the muscle-tendon unit. However, the mechanisms of this adaptation, potentially involving collagen-inducing growth factors (such as transforming growth factor-beta-1 (TGF......-beta-1)), as well as enzymes related to collagen processing, are not clear. Furthermore, possible differential effects of specific contraction types on collagen regulation have not been investigated. Female Sprague-Dawley rats were subjected to 4 days of concentric, eccentric or isometric training (n = 7...

  7. Effect of eccentric training on the plantar flexor muscle-tendon tissue properties.

    Science.gov (United States)

    Mahieu, Nele Nathalie; McNair, Peter; Cools, Ann; D'Haen, Caroline; Vandermeulen, Katrien; Witvrouw, Erik

    2008-01-01

    It has been shown that eccentric training can be effective in the rehabilitation of patients with Achilles tendonopathy. The mechanism behind these results is not clear. However, there is evidence that tendons are able to respond to repeated forces by altering their structure and composition, and, thus, their mechanical properties change. In this regard, the objective of the present study was to investigate whether eccentric training affects the mechanical properties of the plantar flexor's muscle-tendon tissue properties. Seventy-four healthy subjects were randomized into two groups: an eccentric training group and a control group. The eccentric training group performed a 6-wk eccentric training program for the calf muscles. Before and after this period, all subjects were evaluated for dorsiflexion range of motion using universal goniometry, passive resistive torque of the plantar flexors, and stiffness of the Achilles tendon. Passive resistive torque was measured during ankle dorsiflexion on an isokinetic dynamometer. Stiffness of the Achilles tendon was assessed using a dynamometer, in combination with ultrasonography. The results of the study reveal that the dorsiflexion range of motion was significantly increased only in the eccentric training group. The eccentric heel drop program also resulted in a significant decrease of the passive resistive torque of the plantar flexors (from 16.423 +/- 0.827 to 12.651 +/- 0.617 N.m). The stiffness of the Achilles tendon did not change significantly as a result of training. These findings provide evidence that an eccentric training program results in changes to some of the mechanical properties of the plantar flexor muscles. These changes were thought to be associated with modifications to structure rather than to stretch tolerance.

  8. Whey protein hydrolysate augments tendon and muscle hypertrophy independent of resistance exercise contraction mode.

    Science.gov (United States)

    Farup, J; Rahbek, S K; Vendelbo, M H; Matzon, A; Hindhede, J; Bejder, A; Ringgard, S; Vissing, K

    2014-10-01

    In a comparative study, we investigated the effects of maximal eccentric or concentric resistance training combined with whey protein or placebo on muscle and tendon hypertrophy. 22 subjects were allocated into either a high-leucine whey protein hydrolysate + carbohydrate group (WHD) or a carbohydrate group (PLA). Subjects completed 12 weeks maximal knee extensor training with one leg using eccentric contractions and the other using concentric contractions. Before and after training cross-sectional area (CSA) of m. quadriceps and patellar tendon CSA was quantified with magnetic resonance imaging and a isometric strength test was used to assess maximal voluntary contraction (MVC) and rate of force development (RFD). Quadriceps CSA increased by 7.3 ± 1.0% (P tendon CSA increased by 14.9 ± 3.1% (P effect of contraction mode. MVC and RFD increased by 15.6 ± 3.5% (P effects. In conclusion, high-leucine whey protein hydrolysate augments muscle and tendon hypertrophy following 12 weeks of resistance training - irrespective of contraction mode. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Increased cellular proliferation in rat skeletal muscle and tendon in response to exercise

    DEFF Research Database (Denmark)

    Skovgaard, Dorthe; Bayer, Monika L; Mackey, Abigail

    2010-01-01

    PURPOSE: The purpose of this study is to investigate exercise-induced cellular proliferation in rat skeletal muscle/tendon with the use of 3'-[F-18]fluoro-3'deoxythymidine (FLT) and to quantitatively study concomitant changes in the proliferation-associated factor, Ki67. PROCEDURES: Wistar rats (...... = 13) performed 3 days of treadmill running. Cellular proliferation was investigated 3 days before and 48 h after the running exercise with the use of FLT and positron emission tomography/computed tomography (PET/CT). Results were compared to a sedentary control group (n = 10). Image......-derived results were supported by a correlation in calf muscle to Ki67 (protein and mRNA level), while this coherence was not found in tendon. CONCLUSION: FLT-PET seems to be a promising tool for imaging of exercise-induced cellular proliferation in musculo-tendinous tissue....

  10. Architecture and functional ecology of the human gastrocnemius muscle-tendon unit.

    Science.gov (United States)

    Butler, Erin E; Dominy, Nathaniel J

    2016-04-01

    The gastrocnemius muscle-tendon unit (MTU) is central to human locomotion. Structural variation in the human gastrocnemius MTU is predicted to affect the efficiency of locomotion, a concept most often explored in the context of performance activities. For example, stiffness of the Achilles tendon varies among individuals with different histories of competitive running. Such a finding highlights the functional variation of individuals and raises the possibility of similar variation between populations, perhaps in response to specific ecological or environmental demands. Researchers often assume minimal variation in human populations, or that industrialized populations represent the human species as well as any other. Yet rainforest hunter-gatherers, which often express the human pygmy phenotype, contradict such assumptions. Indeed, the human pygmy phenotype is a potential model system for exploring the range of ecomorphological variation in the architecture of human hindlimb muscles, a concept we review here. © 2015 Anatomical Society.

  11. Effects of plyometric training on passive stiffness of gastrocnemii muscles and Achilles tendon.

    Science.gov (United States)

    Fouré, Alexandre; Nordez, Antoine; Cornu, Christophe

    2012-08-01

    Plyometric training is commonly used to improve athletic performance; however, it is unclear how each component of the muscle-tendon complex (MTC) is affected by this intervention. The effects of 14 weeks of plyometric training on the passive stiffness of the gastrocnemii muscles and Achilles tendon was determined simultaneously to assess possible local adaptations of elastic properties. The passive force-length relationship of the gastrocnemii MTC and elongation of the gastrocnemii muscles were determined using ultrasonography during passive cyclic stretching in 19 subjects divided into trained (n = 9) and control (n = 10) groups. An upward trend in stiffness of the gastrocnemii MTC (P = 0.09) and a significant increase in the intrinsic gastrocnemii muscle stiffness were found (P  0.05). Considering the lack of change in gastrocnemii muscle geometry, the change in the gastrocnemii muscle stiffness may be mainly due to a change in the intrinsic mechanical properties of the muscular tissues.

  12. Expression of collagen and related growth factors in rat tendon and skeletal muscle in response to specific contraction types.

    Science.gov (United States)

    Heinemeier, K M; Olesen, J L; Haddad, F; Langberg, H; Kjaer, M; Baldwin, K M; Schjerling, P

    2007-08-01

    Acute exercise induces collagen synthesis in both tendon and muscle, indicating an adaptive response in the connective tissue of the muscle-tendon unit. However, the mechanisms of this adaptation, potentially involving collagen-inducing growth factors (such as transforming growth factor-beta-1 (TGF-beta-1)), as well as enzymes related to collagen processing, are not clear. Furthermore, possible differential effects of specific contraction types on collagen regulation have not been investigated. Female Sprague-Dawley rats were subjected to 4 days of concentric, eccentric or isometric training (n = 7-9 per group) of the medial gastrocnemius, by stimulation of the sciatic nerve. RNA was extracted from medial gastrocnemius and Achilles tendon tissue 24 h after the last training bout, and mRNA levels for collagens I and III, TGF-beta-1, connective tissue growth factor (CTGF), lysyl oxidase (LOX), metalloproteinases (MMP-2 and -9) and their inhibitors (TIMP-1 and 2) were measured by Northern blotting and/or real-time PCR. In tendon, expression of TGF-beta-1 and collagens I and III (but not CTGF) increased in response to all types of training. Similarly, enzymes/factors involved in collagen processing were induced in tendon, especially LOX (up to 37-fold), which could indicate a loading-induced increase in cross-linking of tendon collagen. In skeletal muscle, a similar regulation of gene expression was observed, but in contrast to the tendon response, the effect of eccentric training was significantly greater than the effect of concentric training on the expression of several transcripts. In conclusion, the study supports an involvement of TGF-beta-1 in loading-induced collagen synthesis in the muscle-tendon unit and importantly, it indicates that muscle tissue is more sensitive than tendon to the specific mechanical stimulus.

  13. Female hormones: do they influence muscle and tendon protein metabolism?

    DEFF Research Database (Denmark)

    Hansen, Mette

    2018-01-01

    (or lack of female hormones) on skeletal muscle protein turnover at rest and in response to exercise. This review is primarily based on data from human trials. Many elderly post-menopausal women experience physical disabilities and loss of independence related to sarcopenia, which reduces life quality...

  14. Ultrasonography as a tool to study afferent feedback from the muscle-tendon complex during human walking

    DEFF Research Database (Denmark)

    Cronin, Neil J.; Klint, Richard af; Grey, Michael James

    2011-01-01

    In humans, one of the most common tasks in everyday life is walking, and sensory afferent feedback from peripheral receptors, particularly the muscle spindles and Golgi tendon organs (GTO), makes an important contribution to the motor control of this task. One factor that can complicate the ability...... with an examination of muscle activation to give a broader insight to neuromuscular interaction during walking. Despite the advances in understanding that these techniques have brought, there is clearly still a need for more direct methods to study both neural and mechanical parameters during human walking in order...... of these receptors to act as length, velocity and force transducers is the complex pattern of interaction between muscle and tendinous tissues, as tendon length is often considerably greater than muscle fibre length in the human lower limb. In essence, changes in muscle-tendon mechanics can influence the firing...

  15. Hyaluronic Acid Accelerates Tendon-to-Bone Healing After Rotator Cuff Repair.

    Science.gov (United States)

    Honda, Hirokazu; Gotoh, Masafumi; Kanazawa, Tomonoshin; Ohzono, Hiroki; Nakamura, Hidehiro; Ohta, Keisuke; Nakamura, Kei-Ichiro; Fukuda, Kanji; Teramura, Takeshi; Hashimoto, Takashi; Shichijo, Shigeki; Shiba, Naoto

    2017-12-01

    There is growing evidence that the subacromial injection of hyaluronic acid (HA) is effective for pain relief in rotator cuff tears; however, its effect on tendon-to-bone healing remains unknown. To examine the effect of HA on the chondrogenesis of mesenchymal stem cells (MSCs) in vitro and on tendon-to-bone healing in a rotator cuff repair model. Controlled laboratory study. Bilateral complete tears of the infraspinatus tendon were made in rabbits and subsequently repaired. Before closure, 1 mL HA was applied to the repaired site, and phosphate-buffered saline was used in the opposite side as a control. Biomechanical, histological, and immunohistochemical analyses were performed at 4, 8, and 12 weeks after surgery. After euthanizing each animal, the bone marrow was isolated from the femoral bone in the same rabbits. Then, MSCs were cultured in media for chondrogenic differentiation, and the chondral pellet production and cartilage-related gene expression levels in the cells were examined at various concentrations of HA. At 4 and 8 weeks after surgery, ultimate load-to-failure was significantly greater in the HA group than in the control group (45.61 ± 9.0 N vs 32.42 ± 9.4 N at 4 weeks, 90.7 ± 16.0 N vs 66.97 ± 10.0 N at 8 weeks; both P .05). Linear stiffness was not significant throughout the time point evaluation. The chondroid formation area at the tendon-bone interface stained by safranin O (control vs HA group) was 0.33% ± 0.7% versus 13.5% ± 12.3% at 4 weeks after surgery ( P repaired site stained by PicroSirius Red (control vs HA group) was 16.2 ± 10.6 versus 43.5 ± 21.3 at 4 weeks after surgery ( P .05), and 1.8% ± 4.0% versus 5.4% ± 4.2% at 12 weeks after surgery ( P > .05). Compared with the control group, HA significantly increased the volume of cartilaginous pellet produced by MSCs (0.0016 ± 0.0015 mm 3 at 0 mg/mL of HA, 0.0041 ± 0.0023 mm 3 at 1.0 mg/mL, and 0.0041 ± 0.0018 mm 3 at 4.0 mg/mL), with increased mRNA expression (relative ratio

  16. Three-dimensional study of pectoralis major muscle and tendon architecture.

    Science.gov (United States)

    Fung, Lillia; Wong, Brian; Ravichandiran, Kajeandra; Agur, Anne; Rindlisbacher, Tim; Elmaraghy, Amr

    2009-05-01

    A thorough understanding of the normal structural anatomy of the pectoralis major (PM) is of paramount importance in the planning of PM tendon transfers or repairs following traumatic PM tears. However, there is little consensus regarding the complex musculotendinous architecture of the PM in the anatomic or surgical literature. The purpose of this study is to model and quantify the three-dimensional architecture of the pectoralis muscle and tendon. Eleven formalin embalmed cadaveric specimens were examined: five (2M/3F) were serially dissected, digitized, and modeled in 3D using Autodesk Maya; six (4M/2F) were dissected and photographed. The PM tendon consisted of longer anterior and shorter posterior layers that were continuous inferiorly. The muscle belly consisted of an architecturally uniform clavicular head (CH) and a segmented sternal head (SH) with 6-7 segments. The most inferior SH segment in all specimens was found to fold anteriorly forming a trough that cradled the inferior aspect of the adjacent superior segment. No twisting of either the PM muscle or tendon was noted. Within the CH, the fiber bundle lengths (FBL) were found to increase from superior to inferior, whereas the mean FBLs of SH were greatest in segments 3-5 found centrally. The mean lateral pennation angle was greater in the CH (29.4 +/- 6.9 degrees ) than in the SH (20.6 +/- 2.7 degrees ). The application of these findings could form the basis of future studies to optimize surgical planning and functional recovery of repair/reconstruction procedures.

  17. Bones, Muscles, and Joints: The Musculoskeletal System

    Science.gov (United States)

    ... stabilize it while the bone heals. Muscular dystrophy . Muscular dystrophy is an inherited group of diseases that affect the muscles, causing them to weaken and break down over time. The most common form in childhood is called Duchenne muscular dystrophy, and it most often affects boys. ...

  18. Load Bearing Equipment for Bone and Muscle

    Science.gov (United States)

    Shackelford, Linda; Griffith, Bryan

    2015-01-01

    Resistance exercise on ISS has proven effective in maintaining bone mineral density and muscle mass. Exploration missions require exercise with similar high loads using equipment with less mass and volume and greater safety and reliability than resistance exercise equipment used on ISS (iRED, ARED, FWED). Load Bearing Equipment (LBE) uses each exercising person to create and control the load to the partner.

  19. One-stage Pelnac Reconstruction in Full-thickness Skin Defects with Bone or Tendon Exposure

    Directory of Open Access Journals (Sweden)

    Xianghong Lou, MS

    2018-03-01

    Full Text Available Summary:. Dermal regeneration template, such as Integra and Pelnac, was originally designed for treating large area burn injury by inducing regeneration of dermis. To date, it has been widely applied in various acute and chronic wound sites. The present study demonstrated that application of artificial dermis alone induced 1-stage wound healing for wounds with bone or tendon exposure that should usually be repaired by flap surgery. Eight patients who presented with skin defects with bone and/or tendon exposure were treated by 1-stage Pelnac approach. All wounds healed within 20 weeks without skin graft or flap surgery. The wound area was reconstructed by nearly normal skin structure and linear scar. In the case of scalp defect, evidence of hair follicle cell migration and regeneration during healing process was observed. Thereby, the 1-stage Pelnac reconstitution can be considered as a novel method for inducing regrowth of epidermis and hair follicles to cure large full-thickness skin defect with bone and tendon exposure in 1 stage.

  20. The Improvement of Bone-Tendon Fixation by Porous Titanium Interference Screw: A Rabbit Animal Model.

    Science.gov (United States)

    Tsai, Pei-I; Chen, Chih-Yu; Huang, Shu-Wei; Yang, Kuo-Yi; Lin, Tzu-Hung; Chen, San-Yuan; Sun, Jui-Sheng

    2018-05-04

    The interference screw is a widely used fixation device in the anterior cruciate ligament (ACL) reconstruction surgeries. Despite the generally satisfactory results, problems of using interference screws were reported. By using additive manufacturing (AM) technology, we developed an innovative titanium alloy (Ti 6 Al 4 V) interference screw with rough surface and inter-connected porous structure designs to improve the bone-tendon fixation. An innovative Ti 6 Al 4 V interference screws were manufactured by AM technology. In vitro mechanical tests were performed to validate its mechanical properties. Twenty-seven New Zealand white rabbits were randomly divided into control and AM screw groups for biomechanical analyses and histological analysis at 4, 8 and 12 weeks postoperatively; while micro-CT analysis was performed at 12 weeks postoperatively. The biomechanical tests showed that the ultimate failure load in the AM interference screw group was significantly higher than that in the control group at all tested periods. These results were also compatible with the findings of micro-CT and histological analyses. In micro-CT analysis, the bone-screw gap was larger in the control group; while for the additive manufactured screw, the screw and bone growth was in close contact. In histological study, the bone-screw gaps were wider in the control group and were almost invisible in the AM screw group. The innovative AM interference screws with surface roughness and inter-connected porous architectures demonstrated better bone-tendon-implant integration, and resulted in stronger biomechanical characteristics when compared to traditional screws. These advantages can be transferred to future interference screw designs to improve their clinical performance. The AM interference screw could improve graft fixation and eventually result in better biomechanical performance of the bone-tendon-screw construct. The innovative AM interference screws can be transferred to future

  1. The effect of eccentric and concentric calf muscle training on Achilles tendon stiffness.

    Science.gov (United States)

    Morrissey, Dylan; Roskilly, Anna; Twycross-Lewis, Richard; Isinkaye, Tomide; Screen, Hazel; Woledge, Roger; Bader, Dan

    2011-03-01

    To compare in vivo effects of eccentric and concentric calf muscle training on Achilles tendon stiffness, in subjects without tendinopathy. Thirty-eight recreational athletes completed 6 weeks eccentric (6 males, 13 females, 21.6  ±  2.2 years) or concentric training (8 males, 11 females, 21.1  ±  2.0 years). Achilles tendon stiffness, tendon modulus and single-leg jump height were measured before and after intervention. Exercise adherence was recorded using a diary. All data are reported as mean  ±  SD. Groups were matched for height and weight but the eccentric training group were more active at baseline (P Tendon stiffness was higher in the eccentrically trained group at baseline compared to the concentrically trained group (20.9  ±  7.3 N/mm v 13.38  ±  4.66 N/mm; P = 0.001) and decreased significantly after eccentric training (to 17.2 ( ±  5.9) N/mm (P = 0.035)). There was no stiffness change in the concentric group (P = 0.405). Stiffness modulus showed similar changes to stiffness. An inverse correlation was found between initial, and subsequent, reduction in stiffness (r = -0.66). Jump height did not change and no correlation between stiffness change and adherence was observed in either group (r = 0.01). Six weeks of eccentric training can alter Achilles tendon stiffness while a matched concentric programme shows no similar effects. Studies in patients with Achilles tendinopathy are warranted.

  2. Posterior tibial tendon dysfunction by bone imprisonment | Zejjari ...

    African Journals Online (AJOL)

    The posterior tibial muscle is the main functional support of the plantar arch its dysfunction is the main cause of acquired flat foot. This is a 32 year old patient who consults for progressive pain of the inside of the ankle and right foot with a considerable decrease in its sporting and professional activity. Examination reveals a ...

  3. Stretching Your Energetic Budget: How Tendon Compliance Affects the Metabolic Cost of Running.

    Directory of Open Access Journals (Sweden)

    Thomas K Uchida

    Full Text Available Muscles attach to bones via tendons that stretch and recoil, affecting muscle force generation and metabolic energy consumption. In this study, we investigated the effect of tendon compliance on the metabolic cost of running using a full-body musculoskeletal model with a detailed model of muscle energetics. We performed muscle-driven simulations of running at 2-5 m/s with tendon force-strain curves that produced between 1 and 10% strain when the muscles were developing maximum isometric force. We computed the average metabolic power consumed by each muscle when running at each speed and with each tendon compliance. Average whole-body metabolic power consumption increased as running speed increased, regardless of tendon compliance, and was lowest at each speed when tendon strain reached 2-3% as muscles were developing maximum isometric force. When running at 2 m/s, the soleus muscle consumed less metabolic power at high tendon compliance because the strain of the tendon allowed the muscle fibers to operate nearly isometrically during stance. In contrast, the medial and lateral gastrocnemii consumed less metabolic power at low tendon compliance because less compliant tendons allowed the muscle fibers to operate closer to their optimal lengths during stance. The software and simulations used in this study are freely available at simtk.org and enable examination of muscle energetics with unprecedented detail.

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

    Science.gov (United States)

    Logel, R J

    1976-01-01

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

  5. Muscle-tendon related pain in 100 patients with hip dysplasia: prevalence and associations with self-reported hip disability and muscle strength

    DEFF Research Database (Denmark)

    Jacobsen, Julie Sandell

    2017-01-01

    dysplasia. The secondary aim was to test if muscle-tendon related pain is linearly associated to self-reported hip disability and muscle strength in patients with hip dysplasia. Materials and methods One hundred patients (17 men) with a mean age of 29+9 years were included. Clinical entity approach...

  6. Complex Anatomic Abnormalities of the Lower Leg Muscles and Tendons Associated With Phocomelia: A Case Report.

    Science.gov (United States)

    Hodo, Thomas; Hamrick, Mark; Melenevsky, Yulia

    Musculoskeletal anatomy is widely known to have components that stray from the norm in the form of variant muscle and tendon presence, absence, origin, insertion, and bifurcation. Although these variant muscles and tendons might be deemed incidental and insignificant findings by most, they can be important contributors to pathologic physiology or, more importantly, an option for effective treatment. In the present case report, we describe a patient with phocomelia and Müllerian abnormalities secondary to in utero thalidomide exposure. The patient had experienced recurrent bilateral foot pain accompanied by numbness, stiffness, swelling, and longstanding pes planus. These symptoms persisted despite conservative treatment with orthotics, steroids, and nonsteroidal anti-inflammatory drugs. Radiographic imaging showed dysmorphic and degenerative changes of the ankle and foot joints. Further investigation with magnetic resonance imaging revealed complex anatomic abnormalities, including the absence of the posterior tibialis and peroneus brevis, lateralization of the peroneus longus, and the presence of a variant anterior compartment muscle. The variant structure was likely a previously described anterior compartment variant, anterior fibulocalcaneus, and might have been a source of the recurrent pain. Also, the absence of the posterior tibialis might have caused the pes planus in the present patient, considering that posterior tibialis tendon dysfunction is the most common cause of acquired pes planus. Although thalidomide infrequently affects the lower extremities, its effects on growth and development were likely the cause of this rare array of anatomic abnormalities and resulting ankle and foot pathologic features. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Architectural and biochemical adaptations in skeletal muscle and bone following rotator cuff injury in a rat model.

    Science.gov (United States)

    Sato, Eugene J; Killian, Megan L; Choi, Anthony J; Lin, Evie; Choo, Alexander D; Rodriguez-Soto, Ana E; Lim, Chanteak T; Thomopoulos, Stavros; Galatz, Leesa M; Ward, Samuel R

    2015-04-01

    Injury to the rotator cuff can cause irreversible changes to the structure and function of the associated muscles and bones. The temporal progression and pathomechanisms associated with these adaptations are unclear. The purpose of this study was to investigate the time course of structural muscle and osseous changes in a rat model of a massive rotator cuff tear. Supraspinatus and infraspinatus muscle architecture and biochemistry and humeral and scapular morphological parameters were measured three days, eight weeks, and sixteen weeks after dual tenotomy with and without chemical paralysis via botulinum toxin A (BTX). Muscle mass and physiological cross-sectional area increased over time in the age-matched control animals, decreased over time in the tenotomy+BTX group, and remained nearly the same in the tenotomy-alone group. Tenotomy+BTX led to increased extracellular collagen in the muscle. Changes in scapular bone morphology were observed in both experimental groups, consistent with reductions in load transmission across the joint. These data suggest that tenotomy alone interferes with normal age-related muscle growth. The addition of chemical paralysis yielded profound structural changes to the muscle and bone, potentially leading to impaired muscle function, increased muscle stiffness, and decreased bone strength. Structural musculoskeletal changes occur after tendon injury, and these changes are severely exacerbated with the addition of neuromuscular compromise. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

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

    OpenAIRE

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

    2011-01-01

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

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

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    S. S. Strafun

    2017-12-01

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

  10. Calf Muscle Performance Deficits Remain 7 Years After an Achilles Tendon Rupture.

    Science.gov (United States)

    Brorsson, Annelie; Grävare Silbernagel, Karin; Olsson, Nicklas; Nilsson Helander, Katarina

    2018-02-01

    Optimizing calf muscle performance seems to play an important role in minimizing impairments and symptoms after an Achilles tendon rupture (ATR). The literature lacks long-term follow-up studies after ATR that describe calf muscle performance over time. The primary aim was to evaluate calf muscle performance and patient-reported outcomes at a mean of 7 years after ATR in patients included in a prospective, randomized controlled trial. A secondary aim was to evaluate whether improvement in calf muscle performance continued after the 2-year follow-up. Cohort study; Level of evidence, 2. Sixty-six subjects (13 women, 53 men) with a mean age of 50 years (SD, 8.5 years) were evaluated at a mean of 7 years (SD, 1 year) years after their ATR. Thirty-four subjects had surgical treatment and 32 had nonsurgical treatment. Patient-reported outcomes were evaluated with Achilles tendon Total Rupture Score (ATRS) and Physical Activity Scale (PAS). Calf muscle performance was evaluated with single-leg standing heel-rise test, concentric strength power heel-rise test, and single-legged hop for distance. Limb Symmetry Index (LSI = injured side/healthy side × 100) was calculated for side-to-side differences. Seven years after ATR, the injured side showed decreased values in all calf muscle performance tests ( P performance did not continue after the 2-year follow-up. Heel-rise height increased significantly ( P = .002) between the 1-year (10.8 cm) and the 7-year (11.5 cm) follow-up assessments. The median ATRS was 96 (of a possible score of 100) and the median PAS was 4 (of a possible score of 6), indicating minor patient-reported symptoms and fairly high physical activity. No significant differences were found in calf muscle performance or patient-reported outcomes between the treatment groups except for the LSI for heel-rise repetitions. Continued deficits in calf muscle endurance and strength remained 7 years after ATR. No continued improvement in calf muscle performance

  11. Expression of extracellular matrix components and related growth factors in human tendon and muscle after acute exercise

    DEFF Research Database (Denmark)

    Heinemeier, K M; Bjerrum, S S; Schjerling, P

    2013-01-01

    Acute kicking exercise induces collagen synthesis in both tendon and muscle in humans, but it is not known if this relates to increased collagen transcription and if other matrix genes are regulated. Young men performed 1 h of one-leg kicking at 67% of max workload. Biopsies were taken from...... the patellar tendon and vastus lateralis muscle of each leg at 2 (n = 10), 6 (n = 11), or 26 h (n = 10) after exercise. Levels of messenger ribonucleic acid mRNA for collagens, noncollagenous matrix proteins, and growth factors were measured with real-time reverse transcription polymerase chain reaction...

  12. The Bone-Muscle Relationship in Men and Women

    Directory of Open Access Journals (Sweden)

    Thomas F. Lang

    2011-01-01

    Full Text Available Muscle forces are a strong determinant of bone structure, particularly during the process of growth and development. The gender divergence in the bone-muscle relationship becomes strongly evident during adolescence. In females, growth is characterized by increased estrogen levels and increased mass and strength of bone relative to that of muscle, whereas in men, increases in testosterone fuel large increases in muscle, resulting in muscle forces that coincide with a large growth in bone dimensions and strength. In adulthood, significant age-related losses are observed for both bone and muscle tissues. Large decrease in estrogen levels in women appears to diminish the skeleton's responsiveness to exercise more than in men. In contrast, the aging of the muscle-bone axis in men is a function of age related declines in both hormones. In addition to the well-known age related changes in the mechanical loading of bone by muscle, newer studies appear to provide evidence of age- and gender-related variations in molecular signaling between bone and muscle that are independent of purely mechanical interactions. In summary, gender differences in the acquisition and age-related loss in bone and muscle tissues may be important for developing gender-specific strategies for using exercise to reduce bone loss with aging.

  13. Gross and histological evaluation of early lesions of navicular bone and deep digital flexor tendon in horses

    Directory of Open Access Journals (Sweden)

    Komosa Marcin

    2014-03-01

    Full Text Available The study aimed at evaluation of pathological lesions on flexor surface of navicular bone and deep digital flexor tendon in horses graded in standard X-ray examination as 2 (fair. The evaluation was performed on fifteen horses (6-9 years of age. Analysis procedure involved examining navicular bones on X-ray pictures, post-slaughter preparation of navicular bones from the hoof capsule, macroscopic evaluation of fibrocartilage on flexor surface, and analysis of histologic preparations. In horses with navicular bones graded as 2, early pathological changes have already developed, even if such horses were not lame. The pathological changes included fibrillation and disruption of deep digital flexor tendon surface, loss of fibrocartillage in sagittal ridge area of navicular bone, thinning of subchondral bone on its flexor surface, and fibromyxoid changes in chondroid matrix. In terms of clinical relevance, more studies are needed to understand the sequence of changes in a better way.

  14. Acute calcific tendonitis of dorsal interosseous muscles of the hand: uncommon site of a frequent disease

    Directory of Open Access Journals (Sweden)

    D. Schneider

    2017-05-01

    Full Text Available Acute calcific tendinopathy is one of the manifestations of hydroxyapatite crystal deposition disease. While it is more frequent in the shoulder, it has been described in virtually all areas of the body, but rarely in the muscles of the hand. Its etiopathogenesis is not yet fully understood and despite being a fairly frequent condition, it is commonly misdiagnosed. The onset of the disease is usually acute and resolves spontaneously. Acute calcific tendinitis of the interosseous tendons of the hand is an uncommon site of a frequent condition. The clinical presentation is similar to other entities, thus errors in diagnosis frequently occur, resulting in over-treatment or unnecessary tests. We describe a case of acute calcific tendinitis of the interosseous muscles of the hand with a brief review of the current literature with emphasis on diagnostic imaging methods.

  15. Fatigue and muscle-tendon stiffness after stretch-shortening cycle and isometric exercise.

    Science.gov (United States)

    Toumi, Hechmi; Poumarat, Georges; Best, Thomas M; Martin, Alain; Fairclough, John; Benjamin, Mike

    2006-10-01

    The purpose of the present study was to compare vertical jump performance after 2 different fatigue protocols. In the first protocol, subjects performed consecutive sets of 10 repetitions of stretch-shortening cycle (SSC) contractions. In the second protocol, successive sets of 10 repetitions of isometric contractions were performed for 10 s with the knee at 90 degrees of flexion. The exercises were stopped when the subjects failed to reach 50% of their maximum voluntary isometric contractions. Maximal isometric force and maximal concentric power were assessed by performing supine leg presses, squat jumps, and drop jumps. Surface EMG was used to determine changes in muscle activation before and after fatigue. In both groups, the fatigue exercises reduced voluntary isometric force, maximal concentric power, and drop jump performance. Kinematic data showed a decrease in knee muscle-tendon stiffness accompanied by a lengthened ground contact time. EMG analysis showed that the squat and drop jumps were performed similarly before and after the fatigue exercise for both groups. Although it was expected that the stiffness would decrease more after SSC than after isometric fatigue (as a result of a greater alteration of the reflex sensitivity SSC), our results showed that both protocols had a similar effect on knee muscle stiffness during jumping exercises. Both fatigue protocols induced muscle fatigue, and the decrease in jump performance was linked to a decrease in the strength and stiffness of the knee extensor muscles.

  16. The effect of dynamic knee-extension exercise on patellar tendon and quadriceps femoris muscle glucose uptake in humans studied by positron emission tomography

    DEFF Research Database (Denmark)

    Kalliokoski, Kari K; Langberg, Henning; Ryberg, Ann Kathrine

    2005-01-01

    Both tendon and peritendinous tissue show evidence of metabolic activity, but the effect of acute exercise on substrate turnover is unknown. We therefore examined the influence of acute exercise on glucose uptake in the patellar and quadriceps tendons during dynamic exercise in humans. Glucose...... that tendon glucose uptake is increased during exercise. However, the increase in tendon glucose uptake is less pronounced than in muscle and the increases are uncorrelated. Thus tendon glucose uptake is likely to be regulated by mechanisms independently of those regulating skeletal muscle glucose uptake....... uptake was measured in five healthy men in the patellar and quadriceps tendons and the quadriceps femoris muscle at rest and during dynamic knee-extension exercise (25 W) using positron emission tomography and [18F]-2-fluoro-2-deoxy-D-glucose ([18F]FDG). Glucose uptake index was calculated by dividing...

  17. Changes in Indirect Markers of Muscle Damage and Tendons After Daily Drop Jumping Exercise with Rapid Load Increase

    Directory of Open Access Journals (Sweden)

    Vidas Paleckis, Mantas Mickevičius, Audrius Snieckus, Vytautas Streckis, Mati Pääsuke, Saulius Rutkauskas, Rasa Steponavičiūtė, Albertas Skurvydas, Sigitas Kamandulis

    2015-12-01

    Full Text Available The aim of this study was to assess changes in indirect markers of muscle damage and type I collagen degradation, as well as, patellar and Achilles tendon morphological differences during nine daily drop-jumps sessions with constant load alternated with rapid increases in load to test the hypothesis that frequent drop-jump training results in negative muscular and tendon adaptation. Young men (n = 9 performed daily drop jump workouts with progression every 3 days in terms of number of jumps, platform height and squat amplitude. Voluntary and electrically evoked knee extensor torque, muscle soreness, blood plasma creatine kinase (CK activity and carboxyterminal cross-linked telopeptide (ICTP, patellar and Achilles tendon thickness and cross-sectional area (CSA were assessed at different time points during the training period and again on days 1, 3, 10 and 17 after the training. The findings were as follows: (1 steady decline in maximal muscle strength with major recovery within 24 hours after the first six daily training sessions; (2 larger decline in electrically induced muscle torque and prolonged recovery during last three training sessions; (3 increase in patellar and Achilles tendons CSA without change in thickness towards the end of training period; (4 increase in jump height but not in muscle strength after whole training period. Our findings suggest that frequent drop-jump sessions with constant load alternated with rapid increases in load do not induce severe muscle damage or major changes in tendons, nonetheless, this type of loading is not advisable for muscle strength improvement.

  18. Oedema and fatty degeneration of the soleus and gastrocnemius muscles on MR images in patients with achilles tendon abnormalities

    International Nuclear Information System (INIS)

    Hoffmann, Adrienne; Mamisch, Nadja; Buck, Florian M.; Pfirrmann, Christian W.A.; Zanetti, Marco; Espinosa, Norman

    2011-01-01

    The purpose of this study was to evaluate the frequency of oedema and fatty degeneration of the soleus and gastrocnemius muscles in patients with Achilles tendon abnormalities. Forty-five consecutive patients (mean 51 years; range 14-84 years) with achillodynia were examined with magnetic resonance (MR) images of the calf. The frequency of oedema and fatty degeneration in the soleus and gastrocnemius muscles was determined in patients with normal tendons, tendinopathy and in patients with a partial tear or a complete tear of the Achilles tendon. Oedema was encountered in 35% (7/20) of the patients with tendinopathy (n = 20; range 13-81 years), and in 47% (9/19) of the patients with partial tears or complete tears (n = 19; 28-78 years). Fatty degeneration was encountered in 10% (2/20) of the patients with tendinopathy, and in 32% (6/19) of the patients with tears. The prevalence of fatty degeneration was significantly more common in patients with a partial or complete tear compared with the patients with a normal Achilles tendon (p = 0.032 and p = 0.021, respectively). Oedema and fatty degeneration of the soleus and gastrocnemius muscles are common in patients with Achilles tendon abnormalities. (orig.)

  19. Oedema and fatty degeneration of the soleus and gastrocnemius muscles on MR images in patients with Achilles tendon abnormalities.

    Science.gov (United States)

    Hoffmann, Adrienne; Mamisch, Nadja; Buck, Florian M; Espinosa, Norman; Pfirrmann, Christian W A; Zanetti, Marco

    2011-09-01

    The purpose of this study was to evaluate the frequency of oedema and fatty degeneration of the soleus and gastrocnemius muscles in patients with Achilles tendon abnormalities. Forty-five consecutive patients (mean 51 years; range 14-84 years) with achillodynia were examined with magnetic resonance (MR) images of the calf. The frequency of oedema and fatty degeneration in the soleus and gastrocnemius muscles was determined in patients with normal tendons, tendinopathy and in patients with a partial tear or a complete tear of the Achilles tendon. Oedema was encountered in 35% (7/20) of the patients with tendinopathy (n = 20; range 13-81 years), and in 47% (9/19) of the patients with partial tears or complete tears (n = 19; 28-78 years). Fatty degeneration was encountered in 10% (2/20) of the patients with tendinopathy, and in 32% (6/19) of the patients with tears. The prevalence of fatty degeneration was significantly more common in patients with a partial or complete tear compared with the patients with a normal Achilles tendon (p = 0.032 and p = 0.021, respectively). Oedema and fatty degeneration of the soleus and gastrocnemius muscles are common in patients with Achilles tendon abnormalities.

  20. Calcium-phosphate matrix with or without TGF-β3 improves tendon-bone healing after rotator cuff repair.

    Science.gov (United States)

    Kovacevic, David; Fox, Alice J; Bedi, Asheesh; Ying, Liang; Deng, Xiang-Hua; Warren, Russell F; Rodeo, Scott A

    2011-04-01

    Rotator cuff tendon heals by formation of an interposed zone of fibrovascular scar tissue. Recent studies demonstrate that transforming growth factor-beta 3 (TGF-β(3)) is associated with tissue regeneration and "scarless" healing, in contrast to scar-mediated healing that occurs with TGF-β(1). Delivery of TGF-β(3) in an injectable calcium-phosphate matrix to the healing tendon-bone interface after rotator cuff repair will result in increased attachment strength secondary to improved bone formation and collagen organization and reduced scar formation of the healing enthesis. Controlled laboratory study. Ninety-six male Sprague-Dawley rats underwent unilateral detachment of the supraspinatus tendon followed by acute repair using transosseous suture fixation. Animals were allocated into 1 of 3 groups: (1) repair alone (controls, n = 32), (2) repair augmented by application of an osteoconductive calcium-phosphate (Ca-P) matrix only (n = 32), or (3) repair augmented with Ca-P matrix + TGF-β(3) (2.75 µg) at the tendon-bone interface (n = 32). Animals were euthanized at either 2 weeks or 4 weeks postoperatively. Biomechanical testing of the supraspinatus tendon-bone complex was performed at 2 and 4 weeks (n = 8 per group). Microcomputed tomography was utilized to quantitate bone microstructure at the repair site. The healing tendon-bone interface was evaluated with histomorphometry and immunohistochemical localization of collagen types I (COLI) and III (COLIII). Statistical analysis was performed using 2-way analysis of variance with significance set at P repair site is associated with new bone formation, increased fibrocartilage, and improved collagen organization at the healing tendon-bone interface in the early postoperative period after rotator cuff repair. The addition of TGF-β(3) significantly improved strength of the repair at 4 weeks postoperatively and resulted in a more favorable COLI/COLIII ratio. The delivery of TGF-β(3) with an injectable Ca-P matrix

  1. TOB1 Deficiency Enhances the Effect of Bone Marrow-Derived Mesenchymal Stem Cells on Tendon-Bone Healing in a Rat Rotator Cuff Repair Model

    Directory of Open Access Journals (Sweden)

    Yulei Gao

    2016-01-01

    Full Text Available Background/Aims: This study investigated the effect of silencing TOB1 (Transducer of ERBB2, 1 expression in bone marrow-derived mesenchymal stem cells (MSCs on MSC-facilitated tendon-bone healing in a rat supraspinatus repair model. Methods: Rat MSCs were transduced with a recombinant lentivirus encoding short hairpin RNA (shRNA against TOB1. MSC cell proliferation was analyzed by 3-(4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide (MTT assays. The effect of MSCs with TOB1 deficiency on tendon-bone healing in a rat rotator cuff repair model was evaluated by biomechanical testing, histological analysis and collagen type I and II gene expression. An upstream regulator (miR-218 of TOB1 was determined in MSCs. Results: We found that knockdown of TOB1 significantly increased the proliferative activity of rat MSCs in vitro. When MSCs with TOB1 deficiency were injected into injured rat supraspinatus tendon-bone junctions, the effect on tendon-bone healing was enhanced compared to treatment with control MSCs with normal TOB1 expression, as evidenced by elevated levels of ultimate load to failure and stiffness, increased amount of fibrocartilage and augmented expression of collagen type I and type II genes. In addition, we found that the TOB1 3′ untranslated region is a direct target of miR-218. Similar to the effect of TOB1 deficiency, overexpression of miR-218 effectively promoted tendon-bone healing in rat. Conclusion: These results suggest that TOB1 may play a negative role in the effect of MSCs on tendon-bone healing, and imply that expression of TOB1 may be regulated by miR-218.

  2. 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.

  3. Rotator cuff muscles lose responsiveness to anabolic steroids after tendon tear and musculotendinous retraction: an experimental study in sheep.

    Science.gov (United States)

    Gerber, Christian; Meyer, Dominik C; Von Rechenberg, Brigitte; Hoppeler, Hans; Frigg, Robert; Farshad, Mazda

    2012-11-01

    Long-standing rotator cuff tendon tearing is associated with retraction, loss of work capacity, irreversible fatty infiltration, and atrophy of the rotator cuff muscles. Although continuous musculotendinous relengthening can experimentally restore muscular architecture, restoration of atrophy and fatty infiltration is hitherto impossible. Continuous relengthening with pharmacological stimulation of muscle growth using an anabolic steroid or insulin-like growth factor (IGF) can reverse atrophy and fatty infiltration as well as improve the work capacity of chronically retracted rotator cuff muscles in sheep. Controlled laboratory study. Sixteen weeks after tenotomy of the infraspinatus (ISP) tendon, atrophy and fatty infiltration had developed in the retracted ISP muscle. The musculotendinous unit was continuously relengthened in 14 sheep during 6 weeks: Four sheep were treated without pharmacological stimulation, 4 with intramuscular administration of an anabolic steroid, and 6 with IGF before final repair and rehabilitation (12 weeks). Changes were documented by intraoperative measurements of muscle work capacity, histology, and computed tomography/magnetic resonance imaging. Musculotendinous relengthening by continuous traction resulted in gains of length ranging from 0.7 cm in the IGF group to 1.3 cm in the control group. Fatty infiltration progressed in all groups, and the muscle's cross-sectional area ranged from 71% to 74% of the contralateral side at sacrifice and did not show any differences between groups in weight, volume, histological composition, or work capability of the muscle. The contralateral muscles in the anabolic steroid group, however, showed significantly higher (mean ± standard deviation) muscle work capacity of 10 ± 0.9 N·m than the contralateral muscles of the control group (6.8 ± 2.4 N·m) (P muscle fiber area as well as by an unusual gain in the animals' weight after injection of the anabolic steroid. Subcutaneous continuous

  4. Prevalence and pattern of gluteus medius and minimus tendon pathology and muscle atrophy in older individuals using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Chi, Andrew S. [University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Long, Suzanne S.; Zoga, Adam C.; Read, Paul J.; Deely, Diane M.; Parker, Laurence; Morrison, William B. [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States)

    2015-12-15

    To evaluate gluteus medius and minimus tendon pathology and muscle atrophy in older individuals using MRI. A retrospective MRI study of 185 individuals was performed. The inclusion criterion was age ≥50. Exclusion criteria were hip surgery, fracture, infection, tumor, or inadequate image quality. Greater trochanteric bursitis was graded none, mild, moderate, or severe. Gluteus medius, gluteus minimus, and iliopsoas tendinopathy was graded normal, tendinosis, low-grade partial tear, high-grade partial tear, or full thickness tear. Gluteus medius, gluteus minimus, tensor fascia lata, and iliopsoas muscle atrophy was scored using a standard scale. Insertion site of tendinopathy and location of muscle atrophy were assessed. Descriptive and statistical analysis was performed. There was increasing greater trochanteric bursitis and gluteus medius and minimus tendinopathy and atrophy with advancing age with moderate to strong positive associations (p < 0.0001) for age and tendinopathy, age and atrophy, bursitis and tendinopathy, and tendinopathy and atrophy for the gluteus medius and minimus. There is a weak positive association (p < 0.0001) for age and tensor fascia lata atrophy, and no statistically significant association between age and tendinopathy or between age and atrophy for the iliopsoas. Fisher's exact tests were statistically significant (p < 0.0001) for insertion site of tendon pathology and location of muscle atrophy for the gluteus medius. Gluteus medius and minimus tendon pathology and muscle atrophy increase with advancing age with progression of tendinosis to low-grade tendon tears to high-grade tendon tears. There is an associated progression in atrophy of these muscles, which may be important in fall-related hip fractures. (orig.)

  5. Prevalence and pattern of gluteus medius and minimus tendon pathology and muscle atrophy in older individuals using MRI

    International Nuclear Information System (INIS)

    Chi, Andrew S.; Long, Suzanne S.; Zoga, Adam C.; Read, Paul J.; Deely, Diane M.; Parker, Laurence; Morrison, William B.

    2015-01-01

    To evaluate gluteus medius and minimus tendon pathology and muscle atrophy in older individuals using MRI. A retrospective MRI study of 185 individuals was performed. The inclusion criterion was age ≥50. Exclusion criteria were hip surgery, fracture, infection, tumor, or inadequate image quality. Greater trochanteric bursitis was graded none, mild, moderate, or severe. Gluteus medius, gluteus minimus, and iliopsoas tendinopathy was graded normal, tendinosis, low-grade partial tear, high-grade partial tear, or full thickness tear. Gluteus medius, gluteus minimus, tensor fascia lata, and iliopsoas muscle atrophy was scored using a standard scale. Insertion site of tendinopathy and location of muscle atrophy were assessed. Descriptive and statistical analysis was performed. There was increasing greater trochanteric bursitis and gluteus medius and minimus tendinopathy and atrophy with advancing age with moderate to strong positive associations (p < 0.0001) for age and tendinopathy, age and atrophy, bursitis and tendinopathy, and tendinopathy and atrophy for the gluteus medius and minimus. There is a weak positive association (p < 0.0001) for age and tensor fascia lata atrophy, and no statistically significant association between age and tendinopathy or between age and atrophy for the iliopsoas. Fisher's exact tests were statistically significant (p < 0.0001) for insertion site of tendon pathology and location of muscle atrophy for the gluteus medius. Gluteus medius and minimus tendon pathology and muscle atrophy increase with advancing age with progression of tendinosis to low-grade tendon tears to high-grade tendon tears. There is an associated progression in atrophy of these muscles, which may be important in fall-related hip fractures. (orig.)

  6. Strategies to engineer tendon/ligament-to-bone interface: Biomaterials, cells and growth factors.

    Science.gov (United States)

    Font Tellado, Sonia; Balmayor, Elizabeth R; Van Griensven, Martijn

    2015-11-01

    Integration between tendon/ligament and bone occurs through a specialized tissue interface called enthesis. The complex and heterogeneous structure of the enthesis is essential to ensure smooth mechanical stress transfer between bone and soft tissues. Following injury, the interface is not regenerated, resulting in high rupture recurrence rates. Tissue engineering is a promising strategy for the regeneration of a functional enthesis. However, the complex structural and cellular composition of the native interface makes enthesis tissue engineering particularly challenging. Thus, it is likely that a combination of biomaterials and cells stimulated with appropriate biochemical and mechanical cues will be needed. The objective of this review is to describe the current state-of-the-art, challenges and future directions in the field of enthesis tissue engineering focusing on four key parameters: (1) scaffold and biomaterials, (2) cells, (3) growth factors and (4) mechanical stimuli. Copyright © 2015 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2010-02-01

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

  8. Effect of tendon vibration during wide-pulse neuromuscular electrical stimulation (NMES) on the decline and recovery of muscle force.

    Science.gov (United States)

    Bochkezanian, Vanesa; Newton, Robert U; Trajano, Gabriel S; Vieira, Amilton; Pulverenti, Timothy S; Blazevich, Anthony J

    2017-05-02

    Neuromuscular electrical stimulation (NMES) is commonly used to activate skeletal muscles and reverse muscle atrophy in clinical populations. Clinical recommendations for NMES suggest the use of short pulse widths (100-200 μs) and low-to-moderate pulse frequencies (30-50 Hz). However, this type of NMES causes rapid muscle fatigue due to the (non-physiological) high stimulation intensities and non-orderly recruitment of motor units. The use of both wide pulse widths (1000 μs) and tendon vibration might optimize motor unit activation through spinal reflex pathways and thus delay the onset of muscle fatigue, increasing muscle force and mass. Thus, the objective of this study was to examine the acute effects of patellar tendon vibration superimposed onto wide-pulse width (1000 μs) knee extensor electrical stimulation (NMES, 30 Hz) on peak muscle force, total impulse before "muscle fatigue", and the post-exercise recovery of muscle function. Tendon vibration (Vib), NMES (STIM) or NMES superimposed onto vibration (STIM + Vib) were applied in separate sessions to 16 healthy adults. Total torque-time integral (TTI), maximal voluntary contraction torque (MVIC) and indirect measures of muscle damage were tested before, immediately after, 1 h and 48 h after each stimulus. TTI increased (145.0 ± 127.7%) in STIM only for "positive responders" to the tendon vibration (8/16 subjects), but decreased in "negative responders" (-43.5 ± 25.7%). MVIC (-8.7%) and rectus femoris electromyography (RF EMG) (-16.7%) decreased after STIM (group effect) for at least 1 h, but not after STIM + Vib. No changes were detected in indirect markers of muscle damage in any condition. Tendon vibration superimposed onto wide-pulse width NMES increased TTI only in 8 of 16 subjects, but reduced voluntary force loss (fatigue) ubiquitously. Negative responders to tendon vibration may derive greater benefit from wide-pulse width NMES alone.

  9. Extracorporeal shockwave enhanced regeneration of fibrocartilage in a delayed tendon-bone insertion repair model.

    Science.gov (United States)

    Chow, Dick Ho Kiu; Suen, Pui Kit; Huang, Le; Cheung, Wing-Hoi; Leung, Kwok-Sui; Ng, Chun; Shi, San Qiang; Wong, Margaret Wan Nar; Qin, Ling

    2014-04-01

    Fibrous tissue is often formed in delayed healing of tendon bone insertion (TBI) instead of fibrocartilage. Extracorporeal shockwave (ESW) provides mechanical cues and upregulates expression of fibrocartilage-related makers and cytokines. We hypothesized that ESW would accelerate fibrocartilage regeneration at the healing interface in a delayed TBI healing model. Partial patellectomy with shielding at the TBI interface was performed on 32 female New Zealand White Rabbits for establishing this delayed TBI healing model. The rabbits were separated into the control and ESW group for evaluations at postoperative week 8 and 12. Shielding was removed at week 4 and a single ESW treatment was applied at week 6. Fibrocartilage regeneration was evaluated histomorphologically and immunohistochemically. Vickers hardness of the TBI matrix was measured by micro-indentation. ESW group showed higher fibrocartilage area, thickness, and proteoglycan deposition than the control in week 8 and 12. ESW increased expression of SOX9 and collagen II significantly in week 8 and 12, respectively. ESW group showed a gradual transition of hardness from bone to fibrocartilage to tendon, and had a higher Vickers hardness than the control group at week 12. In conclusion, ESW enhanced fibrocartilage regeneration at the healing interface in a delayed TBI healing model. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  10. The effects of low-intensity pulsed ultrasound on tendon-bone healing in a transosseous-equivalent sheep rotator cuff model.

    Science.gov (United States)

    Lovric, Vedran; Ledger, Michael; Goldberg, Jerome; Harper, Wade; Bertollo, Nicky; Pelletier, Matthew H; Oliver, Rema A; Yu, Yan; Walsh, William R

    2013-02-01

    The purpose of this study was to examine the effects Low-intensity Pulsed Ultrasound has on initial tendon-bone healing in a clinically relevant extra-articular transosseous-equivalent ovine rotator cuff model. Eight skeletally mature wethers, randomly allocated to either control group (n = 4) or treatment group (n = 4), underwent rotator cuff surgery following injury to the infraspinatus tendon. All animals were killed 28 days post surgery to allow examination of early effects of Low-intensity Pulsed Ultrasound treatment. General improvement in histological appearance of tendon-bone integration was noted in the treatment group. Newly formed woven bone with increased osteoblast activity along the bone surface was evident. A continuum was observed between the tendon and bone in an interdigitated fashion with Sharpey's fibres noted in the treatment group. Low-intensity Pulsed Ultrasound treatment also increased bone mineral density at the tendon-bone interface (p < 0.01), while immunohistochemistry results revealed an increase in the protein expression patterns of VEGF (p = 0.038), RUNX2 (p = 0.02) and Smad4 (p = 0.05). The results of this study indicate that Low-intensity Pulsed Ultrasound may aid in the initial phase of tendon-bone healing process in patients who have undergone rotator cuff repair. This treatment may also be beneficial following other types of reconstructive surgeries involving the tendon-bone interface.

  11. Complete rupture of the distal semimembranosus tendon with secondary hamstring muscles atrophy: MR findings in two cases

    International Nuclear Information System (INIS)

    Varela, J.R.; Rodriguez, E.; Soler, R.; Gonzalez, J.; Pombo, S.

    2000-01-01

    Complete rupture of the hamstring muscles is a rare injury. The proximal musculo-tendinous junction is the most frequent site of rupture. We present two cases of complete rupture of the distal semimenbranosus tendon, which clinically presented as soft-tissue masses. MR imaging permitted the correct diagnosis. There has been only one other such case reported. (orig.)

  12. Complete rupture of the distal semimembranosus tendon with secondary hamstring muscles atrophy: MR findings in two cases

    Energy Technology Data Exchange (ETDEWEB)

    Varela, J.R.; Rodriguez, E.; Soler, R.; Gonzalez, J.; Pombo, S. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain)

    2000-06-01

    Complete rupture of the hamstring muscles is a rare injury. The proximal musculo-tendinous junction is the most frequent site of rupture. We present two cases of complete rupture of the distal semimenbranosus tendon, which clinically presented as soft-tissue masses. MR imaging permitted the correct diagnosis. There has been only one other such case reported. (orig.)

  13. Sensitivity of subject-specific models to Hill muscle-tendon model parameters in simulations of gait

    NARCIS (Netherlands)

    Carbone, V.; Krogt, M.M. van der; Koopman, H.F.J.M.; Verdonschot, N.J.

    2016-01-01

    Subject-specific musculoskeletal (MS) models of the lower extremity are essential for applications such as predicting the effects of orthopedic surgery. We performed an extensive sensitivity analysis to assess the effects of potential errors in Hill muscle-tendon (MT) model parameters for each of

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

    Directory of Open Access Journals (Sweden)

    Charles H Rundle

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

  15. Magnetotherapy: The quest for tendon regeneration.

    Science.gov (United States)

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

    2018-05-09

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

  16. Changes in muscle and tendons due to neural motor disorders : implications for therapeutical intervention

    NARCIS (Netherlands)

    Hof, A.L.

    2001-01-01

    Patients with an upper motor neurone syndrome (CP) suffer from many disabling primary symptoms: spasms, weakness, and loss of dexterity. These primary ‘neurogenic’ symptoms often lead to secondary disabilities, muscle contractures, and tertiary effects, bone deformations. A common symptom of CP is

  17. 18F-fluorodeoxyglucose and PET/CT for noninvasive study of exercise-induced glucose uptake in rat skeletal muscle and tendon

    International Nuclear Information System (INIS)

    Skovgaard, Dorthe; Kjaer, Michael; El-Ali, Henrik; Kjaer, Andreas

    2009-01-01

    To investigate exercise-related glucose uptake in rat muscle and tendon using PET/CT and to study possible explanatory changes in gene expression for the glucose transporters (GLUT1 and GLUT4). The sciatic nerve in eight Wistar rats was subjected to electrostimulation to cause unilateral isometric contractions of the calf muscle. 18 F-Fluorodeoxyglucose was administered and a PET/CT scan of the hindlimbs was performed. SUVs were calculated in both Achilles tendons and the triceps surae muscles. To exclude a spill-over effect the tendons and muscles from an ex vivo group of eight rats were cut out and scanned separately (distance≥1 cm). Muscle contractions increased glucose uptake approximately sevenfold in muscles (p<0.001) and 36% in tendons (p<0.01). The ex vivo group confirmed the increase in glucose uptake in intact animals. GLUT1 and GLUT4 were expressed in both skeletal muscle and tendon, but no changes in mRNA levels could be detected. PET/CT can be used for studying glucose uptake in rat muscle and tendon in relation to muscle contractions; however, the increased uptake of glucose was not explained by changes in gene expression of GLUT1 and GLUT4. (orig.)

  18. Tendon neuroplastic training reduces tendon pain and muscle inhibition in-season: Changing the way we think about exercise

    NARCIS (Netherlands)

    Rio, E.; Kidgell, D.; Van Ark, M.; Zwerver, J; Sheek, I.; Moseley, G.L.; Gaida, J.; Docking, S.; Cook, J.

    2015-01-01

    Introduction: Patellar tendon pain is at its highest in-season but there are no published data of successful management when athletes are playing and training. Furthermore, there are changes to the cortical control of the quadriceps in patellar tendinopathy (including excess quadriceps inhibition)

  19. Noninvasive 64Cu-ATSM and PET/CT Assessment of Hypoxia in Rat Skeletal Muscles and Tendons During Muscle Contractions

    DEFF Research Database (Denmark)

    Skovgaard, Dorthe; Kjaer, Michael; Madsen, Jacob

    2009-01-01

    the first PET/CT scan. Standardized uptake values (SUVs) were calculated for the Achilles tendons and triceps surae muscles and were correlated to gene expression of HIF1alpha and CAIII using real-time polymerase chain reaction. RESULTS: Immediately after the contractions, uptake of (64)Cu......The purpose of the present study was to investigate exercise-related changes in oxygenation in rat skeletal muscles and tendons noninvasively with PET/CT and the hypoxia-selective tracer (64)Cu-diacetyl bis(N(4)-methylthiosemicarbazone) (ATSM) and to quantitatively study concomitant changes in gene...... expression of 2 hypoxia-related genes, hypoxia-inducible factor 1alpha (HIF1alpha) and carbonic anhydrase III (CAIII). METHODS: Two groups of Wistar rats performed 1-leg contractions of the calf muscle by electrostimulation of the sciatic nerve. After 10 min of muscle contractions, (64)Cu-ATSM was injected...

  20. Tendon and skeletal muscle matrix gene expression and functional responses to immobilisation and rehabilitation in young males

    DEFF Research Database (Denmark)

    Boesen, Anders Ploug; Dideriksen, Kasper; Couppé, Christian

    2013-01-01

    weeks followed by six weeks of strength training. Cross sectional area (CSA), maximal muscle strength (MVC) and biomechanical properties of m.quadriceps and patellar tendon were determined. Muscle and tendon biopsies were analysed for mRNA of collagen (COL-1A1/3A1), insulin-like growth factors (IGF-1Ea...... in both groups. Likewise, both groups increased in IGF-1Ea/Ec and COL-1A1/3A1 expression in muscle during re-training after immobilisation compared to baseline, and the rise was more pronounced when subjects recieved GH. The tendon CSA did not change during immobilisation, but increased in both groups...... during six weeks of rehabilitation (~14%). A decline in tendon stiffness after immobilisation was observed only in Plc, and an increase during six weeks rehabilitation was observed only in GH. IGF-1Ea and COL-1A1/3A1 mRNA increased with immobilisation in the GH group only, and LOX mRNA was after...

  1. Biochemical Interaction Between Muscle and Bone: A Physiological Reality?

    NARCIS (Netherlands)

    Jaspers, R.T.; Bravenboer, N.

    2014-01-01

    In elderly with a sedentary lifestyle, often suffering from sarcopenia to osteopenia, a training intervention could be an effective countermeasure for bone as well as muscle. Both bone and muscle adapt their mass and strength in response to mechanical loading in part via similar signaling pathways.

  2. Measurement of Gender Differences of Gastrocnemius Muscle and Tendon Using Sonomyography during Calf Raises: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Guang-Quan Zhou

    2017-01-01

    Full Text Available Skeletal muscles are essential to the gender-specific characteristics of human movements. Sonomyography, a new signal for quantifying muscle activation, is of great benefit to understand muscle function through monitoring the real-time muscle architectural changes. The purpose of this pilot study was to investigate gender differences in the architectural changes of gastronomies muscle and tendon by using sonomyography during performing two-legged calf raising exercises. A motion analysis system was developed to extract sonomyography from ultrasound images together with kinematic and kinetic measurements. Tiny fascicle length changes among seven male subjects were observed at the initial part of calf raising, whereas the fascicle of seven female subjects shortened immediately. This result suggested that men would generate higher mechanical power output of plantar flexors to regulate their heavier body mass. In addition, the larger regression coefficient between the fascicle length and muscle force for the male subjects implied that higher muscle stiffness for the men was required in demand of maintaining their heavier body economically. The findings from the current study suggested that the body mass might play a factor in the gender difference in structural changes of muscle and tendon during motion. The sonomyography may provide valuable information in the understanding of the gender difference in human movements.

  3. Specialisation of extracellular matrix for function in tendons and ligaments

    Science.gov (United States)

    Birch, Helen L.; Thorpe, Chavaunne T.; Rumian, Adam P.

    2013-01-01

    Summary Tendons and ligaments are similar structures in terms of their composition, organisation and mechanical properties. The distinction between them stems from their anatomical location; tendons form a link between muscle and bone while ligaments link bones to bones. A range of overlapping functions can be assigned to tendon and ligaments and each structure has specific mechanical properties which appear to be suited for particular in vivo function. The extracellular matrix in tendon and ligament varies in accordance with function, providing appropriate mechanical properties. The most useful framework in which to consider extracellular matrix differences therefore is that of function rather than anatomical location. In this review we discuss what is known about the relationship between functional requirements, structural properties from molecular to gross level, cellular gene expression and matrix turnover. The relevance of this information is considered by reviewing clinical aspects of tendon and ligament repair and reconstructive procedures. PMID:23885341

  4. Clinical results of a surgical technique using endobuttons for complete tendon tear of pectoralis major muscle: report of five cases

    Directory of Open Access Journals (Sweden)

    Uchiyama Yoshiyasu

    2011-09-01

    Full Text Available Abstract Background We herein describe a surgical technique for the repair of complete tear of the pectoralis major (PM tendon using endobuttons to strengthen initial fixation. Methods Five male patients (3 judo players, 1 martial arts player, and 1 body builder were treated within 2 weeks of sustaining complete tear of the PM tendon. Average age at surgery and follow-up period were 28.4 years (range, 23-33 and 28.8 months (range, 24-36. A rectangular bone trough (about 1 × 4 cm was created on the humerus at the insertion of the distal PM tendon. The tendon stump was introduced into this trough, and fixed to the reverse side of the humeral cortex using endobuttons and non-absorbable suture. Clinical assessment of re-tear was examined by MRI. Shoulder range of motion (ROM, outcome of treatment, and isometric power were measured at final follow-up. Results There were no clinical re-tears, and MRI findings also showed continuity of the PM tendon in all cases at final follow-up. Average ROM did not differ significantly between the affected and unaffected shoulders. The clinical outcomes at final follow-up were excellent (4/5 cases or good (1/5. In addition, postoperative isometric power in horizontal flexion of the affected shoulder showed complete recovery when compared with the unaffected side. Conclusions Satisfactory outcomes could be obtained when surgery using the endobutton technique was performed within 2 weeks after complete tear of the PM tendon. Therefore, our new technique appears promising as a useful method to treat complete tear of the PM tendon.

  5. Do peak torque angles of muscles change following anterior cruciate ligament reconstruction using hamstring or patellar tendon graft?

    Science.gov (United States)

    Yosmaoğlu, Hayri Baran; Baltacı, Gül; Sönmezer, Emel; Özer, Hamza; Doğan, Deha

    2017-12-01

    This study aims to compare the effects of anterior cruciate ligament (ACL) reconstruction using autogenous hamstring or patellar tendon graft on the peak torque angle. The study included 132 patients (103 males, 29 females; mean age 29±9 year) who were performed ACL reconstruction with autogenous hamstring or patellar tendon graft. The peak torque angles in the quadriceps and hamstring muscles were recorded using an isokinetic dynamometer. Angle of peak knee flexion torque occurred significantly earlier within the range of motion on the operated side than nonoperated side at 180°/second in the hamstring tendon group. Angle of peak knee extension torque occurred significantly earlier within the range of motion on the operated side than nonoperated side at 180°/second in the patellar tendon group. There were no statistically significant differences in the flexion and extension peak torque angles between the operated and nonoperated knees at 60°/second in both groups. The angle of peak torque at relatively high angular velocities is affected after ACL reconstruction in patients with hamstring or patellar tendon grafts. The graft donor site directly influences this parameter. This finding may be important for clinicians in terms of preventing re-injury.

  6. Exploratory factor analysis for differentiating sensory and mechanical variables related to muscle-tendon unit elongation

    Directory of Open Access Journals (Sweden)

    Mauro H. Chagas

    2016-01-01

    Full Text Available ABSTRACT Background Stretching exercises are able to promote adaptations in the muscle-tendon unit (MTU, which can be tested through physiological and biomechanical variables. Identifying the key variables in MTU adaptations is crucial to improvements in training. Objective To perform an exploratory factor analysis (EFA involving the variables often used to evaluate the response of the MTU to stretching exercises. Method Maximum joint range of motion (ROMMAX, ROM at first sensation of stretching (FSTROM, peak torque (torqueMAX, passive stiffness, normalized stiffness, passive energy, and normalized energy were investigated in 36 participants during passive knee extension on an isokinetic dynamometer. Stiffness and energy values were normalized by the muscle cross-sectional area and their passive mode assured by monitoring the EMG activity. Results EFA revealed two major factors that explained 89.68% of the total variance: 53.13% was explained by the variables torqueMAX, passive stiffness, normalized stiffness, passive energy, and normalized energy, whereas the remaining 36.55% was explained by the variables ROMMAX and FSTROM. Conclusion This result supports the literature wherein two main hypotheses (mechanical and sensory theories have been suggested to describe the adaptations of the MTU to stretching exercises. Contrary to some studies, in the present investigation torqueMAX was significantly correlated with the variables of the mechanical theory rather than those of the sensory theory. Therefore, a new approach was proposed to explain the behavior of the torqueMAX during stretching exercises.

  7. Relationships Between Lower-Body Muscle Structure and Lower-Body Strength, Power, and Muscle-Tendon Complex Stiffness.

    Science.gov (United States)

    Secomb, Josh L; Lundgren, Lina E; Farley, Oliver R L; Tran, Tai T; Nimphius, Sophia; Sheppard, Jeremy M

    2015-08-01

    The purpose of this study was to determine whether any relationships were present between lower-body muscle structure and strength and power qualities. Fifteen elite male surfing athletes performed a battery of lower-body strength and power tests, including countermovement jump (CMJ), squat jump (SJ), isometric midthigh pull (IMTP), and had their lower-body muscle structure assessed with ultrasonography. In addition, lower-body muscle-tendon complex (MTC) stiffness and dynamic strength deficit (DSD) ratio were calculated from the CMJ and IMTP. Significant relationships of large to very large strength were observed between the vastus lateralis (VL) thickness of the left (LVL) and right (RVL) leg and peak force (PF) (r = 0.54-0.77, p well as IMTP PF (r = 0.53-0.60, p = 0.02-0.04). Furthermore, large relationships were found between left lateral gastrocnemius (LG) pennation angle and SJ and IMTP PF (r = 0.53, p = 0.04, and r = 0.70, p < 0.01, respectively) and between LG and IMTP relative PF (r = 0.63, p = 0.01). Additionally, large relationships were identified between lower-body MTC stiffness and DSD ratio (r = 0.68, p < 0.01), right (LG) pennation angle (r = 0.51, p = 0.05), CMJ PF (r = 0.60, p = 0.02), and jump height (r = 0.53, p = 0.04). These results indicate that greater VL thickness and increased LG pennation angle are related to improved performance in the CMJ, SJ, and IMTP. Furthermore, these results suggest that lower-body MTC stiffness explains a large amount of variance in determining an athlete's ability to rapidly apply force during a dynamic movement.

  8. Anterior-Posterior Instability of the Knee Following ACL Reconstruction with Bone-Patellar Tendon-Bone Ligament in Comparison with Four-Strand Hamstrings Autograft

    Directory of Open Access Journals (Sweden)

    A. G. Angoules

    2013-01-01

    Full Text Available Purpose. To evaluate anterior-posterior knee laxity using two different autografts. Material-Methods. 40 patients, (34 males and 6 women, 17–54 years old (mean: 31, were included in the present study. Group A (4SHS = 20 underwent reconstruction using four-strand hamstrings, and group B (BPBT = 20 underwent reconstruction using bone-patellar tendon-bone autograft. Using the KT-1000 arthrometer, knee instability was calculated in both knees of all patients preoperatively and 3, 6, and 12 months after surgery at the ACL-operated knee. The contralateral healthy knee was used as an internal control group. Results. Anterior-posterior instability using the KT1000 Arthrometer was found to be increased after ACL insufficiency. The recorded laxity improved after arthroscopic ACL reconstruction in both groups. However, statistically significant greater values were detected in the bone-patellar tendon-bone group, which revealed reduction of anteroposterior stability values to an extent, where no statistical significance with the normal values even after 3 months after surgery was observed. Conclusions. Anterior-Posterior instability of the knee improved significantly after arthroscopic ACL reconstruction. The bone-patellar tendon-bone graft provided an obvious greater stability.

  9. ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A COMPARISON BETWEEN BONE PATELLAR TENDON BONE GRAFT AND LIPSCOMB PROCEDURE - A FOLLOWUP STUDY OF 7 YEARS

    Directory of Open Access Journals (Sweden)

    Vijayamohan S

    2016-07-01

    Full Text Available BACKGROUND Anterior Cruciate Ligament injury has become more common and the demand by the patients to return to pre-injury level of activity has made reconstruction of the ligament very crucial. Though there are various techniques in reconstructing the anterior cruciate ligament, in this study, we compare two most commonly used techniques to see whether there is any significant difference in the outcome. METHODS Study included 25 patients in the age group of 19-36 years, of which 23 were males. The patients were divided randomly into 2 groups, and 15 patients underwent Anterior Cruciate Ligament reconstruction using Bone Patellar Tendon Bone Graft and 10 patients had Hamstring graft. RESULTS Patients were followed up at regular intervals monthly for the first six months and then at three monthly intervals. Patients were assessed using Knee Scoring Scale of Lysholm and Gillquist and International Knee Documentation Committee (IKDC scoring system. In addition, activity level, harvest site pain, thigh atrophy, kneeling pain and hamstring pain were assessed. All patients were followed up for a minimum period of 2 years. 20% of both groups were able to return to strenuous activity level, and 67% of Patellar tendon group and 50% of the Hamstring tendon group were able to return to moderate level of activity. 55% of patients in the patellar tendon group and 20% of patients in the hamstring tendon group had donor site pain in the first 6 months. 73% of patients in the hamstring group had at least 10 mm of thigh wasting. Pain on kneeling was seen only in the patellar tendon group (35% while hamstring pain was found only in the hamstring group (20%. CONCLUSIONS Patients in the patellar tendon group had increased anterior stability and were able to return to strenuous occupation. The difference in thigh atrophy between the two groups was not significant. The hamstring group had lower graft harvest site morbidity. Lachman test was the single most accurate

  10. A systematic review of the concept and clinical applications of bone marrow aspirate concentrate in tendon pathology

    Directory of Open Access Journals (Sweden)

    Imam Mohamed A.

    2017-01-01

    Full Text Available Tendon pathologies are a group of musculoskeletal conditions frequently seen in clinical practice. They can be broadly classified into traumatic, degenerative and overuse-related tendinopathies. Rotator cuff tears, Achilles tendinopathy and tennis elbow are common examples of these conditions. Conventional treatments have shown inconsistent outcomes and might fail to provide satisfactory clinical improvement. With the growing trend towards the use of mesenchymal stem cells (MSCs in other branches of medicine, there is an increasing interest in treating tendon pathologies using the bone marrow MSC. In this article, we provide a systematic literature review documenting the current status of the use of bone marrow aspirate concentrate (BMAC for the treatment of tendon pathologies. We also asked the question on the safety of BMAC and whether there are potential complications associated with BMAC therapy. Our hypothesis is that the use of BMAC provides safe clinical benefit when used for the treatment of tendinopathy or as a biological augmentation of tendon repair. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA checklist while preparing this systematic review. A literature search was carried out including the online databases of PubMed, EMBASE, ClinicalTrial.gov and the Cochrane Library from 1960 to the end of May 2015. Relevant studies were selected and critically appraised. Data from eligible studies were extracted and classified per type of tendon pathology. We included 37 articles discussing the application and use of BMAC for the treatment of tendon pathologies. The Critical Appraisal Skills Program (CASP appraisal confirmed a satisfactory standard of 37 studies. Studies were sub-categorised into: techniques of extraction, processing and microscopic examination of BMAC (n = 18, where five studies looked at the evaluation of aspiration techniques (n = 5, augmentation of rotator cuff tears (n = 5

  11. Towards human exploration of space: the THESEUS review series on muscle and bone research priorities.

    Science.gov (United States)

    Lang, Thomas; Van Loon, Jack J W A; Bloomfield, Susan; Vico, Laurence; Chopard, Angele; Rittweger, Joern; Kyparos, Antonios; Blottner, Dieter; Vuori, Ilkka; Gerzer, Rupert; Cavanagh, Peter R

    2017-01-01

    Without effective countermeasures, the musculoskeletal system is altered by the microgravity environment of long-duration spaceflight, resulting in atrophy of bone and muscle tissue, as well as in deficits in the function of cartilage, tendons, and vertebral disks. While inflight countermeasures implemented on the International Space Station have evidenced reduction of bone and muscle loss on low-Earth orbit missions of several months in length, important knowledge gaps must be addressed in order to develop effective strategies for managing human musculoskeletal health on exploration class missions well beyond Earth orbit. Analog environments, such as bed rest and/or isolation environments, may be employed in conjunction with large sample sizes to understand sex differences in countermeasure effectiveness, as well as interaction of exercise with pharmacologic, nutritional, immune system, sleep and psychological countermeasures. Studies of musculoskeletal biomechanics, involving both human subject and computer simulation studies, are essential to developing strategies to avoid bone fractures or other injuries to connective tissue during exercise and extravehicular activities. Animal models may be employed to understand effects of the space environment that cannot be modeled using human analog studies. These include studies of radiation effects on bone and muscle, unraveling the effects of genetics on bone and muscle loss, and characterizing the process of fracture healing in the mechanically unloaded and immuno-compromised spaceflight environment. In addition to setting the stage for evidence-based management of musculoskeletal health in long-duration space missions, the body of knowledge acquired in the process of addressing this array of scientific problems will lend insight into the understanding of terrestrial health conditions such as age-related osteoporosis and sarcopenia.

  12. Muscle-bone Interactions During Fracture Healing

    Science.gov (United States)

    2015-03-01

    muscle resection, isotopic or heterotopic minced muscle implants were placed immediately adjacent to the periosteum. Their control groups consisted of...interacting with surrounding muscle. Addition- ally, Utvag et al. showed that significant muscle injury and ab- sence of muscle by resection, or by traumatic

  13. Intraoperative muscle electrical stimulation for accurate positioning of the temporalis muscle tendon during dynamic, one-stage lengthening temporalis myoplasty for facial and lip reanimation.

    Science.gov (United States)

    Har-Shai, Yaron; Gil, Tamir; Metanes, Issa; Labbé, Daniel

    2010-07-01

    Facial paralysis is a significant functional and aesthetic handicap. Facial reanimation is performed either by two-stage microsurgical methods or by regional one-stage muscle pedicle flaps. Labbé has modified and improved the regional muscle pedicle transfer flaps for facial reanimation (i.e., the lengthening temporalis myoplasty procedure). This true myoplasty technique is capable of producing a coordinated, spontaneous, and symmetrical smile. An intraoperative electrical stimulation of the temporal muscle is proposed to simulate the smile of the paralyzed side on the surgical table. The intraoperative electrical stimulation of the temporalis muscle, employing direct percutaneous electrode needles or transcutaneous electrical stimulation electrodes, was utilized in 11 primary and four secondary cases with complete facial palsy. The duration of the facial paralysis was up to 12 years. Postoperative follow-up ranged from 3 to 12 months. The insertion points of the temporalis muscle tendon to the nasolabial fold, upper lip, and oral commissure had been changed according to the intraoperative muscle stimulation in six patients of the 11 primary cases (55 percent) and in all four secondary (revisional) cases. A coordinated, spontaneous, and symmetrical smile was achieved in all patients by 3 months after surgery by employing speech therapy and biofeedback. This adjunct intraoperative refinement provides crucial feedback for the surgeon in both primary and secondary facial palsy cases regarding the vector of action of the temporalis muscle and the accuracy of the anchoring points of its tendon, thus enhancing a more coordinated and symmetrical smile.

  14. Assessment of rotatory instability after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone graft

    International Nuclear Information System (INIS)

    Tashiro, Yasutaka; Okazaki, Ken; Miura, Hiromasa

    2010-01-01

    Anatomically oriented anterior cruciate ligament (ACL) reconstruction has been advocated recently, but its effect on rotatory instability remains to be cleared objectively. The purpose of this study was to quantitatively evaluate rotatory instability in ACL reconstructed knees with a bone-patellar tendon-bone (BTB) graft using an open MRI system. Eighteen subjects underwent arthroscopic ACL reconstruction with a BTB graft. The tibial tunnel was placed in the center of the ACL footprint. The femoral tunnel was drilled transtibially at the 10:00 to 10:30-o'clock position for the right knees. Subjects were examined using a Slocum anterolateral rotatory instability test in open MRI. Anterior tibial translation was measured at the medial and lateral compartments by evaluating sagittal images. Anterior knee stability was evaluated using the KT-2000 arthrometer. The clinical knee function was assessed with the Lysholm and Tegner scoring scales before and after the surgery. Side-to-side differences of anterolateral tibial translation was 0.1 mm. Side-to-side difference on KT-2000 arthrometer measurement was 1.8 mm. The Lysholm score improved to 96 and the latest Tegner score reached substantially the preinjury level. ACL reconstruction with a BTB graft was successful in restoring rotatory stability as well as anterior stability and knee function. (author)

  15. Kinesthetic perception based on integration of motor imagery and afferent inputs from antagonistic muscles with tendon vibration.

    Science.gov (United States)

    Shibata, E; Kaneko, F

    2013-04-29

    The perceptual integration of afferent inputs from two antagonistic muscles, or the perceptual integration of afferent input and motor imagery are related to the generation of a kinesthetic sensation. However, it has not been clarified how, or indeed whether, a kinesthetic perception would be generated by motor imagery if afferent inputs from two antagonistic muscles were simultaneously induced by tendon vibration. The purpose of this study was to investigate how a kinesthetic perception would be generated by motor imagery during co-vibration of the two antagonistic muscles at the same frequency. Healthy subjects participated in this experiment. Illusory movement was evoked by tendon vibration. Next, the subjects imaged wrist flexion movement simultaneously with tendon vibration. Wrist flexor and extensor muscles were vibrated according to 4 patterns such that the difference between the two vibration frequencies was zero. After each trial, the perceived movement sensations were quantified on the basis of the velocity and direction of the ipsilateral hand-tracking movements. When the difference in frequency applied to the wrist flexor and the extensor was 0Hz, no subjects perceived movements without motor imagery. However, during motor imagery, the flexion velocity of the perceived movement was higher than the flexion velocity without motor imagery. This study clarified that the afferent inputs from the muscle spindle interact with motor imagery, to evoke a kinesthetic perception, even when the difference in frequency applied to the wrist flexor and extensor was 0Hz. Furthermore, the kinesthetic perception resulting from integrations of vibration and motor imagery increased depending on the vibration frequency to the two antagonistic muscles. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  16. Imbalances in the Development of Muscle and Tendon as Risk Factor for Tendinopathies in Youth Athletes: A Review of Current Evidence and Concepts of Prevention

    Directory of Open Access Journals (Sweden)

    Falk Mersmann

    2017-12-01

    Full Text Available Tendons feature the crucial role to transmit the forces exerted by the muscles to the skeleton. Thus, an increase of the force generating capacity of a muscle needs to go in line with a corresponding modulation of the mechanical properties of the associated tendon to avoid potential harm to the integrity of the tendinous tissue. However, as summarized in the present narrative review, muscle and tendon differ with regard to both the time course of adaptation to mechanical loading as well as the responsiveness to certain types of mechanical stimulation. Plyometric loading, for example, seems to be a more potent stimulus for muscle compared to tendon adaptation. In growing athletes, the increased levels of circulating sex hormones might additionally augment an imbalanced development of muscle strength and tendon mechanical properties, which could potentially relate to the increasing incidence of tendon overload injuries that has been indicated for adolescence. In fact, increased tendon stress and strain due to a non-uniform musculotendinous development has been observed recently in adolescent volleyball athletes, a high-risk group for tendinopathy. These findings highlight the importance to deepen the current understanding of the interaction of loading and maturation and demonstrate the need for the development of preventive strategies. Therefore, this review concludes with an evidence-based concept for a specific loading program for increasing tendon stiffness, which could be implemented in the training regimen of young athletes at risk for tendinopathy. This program incorporates five sets of four contractions with an intensity of 85–90% of the isometric voluntary maximum and a movement/contraction duration that provides 3 s of high magnitude tendon strain.

  17. Efficient decellularization for tissue engineering of the tendon-bone interface with preservation of biomechanics.

    Directory of Open Access Journals (Sweden)

    Kai Xu

    Full Text Available Interfaces between tendon/ligament and bone ("entheses" are highly specialized tissues that allow for stress transfer between mechanically dissimilar materials. Entheses show very low regenerative capacity resulting in high incidences of failure after surgical repair. Tissue engineering is a promising approach to recover functionality of entheses. Here, we established a protocol to decellularize porcine entheses as scaffolds for enthesis tissue engineering. Chemical detergents as well as physical treatments were investigated with regard to their efficiency to decellularize 2 mm thick porcine Achilles tendon entheses. A two-phase approach was employed: study 1 investigated the effect of various concentrations of sodium dodecyl sulfate (SDS and t-octylphenoxypolyethoxy-ethanol (Triton X-100 as decellularization agents. The most efficient combination of SDS and Triton was then carried forward into study 2, where different physical methods, including freeze-thaw cycles, ultrasound, perfusion, and hydrostatic washing were used to enhance the decellularization effect. Cell counts, DNA quantification, and histology showed that washing with 0.5% SDS + 1% Triton X-100 for 72 h at room temperature could remove ~ 98% cells from the interface. Further investigation of physical methods proved that washing under 200 mmHg hydrostatic pressure shortened the detergent exposing time from 72 h to 48 h. Biomechanical tensile testing showed that the biomechanical features of treated samples were preserved. Washing under 200 mmHg hydrostatic pressure with 0.5% SDS + 1% Triton X-100 for 48 h efficiently decellularized entheses with preservation of matrix structure and biomechanical features. This protocol can be used to efficiently decellularize entheses as scaffolds for tissue engineering.

  18. Biomechanical comparison of expanded polytetrafluoroethylene (ePTFE) and PTFE interpositional patches and direct tendon-to-bone repair for massive rotator cuff tears in an ovine model.

    Science.gov (United States)

    McKeown, Andrew Dj; Beattie, Rebekah F; Murrell, George Ac; Lam, Patrick H

    2016-01-01

    Massive irreparable rotator cuff tears are a difficult problem. Modalities such as irrigation and debridement, partial repair, tendon transfer and grafts have been utilized with high failure rates and mixed results. Synthetic interpositional patch repairs are a novel and increasingly used approach. The present study aimed to examine the biomechanical properties of common synthetic materials for interpositional repairs in contrast to native tendon. Six ovine tendons, six polytetrafluoroethylene (PTFE) felt sections and six expanded PTFE (ePTFE) patch sections were pulled-to-failure to analyze their biomechanical and material properties. Six direct tendon-to-bone surgical method repairs, six interpositional PTFE felt patch repairs and six interpositional ePTFE patch repairs were also constructed in ovine shoulders and pulled-to-failure to examine the biomechanical properties of each repair construct. Ovine tendon had higher load-to-failure (591 N) and had greater stiffness (108 N/mm) than either PTFE felt (296 N, 28 N/mm) or ePTFE patch sections (323 N, 34 N/mm). Both PTFE felt and ePTFE repair techniques required greater load-to-failure (225 N and 177 N, respectively) than direct tendon-to-bone surgical repairs (147 N) in ovine models. Synthetic materials lacked several biomechanical properties, including strength and stiffness, compared to ovine tendon. Interpositional surgical repair models with these materials were significantly stronger than direct tendon-to-bone model repairs.

  19. Bone Marrow Stromal Cells Generate Muscle Cells and Repair Muscle Degeneration

    Science.gov (United States)

    Dezawa, Mari; Ishikawa, Hiroto; Itokazu, Yutaka; Yoshihara, Tomoyuki; Hoshino, Mikio; Takeda, Shin-ichi; Ide, Chizuka; Nabeshima, Yo-ichi

    2005-07-01

    Bone marrow stromal cells (MSCs) have great potential as therapeutic agents. We report a method for inducing skeletal muscle lineage cells from human and rat general adherent MSCs with an efficiency of 89%. Induced cells differentiated into muscle fibers upon transplantation into degenerated muscles of rats and mdx-nude mice. The induced population contained Pax7-positive cells that contributed to subsequent regeneration of muscle upon repetitive damage without additional transplantation of cells. These MSCs represent a more ready supply of myogenic cells than do the rare myogenic stem cells normally found in muscle and bone marrow.

  20. A rare cause of acute dysphagia: acute calcific tendonitis of the longus colli muscle.

    Science.gov (United States)

    Abou Dargham, Hanadi; Bytyci, Faton; Shuman, Christian; Stolear, Anton

    2017-05-27

    We are presenting a case of a 78-year-old female with multiple comorbidities and history of neck surgery, who presented with acute dysphagia, odynophagia and neck pain that has been progressively getting worse over the course of 2 days, with no recent injury or infection. The patient was afebrile. There were no visible signs of infection on routine oropharyngeal examination. Initial workup was unremarkable except for elevated erythrocyte sedimentation rate, C-reactive protein and creatinine. CT of the cervical spine ruled out any fracture or cervical spine injury but showed an area of calcification, prevertebral oedema and fluid collection inferior to the anterior arch of C1. MRI of the cervical spine also showed prevertebral oedema and fluid collection in the retropharyngeal space from the skull base to the C3 level without abnormal surrounding enhancement that supported the diagnosis of acute calcific tendonitis of the longus colli muscle rather than an infectious process. There was significant improvement of symptoms 48 hours after initiating treatment with systemic steroids. The patient remains asymptomatic 6 months after treatment. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Short-term strength training and the expression of myostatin and IGF-I isoforms in rat muscle and tendon

    DEFF Research Database (Denmark)

    Heinemeier, K M; Olesen, J L; Schjerling, P

    2007-01-01

    In skeletal muscle, an increased expression of insulin like growth factor-I isoforms IGF-IEa and mechano-growth factor (MGF) combined with downregulation of myostatin is thought to be essential for training-induced hypertrophy. However, the specific effects of different contraction types on regul......In skeletal muscle, an increased expression of insulin like growth factor-I isoforms IGF-IEa and mechano-growth factor (MGF) combined with downregulation of myostatin is thought to be essential for training-induced hypertrophy. However, the specific effects of different contraction types...... on regulation of these factors in muscle are still unclear, and in tendon the functions of myostatin, IGF-IEa, and MGF in relation to training are unknown. Female Sprague-Dawley rats were subjected to 4 days of concentric, eccentric, or isometric training (n = 7-9 per group) of the medial gastrocnemius......, by stimulation of the sciatic nerve during general anesthesia. mRNA levels for myostatin, IGF-IEa, and MGF in muscle and Achilles' tendon were measured by real-time RT-PCR. Muscle myostatin mRNA decreased in response to all types of training (2- to 8-fold) (P

  2. Effects of knee immobilization on morphological changes in the semitendinosus muscle-tendon complex after hamstring harvesting for anterior cruciate ligament reconstruction. Evaluation using three-dimensional computed tomography

    International Nuclear Information System (INIS)

    Nakamae, Atsuo; Adachi, Nobuo; Nakasa, Tomoyuki; Nishimori, Makoto; Ochi, Mitsuo; Deie, Masataka

    2012-01-01

    It is desirable to maintain the morphology of the semitendinosus muscle-tendon complex after tendon harvesting for anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to evaluate the effect of knee immobilization on morphological changes in the semitendinosus muscle-tendon complex. In total, 39 patients who underwent ACL reconstruction with autologous semitendinosus tendons were included in this study. After surgery, the knee was immobilized for 3 days in 1 group of patients (group 1; 24 patients; control group) and for a longer period (10-14 days) in the other group (group 2; 15 patients). Three-dimensional computed tomography (3D CT) examination was performed at 6 and/or 12 months after the surgery for all patients. Morphological changes in the semitendinosus muscle-tendon complex (proximal shift of the semitendinosus muscle-tendon junction, width of the regenerated semitendinosus tendons, re-insertion sites of the regenerated tendons, and rate of semitendinosus tendon regeneration) were evaluated. Successful regeneration of the semitendinosus tendon was confirmed in all patients in group 2. In group 1, 3D CT showed that regeneration of the semitendinosus tendon was unsuccessful in 1 of the 24 patients. The average length of the proximal shift of the semitendinosus muscle-tendon junction was 7.3±2.5 cm in group 1 and 7.2±1.9 cm in group 2. There were no significant differences between the 2 groups with regard to the morphological changes in the semitendinosus muscle-tendon complex. This study showed that the structure of regenerated tendons could be clearly identified in 38 of 39 cases (97.4%) after ACL reconstruction. However, prolonged knee immobilization (10-14 days) could not prevent morphological changes in the semitendinosus muscle-tendon complex. (author)

  3. Terrestrial applications of bone and muscle research in microgravity

    Science.gov (United States)

    Booth, F. W.

    1994-08-01

    Major applications to people on Earth are possible from NASA-sponsored research on bone and muscle which is conducted either in microgravity or on Earth using models mimicking microgravity. In microgravity bone and muscle mass are lost. Humans experience a similar loss under certain conditions on Earth. Bone and muscle loss exist on Earth as humans age from adulthood to senescence, during limb immobilization for healing of orthopedic injuries, during wheelchair confinement because of certain diseases, and during chronic bed rest prescribed for curing of diseases. NASA-sponsored research is dedicated to learning both what cause bone and muscle loss as well as finding out how to prevent this loss. The health ramifications of these discoveries will have major impact. Objective 1.6 of Healthy People 2000, a report from the U.S. Department of Health and Human Services, states that the performance of physical activities that improve muscular strength, muscular endurance, and flexibility is particularly important to maintaining functional independence and social integration in older adults /1/. This objective further states that these types of physical activities are important because they may protect against disability, an event which costs the U.S. economy hugh sums of money. Thus NASA research related to bone and muscle loss has potential major impact on the quality of life in the U.S. Relative to its potential health benefits, NASA and Congressional support of bone and muscle research is funded is a very low level.

  4. [Evaluation of early physiotherapy in patients after surgical treatment of cruciate ligament injury by bone-tendon-bone method].

    Science.gov (United States)

    Klupiński, Kamil; Krekora, Katarzyna; Woldańska-Okońska, Marta

    2014-01-01

    Anterior cruciate ligament (ACL) is one of the most important structures of the knee joint. It has a stabilizing function and causes sliding movement between the articular surfaces. Most frequently there comes to the anterior cruciate ligament injury during practicing sports such as skiing, football, sports which require sudden turns and those which are associated with jumps for height like basketball and volleyball. The aim of study was to evaluate of the outcomes of complex physiotherapy after reconstruction of anterior cruciate ligament by bone -tendon-bone (BTB) method. The study involved 41 patients, 8 women and 33 men, aged 20 to 45 years, body height 1.60-1.90 cm and body weight 50-100 kg. The patients were divided into two groups. Group I included 26 patients (3 women and 23 men) after arthroscopic ACL reconstruction. Group II--control-group included 15 patients (5 women and 10 men) after ACL injury but not subjected to the ligament reconstruction. The patients from both groups underwent rehabilitation according to the same rehabilitation program suggested by the Medical Magnus Clinic in Lodz, which consisted in performing daily exercises in open and closed kinetic chains. All group I and II patients were examined three times: after surgery (before the start of the rehabilitation), in the sixth week of rehabilitation and 12 weeks afterwards. The clinical examination included: measurement of the range of movement in the knee joint, the measurement of musculoskeletal strength with Lovett scale, knee pain assessment using Visual Analog Scale (VAS), transpatellar anthropometric measurement of the knee joint, linear measurements of the thigh and shin (at two points: 5 and 10 cm above the patellar apex and at two points: 5 and 10 cm below the patellar base). Introduction of early highly specialized physiotherapy has been demonstrated to contribute to the improvement of the rehabilitation outcomes and to the shortening of the therapy. A statistically significant

  5. FUNCTIONAL OUTCOME OF ACCELERATED REHABILITATION IN ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH BONE PATELLAR TENDON BONE GRAFT A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Hiranyakumar

    2016-03-01

    Full Text Available INTRODUCTION An ideal rehabilitation program post anterior cruciate ligament reconstruction enables an individual to return to pre injury levels at a faster rate with minimal to no risk of reinjury to the graft. Rehabilitation protocols have changed considerably over time in the past. It has become “aggressive”, meaning an intensive rehabilitation which includes greater variety of exercises and sports related training. AIM OF THE STUDY The aim of our study is to assess the outcome of accelerated rehabilitation post anterior cruciate ligament (ACL reconstruction. METHODOLOGY 106 patients were operated by a single surgeon underwent arthroscopic anterior cruciate ligament reconstruction using bone patella tendon bone graft and partial meniscectomy for associated meniscal tear. Patients were put on an accelerated rehabilitation protocol designed in our institute on first post-operative day, under the guidance of a physical therapist in consultation with the operated surgeon. Patients were followed up at 3 weeks, 6 months and 9 months, post onset of rehabilitation, patients were assessed using KT1000 Arthrometer and Lysholm knee scoring system. RESULTS Out of 106 patients, who were selected, 96(91% were males and 10(9% were females. The mean pre-operative Lysholm score was 55.09. Post operatively, while on accelerated rehabilitation program the Lysholm scores were 69.73 at 3 weeks, 89.13 at 6 months and 89.19 at 9 months. In our pre-operative evaluation mean KT 1000 arthrometer score was 10.53 and post-operative at six months was 3.49. At nine months 105 patients had excellent results whereas 1 patient had good result. CONCLUSION Accelerated rehabilitation protocol enables the patient to functionally recover faster to pre injury levels. A rehabilitation protocol for 6 months is sufficient in enabling a patient to get back to pre-injury levels. Functional outcome is the same with or without associated meniscal injuries.

  6. Bones, Muscles, and Joints: The Musculoskeletal System

    Science.gov (United States)

    ... Skeletal muscles are called striated (pronounced: STRY-ay-ted) because they are made up of fibers that ... blood through your body. When we smile and talk, muscles are helping us communicate, and when we ...

  7. A simple model to estimate plantarflexor muscle-tendon mechanics and energetics during walking with elastic ankle exoskeletons

    Science.gov (United States)

    Sawicki, Gregory S.; Khan, Nabil S.

    2016-01-01

    Goal A recent experiment demonstrated that when humans wear unpowered elastic ankle exoskeletons with intermediate spring stiffness they can reduce their metabolic energy cost to walk by ~7%. Springs that are too compliant or too stiff have little benefit. The purpose of this study was to use modeling and simulation to explore the muscle-level mechanisms for the ‘sweet-spot’ in stiffness during exoskeleton assisted walking. Methods We developed a simple lumped, uniarticular musculoskeletal model of the plantarflexors operating in parallel with an elastic ‘exo-tendon’. Using an inverse approach with constrained kinematics and kinetics, we rapidly simulated human walking over a range of exoskeleton stiffness values and examined the underlying neuromechanics and energetics of the biological plantarflexors. Results Stiffer ankle exoskeleton springs resulted in larger decreases in plantarflexor muscle forces, activations and metabolic energy consumption. However, in the process of unloading the compliant biological muscle-tendon unit (MTU), the muscle fascicles (CE) experienced larger excursions that negatively impacted series elastic element (SEE) recoil that is characteristic of a tuned ‘catapult mechanism’. Conclusion The combination of disrupted muscle-tendon dynamics and the need to produce compensatory forces/moments to maintain overall net ankle moment invariance could explain the ‘sweet spot’ in metabolic performance at intermediate ankle exoskeleton stiffness. Future work will aim to provide experimental evidence to support the model predictions presented here using ultrasound imaging of muscle-level dynamics during walking with elastic ankle exoskeletons. Significance Engineers must account for the muscle-level effects of exoskeleton designs in order to achieve maximal performance objectives. PMID:26485350

  8. Involvement of the Interosseous and Lumbrical Muscle-Tendon Units in the Lateral and Spiral Cords in Dupuytren's Disease of the Middle Fingers.

    Science.gov (United States)

    Thoma, Achilleas; Karpinski, Marta

    2017-07-01

    The nature of intrinsic muscle involvement in Dupuytren's disease of the middle fingers (long and ring) remains poorly characterized. Over the years, the authors have observed that both the spiral and lateral digital cords in the middle fingers receive contribution from intrinsic muscle-tendon units. This report describes the anatomical characteristics and frequency of intrinsic muscle-tendon unit involvement in Dupuytren's disease of the middle fingers. Intrinsic muscle involvement in the middle digits was recorded in the operative reports of patients undergoing Dupuytren's surgery between October of 2013 and February of 2016. The anatomical variations of diseased fascia were delineated and classified. Of the 113 digits with Dupuytren's contracture operated on during this period, 52 involved the middle fingers (12 long and 40 ring fingers). Intrinsic muscles were found to be involved in the contracture of 14 of these digits. Two unique contracture patterns were identified: type I contracture, which involves a lateral digital cord originating from intrinsic muscle-tendon units and contracting only the proximal interphalangeal joint; and type II contracture, which involves a spiral cord receiving contribution from intrinsic muscle-tendon units and contracting both the metacarpophalangeal and proximal interphalangeal joints. The frequency of type I and type II contractures was 6 percent and 12 percent, respectively. Intrinsic hand muscles may contribute to Dupuytren's disease in the middle digits, and the authors suggest resecting cords as close as possible to their musculotendinous origin to improve postoperative outcomes.

  9. Functional adaptation of tendon and skeletal muscle to resistance training in three patients with genetically verified classic Ehlers Danlos Syndrome

    DEFF Research Database (Denmark)

    Møller, Mathias Bech; Kjær, Michael; Svensson, René Brüggebusch

    2014-01-01

    undergoing muscle strength training. We investigated patients with classical Ehlers Danlos Syndrome (EDS) (collagen type V defect) who display articular hypermobility, skin extensibility and tissue fragility. METHODS: subjects underwent strength training 3 times a week for 4 months and were tested before...... and after intervention in regards to muscle strength, tendon mechanical properties, and muscle function. RESULTS: three subjects completed the scheduled 48 sessions and had no major adverse events. Mean isometric leg extension force and leg extensor power both increased by 8 and 11% respectively (358 to 397...... sway-area of the participants decreased by 26% (0.144 to 0.108 m(2)). On the subscale of CIS20 the participants lowered their average subjective fatigue score from 33 to 25. CONCLUSION: in this small pilot study, heavy resistance training was both feasible and effective in classic Ehlers Danlos...

  10. Three-Dimensional Bio-Printed Scaffold Sleeves With Mesenchymal Stem Cells for Enhancement of Tendon-to-Bone Healing in Anterior Cruciate Ligament Reconstruction Using Soft-Tissue Tendon Graft.

    Science.gov (United States)

    Park, Sin Hyung; Choi, Yeong-Jin; Moon, Sang Won; Lee, Byung Hoon; Shim, Jin-Hyung; Cho, Dong-Woo; Wang, Joon Ho

    2018-01-01

    To investigate the efficacy of the insertion of 3-dimensional (3D) bio-printed scaffold sleeves seeded with mesenchymal stem cells (MSCs) to enhance osteointegration between the tendon and tunnel bone in anterior cruciate ligament (ACL) reconstruction in a rabbit model. Scaffold sleeves were fabricated by 3D bio-printing. Before ACL reconstruction, MSCs were seeded into the scaffold sleeves. ACL reconstruction with hamstring tendon was performed on both legs of 15 adult rabbits (aged 12 weeks). We implanted 15 bone tunnels with scaffold sleeves with MSCs and implanted another 15 bone tunnels with scaffold sleeves without MSCs before passing the graft. The specimens were harvested at 4, 8, and 12 weeks. H&E staining, immunohistochemical staining of type II collagen, and micro-computed tomography of the tunnel cross-sectional area were evaluated. Histologic assessment was conducted with a histologic scoring system. In the histologic assessment, a smooth bone-to-tendon transition through broad fibrocartilage formation was identified in the treatment group, and the interface zone showed abundant type II collagen production on immunohistochemical staining. Bone-tendon healing histologic scores were significantly higher in the treatment group than in the control group at all time points. Micro-computed tomography at 12 weeks showed smaller tibial (control, 9.4 ± 0.9 mm 2 ; treatment, 5.8 ± 2.9 mm 2 ; P = .044) and femoral (control, 9.6 ± 2.9 mm 2 ; treatment, 6.0 ± 1.0 mm 2 ; P = .03) bone-tunnel areas in the treated group than in the control group. The 3D bio-printed scaffold sleeve with MSCs exhibited excellent results in osteointegration enhancement between the tendon and tunnel bone in ACL reconstruction in a rabbit model. If secure biological healing between the tendon graft and tunnel bone can be induced in the early postoperative period, earlier, more successful rehabilitation may be facilitated. Three-dimensional bio-printed scaffold sleeves with

  11. EFFECT OF UNIPOLAR ACU-STIM ON MUSCLE RE-EDUCATION FOLLOWING TENDON TRANSFER - A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Prof. Srikanth R

    2015-02-01

    Full Text Available Background: Tendon transfer surgery is usually done to improve function, following damage to either major nerve trunks or peripheral nerves. Re-education of the muscle is of utmost importance to gain functional activity.To achieve this, along with re-education exercises, faradic stimulation is usually used. Unipolar Acu-Stim (UAS, is an innovative technique where an acupuncture needle is used to stimulate the transferred tendon with Surged Faradic Currents (SFC. The objective of the study is to identify if the application of SFC using UAS method, is effective to re-educate a transferred muscle. Case Description: The subject was a 24 year old male who had a loss of finger and thumb extension following Posterior Interosseous Nerve (PIN palsy, for which Flexor Carpi Radialis (FCR was transferred to Extensor Digitorum Communis (EDC and Palmaris Longus (PL was transferred to Extensor Pollicis Longus (EPL. Following removal of the POP, UAS with surged faradic current was applied for 4 weeks along with re-education exercises. Prognosis of finger extension was assessed by goniometry and video recordings. Outcome: At the end of 8th week, as observed on goniometry and video recordings, complete finger extension was achieved. Discussion: UAS with SFC, is useful in re-education of a transferred muscle, as desired movement can be achieved with low intensity.

  12. Pullout strength of bone-patellar tendon-bone allograft bone plugs: a comparison of cadaver tibia and rigid polyurethane foam.

    Science.gov (United States)

    Barber, F Alan

    2013-09-01

    To compare the load-to-failure pullout strength of bone-patellar tendon-bone (BPTB) allografts in human cadaver tibias and rigid polyurethane foam blocks. Twenty BPTB allografts were trimmed creating 25 mm × 10 mm × 10 mm tibial plugs. Ten-millimeter tunnels were drilled in 10 human cadaver tibias and 10 rigid polyurethane foam blocks. The BPTB anterior cruciate ligament allografts were inserted into these tunnels and secured with metal interference screws, with placement of 10 of each type in each material. After preloading (10 N), cyclic loading (500 cycles, 10 to 150 N at 200 mm/min) and load-to-failure testing (200 mm/min) were performed. The endpoints were ultimate failure load, cyclic loading elongation, and failure mode. No difference in ultimate failure load existed between grafts inserted into rigid polyurethane foam blocks (705 N) and those in cadaver tibias (669 N) (P = .69). The mean rigid polyurethane foam block elongation (0.211 mm) was less than that in tibial bone (0.470 mm) (P = .038), with a smaller standard deviation (0.07 mm for foam) than tibial bone (0.34 mm). All BPTB grafts successfully completed 500 cycles. The rigid polyurethane foam block showed less variation in test results than human cadaver tibias. Rigid polyurethane foam blocks provide an acceptable substitute for human cadaver bone tibia for biomechanical testing of BPTB allografts and offer near-equivalent results. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  13. The Physiological Mechanisms of Effect of Vitamins and Amino Acids on Tendon and Muscle Healing: A Systematic Review.

    Science.gov (United States)

    Tack, Christopher; Shorthouse, Faye; Kass, Lindsy

    2018-05-01

    To evaluate the current literature via systematic review to ascertain whether amino acids/vitamins provide any influence on musculotendinous healing and if so, by which physiological mechanisms. EBSCO, PubMed, ScienceDirect, Embase Classic/Embase, and MEDLINE were searched using terms including "vitamins," "amino acids," "healing," "muscle," and "tendon." The primary search had 479 citations, of which 466 were excluded predominantly due to nonrandomized design. Randomized human and animal studies investigating all supplement types/forms of administration were included. Critical appraisal of internal validity was assessed using the Cochrane risk of Bias Tool or the Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias Tool for human and animal studies, respectively. Two reviewers performed duel data extraction. Twelve studies met criteria for inclusion: eight examined tendon healing and four examined muscle healing. All studies used animal models, except two human trials using a combined integrator. Narrative synthesis was performed via content analysis of demonstrated statistically significant effects and thematic analysis of proposed physiological mechanisms of intervention. Vitamin C/taurine demonstrated indirect effects on tendon healing through antioxidant activity. Vitamin A/glycine showed direct effects on extracellular matrix tissue synthesis. Vitamin E shows an antiproliferative influence on collagen deposition. Leucine directly influences signaling pathways to promote muscle protein synthesis. Preliminary evidence exists, demonstrating that vitamins and amino acids may facilitate multilevel changes in musculotendinous healing; however, recommendations on clinical utility should be made with caution. All animal studies and one human study showed high risk of bias with moderate interobserver agreement (k = 0.46). Currently, there is limited evidence to support the use of vitamins and amino acids for musculotendinous injury. Both

  14. More is not always better: modeling the effects of elastic exoskeleton compliance on underlying ankle muscle-tendon dynamics.

    Science.gov (United States)

    Robertson, Benjamin D; Farris, Dominic J; Sawicki, Gregory S

    2014-11-24

    Development of robotic exoskeletons to assist/enhance human locomotor performance involves lengthy prototyping, testing, and analysis. This process is further convoluted by variability in limb/body morphology and preferred gait patterns between individuals. In an attempt to expedite this process, and establish a physiological basis for actuator prescription, we developed a simple, predictive model of human neuromechanical adaptation to a passive elastic exoskeleton applied at the ankle joint during a functional task. We modeled the human triceps surae-Achilles tendon muscle tendon unit (MTU) as a single Hill-type muscle, or contractile element (CE), and series tendon, or series elastic element (SEE). This modeled system was placed under gravitational load and underwent cyclic stimulation at a regular frequency (i.e. hopping) with and without exoskeleton (Exo) assistance. We explored the effect that both Exo stiffness (kExo) and muscle activation (Astim) had on combined MTU and Exo (MTU + Exo), MTU, and CE/SEE mechanics and energetics. Model accuracy was verified via qualitative and quantitative comparisons between modeled and prior experimental outcomes. We demonstrated that reduced Astim can be traded for increased kExo to maintain consistent MTU + Exo mechanics (i.e. average positive power (P⁺mech) output) from an unassisted condition (i.e. kExo = 0 kN · m⁻¹). For these regions of parameter space, our model predicted a reduction in MTU force, SEE energy cycling, and metabolic rate (Pmet), as well as constant CE P⁺mech output compared to unassisted conditions. This agreed with previous experimental observations, demonstrating our model's predictive ability. Model predictions also provided insight into mechanisms of metabolic cost minimization, and/or enhanced mechanical performance, and we concluded that both of these outcomes cannot be achieved simultaneously, and that one must come at the detriment of the other in a spring-assisted compliant MTU.

  15. Using chemical-shift MR imaging to quantify fatty degeneration within supraspinatus muscle due to supraspinatus tendon injuries

    Energy Technology Data Exchange (ETDEWEB)

    Gokalp, Gokhan; Yildirim, Nalan; Yazici, Zeynep [Uludag University Medical Faculty, Department of Radiology, Gorukle, Bursa (Turkey); Ercan, Ilker [Uludag University Medical Faculty, Department of Biostatistics, Gorukle, Bursa (Turkey)

    2010-12-15

    The objective of this study was to prospectively quantify the fatty degeneration of supraspinatus (SSP) muscle due to SSP tendon injuries by using chemical-shift magnetic resonance imaging (CS-MRI). Forty-one patients with suspected rotator cuff tear or impingement examined with MR arthrography were included in the study. The following images were obtained after injection of diluted gadolinium chelate into glenohumeral joint: fat-saturated T1-weighted spin echo in the coronal, axial, and sagittal-oblique plane; fat-saturated T2-weighted and intermediate-weighted fast spin-echo in the coronal-oblique plane; and T1-weighted spin echo in the sagittal-oblique plane. CS-MRI was performed in the coronal plane using a double-echo fast low-angle shot (FLASH) sequence. SSP tendon changes were classified as normal, tendinosis, and partial and complete tear according to MR arthrography findings. Fatty degeneration was quantified after measurement of signal intensity values within the region of interest (ROI) placed over SSP muscle. Signal intensity (SI) suppression ratio and SI index were calculated with the values obtained. Degrees of fatty degeneration depicted in normal subjects and subjects with rotator cuff injuries were compared. Median (min:max) was used as descriptive values. SI suppression ratio was -3.5% (-15.5:3.03) in normal subjects, whereas it was -13.5% (-28.55:-6.60), -30.7% (-41.5:-20.35), and -43.75% (-62:-24.90) in tendinosis, partial and complete tears, respectively. SI index was 0.75% (-6:11.5) in normal subjects. It was 10% (4.50:27), 26.5% (19.15:35.5), and 41% (23.9:57) in tendinosis, partial and complete tears, respectively. The increase in degree of fatty degeneration parallels the seriousness of tendon pathology. CS-MRI is a useful method for grading fat accumulation within SSP muscle. (orig.)

  16. Using chemical-shift MR imaging to quantify fatty degeneration within supraspinatus muscle due to supraspinatus tendon injuries

    International Nuclear Information System (INIS)

    Gokalp, Gokhan; Yildirim, Nalan; Yazici, Zeynep; Ercan, Ilker

    2010-01-01

    The objective of this study was to prospectively quantify the fatty degeneration of supraspinatus (SSP) muscle due to SSP tendon injuries by using chemical-shift magnetic resonance imaging (CS-MRI). Forty-one patients with suspected rotator cuff tear or impingement examined with MR arthrography were included in the study. The following images were obtained after injection of diluted gadolinium chelate into glenohumeral joint: fat-saturated T1-weighted spin echo in the coronal, axial, and sagittal-oblique plane; fat-saturated T2-weighted and intermediate-weighted fast spin-echo in the coronal-oblique plane; and T1-weighted spin echo in the sagittal-oblique plane. CS-MRI was performed in the coronal plane using a double-echo fast low-angle shot (FLASH) sequence. SSP tendon changes were classified as normal, tendinosis, and partial and complete tear according to MR arthrography findings. Fatty degeneration was quantified after measurement of signal intensity values within the region of interest (ROI) placed over SSP muscle. Signal intensity (SI) suppression ratio and SI index were calculated with the values obtained. Degrees of fatty degeneration depicted in normal subjects and subjects with rotator cuff injuries were compared. Median (min:max) was used as descriptive values. SI suppression ratio was -3.5% (-15.5:3.03) in normal subjects, whereas it was -13.5% (-28.55:-6.60), -30.7% (-41.5:-20.35), and -43.75% (-62:-24.90) in tendinosis, partial and complete tears, respectively. SI index was 0.75% (-6:11.5) in normal subjects. It was 10% (4.50:27), 26.5% (19.15:35.5), and 41% (23.9:57) in tendinosis, partial and complete tears, respectively. The increase in degree of fatty degeneration parallels the seriousness of tendon pathology. CS-MRI is a useful method for grading fat accumulation within SSP muscle. (orig.)

  17. Short-term strength training and the expression of myostatin and IGF-I isoforms in rat muscle and tendon: differential effects of specific contraction types.

    Science.gov (United States)

    Heinemeier, K M; Olesen, J L; Schjerling, P; Haddad, F; Langberg, H; Baldwin, K M; Kjaer, M

    2007-02-01

    In skeletal muscle, an increased expression of insulin like growth factor-I isoforms IGF-IEa and mechano-growth factor (MGF) combined with downregulation of myostatin is thought to be essential for training-induced hypertrophy. However, the specific effects of different contraction types on regulation of these factors in muscle are still unclear, and in tendon the functions of myostatin, IGF-IEa, and MGF in relation to training are unknown. Female Sprague-Dawley rats were subjected to 4 days of concentric, eccentric, or isometric training (n = 7-9 per group) of the medial gastrocnemius, by stimulation of the sciatic nerve during general anesthesia. mRNA levels for myostatin, IGF-IEa, and MGF in muscle and Achilles' tendon were measured by real-time RT-PCR. Muscle myostatin mRNA decreased in response to all types of training (2- to 8-fold) (P effect of eccentric training was greater than concentric and isometric training (P tendon, myostatin mRNA was detected, but no changes were seen after exercise. IGF-IEa and MGF increased in muscle (up to 15-fold) and tendon (up to 4-fold) in response to training (P tendon no difference was seen between training types, but in muscle the effect of eccentric training was greater than concentric training for both IGF-IEa and MGF (P effect than concentric (P tendon to training, and the combined changes in myostatin and IGF-IEa/MGF expression could explain the important effect of eccentric actions for muscle hypertrophy.

  18. GH receptor blocker administration and muscle-tendon collagen synthesis in humans

    DEFF Research Database (Denmark)

    Nielsen, Rie Harboe; Doessing, Simon; Goto, Kazushige

    2011-01-01

    Collagen is the predominant structural protein in tendons and ligaments, and can be controlled by hormonal changes. In animals, injections of insulin-like growth factor I (IGF-I) has been shown to increase collagen synthesis in tendons and ligaments and to improve structural tissue healing......, but the effect of local IGF-I administration on tendon collagen synthesis in human has not been studied. The purpose of this study was to study whether local injections of IGF-I would have a stimulating effect on tendon collagen synthesis. Twelve healthy nonsmoking men [age 62 ± 1 years (mean ± SEM), BMI 27 ± 1......] participated. Two injections of either human recombinant IGF-I (0.1 mL Increlex©) or saline (control) into each patellar tendon were performed 24-h apart, respectively. Tendon collagen fractional synthesis rate (FSR) was measured by stable isotope technique in the hours after the second injection...

  19. Bone marrow mesenchymal cells improve muscle function in a skeletal muscle re-injury model.

    Directory of Open Access Journals (Sweden)

    Bruno M Andrade

    Full Text Available Skeletal muscle injury is the most common problem in orthopedic and sports medicine, and severe injury leads to fibrosis and muscle dysfunction. Conventional treatment for successive muscle injury is currently controversial, although new therapies, like cell therapy, seem to be promise. We developed a model of successive injuries in rat to evaluate the therapeutic potential of bone marrow mesenchymal cells (BMMC injected directly into the injured muscle. Functional and histological assays were performed 14 and 28 days after the injury protocol by isometric tension recording and picrosirius/Hematoxilin & Eosin staining, respectively. We also evaluated the presence and the fate of BMMC on treated muscles; and muscle fiber regeneration. BMMC treatment increased maximal skeletal muscle contraction 14 and 28 days after muscle injury compared to non-treated group (4.5 ± 1.7 vs 2.5 ± 0.98 N/cm2, p<0.05 and 8.4 ± 2.3 vs. 5.7 ± 1.3 N/cm2, p<0.05 respectively. Furthermore, BMMC treatment increased muscle fiber cross-sectional area and the presence of mature muscle fiber 28 days after muscle injury. However, there was no difference in collagen deposition between groups. Immunoassays for cytoskeleton markers of skeletal and smooth muscle cells revealed an apparent integration of the BMMC within the muscle. These data suggest that BMMC transplantation accelerates and improves muscle function recovery in our extensive muscle re-injury model.

  20. Effect of Footprint Preparation on Tendon-to-Bone Healing: A Histologic and Biomechanical Study in a Rat Rotator Cuff Repair Model.

    Science.gov (United States)

    Nakagawa, Haruhiko; Morihara, Toru; Fujiwara, Hiroyoshi; Kabuto, Yukichi; Sukenari, Tsuyoshi; Kida, Yoshikazu; Furukawa, Ryuhei; Arai, Yuji; Matsuda, Ken-Ichi; Kawata, Mitsuhiro; Tanaka, Masaki; Kubo, Toshikazu

    2017-08-01

    To compare the histologic and biomechanical effects of 3 different footprint preparations for repair of tendon-to-bone insertions and to assess the behavior of bone marrow-derived cells in each method of insertion repair. We randomized 81 male Sprague-Dawley rats and green fluorescent protein-bone marrow chimeric rats into 3 groups. In group A, we performed rotator cuff repair after separating the supraspinatus tendon from the greater tuberosity and removing the residual tendon tissue. In group B, we also drilled 3 holes into the footprint. The native fibrocartilage was preserved in groups A and B. In group C, we excavated the footprint until the cancellous bone was exposed. Histologic repair of the tendon-to-bone insertion, behavior of the bone marrow-derived cells, and ultimate force to failure were examined postoperatively. The areas of metachromasia in groups A, B, and C were 0.033 ± 0.019, 0.089 ± 0.022, and 0.002 ± 0.001 mm 2 /mm 2 , respectively, at 4 weeks and 0.029 ± 0.022, 0.090 ± 0.039, and 0.003 ± 0.001 mm 2 /mm 2 , respectively, at 8 weeks. At 4 and 8 weeks postoperatively, significantly higher cartilage matrix production was observed in group B than in group C (4 weeks, P = .002; 8 weeks, P repair tissue and biomechanical strength at the tendon-to-bone insertion after rotator cuff repair in an animal model. Drilling into the footprint and preserving the fibrocartilage can enhance repair of tendon-to-bone insertions. This method may be clinically useful in rotator cuff repair. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  1. Ruptures of the pectoralis major muscle and it’s tendon: review of the literature and our experience in the treatment

    Directory of Open Access Journals (Sweden)

    G. M. Kavalersky

    2015-01-01

    Full Text Available Tendon ruptures of the pectoralis major muscle are considered a rare type of injury, but there is a tendency for a greater frequency of occurrence in such cases, which is associated with an increased interest in sport and fitness among the population. Despite the seeming simplicity of diagnosis, many complete ruptures remain unrecognized and many patients do not seek medical help or being treated for bruises, sprains and partial damage, although in fact there a complete ruptures of the pectoralis major muscle or it’s tendon. Currently there is no consensus on diagnostic tactics, surgical approach, the optimal method of fixation, indications for use of plastic material; disputable tactics of chronic ruptures and rehabilitation program in the treatment of tendon ruptures of the pectoralis major muscle.

  2. Mechanical alterations of rabbit Achilles' tendon after immobilization correlate with bone mineral density but not with magnetic resonance or ultrasound imaging.

    Science.gov (United States)

    Trudel, Guy; Koike, Yoichi; Ramachandran, Nanthan; Doherty, Geoff; Dinh, Laurent; Lecompte, Martin; Uhthoff, Hans K

    2007-12-01

    To assess the usefulness of magnetic resonance imaging (MRI), ultrasound (US) imaging, or bone mineral density (BMD) in predicting the mechanical properties of immobilized rabbit Achilles' tendons. Experimental study. Basic university laboratory. Twenty-eight rabbits. Twelve rabbits had 1 hindlimb casted for 4 weeks and 10 rabbits were casted for 8 weeks. Contralateral legs and 12 normal hindlimbs served as controls. Achilles' tendon dimensions on MRI and US, T1- and T2-signal intensities on MRI, classification of abnormalities on MRI and US; BMD of the calcaneus with dual-energy x-ray absorptiometry. Biomechanic measures consisted of peak load, stiffness, and stress. Imaging variables were correlated with biomechanic alterations. Immobilized Achilles' tendons were weaker and showed decreased mechanical stress compared with their contralateral legs and controls (all PAchilles' tendons after immobilization. However, neither increased MRI nor US signal abnormality was found. BMD was lower in immobilized calcanei and larger in contralateral legs than controls. Only BMD correlated with both the decreased peak load (R2=.42, PAchilles' tendon. This study established weakened mechanical properties of immobilized Achilles' tendons. BMD of the calcaneus, but not MRI and US, was predictive of the mechanical alterations in immobilized Achilles' tendons. BMD may be a useful biomarker to monitor disease and recovery in Achilles' tendons.

  3. Role of IGF-I Signaling in Muscle Bone Interactions

    Science.gov (United States)

    Bikle, Daniel D; Tahimic, Candice; Chang, Wenhan; Wang, Yongmei; Philippou, Anastassios; Barton, Elisabeth R.

    2015-01-01

    Skeletal muscle and bone rely on a number of growth factors to undergo development, modulate growth, and maintain physiological strength. A major player in these actions is insulin-like growth factor I (IGF-I). However, because this growth factor can directly enhance muscle mass and bone density, it alters the state of the musculoskeletal system indirectly through mechanical crosstalk between these two organ systems. Thus, there are clearly synergistic actions of IGF-I that extend beyond the direct activity through its receptor. This review will cover the production and signaling of IGF-I as it pertains to muscle and bone, the chemical and mechanical influences that arise from IGF-I activity, and the potential for therapeutic strategies based on IGF-I. PMID:26453498

  4. Percutaneous Needle Tenotomy for the Treatment of Muscle and Tendon Contractures in Adults With Brain Damage: Results and Complications.

    Science.gov (United States)

    Coroian, Flavia; Jourdan, Claire; Froger, Jérome; Anquetil, Claire; Choquet, Olivier; Coulet, Bertand; Laffont, Isabelle

    2017-05-01

    To study the results and complications of percutaneous needle tenotomy for superficial retracted tendons in patients with brain damage. Prospective observational study. University hospital. Patients with severe brain damage (N=38; mean age, 60.7y; age range, 24-93y; 21 women) requiring surgical management of contractures and eligible for percutaneous needle tenotomy were enrolled between February 2015 and February 2016. The percutaneous needle tenotomy gesture was performed by a physical medicine and rehabilitation physician trained by an orthopedic surgeon, under local or locoregional anesthesia. Treated tendons varied among patients. All patients were evaluated at 1, 3, and 6 months to assess surgical outcomes (joint range of motion [ROM], pain, and functional improvement) while screening for complications. Improvements in ROM (37/38) and contractures-related pain (12/12) were satisfactory. Functional results were satisfactory (Goal Attainment Scale score ≥0) for most patients (37/38): nursing (n=12), putting shoes on (n=8), getting in bed or sitting on a chair (n=6), verticalization (n=7), transfers and gait (n=8), and grip (n=2). Five patients had complications related to the surgical gesture: cast-related complications (n=2), hand hematoma (n=2), and cutaneous necrosis of the Achilles tendon in a patient with previous obliterative arteriopathy of the lower limbs (n=1). Percutaneous needle tenotomy yields good results in the management of selected superficial muscle and tendon contractures. The complications rate is very low, and this treatment can be an alternative to conventional surgery in frail patients with neurologic diseases. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  5. Icariin Promotes Tendon-Bone Healing during Repair of Rotator Cuff Tears: A Biomechanical and Histological Study.

    Science.gov (United States)

    Ye, Chenyi; Zhang, Wei; Wang, Shengdong; Jiang, Shuai; Yu, Yuanbin; Chen, Erman; Xue, Deting; Chen, Jianzhong; He, Rongxin

    2016-10-25

    To investigate whether the systematic administration of icariin (ICA) promotes tendon-bone healing after rotator cuff reconstruction in vivo, a total of 64 male Sprague Dawley rats were used in a rotator cuff injury model and underwent rotator cuff reconstruction (bone tunnel suture fixation). Rats from the ICA group ( n = 32) were gavage-fed daily with ICA at 0.125 mg/g, while rats in the control group ( n = 32) received saline only. Micro-computed tomography, biomechanical tests, serum ELISA (calcium; Ca, alkaline phosphatase; AP, osteocalcin; OCN) and histological examinations (Safranin O and Fast Green staining, type I, II and III collagen (Col1, Col2, and Col3), CD31, and vascular endothelial growth factor (VEGF)) were analyzed two and four weeks after surgery. In the ICA group, the serum levels of AP and OCN were higher than in the control group. More Col1-, Col2-, CD31-, and VEGF-positive cells, together with a greater degree of osteogenesis, were detected in the ICA group compared with the control group. During mechanical testing, the ICA group showed a significantly higher ultimate failure load than the control group at both two and four weeks. Our results indicate that the systematic administration of ICA could promote angiogenesis and tendon-bone healing after rotator cuff reconstruction, with superior mechanical strength compared with the controls. Treatment for rotator cuff injury using systematically-administered ICA could be a promising strategy.

  6. Aging changes in the bones - muscles - joints

    Science.gov (United States)

    ... the 40s in women. Lipofuscin (an age-related pigment) and fat are deposited in muscle tissue. The ... changes in body shape Aging changes in hormone production Aging changes in organs, tissues, and cells Aging ...

  7. Assessment of the mechanical properties of the muscle-tendon unit by supersonic shear wave imaging elastography: a review

    Directory of Open Access Journals (Sweden)

    Kelly Mônica Marinho e Lima

    2018-01-01

    Full Text Available This review aimed to describe the state of the art in muscle-tendon unit (MTU assessment by supersonic shear wave imaging (SSI elastography in states of muscle contraction and stretching, during aging, and in response to injury and therapeutic interventions. A consensus exists that MTU elasticity increases during passive stretching or contraction, and decreases after static stretching, electrostimulation, massage, and dry needling. There is currently no agreement regarding changes in the MTU due to aging and injury. Currently, the application of SSI for the purpose of diagnosis, rehabilitation, and physical training remains limited by a number of issues, including the lack of normative value ranges, the lack of consensus regarding the appropriate terminology, and an inadequate understanding of the main technical limitations of this novel technology.

  8. Knitted poly-lactide-co-glycolide scaffold loaded with bone marrow stromal cells in repair and regeneration of rabbit Achilles tendon.

    Science.gov (United States)

    Ouyang, Hong Wei; Goh, James C H; Thambyah, Ashvin; Teoh, Swee Hin; Lee, Eng Hin

    2003-06-01

    The objectives of this study were to evaluate the morphology and biomechanical function of Achilles tendons regenerated using knitted poly-lactide-co-glycolide (PLGA) loaded with bone marrow stromal cells (bMSCs). The animal model used was that of an adult female New Zealand White rabbit with a 10-mm gap defect of the Achilles tendon. In group I, 19 hind legs with the created defects were treated with allogeneic bMSCs seeded on knitted PLGA scaffold. In group II, the Achilles tendon defects in 19 hind legs were repaired using the knitted PLGA scaffold alone, and in group III, 6 hind legs were used as normal control. The tendon-implant constructs of groups I and II were evaluated postoperatively at 2, 4, 8, and 12 weeks using macroscopic, histological, and immunohistochemical techniques. In addition, specimens from group I (n = 7), group II (n = 7), and group III (n = 6) were harvested for biomechanical test 12 weeks after surgery. Postoperatively, at 2 and 4 weeks, the histology of group I specimens exhibited a higher rate of tissue formation and remodeling as compared with group II, whereas at 8 and 12 weeks postoperation, the histology of both group I and group II was similar to that of native tendon tissue. The wound sites of group I healed well and there was no apparent lymphocyte infiltration. Immunohistochemical analysis showed that the regenerated tendons were composed of collagen types I and type III fibers. The tensile stiffness and modulus of group I were 87 and 62.6% of normal tendon, respectively, whereas those of group II were about 56.4 and 52.9% of normal tendon, respectively. These results suggest that the knitted PLGA biodegradable scaffold loaded with allogeneic bone marrow stromal cells has the potential to regenerate and repair gap defect of Achilles tendon and to effectively restore structure and function.

  9. Botulinum Neurotoxin A Injections Influence Stretching of the Gastrocnemius Muscle-Tendon Unit in an Animal Model

    Directory of Open Access Journals (Sweden)

    Christopher J. Tuohy

    2012-08-01

    Full Text Available Botulinum Neurotoxin A (BoNT-A injections have been used for the treatment of muscle contractures and spasticity. This study assessed the influence of (BoNT-A injections on passive biomechanical properties of the muscle-tendon unit. Mouse gastrocnemius muscle (GC was injected with BoNT-A (n = 18 or normal saline (n = 18 and passive, non-destructive, in vivo load relaxation experimentation was performed to examine how the muscle-tendon unit behaves after chemical denervation with BoNT-A. Injection of BoNT-A impaired passive muscle recovery (15% vs. 35% recovery to pre-stretching baseline, p < 0.05 and decreased GC stiffness (0.531 ± 0.061 N/mm vs. 0.780 ± 0.037 N/mm, p < 0.05 compared to saline controls. The successful use of BoNT-A injections as an adjunct to physical therapy may be in part attributed to the disruption of the stretch reflex; thereby modulating in vivo passive muscle properties. However, it is also possible that BoNT-A injection may alter the structure of skeletal muscle; thus modulating the in vivo passive biomechanical properties of the muscle-tendon unit.

  10. The role of human ankle plantar flexor muscle-tendon interaction and architecture in maximal vertical jumping examined in vivo.

    Science.gov (United States)

    Farris, Dominic James; Lichtwark, Glen A; Brown, Nicholas A T; Cresswell, Andrew G

    2016-02-01

    Humans utilise elastic tendons of lower limb muscles to store and return energy during walking, running and jumping. Anuran and insect species use skeletal structures and/or dynamics in conjunction with similarly compliant structures to amplify muscle power output during jumping. We sought to examine whether human jumpers use similar mechanisms to aid elastic energy usage in the plantar flexor muscles during maximal vertical jumping. Ten male athletes performed maximal vertical squat jumps. Three-dimensional motion capture and a musculoskeletal model were used to determine lower limb kinematics that were combined with ground reaction force data in an inverse dynamics analysis. B-mode ultrasound imaging of the lateral gastrocnemius (GAS) and soleus (SOL) muscles was used to measure muscle fascicle lengths and pennation angles during jumping. Our results highlighted that both GAS and SOL utilised stretch and recoil of their series elastic elements (SEEs) in a catapult-like fashion, which likely serves to maximise ankle joint power. The resistance of supporting of body weight allowed initial stretch of both GAS and SOL SEEs. A proximal-to-distal sequence of joint moments and decreasing effective mechanical advantage early in the extension phase of the jumping movement were observed. This facilitated a further stretch of the SEE of the biarticular GAS and delayed recoil of the SOL SEE. However, effective mechanical advantage did not increase late in the jump to aid recoil of elastic tissues. © 2016. Published by The Company of Biologists Ltd.

  11. Sensitivity of subject-specific models to Hill muscle-tendon model parameters in simulations of gait.

    Science.gov (United States)

    Carbone, V; van der Krogt, M M; Koopman, H F J M; Verdonschot, N

    2016-06-14

    Subject-specific musculoskeletal (MS) models of the lower extremity are essential for applications such as predicting the effects of orthopedic surgery. We performed an extensive sensitivity analysis to assess the effects of potential errors in Hill muscle-tendon (MT) model parameters for each of the 56 MT parts contained in a state-of-the-art MS model. We used two metrics, namely a Local Sensitivity Index (LSI) and an Overall Sensitivity Index (OSI), to distinguish the effect of the perturbation on the predicted force produced by the perturbed MT parts and by all the remaining MT parts, respectively, during a simulated gait cycle. Results indicated that sensitivity of the model depended on the specific role of each MT part during gait, and not merely on its size and length. Tendon slack length was the most sensitive parameter, followed by maximal isometric muscle force and optimal muscle fiber length, while nominal pennation angle showed very low sensitivity. The highest sensitivity values were found for the MT parts that act as prime movers of gait (Soleus: average OSI=5.27%, Rectus Femoris: average OSI=4.47%, Gastrocnemius: average OSI=3.77%, Vastus Lateralis: average OSI=1.36%, Biceps Femoris Caput Longum: average OSI=1.06%) and hip stabilizers (Gluteus Medius: average OSI=3.10%, Obturator Internus: average OSI=1.96%, Gluteus Minimus: average OSI=1.40%, Piriformis: average OSI=0.98%), followed by the Peroneal muscles (average OSI=2.20%) and Tibialis Anterior (average OSI=1.78%) some of which were not included in previous sensitivity studies. Finally, the proposed priority list provides quantitative information to indicate which MT parts and which MT parameters should be estimated most accurately to create detailed and reliable subject-specific MS models. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Effect of platelet-rich plasma on tendon-to-bone healing after rotator cuff repair in rats: an in vivo experimental study.

    Science.gov (United States)

    Hapa, Onur; Cakıcı, Hüsamettin; Kükner, Aysel; Aygün, Hayati; Sarkalan, Nazlı; Baysal, Gökhan

    2012-01-01

    The purpose of this experimental study was to analyze the effects of local autologous platelet-rich plasma (PRP) injection on tendon-to-bone healing in a rotator cuff repair model in rats. Rotator cuff injury was created in 68 left shoulders of rats. PRP was obtained from the blood of an additional 15 rats. The 68 rats were divided into 4 groups with 17 rats in each group; PRP group (Week 2), control group (Week 2), PRP group (Week 4), and control group (Week 4). Platelet-rich plasma or saline was injected to the repair area intraoperatively. Rats were sacrificed 2 and 4 weeks after the surgery. Histological analysis using a semiquantitative scoring was performed on 7 rats per group. Tendon integrity and increases in vascularity and inflammatory cells and the degree of new bone formation were evaluated and compared between the groups. The remaining tendons (n=10) were mechanically tested. Degree of inflammation and vascularity were less in the study group at both time intervals (protator cuff tendon-to-bone healing and enhance initial tendon-to-bone healing remodeling. This may represent a clinically important improvement in rotator cuff repair.

  13. Tendon synovial cells secrete fibronectin in vivo and in vitro

    International Nuclear Information System (INIS)

    Banes, A.J.; Link, G.W.; Bevin, A.G.; Peterson, H.D.; Gillespie, Y.; Bynum, D.; Watts, S.; Dahners, L.

    1988-01-01

    The chemistry and cell biology of the tendon have been largely overlooked due to the emphasis on collagen, the principle structural component of the tendon. The tendon must not only transmit the force of muscle contraction to bone to effect movement, but it must also glide simultaneously over extratendonous tissues. Fibronectin is classified as a cell attachment molecule that induces cell spreading and adhesion to substratum. The external surface of intact avian flexor tendon stained positively with antibody to cellular fibronectin. However, if the surface synovial cells were first removed with collagenase, no positive reaction with antifibronectin antibody was detected. Analysis of immunologically stained frozen sections of tendon also revealed fibronectin at the tendon synovium, but little was associated with cells internal in tendon. The staining pattern with isolated, cultured synovial cells and fibroblasts from the tendon interior substantiated the histological observations. Analysis of polyacrylamide gel profiles of 35 S-methionine-labeled proteins synthesized by synovial cells and internal fibroblasts indicated that fibronectin was synthesized principally by synovial cells. Fibronectin at the tendon surface may play a role in cell attachment to prevent cell removal by the friction of gliding. Alternatively, fibronectin, with its binding sites for hyaluronic acid and collagen, may act as a complex for boundary lubrication

  14. A survey of the FDA's AERS database regarding muscle and tendon adverse events linked to the statin drug class.

    Directory of Open Access Journals (Sweden)

    Keith B Hoffman

    Full Text Available BACKGROUND: Cholesterol management drugs known as statins are widely used and often well tolerated; however, a variety of muscle-related side effects can arise. These adverse events (AEs can have serious impact, and form a significant barrier to therapy adherence. Surveillance of post-marketing AEs is of vital importance to understand real-world AEs and reporting differences between individual statin drugs. We conducted a review of post-approval muscle and tendon AE reports in association with statin use, to assess differences within the drug class. METHODS: We analyzed all case reports from the FDA AE Reporting System (AERS database linking muscle-related AEs to statin use (07/01/2005-03/31/2011. Drugs examined were: atorvastatin, simvastatin, lovastatin, pravastatin, rosuvastatin, and fluvastatin. RESULTS: Relative risk rates for rosuvastatin were consistently higher than other statins. Atorvastatin and simvastatin showed intermediate risks, while pravastatin and lovastatin appeared to have the lowest risk rates. Relative risk of muscle-related AEs, therefore, approximately tracked with per milligram LDL-lowering potency, with fluvastatin an apparent exception. Incorporating all muscle categories, rates for atorvastatin, simvastatin, pravastatin, and lovastatin were, respectively, 55%, 26%, 17%, and 7.5% as high, as rosuvastatin, approximately tracking per milligram potency (Rosuvastatin>Atorvastatin>Simvastatin>Pravastatin ≈ Lovastatin and comporting with findings of other studies. Relative potency, therefore, appears to be a fundamental predictor of muscle-related AE risk, with fluvastatin, the least potent statin, an apparent exception (risk 74% vs rosuvastatin. INTERPRETATION: AE reporting rates differed strikingly for drugs within the statin class, with relative reporting aligning substantially with potency. The data presented in this report offer important reference points for the selection of statins for cholesterol management in

  15. Frontal plane fractures of the accessory carpal bone and implications for the carpal sheath of the digital flexor tendons.

    Science.gov (United States)

    Minshall, G J; Wright, I M

    2014-09-01

    Accurate radiological and ultrasonographic descriptions of frontal plane fractures of the accessory carpal bone (ACB) are lacking, and implications of these fractures for the carpal sheath and its contents have not previously been reported. Aims were as follows: 1) to describe the location and radiological features of frontal plane fractures of the ACB; 2) to document communication of displaced fractures with the carpal sheath and consequent injury to the deep digital flexor tendon (DDFT); 3) to describe ultrasonographic identification of lesions; and 4) to report tenoscopic evaluation and treatment. Retrospective case series. Analysis of frontal plane fractures of the ACB referred to a single hospital between 2006 and 2012, including review of radiographic, ultrasonographic and tenoscopic images. Nine fractures were identified, of which 8 displaced fractures all communicated with the carpal sheath. Comminuted fragments and/or protruding fracture margins lacerated the lateral margin of the enclosed DDFT. This was identifiable ultrasonographically and confirmed at tenoscopy in 7 cases. Treatment in these horses consisted of removal of torn tendon tissue together with fragmentation and protuberant fracture edges, and 7 of 7 cases returned to work. One horse with a nondisplaced fracture was managed with immobilisation; the fracture healed, and the horse returned to work. One horse with a displaced fracture was retired to stud. Frontal plane fractures of the ACB occur palmar to the groove in its lateral margin for the tendon of insertion of ulnaris lateralis. Comminuted fragments can displace distally within the carpal sheath to a mid-metacarpal level or abaxially to lie extrathecally, lateral to the parent bone. Displaced fractures communicate with the carpal sheath and traumatise the DDFT. © 2013 EVJ Ltd.

  16. Human growth hormone may be detrimental when used to accelerate recovery from acute tendon-bone interface injuries.

    Science.gov (United States)

    Baumgarten, Keith M; Oliver, Harvey A; Foley, Jack; Chen, Ding-Geng; Autenried, Peter; Duan, Shanzhong; Heiser, Patrick

    2013-05-01

    There have been few scientific studies that have examined usage of human growth hormone to accelerate recovery from injury. The hypothesis of this study was that human growth hormone would accelerate tendon-to-bone healing compared with control animals treated with placebo in a rat model of acute rotator cuff injury repair. Seventy-two rats underwent repair of acute rotator cuff injuries and were randomized into the following postoperative dosing regimens: placebo, and human growth hormone at 0.1, 1, 2, 5, and 10 mg/kg/day, administered subcutaneously once per day for fourteen days (Protocol 1). An additional twenty-four rats were randomized to receive either (1) placebo or (2) human growth hormone at 5 mg/kg, administered subcutaneously twice per day for seven days preoperatively and twenty-eight days postoperatively (Protocol 2). All rats were killed twenty-eight days postoperatively. Mechanical testing was performed. Ultimate stress, ultimate force, stiffness, energy to failure, and ultimate distension were determined. For Protocol 1, analysis of variance testing showed no significant difference between the groups with regard to ultimate stress, ultimate force, stiffness, energy to failure, or ultimate distension. In Protocol 2, ultimate force to failure was significantly worse in the human growth hormone group compared with the placebo group (21.1 ± 5.85 versus 26.3 ± 5.47 N; p = 0.035). Failure was more likely to occur through the bone than the tendon-bone interface in the human growth hormone group compared with the placebo group (p = 0.001). No significant difference was found for ultimate stress, ultimate force, stiffness, energy to failure, or ultimate distension between the groups in Protocol 2. In this rat model of acute tendon-bone injury repair, daily subcutaneous postoperative human growth hormone treatment for fourteen days failed to demonstrate a significant difference in any biomechanical parameter compared with placebo. Furthermore, subcutaneous

  17. Tendon retraction with rotator cuff tear causes a decrease in cross-sectional area of the supraspinatus muscle on magnetic resonance imaging.

    Science.gov (United States)

    Fukuta, Shoji; Tsutsui, Takahiko; Amari, Rui; Wada, Keizo; Sairyo, Koichi

    2016-07-01

    Muscle atrophy and fatty degeneration of the rotator cuff muscles have been reported as negative prognostic indicators after rotator cuff repair. Although the Y-shaped view is widely used for measuring the cross-sectional area of the supraspinatus muscle, the contribution of retraction of the torn tendon as well as muscle atrophy must be considered. The purpose of this study was to clarify the relationship between cross-sectional area and tendon retraction or size of the tear. This study included 76 shoulders that were evaluated arthroscopically for the presence and size of tears. Cross-sectional areas of rotator cuff muscles were measured from the Y-shaped view to 3 more medial slices. The occupation ratio and tangent sign were evaluated on the Y-shaped view. The retraction of torn tendon was also measured on the oblique coronal images. On the Y-shaped view, the cross-sectional area of the supraspinatus and the occupation ratio decreased in conjunction with the increase in tear size. A significant decrease in cross-sectional area was noted only in large and massive tears on more medial slices from the Y-shaped view. Significant decreases in the cross-sectional area of the infraspinatus were observed in large and massive tears on all images. A negative correlation was found between tendon retraction and cross-sectional area, which was strongest on the Y-shaped view. To avoid the influence of retraction of the supraspinatus tendon, sufficient medial slices from the musculotendinous junction should be used for evaluation of muscle atrophy. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  18. Effects of pretension on work and power output of the muscle-tendon complex in dynamic elbow flexion.

    Science.gov (United States)

    Wakayama, Akinobu; Nagano, Akinori; Hay, Dean; Fukashiro, Senshi

    2005-06-01

    The purpose of the present study was to investigate the effects of pretension on work and power output of the muscle-tendon complex during dynamic elbow flexion under several submaximal and maximal conditions. The subjects were 10 healthy female students. Randomized trials from 0% to 100% maximal voluntary contraction (MVC) pretension (PT) at 60 degrees elbow flexion were conducted. After about 3 s of static PT, subjects maximally flexed the elbow joint to 90 degrees using a quick release method. The weight was individually selected for each subject to provide an optimal load for the development of maximal power. A Hill-type model was utilized to analyze the performance of the elbow muscle-tendon complex (MTC). PT 0, 30, 60 and 90% MVC data were used for comparison, and all data were expressed as the mean and standard deviation. Multiple paired comparisons between the value of PT 0% MVC and that of the other PT levels were performed post-hoc using Dunnett's method. The work of the series elastic component (SEC) increased gradually with the PT level because elastic energy was stored in the PT phase. However, the work of the contractile component (CC) decreased gradually with an increase in PT level. Moreover, the work of the MTC also decreased, closely related to the CC work decrement. The phenomenon of CC work decrement was caused by force depression and was not related to either the force-length or force-velocity relationships of the CC. EMG activity (agonist and antagonist) showed no significant differences. Muscle geometry changes or intracellular chemical shifts may have occurred in the PT phase.

  19. A relationship between spinal new bone formation in ankylosing spondylitis and the sonographically determined Achilles tendon enthesophytes.

    Science.gov (United States)

    Aydin, Sibel Zehra; Can, Meryem; Alibaz-Oner, Fatma; Keser, Gokhan; Kurum, Esra; Inal, Vedat; Yazisiz, Veli; Birlik, Merih; Emmungil, Hakan; Atagunduz, Pamir; Direskeneli, Haner; McGonagle, Dennis; Pay, Salih

    2016-03-01

    Spinal new bone formation is a major but incompletely understood manifestation of ankylosing spondylitis (AS). We explored the relationship between spinal new bone formation and ultrasound (US)-determined Achilles enthesophytes to test the hypothesis that spinal new bone formation is part of a generalized enthesis bone-forming phenotype. A multicenter, case control study of 225 consecutive AS patients and 95 age/body mass index (BMI) matched healthy controls (HC) was performed. US scans of Achilles tendons and cervical and lumbar spine radiographs were obtained. All images were centrally scored by one investigator for US and one for radiographs, blinded to medical data. The relation between syndesmophytes (by modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) and the number of syndesmophytes) and enthesophytes (with a semi-quantitative scoring of the US findings) was investigated. AS patients had significantly higher US enthesophyte scores than HCs (2.1(1.6) vs. 1.6(1.6); p = 0.004). The difference was significant in males (p = 0.001) but not in females (p = 0.5). The enthesophyte scores significantly correlated with mSASSS scores (ρ = 0.274, p gender-specific phenotype that could be a useful marker predicting of new bone formation.

  20. Effect of growth hormone on aging connective tissue in muscle and tendon - gene expression, morphology and function following immobilization and rehabilitation

    DEFF Research Database (Denmark)

    Boesen, Anders Ploug; Dideriksen, Kasper Juel; Couppe, Christian

    2014-01-01

    assigned to daily injections of recombinant GH(rhGH, n=6) or placebo(Plc, n=6). Cross sectional area(CSA), muscle strength(MVC) and biomechanical properties of m. quadriceps and patellar tendon were determined. Muscle and tendon biopsies were analyzed for gene expressions (mRNA) of collagen(COL1A1/3A1...... pronounced when GH was injected. Furthermore, tendon stiffness increased in GH group. Muscle CSA declined after immobilization in Plc but not in GH group. Muscle CSA increased during re-training with a significant larger increase in GH group compared to Plc. Both a time and group effect was seen for IGF-1Ea....../Ec and COL1A1/3A1 mRNA expression in muscle with a difference between GH and Plc. IGF-1Ea/Ec and COL-1A1/3A1 mRNA expression increased in muscle following immobilization and re-training in subjects receiving GH, whereas an increase in IGF-1Ec mRNA expression was seen in the Plc group only after re...

  1. Muscles, Ligaments and Tendons Journal – Basic principles and recommendations in clinical and field Science Research: 2016 Update

    Science.gov (United States)

    Padulo, Johnny; Oliva, Francesco; Frizziero, Antonio; Maffulli, Nicola

    2016-01-01

    Summary The proper design and implementation of a study as well as a balanced and well-supported evaluation and interpretation of its main findings are of crucial importance when reporting and disseminating research. Also accountability, funding acknowledgement and adequately declaring any conflict of interest play a major role in science. Since the Muscles, Ligaments and Tendons Journal (MLTJ) is committed to the highest scientific and ethical standards, we encourage all Authors to take into account and to comply, as much as possible, to the contents and issues discussed in this official editorial. This could be useful for improving the quality of the manuscripts, as well as to stimulate interest and debate and to promote constructive change, reflecting upon uses and misuses within our disciplines belonging to the field of “Clinical and Sport - Science Research”. PMID:27331026

  2. Muscles, Ligaments and Tendons Journal - Basic principles and recommendations in clinical and field Science Research: 2016 Update.

    Science.gov (United States)

    Padulo, Johnny; Oliva, Francesco; Frizziero, Antonio; Maffulli, Nicola

    2016-01-01

    The proper design and implementation of a study as well as a balanced and well-supported evaluation and interpretation of its main findings are of crucial importance when reporting and disseminating research. Also accountability, funding acknowledgement and adequately declaring any conflict of interest play a major role in science. Since the Muscles, Ligaments and Tendons Journal (MLTJ) is committed to the highest scientific and ethical standards, we encourage all Authors to take into account and to comply, as much as possible, to the contents and issues discussed in this official editorial. This could be useful for improving the quality of the manuscripts, as well as to stimulate interest and debate and to promote constructive change, reflecting upon uses and misuses within our disciplines belonging to the field of "Clinical and Sport - Science Research".

  3. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... views of bone, they provide little information about muscles, tendons or joints. An MRI may be more useful in identifying bone and joint injuries (e.g., meniscal and ligament tears in the knee, rotator cuff and labrum tears ...

  4. Stability of double-row rotator cuff repair is not adversely affected by scaffold interposition between tendon and bone.

    Science.gov (United States)

    Beitzel, Knut; Chowaniec, David M; McCarthy, Mary Beth; Cote, Mark P; Russell, Ryan P; Obopilwe, Elifho; Imhoff, Andreas B; Arciero, Robert A; Mazzocca, Augustus D

    2012-05-01

    Rotator cuff reconstructions may be improved by adding growth factors, cells, or other biologic factors into the repair zone. This usually requires a biological carrier (scaffold) to be integrated into the construct and placed in the area of tendon-to-bone healing. This needs to be done without affecting the constructs mechanics. Hypothesis/ The hypothesis was that scaffold placement, as an interposition, has no adverse effects on biomechanical properties of double-row rotator cuff repair. The purpose of this study was to examine the effect of scaffold interposition on the initial strength of rotator cuff repairs. Controlled laboratory study. Twenty-five fresh-frozen shoulders (mean age: 65.5 ± 8.9 years) were randomly assigned to 5 groups. Groups were chosen to represent a broad spectrum of commonly used scaffold types: (1) double-row repair without augmentation, (2) double-row repair with interposition of a fibrin clot (Viscogel), (3) double-row repair with interposition of a collagen scaffold (Mucograft) between tendon and bone, (4) double-row repair with interposition of human dermis patch (ArthroFlex) between tendon and bone, and (5) double-row repair with human dermis patch (ArthroFlex) placed on top of the repair. Cyclic loading to measure displacement was performed to 3000 cycles at 1 Hz with an applied 10- to 100-N load. The ultimate load to failure was determined at a rate of 31 mm/min. There were no significant differences in mean displacement under cyclic loading, slope, or energy absorbed to failure between all groups (P = .128, P = .981, P = .105). Ultimate load to failure of repairs that used the collagen patch as an interposition (573.3 ± 75.6 N) and a dermis patch on top of the reconstruction (575.8 ± 22.6 N) was higher compared with the repair without a scaffold (348.9 ± 98.8 N; P = .018 and P = .025). No significant differences were found for repairs with the fibrin clot as an interposition (426.9 ± 103.6 N) and the decellularized dermis

  5. Effect of Platelet-Rich Plasma and Bioactive Glass Powder for the Improvement of Rotator Cuff Tendon-to-Bone Healing in a Rabbit Model

    Directory of Open Access Journals (Sweden)

    Yang Wu

    2014-11-01

    Full Text Available To test the hypothesis that a platelet-rich plasma (PRP plus bioactive glass (BG mixture could shorten the tendon-bone healing process in rotator cuff tendon repair, thirty mature male New Zealand white rabbits were randomly divided into three groups, Control, PRP, and PRP + BG. All groups underwent a surgical procedure to establish a rotator cuff tendon healing model. Mechanical examinations and histological assays were taken to verify the adhesion of the tendon-bone. Real-time PCR was adopted to analyze Bone Morphogenetic Protein-2 (BMP-2. The maximum load-to-failure value in mechanical examinations was significantly higher in the PRP + BG group than that in the control group after six weeks (Control 38.73 ± 8.58, PRP 54.49 ± 8.72, PRP + BG 79.15 ± 7.62, p < 0.001, but it was not significantly different at 12 weeks (PRP 74.27 ± 7.74, PRP + BG 82.57 ± 6.63, p = 0.145. In histological assays, H&E (hematoxylin-eosin staining showed that the interface between the tendon-bone integration was much sturdier in the PRP + BG group compared to the other two groups at each time point, and more ordered arranged tendon fibers can be seen at 12 weeks. At six weeks, the mRNA expression levels of BMP-2 in the PRP + BG group were higher than those in the other groups (PRP + BG 0.65 ± 0.11, PRP 2.284 ± 0.07, Control 0.12 ± 0.05, p < 0.05. However, there was no significant difference in the mRNA expression levels of BMP-2 among the three groups at 12 weeks (p = 0.922, 0.067, 0.056. BMP-2 levels in PRP and PRP+BG groups were significantly lower at 12 weeks compared to six weeks (p = 0.006, <0.001.We found that the PRP + BG mixture could enhance tendon-bone healing in rotator cuff tendon repair.

  6. Stem Cell Applications in Tendon Disorders: A Clinical Perspective

    Directory of Open Access Journals (Sweden)

    Mark Young

    2012-01-01

    Full Text Available Tendon injuries are a common cause of morbidity and a significant health burden on society. Tendons are structural tissues connecting muscle to bone and are prone to tearing and tendinopathy, an overuse or degenerative condition that is characterized by failed healing and cellular depletion. Current treatments, for tendon tear are conservative, surgical repair or surgical scaffold reconstruction. Tendinopathy is treated by exercises, injection therapies, shock wave treatments or surgical tendon debridement. However, tendons usually heal with fibrosis and scar tissue, which has suboptimal tensile strength and is prone to reinjury, resulting in lifestyle changes with activity restriction. Preclinical studies show that cell therapies have the potential to regenerate rather than repair tendon tissue, a process termed tenogenesis. A number of different cell lines, with varying degrees of differentiation, have being evaluated including stem cells, tendon derived cells and dermal fibroblasts. Even though cellular therapies offer some potential in treating tendon disorders, there have been few published clinical trials to determine the ideal cell source, the number of cells to administer, or the optimal bioscaffold for clinical use.

  7. 2014 Bone and Muscle Risks Standing Review Panel

    Science.gov (United States)

    Steinberg, Susan; Glowacki, Julie; Gregor, Robert; Cullen, Diane; Drake, Almond; Enoka, Roger; Hanley, Edward, Jr.; Kraemer, William; Raven, Peter; Sumner, D. Rick

    2015-01-01

    The 2014 Bone and Muscle Risks Standing Review Panel (from here on referred to as the SRP) met for a site visit in Houston, TX on December 17 - 18, 2014. The SRP reviewed the updated Evidence Reports for the Risk of Impaired Performance Due to Reduced Muscle Mass, Strength and Endurance and (from here on referred to as the 2014 Muscle Evidence Report) and the Risk of Reduced Physical Performance Capabilities Due to Reduced Aerobic Capacity (from here on referred to as the 2014 Aerobic Evidence Report), as well as the Research Plans for these Risks. The SRP agreed the Evidence Reports were comprehensive and described a logical sequence of steps taken by NASA and the scientific community to address the risk of impaired performance as a result of muscle atrophy, i.e., reduced muscle mass, loss of strength and loss of endurance in a microgravity environment. The interdependence of the three physiological systems represented by this SRP (i.e., skeletal, muscular and cardiovascular) supports a level of discussion on system integration that is now appreciated by the Chief Scientist of the Human Research Program (HRP). The Evidence Reports cover the effects of microgravity on muscle, ranging from the cellular and molecular levels to whole muscle function. The reports also addressed other factors related to muscle (e.g., neural influences, insulin resistance, heat stress, and nutrition) that will serve as a basis for future discussions on the integration of physiological systems and the response to microgravity. The SRP agreed the Evidence Reports were balanced, provided insight to muscle function, and laid the foundation for the integrated approach now taken by the SRP.

  8. Heparin functionalization increases retention of TGF-β2 and GDF5 on biphasic silk fibroin scaffolds for tendon/ligament-to-bone tissue engineering.

    Science.gov (United States)

    Font Tellado, Sònia; Chiera, Silvia; Bonani, Walter; Poh, Patrina S P; Migliaresi, Claudio; Motta, Antonella; Balmayor, Elizabeth R; van Griensven, Martijn

    2018-05-01

    The tendon/ligament-to-bone transition (enthesis) is a highly specialized interphase tissue with structural gradients of extracellular matrix composition, collagen molecule alignment and mineralization. These structural features are essential for enthesis function, but are often not regenerated after injury. Tissue engineering is a promising strategy for enthesis repair. Engineering of complex tissue interphases such as the enthesis is likely to require a combination of biophysical, biological and chemical cues to achieve functional tissue regeneration. In this study, we cultured human primary adipose-derived mesenchymal stem cells (AdMCs) on biphasic silk fibroin scaffolds with integrated anisotropic (tendon/ligament-like) and isotropic (bone/cartilage like) pore alignment. We functionalized those scaffolds with heparin and explored their ability to deliver transforming growth factor β2 (TGF-β2) and growth/differentiation factor 5 (GDF5). Heparin functionalization increased the amount of TGF-β2 and GDF5 remaining attached to the scaffold matrix and resulted in biological effects at low growth factor doses. We analyzed the combined impact of pore alignment and growth factors on AdMSCs. TGF-β2 and pore anisotropy synergistically increased the expression of tendon/ligament markers and collagen I protein content. In addition, the combined delivery of TGF-β2 and GDF5 enhanced the expression of cartilage markers and collagen II protein content on substrates with isotropic porosity, whereas enthesis markers were enhanced in areas of mixed anisotropic/isotropic porosity. Altogether, the data obtained in this study improves current understanding on the combined effects of biological and structural cues on stem cell fate and presents a promising strategy for tendon/ligament-to-bone regeneration. Regeneration of the tendon/ligament-to-bone interphase (enthesis) is of significance in the repair of ruptured tendons/ligaments to bone to improve implant integration and

  9. Does footprint preparation influence tendon-to-bone healing after rotator cuff repair in an animal model?

    Science.gov (United States)

    Ficklscherer, Andreas; Loitsch, Thomas; Serr, Michaela; Gülecyüz, Mehmet F; Niethammer, Thomas R; Müller, Hans-Helge; Milz, Stefan; Pietschmann, Matthias F; Müller, Peter E

    2014-02-01

    The aim of this study was to investigate the influence of footprint spongialization and radiofrequency ablation on rotator cuff repair outcomes compared with an untreated group in a rat model. We randomly assigned 189 Sprague-Dawley rats to either a spongialization, radiofrequency ablation, or untreated group. After separation of the supraspinatus tendon from the greater tubercle, the footprint was prepared by removing the cortical bone with a burr (spongialization), was prepared by ablating soft tissue with a radiofrequency ablation device, or was left unaltered (untreated). Biomechanical testing (after 7 weeks, n = 165) and histologic analysis after 1 and 7 weeks (n = 24) followed reinsertion. The mean load to failure was 17.51 ± 4.46 N/mm(2) in the spongialization group, 15.56 ± 4.85 N/mm(2) in the radiofrequency ablation group, and 19.21 ± 5.19 N/mm(2) in the untreated group. A significant difference was found between the spongialization and radiofrequency ablation groups (P = .0409), as well as between the untreated and radiofrequency ablation groups (P = .0014). There was no significant difference between the spongialization and untreated groups (P = .2456). The mean area of fibrocartilage transition, characterized by the presence of type II collagen, was larger after 1 and 7 weeks in the spongialization group (0.57 ± 0.1 mm(2) and 0.58 ± 0.1 mm(2), respectively) and untreated group (0.51 ± 0.1 mm(2) and 0.51 ± 0.2 mm(2), respectively) than in the radiofrequency ablation group (0.11 ± 0.1 mm(2) and 0.4 ± 0.1 mm(2), respectively) with P rotator cuff repair may influence tendon-to-bone healing. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  10. Pulsed electromagnetic field therapy improves tendon-to-bone healing in a rat rotator cuff repair model.

    Science.gov (United States)

    Tucker, Jennica J; Cirone, James M; Morris, Tyler R; Nuss, Courtney A; Huegel, Julianne; Waldorff, Erik I; Zhang, Nianli; Ryaby, James T; Soslowsky, Louis J

    2017-04-01

    Rotator cuff tears are common musculoskeletal injuries often requiring surgical intervention with high failure rates. Currently, pulsed electromagnetic fields (PEMFs) are used for treatment of long-bone fracture and lumbar and cervical spine fusion surgery. Clinical studies examining the effects of PEMF on soft tissue healing show promising results. Therefore, we investigated the role of PEMF on rotator cuff healing using a rat rotator cuff repair model. We hypothesized that PEMF exposure following rotator cuff repair would improve tendon mechanical properties, tissue morphology, and alter in vivo joint function. Seventy adult male Sprague-Dawley rats were assigned to three groups: bilateral repair with PEMF (n = 30), bilateral repair followed by cage activity (n = 30), and uninjured control with cage activity (n = 10). Rats in the surgical groups were sacrificed at 4, 8, and 16 weeks. Control group was sacrificed at 8 weeks. Passive joint mechanics and gait analysis were assessed over time. Biomechanical analysis and μCT was performed on left shoulders; histological analysis on right shoulders. Results indicate no differences in passive joint mechanics and ambulation. At 4 weeks the PEMF group had decreased cross-sectional area and increased modulus and maximum stress. At 8 weeks the PEMF group had increased modulus and more rounded cells in the midsubstance. At 16 weeks the PEMF group had improved bone quality. Therefore, results indicate that PEMF improves early tendon healing and does not alter joint function in a rat rotator cuff repair model. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:902-909, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  11. In vitro investigation of a tissue-engineered cell-tendon complex mimicking the transitional architecture at the ligament-bone interface.

    Science.gov (United States)

    Wang, Zhibing; Zhang, Yuan; Zhu, Jie; Dong, Shiwu; Jiang, Tao; Zhou, Yue; Zhang, Xia

    2015-03-01

    Restoration of the transitional ligament-bone interface is critical for graft-bone integration. We postulated that an allogenic scaffold mimicking the fibrogenic, chondrogenic, and osteogenic transition gradients could physiologically promote ligament-bone incorporation. The aim of this study was to construct and characterize a composite tendon scaffold with a continuous and heterogeneous transition region mimicking a native ligament insertion site. Genetically modified heterogeneous cell populations were seeded within specific regions of decellularized rabbit Achilles tendons to fabricate a stratified scaffold containing three biofunctional regions supporting fibrogenesis, chondrogenesis, and osteogenesis. The observed morphology, architecture, cytocompatibility, and biomechanics of the scaffolds demonstrated their improved bio-physico-chemical properties. The formation of the transitional regions was augmented via enhanced delivery of two transcription factors, sex determining region Y-box 9 and runt-related transcription factor 2, which also triggered early up-regulated expression of cartilage- and bone-relevant markers, according to quantitative PCR and immunoblot analyses. Gradient tissue-specific matrix formation was also confirmed within the predesignated regions via histological staining and immunofluorescence assays. These results suggest that a transitional interface could be replicated on an engineered tendon through stratified tissue integration. The scaffold offers the advantages of a multitissue transition involving controlled cellular interactions and matrix heterogeneity, which can be applied for the regeneration of the ligament-bone interface. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  12. Is Soleus Muscle-Tendon-Unit Behavior Related to Ground-Force Application During the Sprint Start?

    Science.gov (United States)

    Schrödter, Erik; Brüggemann, Gert-Peter; Willwacher, Steffen

    2017-04-01

    To describe the stretch-shortening behavior of ankle plantar-flexing muscle-tendon units (MTUs) during the push-off in a sprint start. Fifty-four male (100-m personal best: 9.58-12.07 s) and 34 female (100-m personal best: 11.05-14.00 s) sprinters were analyzed using an instrumented starting block and 2-dimensional high-speed video imaging. Analysis was performed separately for front and rear legs, while accounting for block obliquities and performance levels. The results showed clear signs of a dorsiflexion in the upper ankle joint (front block 15.8° ± 7.4°, 95% CI 13.2-18.2°; rear block 8.0° ± 5.7°, 95% CI 6.4-9.7°) preceding plantar flexion. When observed in their natural block settings, the athletes' block obliquity did not significantly affect push-off characteristics. It seems that the stretch-shortening-cycle-like motion of the soleus MTU has an enhancing influence on push-off force generation. This study provides the first systematic observation of ankle-joint stretch-shortening behavior for sprinters of a wide range of performance levels. The findings highlight the importance of reactive-type training for the improvement of starting performance. Nonetheless, future studies need to resolve the independent contributions of tendinous and muscle-fascicle structures to overall MTU performance.

  13. Sonographic swelling of pronator quadratus muscle in patients with occult bone injury

    International Nuclear Information System (INIS)

    Sato, Junko; Ishii, Yoshinori; Noguchi, Hideo; Toyabe, Shin-ichi

    2015-01-01

    The disarranged fat stripe of the pronator quadratus muscle (PQ) on radiographs (the PQ sign) is reported to be predictive of subtle bone fractures. This study aimed to report the results of magnetic resonance imaging (MRI) study in the patients in whom bone injury was not radiographically detected around the wrist joint, and the PQ was sonographically swollen following acute trauma. We evaluated sonographically the PQ of 55 patients who showed normal radiographs following acute trauma. The sonographic appearance of the PQ was checked on both longitudinal and transverse images. On the longitudinal image, the probe was positioned along the flexor carpi radialis tendon. For the transverse image, we adopted the image of the same level in which the PQ of the unaffected hand showed maximal thickness. The PQ was considered to be swollen with disproportionate hyperechogenicity and/or thickening compared with the unaffected side at least in one of the two images. Of the 55 patients, 25 patients whose PQ was considered to be swollen underwent MRI study. PQ thickness in millimeters was retrospectively measured on longitudinal and transverse sonographic images. Twenty-three patients (92.0%) had occult bone injury, and two adult patients (8.0%) showed only wrist joint effusion on MRI. Among these 23, the distal radius was the most frequent location of the occult bone injury (20 patients; 9 [36.0%] with an occult fracture line and 11 [44.0%] with bone bruising). In longitudinal image, the mean value of the PQ thickness of affected hands was 6.2 (3.7–9.6 mm; standard deviation [SD], 1.5) and that of unaffected hands was 4.5 (2.3–6.7 mm; SD, 1.2), respectively. In transverse image, that of dominant and nondominant hands was 7.6 (4.6–13.2 mm; SD, 2.0) and 5.5 (3.6–7.5 mm; SD, 1.1), respectively. The mean difference in PQ thickness between affected and unaffected hands was 1.7 (0.1–5.0 mm; SD, 1.1) in longitudinal image and 2.0 (0.3–6.8 mm; SD, 1.7) in transverse image

  14. Muscle and bone follow similar temporal patterns of recovery from muscle-induced disuse due to botulinum toxin injection.

    Science.gov (United States)

    Manske, Sarah L; Boyd, Steven K; Zernicke, Ronald F

    2010-01-01

    If muscle force is a primary source for triggering bone adaptation, with disuse and reloading, bone changes should follow muscle changes. We examined the timing and magnitude of changes in muscle cross-sectional area (MCSA) and bone architecture in response to muscle inactivity following botulinum toxin (BTX) injection. We hypothesized that MCSA would return to baseline levels sooner than bone properties following BTX injection. Female BALB mice (15 weeks old) were injected with 20 muL of BTX (1 U/100 g body mass, n=18) or saline (SAL, n=18) into the posterior calf musculature of one limb. The contralateral limb (CON) served as an internal control. MCSA and bone properties were assessed at baseline, 2, 4, 8, 12, and 16 weeks post-injection using in vivo micro-CT at the tibia proximal metaphysis (bone only) and diaphysis. Muscles were dissected and weighed after sacrifice. Significant GroupxLegxTime interactions indicated that the maximal decrease in MCSA (56%), proximal metaphyseal BV/TV (38%) and proximal diaphyseal Ct.Ar (7%) occurred 4 weeks after injection. There was no delay prior to bone recovery as both muscle and bone properties began to recover after this time, but MCSA and BV/TV remained 15% and 20% lower, respectively, in the BTX-injected leg than the BTX-CON leg 16 weeks post-injection. Gastrocnemius mass (primarily fast-twitch) was 14% lower in the BTX-injected leg than the SAL-injected leg, while soleus mass (primarily slow-twitch) was 15% greater in the BTX group than the SAL group. Our finding that muscle size and bone began to recover at similar times after BTX injection was unexpected. This suggested that partial weight-bearing and/or return of slow-twitch muscle activity in the BTX leg may have been sufficient to stimulate bone recovery. Alternatively, muscle function may have recovered sooner than MCSA. Our results indicated that muscle cross-sectional area, while important, may not be the primary factor associated with bone loss and recovery

  15. A benchtop biorobotic platform for in vitro observation of muscle-tendon dynamics with parallel mechanical assistance from an elastic exoskeleton.

    Science.gov (United States)

    Robertson, Benjamin D; Vadakkeveedu, Siddarth; Sawicki, Gregory S

    2017-05-24

    We present a novel biorobotic framework comprised of a biological muscle-tendon unit (MTU) mechanically coupled to a feedback controlled robotic environment simulation that mimics in vivo inertial/gravitational loading and mechanical assistance from a parallel elastic exoskeleton. Using this system, we applied select combinations of biological muscle activation (modulated with rate-coded direct neural stimulation) and parallel elastic assistance (applied via closed-loop mechanical environment simulation) hypothesized to mimic human behavior based on previously published modeling studies. These conditions resulted in constant system-level force-length dynamics (i.e., stiffness), reduced biological loads, increased muscle excursion, and constant muscle average positive power output-all consistent with laboratory experiments on intact humans during exoskeleton assisted hopping. Mechanical assistance led to reduced estimated metabolic cost and MTU apparent efficiency, but increased apparent efficiency for the MTU+Exo system as a whole. Findings from this study suggest that the increased natural resonant frequency of the artificially stiffened MTU+Exo system, along with invariant movement frequencies, may underlie observed limits on the benefits of exoskeleton assistance. Our novel approach demonstrates that it is possible to capture the salient features of human locomotion with exoskeleton assistance in an isolated muscle-tendon preparation, and introduces a powerful new tool for detailed, direct examination of how assistive devices affect muscle-level neuromechanics and energetics. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Effect of tendon vibration during wide-pulse neuromuscular electrical stimulation (NMES) on muscle force production in people with spinal cord injury (SCI).

    Science.gov (United States)

    Bochkezanian, Vanesa; Newton, Robert U; Trajano, Gabriel S; Vieira, Amilton; Pulverenti, Timothy S; Blazevich, Anthony J

    2018-02-13

    Neuromuscular electrical stimulation (NMES) is commonly used in skeletal muscles in people with spinal cord injury (SCI) with the aim of increasing muscle recruitment and thus muscle force production. NMES has been conventionally used in clinical practice as functional electrical stimulation (FES), using low levels of evoked force that cannot optimally stimulate muscular strength and mass improvements, and thus trigger musculoskeletal changes in paralysed muscles. The use of high intensity intermittent NMES training using wide-pulse width and moderate-intensity as a strength training tool could be a promising method to increase muscle force production in people with SCI. However, this type of protocol has not been clinically adopted because it may generate rapid muscle fatigue and thus prevent the performance of repeated high-intensity muscular contractions in paralysed muscles. Moreover, superimposing patellar tendon vibration onto the wide-pulse width NMES has been shown to elicit further increases in impulse or, at least, reduce the rate of fatigue in repeated contractions in able-bodied populations, but there is a lack of evidence to support this argument in people with SCI. Nine people with SCI received two NMES protocols with and without superimposing patellar tendon vibration on different days (i.e. STIM and STIM+vib), which consisted of repeated 30 Hz trains of 58 wide-pulse width (1000 μs) symmetric biphasic pulses (0.033-s inter-pulse interval; 2 s stimulation train; 2-s inter-train interval) being delivered to the dominant quadriceps femoris. Starting torque was 20% of maximal doublet-twitch torque and stimulations continued until torque declined to 50% of the starting torque. Total knee extensor impulse was calculated as the primary outcome variable. Total knee extensor impulse increased in four subjects when patellar tendon vibration was imposed (59.2 ± 15.8%) but decreased in five subjects (- 31.3 ± 25.7%). However, there were no

  17. In Vivo Study of Ligament-Bone Healing after Anterior Cruciate Ligament Reconstruction Using Autologous Tendons with Mesenchymal Stem Cells Affinity Peptide Conjugated Electrospun Nanofibrous Scaffold

    Directory of Open Access Journals (Sweden)

    Jingxian Zhu

    2013-01-01

    Full Text Available Electrospinning nanofibrous scaffold was commonly used in tissue regeneration recently. Nanofibers with specific topological characteristics were reported to be able to induce osteogenic differentiation of MSCs. In this in vivo study, autologous tendon grafts with lattice-like nanofibrous scaffold wrapping at two ends of autologous tendon were used to promote early stage of ligament-bone healing after rabbit ACL reconstruction. To utilize native MSCs from bone marrow, an MSCs specific affinity peptide E7 was conjugated to nanofibrous meshes. After 3 months, H-E assessment and specific staining of collagen type I, II, and III showed direct ligament-bone insertion with typical four zones (bone, calcified fibrocartilage, fibrocartilage, and ligament in bioactive scaffold reconstruction group. Diameters of bone tunnel were smaller in nanofibrous scaffold conjugated E7 peptide group than those in control group. The failure load of substitution complex also indicated a stronger ligament-bone insertion healing using bioactive scaffold. In conclusion, lattice-like nanofibrous scaffold with specific MSCs affinity peptide has great potential in promoting early stage of ligament-bone healing after ACL reconstruction.

  18. Evaluation of 99mTc-MDP bone imaging in monitoring the muscle-pedicle bone graft osteogenic activation

    International Nuclear Information System (INIS)

    Sang Shibiao; Wu Yiwei; Zhang Wei; Jiang Yimin; Chen Guangxiang; Dong Tianhua

    2002-01-01

    Nine mature and healthy dogs were divided into 4 groups randomly. The first group consists of 3 dogs, and the rest groups, 2 dogs. Self-control way was used. The left ilium was the experimental site, where the bone piece with sartorial muscle attached was cut from ilium. The right side served as control, where the graft bone from ilium was wrapped up with silica gel, then fixed subcutaneously. The pedicled bone pieces were retrieved in 2, 4, 6, 8 weeks after surgery, the size of graft bones from two sides were the same. Survival range, osteogenic formation of muscle-pedicle bone were examined by 99m Tc-MDP bone imaging and histological method to evaluate the clinical value of treatment of ischemic osteonecrosis of the femoral head with muscle-pedicle bone grafting. The results were as follows: 1. The part of bone attached by the sartorial survived, but osteonecrosis was observed at the location of 1.2-1.7 cm from attached point of muscle. 2. There were two forms observed in the course of osteogenic activation of muscle-pedicle bone. Under the reduction of mechanical stimulation and blood supply, bone marrow tissue was replaced by fibro-granulation tissue and new capillary in the survival part, while the survival bone of proximal part grew distally and gradually replace the dead bone of distal part. 3. Histological examination revealed that small amounts of fibro-granulation tissue and new capillary appeared in 2nd week, primary trabeculae appeared in 6th week, and in 8th week, some trabeculae recovered their normal appearance and osteogenic cell reduced remarkably. 4. Survival range of muscle-pedicle graft bone was directly proportional to the width of muscle pedicle. Therefore, radionuclide bone imaging and histological examination demonstrated that muscle-pedicle graft bone was a piece of bone with relatively poor blood supply, its effect is repairing necrosis and collapse of the femoral head is limited. 99m Tc-MDP bone imaging may be an effective and first

  19. The anatomical footprint of the Achilles tendon: a cadaveric study.

    Science.gov (United States)

    Ballal, M S; Walker, C R; Molloy, A P

    2014-10-01

    We dissected 12 fresh-frozen leg specimens to identify the insertional footprint of each fascicle of the Achilles tendon on the calcaneum in relation to their corresponding muscles. A further ten embalmed specimens were examined to confirm an observation on the retrocalcaneal bursa. The superficial part of the insertion of the Achilles tendon is represented by fascicles from the medial head of the gastrocnemius muscle, which is inserted over the entire width of the inferior facet of the calcaneal tuberosity. In three specimens this insertion was in continuity with the plantar fascia in the form of periosteum. The deep part of the insertion of the Achilles tendon is made of fascicles from the soleus tendon, which insert on the medial aspect of the middle facet of the calcaneal tuberosity, while the fascicles of the lateral head of the gastrocnemius tendon insert on the lateral aspect of the middle facet of the calcaneal tuberosity. A bicameral retrocalcaneal bursa was present in 15 of the 22 examined specimens. This new observation and description of the insertional footprint of the Achilles tendon and the retrocalcaneal bursa may allow a better understanding of the function of each muscular part of the gastrosoleus complex. This may have clinical relevance in the treatment of Achilles tendinopathies. ©2014 The British Editorial Society of Bone & Joint Surgery.

  20. Load Bearing Equipment for Bone and Muscle Project

    Science.gov (United States)

    Terrier, Douglas; Clayton, Ronald G.; Shackelford, Linda

    2015-01-01

    Axial skeletal loads coupled with muscle torque forces around joints maintain bone. Astronauts working in pairs to exercise can provide high eccentric loads for each other that are most effective. A prototype of load bearing equipment that will allow astronauts to perform exercises using each other for counter force generation in a controlled fashion and provide eccentric overload is proposed. A frame and attachments that can be rapidly assembled for use and easily stored will demonstrate feasibility of a design that can be adapted for ISS testing and Orion use.

  1. Magnetic resonance evaluation of anterior cruciate ligament repair using the patellar tendon double bone block technique

    International Nuclear Information System (INIS)

    Autz, G.; Singson, R.D.; Goodwin, C.

    1991-01-01

    The magnetic resonance (MR) appearance of the anterior cruciate ligament reconstruction was determined in 20 clinically stable and 2 clinically unstable knees for a total of 22 examinations. All patients studied had undergone knee reconstruction using the patellar tendon as graft material. The reconstructed anterior cruciate ligament varies in appearance. It appeared as a thick, well-defined, low signal band on T1- and T2-weighted sagittal and coronal images in 14 of 22 examinations. The remaining 8 knees showed a graft having one or more thin and attenuated, low signal intensity bands in the sagittal and/or coronal plane. Arthroscopy confirmed an intact but lax graft in the clinically unstable knees. (orig.)

  2. Magnetic resonance evaluation of anterior cruciate ligament repair using the patellar tendon double bone block technique

    Energy Technology Data Exchange (ETDEWEB)

    Autz, G.; Singson, R.D. (St. Luke' s Roosevelt Hospital Center, New York, NY (United States). Dept. of Radiology); Goodwin, C. (St. Luke' s Roosevelt Hospital Center, New York, NY (United States). Dept. of Orthopedics)

    1991-11-01

    The magnetic resonance (MR) appearance of the anterior cruciate ligament reconstruction was determined in 20 clinically stable and 2 clinically unstable knees for a total of 22 examinations. All patients studied had undergone knee reconstruction using the patellar tendon as graft material. The reconstructed anterior cruciate ligament varies in appearance. It appeared as a thick, well-defined, low signal band on T1- and T2-weighted sagittal and coronal images in 14 of 22 examinations. The remaining 8 knees showed a graft having one or more thin and attenuated, low signal intensity bands in the sagittal and/or coronal plane. Arthroscopy confirmed an intact but lax graft in the clinically unstable knees. (orig.).

  3. Sonographic evaluation of the immediate effects of eccentric heel drop exercise on Achilles tendon and gastrocnemius muscle stiffness using shear wave elastography

    Science.gov (United States)

    Leung, Wilson K.C.; Chu, KL

    2017-01-01

    Background Mechanical loading is crucial for muscle and tendon tissue remodeling. Eccentric heel drop exercise has been proven to be effective in the management of Achilles tendinopathy, yet its induced change in the mechanical property (i.e., stiffness) of the Achilles tendon (AT), medial and lateral gastrocnemius muscles (MG and LG) was unknown. Given that shear wave elastography has emerged as a powerful tool in assessing soft tissue stiffness with promising intra- and inter-operator reliability, the objective of this study was hence to characterize the stiffness of the AT, MG and LG in response to an acute bout of eccentric heel drop exercise. Methods Forty-five healthy young adults (36 males and nine females) performed 10 sets of 15-repetition heel drop exercise on their dominant leg with fully-extended knee, during which the AT and gastrocnemius muscles, but not soleus, were highly stretched. Before and immediately after the heel drop exercise, elastic moduli of the AT, MG and LG were measured by shear wave elastography. Results After the heel drop exercise, the stiffness of AT increased significantly by 41.8 + 33.5% (P eccentric heel drop exercise. The findings from this pilot study shed some light on how and to what extent the AT and gastrocnemius muscles mechanically responds to an isolated set of heel drop exercise. Taken together, appropriate eccentric load might potentially benefit mechanical adaptations of the AT and gastrocnemius muscles in the rehabilitation of patients with Achilles tendinopathy. PMID:28740756

  4. Full-Thickness Skin Grafting with De-Epithelization of the Wound Margin for Finger Defects with Bone or Tendon Exposure

    Directory of Open Access Journals (Sweden)

    Jun Hee Lee

    2015-05-01

    Full Text Available BackgroundFull-thickness skin grafts (FTSGs are generally considered unreliable for coverage of full-thickness finger defects with bone or tendon exposure, and there are few clinical reports of its use in this context. However, animal studies have shown that an FTSG can survive over an avascular area ranging up to 12 mm in diameter. In our experience, the width of the exposed bones or tendons in full-thickness finger defects is <7 mm. Therefore, we covered the bone- or tendon-exposed defects of 16 fingers of 10 patients with FTSGs.MethodsThe surgical objectives were healthy granulation tissue formation in the wound bed, marginal de-epithelization of the normal skin surrounding the defect, preservation of the subdermal plexus of the central graft, and partial excision of the dermis along the graft margin. The donor site was the mastoid for small defects and the groin for large defects.ResultsMost of the grafts (15 of 16 fingers survived without significant surgical complications and achieved satisfactory functional and aesthetic results. Minor complications included partial graft loss in one patient, a minimal extension deformity in two patients, a depression deformity in one patient, and mild hyperpigmentation in four patients.ConclusionsWe observed excellent graft survival with this method with no additional surgical injury of the normal finger, satisfactory functional and aesthetic outcomes, and no need for secondary debulking procedures. Potential disadvantages include an insufficient volume of soft tissue and graft hyperpigmentation. Therefore, FTSGs may be an option for treatment of full-thickness finger defects with bone or tendon exposure.

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-02-15

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

  7. Positive effects of bisphosphonates on bone and muscle in a mouse model of Duchenne muscular dystrophy.

    Science.gov (United States)

    Yoon, Sung-Hee; Sugamori, Kim S; Grynpas, Marc D; Mitchell, Jane

    2016-01-01

    Patients with Duchenne muscular dystrophy are at increased risk of decreased bone mineral density and bone fracture as a result of inactivity. To determine if antiresorptive bisphosphonates could improve bone quality and their effects on muscle we studied the Mdx mouse, treated with pamidronate during peak bone growth at 5 and 6 weeks of age, and examined the outcome at 13 weeks of age. Pamidronate increased cortical bone architecture and strength in femurs with increased resistance to fracture. While overall long bone growth was not affected by pamidronate, there was significant inhibition of remodeling in metaphyseal trabecular bone with evidence of residual calcified cartilage. Pamidronate treatment had positive effects on skeletal muscle in the Mdx mice with decreased serum and muscle creatine kinase and evidence of improved muscle histology and grip strength. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Early integration of a bone plug in the femoral tunnel in rectangular tunnel ACL reconstruction with a bone-patellar tendon-bone graft: a prospective computed tomography analysis.

    Science.gov (United States)

    Suzuki, Tomoyuki; Shino, Konsei; Nakagawa, Shigeto; Nakata, Ken; Iwahashi, Takehiko; Kinugasa, Kazutaka; Otsubo, Hidenori; Yamashita, Toshihiko

    2011-12-01

    The purpose of this prospective study was to evaluate how early the bone plug was integrated into the rectangular femoral tunnel after anatomical ACL reconstruction using a bone-patellar tendon-bone (BTB) graft via a rectangular tunnel (RT BTB ACL-R). Twenty consecutive patients who had undergone the reconstruction procedure were evaluated by CT scans at 4 and 8 weeks postoperatively. In each scan, 30 slices for multiplanar reconstruction were collected parallel to the long axis of the parallelepiped femoral tunnel and perpendicular to the tendinous plane of the bone plug. Each slice was classified as "complete," indicating no visible gap between the plug and the tunnel wall or trabecular continuity or "incomplete," showing a visible gap. Bone plug-tunnel integration was evaluated as "excellent," "good," "fair," or "poor" for >20, 11-20, 5-10, and values at the anterior interface between the bone plug and the tunnel wall were also measured on both scans. The mean changes in CT value at 8 weeks were significantly lower than those at 4 weeks. This study shows that bone plug-femoral tunnel integration was almost complete by 8 weeks after surgery using RT BTB ACL-R.

  9. Pentadecapeptide BPC 157 Enhances the Growth Hormone Receptor Expression in Tendon Fibroblasts

    Directory of Open Access Journals (Sweden)

    Chung-Hsun Chang

    2014-11-01

    Full Text Available BPC 157, a pentadecapeptide derived from human gastric juice, has been demonstrated to promote the healing of different tissues, including skin, muscle, bone, ligament and tendon in many animal studies. However, the underlying mechanism has not been fully clarified. The present study aimed to explore the effect of BPC 157 on tendon fibroblasts isolated from Achilles tendon of male Sprague-Dawley rat. From the result of cDNA microarray analysis, growth hormone receptor was revealed as one of the most abundantly up-regulated genes in tendon fibroblasts by BPC 157. BPC 157 dose- and time-dependently increased the expression of growth hormone receptor in tendon fibroblasts at both the mRNA and protein levels as measured by RT/real-time PCR and Western blot, respectively. The addition of growth hormone to BPC 157-treated tendon fibroblasts dose- and time-dependently increased the cell proliferation as determined by MTT assay and PCNA expression by RT/real-time PCR. Janus kinase 2, the downstream signal pathway of growth hormone receptor, was activated time-dependently by stimulating the BPC 157-treated tendon fibroblasts with growth hormone. In conclusion, the BPC 157-induced increase of growth hormone receptor in tendon fibroblasts may potentiate the proliferation-promoting effect of growth hormone and contribute to the healing of tendon.

  10. Muscle-tendon interaction and elastic energy usage in human walking

    DEFF Research Database (Denmark)

    Ishikawa, Masaki; Komi, Paavo V.; Grey, Michael James

    2005-01-01

    The present study was designed to explore how the interaction between the fascicles and tendinous tissues is involved in storage and utilization of elastic energy during human walking. Eight male subjects walked with a natural cadence (1.4 +/- 0.1 m/s) on a 10-m-long force plate system. In vivo......-stance phase. In contrast, the soleus fascicles were lengthened until the end of the single-stance phase. These findings suggest that the elastic recoil takes place not as a spring-like bouncing but as a catapult action in natural human walking. The interaction between the muscle fascicles and tendinous...

  11. VEGF and BFGF Expression and Histological Characteristics of the Bone-Tendon Junction during Acute Injury Healing

    Directory of Open Access Journals (Sweden)

    Lin Wang

    2014-03-01

    Full Text Available Bone-tendon junction (BTJ injuries are common and may be caused by acute trauma and delayed healing during exercise or work. To understand the nature of the healing process of BTJ injuries would help to prevent injuries and improve treatment. Thirty-three mature female rabbit hindlimbs were assigned to normal control (CON, n = 7 and injury groups (n = 26. The acute injury was established by administering one 7 plum-blossom needle puncture. Specimens were harvested post injury at 1, 2, 4, and 8 weeks (ND1W, n = 6; ND2W, n = 6; ND4W, n = 7; and ND8W, n = 7. The injury existed in all of the injury groups. Compared with the CON group, all of the animals in the injury group showed poor cell profiles, an unclear or undetectable tide mark, a proteoglycan area and profile changes; the BTJ cell density diminished significantly in the ND1W (p 0.05. The basic fibroblast growth factor (bFGF expression in the CON group was significantly less than in the ND1W group (p 0.05. The bFGF and VEGF expression levels indicated that the healing process stopped at 8 weeks post injury or was not activated, although the injury had not healed by histological examination. A repeatable animal model of BTJ acute injury was established in this study, and the results described the BTJ acute injury healing difficult concerned with the repairing stop.

  12. Effect of exercise-induced enhancement of the leg-extensor muscle-tendon unit capacities on ambulatory mechanics and knee osteoarthritis markers in the elderly.

    Science.gov (United States)

    Karamanidis, Kiros; Oberländer, Kai Daniel; Niehoff, Anja; Epro, Gaspar; Brüggemann, Gert-Peter

    2014-01-01

    Leg-extensor muscle weakness could be a key component in knee joint degeneration in the elderly because it may result in altered muscular control during locomotion influencing the mechanical environment within the joint. This work aimed to examine whether an exercise-induced enhancement of the triceps surae (TS) and quadriceps femoris (QF) muscle-tendon unit (MTU) capacities would affect mechanical and biological markers for knee osteoarthritis in the elderly. Twelve older women completed a 14-week TS and QF MTU exercise intervention, which had already been established as increasing muscle strength and tendon stiffness. Locomotion mechanics and serum cartilage oligomeric matrix protein (COMP) levels were examined during incline walking. MTU mechanical properties were assessed using simultaneously ultrasonography and dynamometry. Post exercise intervention, the elderly had higher TS and QF contractile strength and tendon-aponeurosis stiffness. Regarding the incline gait task, the subjects demonstrated a lower external knee adduction moment and lower knee adduction angular impulse during the stance phase post-intervention. Furthermore, post-intervention compared to pre-intervention, the elderly showed lower external hip adduction moment, but revealed higher plantarflexion pushoff moment. The changes in the external knee adduction moment were significantly correlated with the improvement in ankle pushoff function. Serum COMP concentration increased in response to the 0.5-h incline walking exercise with no differences in the magnitude of increment between pre- and post-intervention. This work emphasizes the important role played by the ankle pushoff function in knee joint mechanical loading during locomotion, and may justify the inclusion of the TS MTU in prevention programs aiming to positively influence specific mechanical markers for knee osteoarthritis in the elderly. However, the study was unable to show that COMP is amenable to change in the elderly following a

  13. Favorable effects of skeletal muscle on bone are distinguished according to gender and skeletal sites

    Directory of Open Access Journals (Sweden)

    Kyoung Min Kim

    2017-03-01

    Conclusions: Higher RASM was significantly associated with lower risk for osteoporosis and the areas at the femur neck and total hip appeared to more likely be affected positively by muscle. Moreover, because males showed faster muscle loss with aging than females, the bones of males may be more prone to favorable effects of muscle.

  14. The interfascicular matrix enables fascicle sliding and recovery in tendon, and behaves more elastically in energy storing tendons.

    Science.gov (United States)

    Thorpe, Chavaunne T; Godinho, Marta S C; Riley, Graham P; Birch, Helen L; Clegg, Peter D; Screen, Hazel R C

    2015-12-01

    While the predominant function of all tendons is to transfer force from muscle to bone and position the limbs, some tendons additionally function as energy stores, reducing the cost of locomotion. Energy storing tendons experience extremely high strains and need to be able to recoil efficiently for maximum energy storage and return. In the equine forelimb, the energy storing superficial digital flexor tendon (SDFT) has much higher failure strains than the positional common digital extensor tendon (CDET). However, we have previously shown that this is not due to differences in the properties of the SDFT and CDET fascicles (the largest tendon subunits). Instead, there is a greater capacity for interfascicular sliding in the SDFT which facilitates the greater extensions in this particular tendon (Thorpe et al., 2012). In the current study, we exposed fascicles and interfascicular matrix (IFM) from the SDFT and CDET to cyclic loading followed by a test to failure. The results show that IFM mechanical behaviour is not a result of irreversible deformation, but the IFM is able to withstand cyclic loading, and is more elastic in the SDFT than in the CDET. We also assessed the effect of ageing on IFM properties, demonstrating that the IFM is less able to resist repetitive loading as it ages, becoming stiffer with increasing age in the SDFT. These results provide further indications that the IFM is important for efficient function in energy storing tendons, and age-related alterations to the IFM may compromise function and predispose older tendons to injury. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. The biomechanical effects of limb lengthening and botulinum toxin type A on rabbit tendon.

    Science.gov (United States)

    Olabisi, Ronke M; Best, Thomas M; Hurschler, Christof; Vanderby, Ray; Noonan, Kenneth J

    2010-12-01

    Numerous studies have examined the effects of distraction osteogenesis (DO) on bone, but relatively fewer have explored muscle adaptation, and even less have addressed the concomitant alterations that occur in the tendon. The purpose herein was to characterize the biomechanical properties of normal and elongated rabbit (N = 20) tendons with and without prophylactic botulinum toxin type A (BTX-A) treatment. Elastic and viscoelastic properties of Achilles and Tibialis anterior (TA) tendons were evaluated through pull to failure and stress relaxation tests. All TA tendons displayed nonlinear viscoelastic responses that were strain dependent. A power law formulation was used to model tendon viscoelastic responses and tendon elastic responses were fit with a microstructural model. Distraction-elongated tendons displayed increases in compliance and stress relaxation rates over undistracted tendons; BTX-A administration offset this result. The elastic moduli of distraction-lengthened TA tendons were diminished (p = 0.010) when distraction was combined with gastrocnemius (GA) BTX-A administration, elastic moduli were further decreased (p = 0.004) and distraction following TA BTX-A administration resulted in TA tendons with moduli not different from contralateral control (p > 0.05). Compared to contralateral control, distraction and GA BTX-A administration displayed shortened toe regions, (p = 0.031 and 0.038, respectively), while tendons receiving BTX-A in the TA had no differences in the toe region (p > 0.05). Ultimate tensile stress was unaltered by DO, but stress at the transition from the toe to the linear region of the stress-stretch curve was diminished in all distraction-elongated TA tendons (p properties. Copyright © 2010 Elsevier Ltd. All rights reserved.

  16. MUSCLE-BONE INTERACTIONS ACROSS AGE IN MEN

    Directory of Open Access Journals (Sweden)

    Ian J. Palmer

    2006-03-01

    Full Text Available This study examined the relationship of muscular strength and lean tissue with age-related patterns in bone mineral density (BMD in men 20-81 years of age. Subjects were assigned to one of three age groups, Young Men (YM, (n = 25, 20-39 yrs, Middle-aged Men (MM (n = 24, 40-59 yrs, and Older Men (OM (n = 23, 60-81 yrs. Isotonic and isokinetic strength was assessed for the quadriceps and hamstrings muscle groups. DXA (Lunar DPX-IQ was used to measure spine, hip, and total body BMD and body composition. OM had significantly lower (p < 0.05 total lean body mass (LBM than MM and lower leg lean mass (LM than YM and MM. OM had significantly lower (p < 0.01 BMD than YM and MM at the femoral neck and total hip sites and a higher proportion of OM were osteopenic and osteoporotic at the total hip site. Isotonic and isokinetic strength for both muscle groups was positively related (p < 0.05 with the hip BMD sites (r = 0.38-.67. Leg LM also was positively related to hip BMD (r = 0.37-.58. Multiple Regression analyses determined that age and lean mass (LBM or leg LM were significant predictors (p < 0.05 of femoral neck, and total hip BMD, while lean mass (LBM or leg LM was a significant predictor (p < 0.05 of BMD at the spine and trochanter sites. Isotonic and isokinetic leg strength variables were significant predictors (p < 0.05 of the total body, total hip and trochanter BMD. In conclusion, leg strength, leg LM, and total LBM were significant predictors of BMD in men, independent of age. These findings emphasize the importance of maintaining lean body mass for the bone health of aging men

  17. Methods for demonstration of enzyme activity in muscle fibres at the muscle/bone interface in demineralized tissue

    DEFF Research Database (Denmark)

    Kirkeby, S; Vilmann, H

    1981-01-01

    A method for demonstration of activity for ATPase and various oxidative enzymes (succinic dehydrogenase, alpha-glycerophosphate dehydrogenase, and lactic dehydrogenase) in muscle/bone sections of fixed and demineralized tissue has been developed. It was found that it is possible to preserve...... considerable amounts of the above mentioned enzymes in the muscle fibres at the muscle/bone interfaces. The best results were obtained after 20 min fixation, and 2-3 weeks of storage in MgNa2EDTA containing media. As the same technique previously has been used to describe patterns of resorption and deposition...

  18. COMPARATIVE STUDY OF CLINICAL OUTCOME OF ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION BONE PATELLAR TENDON BONE GRAFT V/S HAMSTRING GRAFT

    Directory of Open Access Journals (Sweden)

    Priyank

    2015-08-01

    fulfilling the predetermined inclusion and exclusion criteria were included in the study. STATISTICAL METHODS : Intergroup comparison was analysed by K - Independent sample t test. Intragroup comparison was analysed by Paired t - test. RESULTS : Patients were divided into two groups and treated with using Bone - patellar tendon - bone graft and Hamstring graft respectively. Mean age group of patients was 29.16 yrs. (range 16 - 51yrs and 30.88 yrs. (range 19 - 48yrs in group A and B respectively we found the incidence of ACL injury in 15 - 44 years age group to be greater than twice the general population. A mean delay in surgery of 4.66 months (range 2 - 12 months since the time of injury in group A and 4.46 months (range 2 - 7 months in group B was observed. Subjective IKDC evaluation was done at the end of 12 months. Ther e was no difference in both the groups in the terms of effusion, passive motion, knee compartment findings, ligament examination, X - ray findings. Functional test and IKDC grade of both the groups showed statistically very highly significant improvement. Ho wever, there was statistically very high Harvest site pathology in group A. CONCLUSION : We found that there is statistically no significant difference in the overall clinical outcome between hamstring autograft with transfix and bone - patellar tendon bone autograft with interference screw except that the patellar tendon group had a greater tendency of having donor site morbidity compared to the hamstring tendon group.

  19. Muscle changes can account for bone loss after botulinum toxin injection.

    Science.gov (United States)

    Manske, Sarah L; Boyd, Steven K; Zernicke, Ronald F

    2010-12-01

    Studies to date have assumed that botulinum toxin type A (BTX) affects bone indirectly, through its action on muscle. We hypothesized that BTX has no discernable effect on bone morphometry, independent of its effect on muscle. Therefore, we investigated whether BTX had an additional effect on bone when combined with tenotomy compared to tenotomy in isolation. Female BALB/c mice (n = 73) underwent one of the following procedures in the left leg: BTX injection and Achilles tenotomy (BTX-TEN), BTX injection and sham surgery (BTX-sham), Achilles tenotomy (TEN), or sham surgery (sham). BTX groups were injected with 20 μL of BTX (1 U/100 g) in the posterior lower hindlimb. At 4 weeks, muscle cross-sectional area (MCSA) and tibial bone morphometry were assessed using micro-CT. Each treatment, other than sham, resulted in significant muscle and bone loss (P properties. We found that BTX injection resulted in more adverse muscle and bone effects than tenotomy and that effects were amplified when the procedures were combined. However, between-group differences in bone could be accounted for by MCSA. We conclude that any independent effect of BTX on bone morphometry is likely small or negligible compared with the effect on muscle.

  20. Associations of muscle force, power, cross-sectional muscle area and bone geometry in older UK men.

    Science.gov (United States)

    Zengin, Ayse; Pye, Stephen R; Cook, Michael J; Adams, Judith E; Rawer, Rainer; Wu, Frederick C W; O'Neill, Terence W; Ward, Kate A

    2017-08-01

    Ageing is associated with sarcopenia, osteoporosis, and increased fall risk, all of which contribute to increased fracture risk. Mechanically, bone strength adapts in response to forces created by muscle contractions. Adaptations can be through changes in bone size, geometry, and bending strength. Muscle mass is often used as a surrogate for muscle force; however, force can be increased without changes in muscle mass. Increased fall risk with ageing has been associated with a decline in muscle power-which is a measure of mobility. The aims of this study were as follows: (i) to investigate the relationship between muscle parameters in the upper and lower limbs with age in UK men and the influence of ethnicity on these relationships; (ii) to examine the relationships between jump force/grip strength/cross-sectional muscle area (CSMA) with bone outcomes at the radius and tibia. White European, Black Afro-Caribbean, and South Asian men aged 40-79 years were recruited from Manchester, UK. Cortical bone mineral content, cross-sectional area, cortical area, cross-sectional moment of inertia, and CSMA were measured at the diaphysis of the radius and tibia using peripheral quantitative computed tomography. Lower limb jump force and power were measured from a single two-legged jump performed on a ground-reaction force platform. Grip strength was measured using a dynamometer. Associations between muscle and bone outcomes was determined using linear regression with adjustments for age, height, weight, and ethnicity. Three hundred and one men were recruited. Jump force was negatively associated with age; for every 10 year increase in age, there was a 4% reduction in jump force (P force was positively associated with tibial bone outcomes: a 1 standard deviation greater jump force was associated with significantly higher cortical bone mineral content 3.1%, cross-sectional area 4.2%, cortical area 3.4%, and cross-sectional moment of inertia 6.8% (all P force and power are

  1. Achilles Tendonitis

    Science.gov (United States)

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

  2. Effect of single- and double-row rotator cuff repair at the tendon-to-bone interface: preliminary results using an in vivo sheep model.

    Science.gov (United States)

    Baums, M H; Schminke, B; Posmyk, A; Miosge, N; Klinger, H-M; Lakemeier, S

    2015-01-01

    The clinical superiority of the double-row technique is still a subject of controversial debate in rotator cuff repair. We hypothesised that the expression of different collagen types will differ between double-row and single-row rotator cuff repair indicating a faster healing response by the double-row technique. Twenty-four mature female sheep were randomly assembled to two different groups in which a surgically created acute infraspinatus tendon tear was fixed using either a modified single- or double-row repair technique. Shoulder joints from female sheep cadavers of identical age, bone maturity, and weight served as untreated control cluster. Expression of type I, II, and III collagen was observed in the tendon-to-bone junction along with recovering changes in the fibrocartilage zone after immunohistological tissue staining at 1, 2, 3, 6, 12, and 26 weeks postoperatively. Expression of type III collagen remained positive until 6 weeks after surgery in the double-row group, whereas it was detectable for 12 weeks in the single-row group. In both groups, type I collagen expression increased after 12 weeks. Type II collagen expression was increased after 12 weeks in the double-row versus single-row group. Clusters of chondrocytes were only visible between week 6 and 12 in the double-row group. The study demonstrates differences regarding the expression of type I and type III collagen in the tendon-to-bone junction following double-row rotator cuff repair compared to single-row repair. The healing response in this acute repair model is faster in the double-row group during the investigated healing period.

  3. Alfacalcidol improves muscle power, muscle function and balance in elderly patients with reduced bone mass.

    Science.gov (United States)

    Schacht, E; Ringe, Johann D

    2012-01-01

    We investigated the effect of daily therapy with 1 mcg alfacalcidol (Doss(®)-TEVA/AWD-pharma) on muscle power, muscle function, balance performance and fear of falls in an open, multi-centered, uncontrolled, prospective study on a cohort of patients with reduced bone mass. Among the 2,097 participants, 87.1% were post-menopausal women and 12.9% were men. Mean age was 74.8 years and mean body mass index (BMI) 26.3 kg/m². A total of 75.3% of the study population had osteoporosis, 81% a diagnosis of "increased risk of falls" and 70.1% had a creatinine clearance (CrCl) of power tests at onset and after 3 and 6 months: the timed up and go test (TUG) and the chair rising test (CRT). At baseline and after 6 months, participants performed the tandem gait test (TGT) and filled out a questionnaire evaluating fear of falling. Successful performance in the muscle tests is associated with a significantly lower risk of falls and non-vertebral fractures in elderly patients (successful test performance: TUG ≤ 10 s (sec), CRT ≤ 10 s, TGT ≥ 8 steps). A significant improvement in the performance of the two muscle tests was proved already after 3 months of treatment with alfacalcidol and further increased by the end of the therapeutic intervention. There were significant increases in the number of participants able to successfully perform the tests: 24.6% at baseline and 46.3% at the end of trial for the TUG (P balance test (TGT) increased from 36.0% at onset to 58.6% at the end of the trial (P power, muscle function and balance and reduces fear of falls. The significant improvement in the three muscle and balance tests and fear of falls may have a preventative effect on falls and fractures. We suggest that the quantitative risk tests used in this study could be reliable surrogate parameters for the risk of falls and fractures in elderly patients.

  4. [EFFECT OF RECOMBINANT ADENOVIRUS-BONE MORPHOGENETIC PROTEIN 12 TRANSFECTION ON DIFFERENTIATION OF PERIPHERAL BLOOD MESENCHYMAL STEM CELLS INTO TENDON/LIGAMENT CELLS].

    Science.gov (United States)

    Fu, Weili; Chen, Gang; Tang, Xin; Li, Qi; Ll, Jian

    2015-04-01

    To research the effect of recombinant adenovirus-bone morphogenetic protein 12 (Ad-BMP-12) transfection on the differentiation of peripheral blood mesenchymal stem cells (MSCs) into tendon/ligament cells. Peripheral blood MSCs were isolated from New Zealand rabbits (3-4 months old) and cultured in vitro until passage 3. The recombinant adenoviral vector system was prepared using AdEasy system, then transfected into MSCs at passage 3 (transfected group); untransfected MSCs served as control (untransfected group). The morphological characteristics and growth of transfected cells were observed under inverted phase contrast microscope. The transfection efficiency and green fluorescent protein (GFP) expression were detected by flow cytometry (FCM) and fluorescence microscopy. After cultured for 14 days in vitro, the expressions of tendon/ligament-specific markers were determined by immunohistochemistry and real-time fluorescent quantitative PCR. GFP expression could be observed in peripheral blood MSCs at 8 hours after transfection. At 24 hours after transfection, the cells had clear morphology and grew slowly under inverted phase contrast microscope and almost all expressed GFP at the same field under fluorescence microscopy. FCM analysis showed that the transfection efficiency of the transfected group was 99.57%, while it was 2.46% in the untransfected group. The immunohistochemistry showed that the expression of collagen type I gradually increased with culture time in vitro. Real-time fluorescent quantitative PCR results showed that the mRNA expressions of the tendon/ligament-specific genes (Tenomodulin, Tenascin-C, and Decorin) in the transfected group were significantly higher than those in untransfected group (0.061+/- 0.013 vs. 0.004 +/- 0.002, t = -7.700, P=0.031; 0.029 +/- 0.008 vs. 0.003 +/- 0.001, t = -5.741, P=0.020; 0.679 +/- 0.067 vs. 0.142 +/- 0.024, t = -12.998, P=0.000). Ad-BMP-12 can significantly promote differentiation of peripheral blood MSCs into

  5. On-Command Exoskeleton for Countermeasure Microgravity Effects on Muscles and Bones

    Science.gov (United States)

    Bar-Cohen, Y.; Bao, X.; Badescu, M.; Sherrit, S.; Mavroidis, C.; Unluhisarcikh, O.; Pietrusinski, M.; Rajulu, S.; Berka, R.; Cowley, M.

    2012-06-01

    On-command exoskeleton with impeding and augmenting elements would support the operation of astronauts traveling to Mars. Thus, countermeasure deleterious effects on the muscles and bones during travel and assist their physical activity on Mars.

  6. Vitamin D, muscle and bone: Integrating effects in development, aging and injury.

    Science.gov (United States)

    Girgis, Christian M; Baldock, Paul A; Downes, Michael

    2015-07-15

    Beyond the established effects of muscle loading on bone, a complex network of hormones and growth factors integrates these adjacent tissues. One such hormone, vitamin D, exerts broad-ranging effects in muscle and bone calcium handling, differentiation and development. Vitamin D also modulates muscle and bone-derived hormones, potentially facilitating cross-talk between these tissues. In the clinical setting, vitamin D deficiency or mutations of the vitamin D receptor result in generalized atrophy of muscle and bone, suggesting coordinated effects of vitamin D at these sites. In this review, we discuss emerging evidence that vitamin D exerts specific effects throughout the life of the musculoskeletal system - in development, aging and injury. From this holistic viewpoint, we offer new insights into an old debate: whether vitamin D's effects in the musculoskeletal system are direct via local VDR signals or indirect via its systemic effects in calcium and phosphate homeostasis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Temporal growth factor release from platelet-rich plasma, trehalose lyophilized platelets, and bone marrow aspirate and their effect on tendon and ligament gene expression.

    Science.gov (United States)

    McCarrel, Taralyn; Fortier, Lisa

    2009-08-01

    Platelet-rich plasma (PRP) has generated substantial interest for tendon and ligament regeneration because of the high concentrations of growth factors in platelet alpha-granules. This study compared the temporal release of growth factors from bone marrow aspirate (BMA), PRP, and lyophilized platelet product (PP), and measured their effects on tendon and ligament gene expression. Blood and BMA were collected and processed to yield PRP and plasma. Flexor digitorum superficialis tendon (FDS) and suspensory ligament (SL) explants were cultured in 10% plasma in DMEM (control), BMA, PRP, or PP. TGF-beta1 and PDGF-BB concentrations were determined at 0, 24, and 96 h of culture using ELISA. Quantitative RT-PCR for collagen types I and III (COL1A1, COL3A1), cartilage oligomeric matrix protein (COMP), decorin, and matrix metalloproteinases-3 and 13 (MMP-3, MMP-13) was performed. TGF-beta1 and PDGF-BB concentrations were highest in PRP and PP. Growth factor quantity was unchanged in BMA, increased in PRP, and decreased in PP over 4 days. TGF-beta1 and platelet concentrations were positively correlated. Lyophilized PP and PRP resulted in increased COL1A1:COL3A1 ratio, increased COMP, and decreased MMP-13 expression. BMA resulted in decreased COMP and increased MMP-3 and MMP-13 gene expression. Platelet concentration was positively correlated with COL1A1, ratio of COL1A1:COL3A1, and COMP, and negatively correlated with COL3A1, MMP-13, and MMP-3. White blood cell concentration was positively correlated with COL3A1, MMP3, and MMP13, and negatively correlated with a ratio of COL1A1:COL3A1, COMP, and decorin. These findings support further in vivo investigation of PRP and PP for treatment of tendonitis and desmitis. Copyright 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  8. Testosterone Combined with Electrical Stimulation and Standing: Effect on Muscle and Bone

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-14-2-0190 TITLE: Testosterone Combined with Electrical Stimulation and Standing: Effect on Muscle and Bone PRINCIPAL...including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing...29 Sep 2017 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Testosterone Combined with Electrical Stimulation and Standing: Effect on Muscle and Bone 5b

  9. Human brain activity associated with painful mechanical stimulation to muscle and bone

    OpenAIRE

    Maeda, Lynn; Ono, Mayu; Koyama, Tetsuo; Oshiro, Yoshitetsu; Sumitani, Masahiko; Mashimo, Takashi; Shibata, Masahiko

    2011-01-01

    Purpose The purpose of this study was to elucidate the central processing of painful mechanical stimulation to muscle and bone by measuring blood oxygen level-dependent signal changes using functional magnetic resonance imaging (fMRI). Methods Twelve healthy volunteers were enrolled. Mechanical pressure on muscle and bone were applied at the right lower leg by an algometer. Intensities were adjusted to cause weak and strong pain sensation at either target site in preliminary testing. Brain ac...

  10. Isolated Femoral Muscle and Bone Metastases Rarely Encountered in Testicular Seminoma

    Directory of Open Access Journals (Sweden)

    Serkan Degirmencioglu

    2013-01-01

    Full Text Available Isolated muscle and bone metastases are rarely encountered in patients with testicular seminomas. In the present study, a patient who was admitted with pain, loss of motion, and swelling in the right leg 20 months following surgery for stage I seminoma was presented. Hypermetabolic lesion was detected in the right femoral muscle and bone via positron emission tomography. After the presence of metastasis from seminoma was confirmed by biopsy, bleomycin, cisplatin, and etoposide, combination chemotherapy was administered to the patient.

  11. In vitro bone formation using muscle-derived cells: a new paradigm for bone tissue engineering using polymer-bone morphogenetic protein matrices.

    Science.gov (United States)

    Lu, Helen H; Kofron, Michelle D; El-Amin, Saadiq F; Attawia, Mohammed A; Laurencin, Cato T

    2003-06-13

    Over 800,000 bone grafting procedures are performed in the United States annually, creating a demand for viable alternatives to autogenous bone, the grafting standard in osseous repair. The objective of this study was to examine the efficacy of a BMP-polymer matrix in inducing the expression of the osteoblastic phenotype and in vitro bone formation by muscle-derived cells. Specifically, we evaluated the ability of bone morphogenetic protein-7 (BMP-7), delivered from a poly(lactide-co-glycolide) (PLAGA) matrix, to induce the differentiation of cells derived from rabbit skeletal muscle into osteoblast-like cells and subsequently form mineralized tissue. Results confirmed that muscle-derived cells attached and proliferated on the PLAGA substrates. BMP-7 released from PLAGA induced the muscle-derived cells to increase bone marker expression and form mineralized cultures. These results demonstrate the efficacy of a BMP-polymer matrix in inducing the expression of the osteoblastic phenotype by muscle-derived cells and present a new paradigm for bone tissue engineering.

  12. Human brain activity associated with painful mechanical stimulation to muscle and bone.

    Science.gov (United States)

    Maeda, Lynn; Ono, Mayu; Koyama, Tetsuo; Oshiro, Yoshitetsu; Sumitani, Masahiko; Mashimo, Takashi; Shibata, Masahiko

    2011-08-01

    The purpose of this study was to elucidate the central processing of painful mechanical stimulation to muscle and bone by measuring blood oxygen level-dependent signal changes using functional magnetic resonance imaging (fMRI). Twelve healthy volunteers were enrolled. Mechanical pressure on muscle and bone were applied at the right lower leg by an algometer. Intensities were adjusted to cause weak and strong pain sensation at either target site in preliminary testing. Brain activation in response to mechanical nociceptive stimulation targeting muscle and bone were measured by fMRI and analyzed. Painful mechanical stimulation targeting muscle and bone activated the common areas including bilateral insula, anterior cingulate cortex, posterior cingulate cortex, secondary somatosensory cortex (S2), inferior parietal lobe, and basal ganglia. The contralateral S2 was more activated by strong stimulation than by weak stimulation. Some areas in the basal ganglia (bilateral putamen and caudate nucleus) were more activated by muscle stimulation than by bone stimulation. The putamen and caudate nucleus may have a more significant role in brain processing of muscle pain compared with bone pain.

  13. Anterior cruciate ligament reconstruction using bone plug-free quadriceps tendon autograft: intermediate-term clinical outcome after 24-36 months.

    Science.gov (United States)

    Schulz, Arndt P; Lange, Vivien; Gille, Justus; Voigt, Christine; Fröhlich, Susanne; Stuhr, Markus; Jürgens, Christian

    2013-01-01

    Although known as a possible graft option for decades, quadriceps tendon grafts have often been termed a second-line graft option. We report a consecutive case series using this method as the primary treatment line. The rationale for this study was to evaluate the midterm results of this method in a prospective and consecutive case series. The primary study question was to determine the clinical results 24-36 months after primary anterior cruciate ligament (ACL) reconstruction using a bone plug-free quadriceps tendon autograft fixed with bioabsorbable cross-pins. The study population included 55 patients, of whom 24 were female (43.6%). The mean age at the index procedure was 31.7 years (15-58 years). All patients received an ACL construction using a bone block-free quadriceps tendon graft fixed with resorbable cross-pins. The postoperative regimen included partial weight-bearing for 3 weeks and flexion limited to 90° for six weeks; an orthosis was not used. The mean follow-up duration was 29.5 months (24.3-38.5 months) after the index procedure. The International Knee Documentation Committee (IKDC) subjective score and examination form was assessed, as well as the Lysholm and Gillquist score and the Tegner activity index. The Rolimeter arthrometer was used to assess the anterior laxity of the knee. Graft harvesting was possible in all cases; a bony extension was never required. On average, graft length was measured at 8.8 cm (7.5-10 cm). The mean IKDC subjective score at follow-up was 80.44 points (55.17-100 points, standard deviation [SD] 12.05). The mean preinjury Tegner activity index was 4.98 (2-7) compared to a mean value of 4.16 (2-7, SD 0.8) at follow-up. There was a mean loss of 0.82 index points. The average Lysholm and Gillquist score was 89 points (65-100, SD 17.7). Of the results, 89.1% were in the good or very good groups; in one case (1.8%), the result was poor, while the rest were fair. ACL reconstruction using a bone plug-free quadriceps tendon

  14. EFFECT OF USE OF BONE-MARROW CENTRIFUGATE ON MUSCLE INJURY TREATMENT: EXPERIMENTAL STUDY ON RABBITS

    Science.gov (United States)

    Vieira, Daniel Ferreira Fernandes; Guarniero, Roberto; Vaz, Carlos Eduardo Sanches; de Santana, Paulo José

    2015-01-01

    Objective: The objective of this study was to evaluate the effect of bone-marrow centrifugate on the healing of muscle injuries in rabbits. Methods: This experimental study involved use of fifteen adult male New Zealand White rabbits. Each animal received a transverse lesion in the middle of the right tibialis anterior muscle, to which an absorbable collagen sponge, soaked in a centrifugate of bone marrow aspirate from the ipsilateral iliac bone, was added. The left hind limb was used as a control and underwent the same injury, but in this case only the absorbable collagen sponge. Thirty days later, the animals were sacrificed to study the muscle healing. These muscle areas were subjected to histological analysis with histomorphometry, with the aim of measuring the number of muscle cells per square micrometer undergoing regeneration and the proportion of resultant fibrosis. Results: The centrifugation method used in this study resulted in an average concentration of nucleated cells greater than the number of these cells in original aspirates, without causing significant cell destruction. Addition of the bone marrow centrifugate did not result in any significant increase in the number of muscle cells undergoing regeneration, in relation to the control group. There was also no significant difference in the proportion of resultant fibrosis, compared with the control group. Conclusion: Administration of the bone marrow centrifugate used in this study did not favor healing of muscle injuries in rabbits. PMID:27047832

  15. Sensitivity of subject-specific models to Hill muscle-tendon model parameters in simulations of gait

    NARCIS (Netherlands)

    Carbone, Vincenzo; van der Krogt, Marjolein; Koopman, Hubertus F.J.M.; Verdonschot, Nicolaas Jacobus Joseph

    2016-01-01

    Subject-specific musculoskeletal (MS) models of the lower extremity are essential for applications such as predicting the effects of orthopedic surgery. We performed an extensive sensitivity analysis to assess the effects of potential errors in Hill muscle–tendon (MT) model parameters for each of

  16. Bone geometry, strength, and muscle size in runners with a history of stress fracture.

    Science.gov (United States)

    Popp, Kristin L; Hughes, Julie M; Smock, Amanda J; Novotny, Susan A; Stovitz, Steven D; Koehler, Scott M; Petit, Moira A

    2009-12-01

    Our primary aim was to explore differences in estimates of tibial bone strength, in female runners with and without a history of stress fractures. Our secondary aim was to explore differences in bone geometry, volumetric density, and muscle size that may explain bone strength outcomes. A total of 39 competitive distance runners aged 18-35 yr, with (SFX, n = 19) or without (NSFX, n = 20) a history of stress fracture were recruited for this cross-sectional study. Peripheral quantitative computed tomography (XCT 3000; Orthometrix, White Plains, NY) was used to assess volumetric bone mineral density (vBMD, mg x mm(-3)), bone area (ToA, mm(2)), and estimated compressive bone strength (bone strength index (BSI) = ToA x total volumetric density (ToD(2))) at the distal tibia (4%). Total (ToA, mm(2)) and cortical (CoA, mm(2)) bone area, cortical vBMD, and estimated bending strength (strength-strain index (SSIp), mm(3)) were measured at the 15%, 25%, 33%, 45%, 50%, and 66% sites. Muscle cross-sectional area (MCSA) was measured at the 50% and 66% sites. Participants in the SFX group had significantly smaller (7%-8%) CoA at the 45%, 50%, and 66% sites (P stress fracture. However, the lower strength was appropriate for the smaller muscle size, suggesting that interventions to reduce stress fracture risk might be aimed at improving muscle size and strength.

  17. Osmotic pressure induced tensile forces in tendon collagen.

    Science.gov (United States)

    Masic, Admir; Bertinetti, Luca; Schuetz, Roman; Chang, Shu-Wei; Metzger, Till Hartmut; Buehler, Markus J; Fratzl, Peter

    2015-01-22

    Water is an important component of collagen in tendons, but its role for the function of this load-carrying protein structure is poorly understood. Here we use a combination of multi-scale experimentation and computation to show that water is an integral part of the collagen molecule, which changes conformation upon water removal. The consequence is a shortening of the molecule that translates into tensile stresses in the range of several to almost 100 MPa, largely surpassing those of about 0.3 MPa generated by contractile muscles. Although a complete drying of collagen would be relevant for technical applications, such as the fabrication of leather or parchment, stresses comparable to muscle contraction already occur at small osmotic pressures common in biological environments. We suggest, therefore, that water-generated tensile stresses may play a role in living collagen-based materials such as tendon or bone.

  18. Treatment with vacuum-assisted closure and cryo-preserved homologous de-epidermalised dermis of complex traumas to the lower limbs with loss of substance, and bones and tendons exposure.

    Science.gov (United States)

    Brandi, C; Grimaldi, L; Nisi, G; Silvestri, A; Brafa, A; Calabrò, M; D'Aniello, C

    2008-12-01

    Lower-limb injuries with loss of tissue and exposure of bones and tendons are an increasing problem. The condition of the wound locally and the patient in general does not always allow immediate and adequate coverage of the structures exposed by the trauma. Therefore, new therapeutic solutions are needed. A reduction in the time that bones and tendons are exposed is essential to achieve complete healing of bone fractures, with reduced risks of infection and less disabling outcomes. The effectiveness of vacuum-assisted closure (VAC) therapy in supporting wound healing and of cryopreserved homologous de-epidermalised dermis (DED) in providing an effective template for re-epithelialisation has been previously reported. We carried out a study to evaluate the effectiveness of the synergistic and combined use of the two methodologies. Eighteen patients with traumatic loss of tissue in the lower limbs, involving exposure of bone and tendon structures, were enrolled in the study. All participants had local, general contraindications to first-instance reconstructions, or both. All patients received a combination of VAC therapy and DED implants. Granulation tissue was obtained in all wounds, with complete coverage of exposed structures. No infections were detected in the cohort, and all patients were prepared for further necessary reconstructive treatments. In our experience, the combination of VAC therapy and DED could, in selected cases, constitute an effective treatment for complex lower limb traumatic injuries with bone and tendon exposure.

  19. Growth hormone mitigates loss of periosteal bone formation and muscle mass in disuse osteopenic rats

    DEFF Research Database (Denmark)

    Grubbe, M-C; Thomsen, Jesper Skovhus; Nyengaard, J R

    2014-01-01

    Growth hormone (GH) is a potent anabolic agent capable of increasing both bone and muscle mass. The aim was to investigate whether GH could counteract disuse-induced loss of bone and muscle mass in a rat model. Paralysis was induced by injecting 4 IU Botox (BTX) into the muscles of the right hind...... of periosteal BFR/BS (2-fold increase vs. BTX, Pmuscle mass (+29% vs. BTX, Pmuscle CSA (+11%, P=0.064). In conclusion, GH mitigates disuse......BMD, -13%, Pmuscle mass (-69%, Pmuscle cell cross sectional area (CSA) (-73%, P

  20. In vivo functional and morphological characterization of bone and striated muscle microcirculation in NSG mice.

    Directory of Open Access Journals (Sweden)

    Haider Mussawy

    Full Text Available Organ-specific microcirculation plays a central role in tumor growth, tumor cell homing, tissue engineering, and wound healing. Mouse models are widely used to study these processes; however, these mouse strains often possess unique microhemodynamic parameters, making it difficult to directly compare experiments. The full functional characterization of bone and striated muscle microcirculatory parameters in non-obese diabetic-severe combined immunodeficiency/y-chain; NOD-Prkds IL2rg (NSG mice has not yet been reported. Here, we established either a dorsal skinfold chamber or femur window in NSG mice (n = 23, allowing direct analysis of microcirculatory parameters in vivo by intravital fluorescence microscopy at 7, 14, 21, and 28 days after chamber preparation. Organ-specific differences were observed. Bone had a significantly lower vessel density but a higher vessel diameter than striated muscle. Bone also showed higher effective vascular permeability than striated muscle. The centerline velocity values were similar in the femur window and dorsal skinfold chamber, with a higher volumetric blood flow in bone. Interestingly, bone and striated muscle showed similar tissue perfusion rates. Knowledge of physiological microhemodynamic values of bone and striated muscle in NSG mice makes it possible to analyze pathophysiological processes at these anatomic sites, such as tumor growth, tumor metastasis, and tumor microcirculation, as well as the response to therapeutic agents.

  1. A retrospective review of bone tunnel enlargement after anterior cruciate ligament reconstruction with hamstring tendons fixed with a metal round cannulated interference screw in the femur.

    Science.gov (United States)

    Kobayashi, Masahiko; Nakagawa, Yasuaki; Suzuki, Takashi; Okudaira, Shuzo; Nakamura, Takashi

    2006-10-01

    To assess bone tunnel enlargement after anterior cruciate ligament (ACL) reconstruction with the use of hamstring tendons fixed with a round cannulated interference (RCI) screw in the femur. A consecutive series of 30 ACL reconstructions performed with hamstring tendons fixed with an RCI screw in the femur and with staples via Leeds-Keio ligament in the tibia was retrospectively reviewed. The clinical outcome was evaluated through the Lysholm score. Anterior instability was tested by Telos-SE (Telos Japan, Tokyo, Japan) measurement. The location and angle of each femoral and tibial tunnel were measured with the use of plain radiographs, and bone tunnel enlargement greater than 2 mm detected any time 3, 6, 12, and 24 months postoperatively was defined as positive. Each factor (location and angle of the tunnels, sex, affected side, age, Lysholm score, and Telos-SE measurement) was compared between enlarged and nonenlarged groups. Positive enlargement of the bone tunnel (>2.0 mm) was observed in 36.7% (11 of 30) on the femoral side and 33.3% (10 of 30) on the tibial side, and in 6 knees of both sides. Half of patients (15 of 30) had an enlarged tunnel on the femoral or the tibial side until 1 year postoperatively. In most cases, enlargement reached maximum at 6 months postoperatively. Female patients tended to have an enlarged tunnel, especially on the femoral side (P < .05). Tunnel enlargement was not correlated with location and angle of the tunnels. Moreover, no difference was found in Lysholm score and Telos-SE measurement between enlarged and nonenlarged groups, although the nonenlarged group tended to exhibit higher Lysholm score and lesser instability. Bone tunnel enlargement of the femoral or tibial side was observed in half of patients (6 in both sides, 5 only in the femur, and 4 only in the tibia) after ACL reconstruction was performed with a hamstring tendon fixed with an RCI screw. Female patients had a greater chance for enlargement of the femoral tunnel

  2. Cortical bone deficit and fat infiltration of bone marrow and skeletal muscle in ambulatory children with mild spastic cerebral palsy.

    Science.gov (United States)

    Whitney, Daniel G; Singh, Harshvardhan; Miller, Freeman; Barbe, Mary F; Slade, Jill M; Pohlig, Ryan T; Modlesky, Christopher M

    2017-01-01

    Nonambulatory children with severe cerebral palsy (CP) have underdeveloped bone architecture, low bone strength and a high degree of fat infiltration in the lower extremity musculature. The present study aims to determine if such a profile exists in ambulatory children with mild CP and if excess fat infiltration extends into the bone marrow. Ambulatory children with mild spastic CP and typically developing children (4 to 11years; 12/group) were compared. Magnetic resonance imaging was used to estimate cortical bone, bone marrow and total bone volume and width, bone strength [i.e., section modulus (Z) and polar moment of inertia (J)], and bone marrow fat concentration in the midtibia, and muscle volume, intermuscular, subfascial, and subcutaneous adipose tissue (AT) volume and intramuscular fat concentration in the midleg. Accelerometer-based activity monitors worn on the ankle were used to assess physical activity. There were no group differences in age, height, body mass, body mass percentile, BMI, BMI percentile or tibia length, but children with CP had lower height percentile (19th vs. 50th percentile) and total physical activity counts (44%) than controls (both pChildren with CP also had lower cortical bone volume (30%), cortical bone width in the posterior (16%) and medial (32%) portions of the shaft, total bone width in the medial-lateral direction (15%), Z in the medial-lateral direction (34%), J (39%) and muscle volume (39%), and higher bone marrow fat concentration (82.1±1.8% vs. 80.5±1.9%), subfascial AT volume (3.3 fold) and intramuscular fat concentration (25.0±8.0% vs. 16.1±3.3%) than controls (all pfat infiltration estimates, except posterior cortical bone width, were still present (all pchildren with CP compared to controls emerged (pchildren with mild spastic CP exhibit an underdeveloped bone architecture and low bone strength in the midtibia and a greater infiltration of fat in the bone marrow and surrounding musculature compared to typically

  3. Relationships of muscle strength and bone mineral density in ambulatory children with cerebral palsy.

    Science.gov (United States)

    Chen, C-L; Lin, K-C; Wu, C-Y; Ke, J-Y; Wang, C-J; Chen, C-Y

    2012-02-01

    This work explores the relationships of muscle strength and areal bone mineral density (aBMD) in ambulatory children with cerebral palsy (CP). The knee extensor strength, but not motor function, was related to aBMD. Thus, muscle strength, especially antigravity muscle strength, was more associated with aBMD in these children than motor function. Muscle strength is related to bone density in normal children. However, no studies have examined these relationships in ambulatory children with CP. This work explores the relationships of muscle strength and aBMD in ambulatory children with CP. Forty-eight ambulatory children with spastic CP, aged 5-15 years, were classified into two groups based on Gross Motor Function Classification System levels: I (n = 28) and II (n = 20). Another 31 normal development (ND) children were recruited as the comparison group for the aBMD. Children with CP underwent assessments of growth, lumbar and distal femur aBMD, Gross Motor Function Measure-66 (GMFM-66), and muscle strength of knee extensor and flexor by isokinetic dynamometer. The distal femur aBMD, but not lumbar aBMD, was lower in children with CP than in ND children (p antigravity muscle strength, were more associated with the bone density of ambulatory children with CP than motor function. The data may allow clinicians for early identifying the ambulatory CP children of potential low bone density.

  4. Effects of the activin A-myostatin-follistatin system on aging bone and muscle progenitor cells

    Science.gov (United States)

    Bowser, Matthew; Herberg, Samuel; Arounleut, Phonepasong; Shi, Xingming; Fulzele, Sadanand; Hill, William D.; Isales, Carlos M.; Hamrick, Mark W.

    2013-01-01

    The activin A-myostatin-follistatin system is thought to play an important role in the regulation of muscle and bone mass throughout growth, development, and aging; however, the effects of these ligands on progenitor cell proliferation and differentiation in muscle and bone are not well understood. In addition, age-associated changes in the relative expression of these factors in musculoskeletal tissues have not been described. We therefore examined changes in protein levels of activin A, follistatin, and myostatin (GDF-8) in both muscle and bone with age in C57BL6 mice using ELISA. We then investigated the effects of activin A, myostatin and follistatin on the proliferation and differentiation of primary myoblasts and mouse bone marrow stromal cells (BMSCs) in vitro. Myostatin levels and the myostatin:follistatin ratio increased with age in the primarily slow-twitch mouse soleus muscle, whereas the pattern was reversed with age in the fast-twitch extensor digitorum longus muscle. Myostatin levels and the myostatin: follistatin ratio increased significantly (+75%) in mouse bone marrow with age, as did activin A levels (+17%). Follistatin increased the proliferation of primary myoblasts from both young and aged mice, whereas myostatin increased proliferation of younger myoblasts but decreased proliferation of older myoblasts. Myostatin reduced proliferation of both young and aged BMSCs in a dose-dependent fashion, and activin A increased mineralization in both young and aged BMSCs. Together these data suggest that aging in mice is accompanied by changes in the expression of activin A and myostatin, as well as changes in the response of bone and muscle progenitor cells to these factors. Myostatin appears to play a particularly important role in the impaired proliferative capacity of muscle and bone progenitor cells from aged mice. PMID:23178301

  5. THE EFFECTS OF AN EARLY RETURN TO TRAINING ON THE BONE-TENDON JUNCTION POST-ACUTE MICRO-INJURY HEALING

    Directory of Open Access Journals (Sweden)

    Lin Wang

    2012-06-01

    Full Text Available Bone-tendon junction (BTJ overuse injuries are common athletic and occupational problems. BTJ injuries may sometimes be caused by resuming training too early after injury. To study the effects of post-injury resuming training within 48 hours on the acute injury healing process, as it is often the case for athletes. Twelve mature female rabbits were assigned to one of the following groups: acute injury (AI, n = 6, post-injury early return to training (PIERT, n = 6 and normal control (CON, n = 6. Tissue specimens were harvested at week 4. The radiological and histological characteristics of the AI and PIERT groups were compared among the groups. The trabecular thickness of the PIERT group was significantly different from those of the AI and CON group. A histological evaluation revealed poor collagen fibre alignment, extensive scar tissue and lowered cell density in the AI and PIERT groups compared with the CON group, but no significant differences were observed between the AI group and the PIERT group. The fibrocartilage zone and proteoglycan area in the PIERT group were significantly different from those in AI group. No differences were observed in the Total VOI volume (TV, Object volume (OBV, Percent object volume (BV/TV and trabecular number (Tb.N among the AI, PIERT and CON groups. In conclusion, a repeatable animal model of bone-tendon junction acute micro-damage by puncture was established. Resuming training in 48 hours did not significantly deteriorate the BTJ injury healing, but improved bone remodelling and increased fibrocartilage zone thickness

  6. IL-6 and IGF-1 signaling within and between muscle and bone: how important is the mTOR pathway for bone metabolism?

    NARCIS (Netherlands)

    Bakker, A.D.; Jaspers, R.T.

    2015-01-01

    Insulin-like growth factor 1 (IGF-1) and interleukin 6 (IL-6) play an important role in the adaptation of both muscle and bone to mechanical stimuli. Here, we provide an overview of the functions of IL-6 and IGF-1 in bone and muscle metabolism, and the intracellular signaling pathways that are well

  7. IL-6 and IGF-1 Signaling within, and between, Muscle and Bone: How Important is the mTOR Pathway for Bone Metabolism?

    NARCIS (Netherlands)

    Bakker, A.D.; Jaspers, R.T.

    2015-01-01

    Insulin-like growth factor 1 (IGF-1) and interleukin 6 (IL-6) play an important role in the adaptation of both muscle and bone to mechanical stimuli. Here, we provide an overview of the functions of IL-6 and IGF-1 in bone and muscle metabolism, and the intracellular signaling pathways that are well

  8. Anterior cruciate ligament reconstruction using bone plug-free quadriceps tendon autograft: intermediate-term clinical outcome after 24–36 months

    Directory of Open Access Journals (Sweden)

    Schulz AP

    2013-11-01

    Full Text Available Arndt P Schulz,1 Vivien Lange,2 Justus Gille,1 Christine Voigt,3 Susanne Fröhlich,4 Markus Stuhr,1 Christian Jürgens5 1Department of Orthopedics, Trauma, and Sports Medicine, University Hospital Lübeck, Lübeck, Germany; 2Department of Rehabilitation, Sana Regio Klinikum, Wedel, Germany; 3Department of Sports Medicine and Arthroscopy, Diakoniekrankenhaus Friederikenstift, Hannover, Germany; 4Department of Orthopedics, University of Rostock, Rostock, Germany; 5Department of Orthopedics, Trauma, and Sports Medicine, BG Trauma Hospital Hamburg, Hamburg, Germany Introduction: Although known as a possible graft option for decades, quadriceps tendon grafts have often been termed a second-line graft option. We report a consecutive case series using this method as the primary treatment line. The rationale for this study was to evaluate the midterm results of this method in a prospective and consecutive case series. The primary study question was to determine the clinical results 24–36 months after primary anterior cruciate ligament (ACL reconstruction using a bone plug-free quadriceps tendon autograft fixed with bioabsorbable cross-pins. Materials and methods: The study population included 55 patients, of whom 24 were female (43.6%. The mean age at the index procedure was 31.7 years (15–58 years. All patients received an ACL construction using a bone block-free quadriceps tendon graft fixed with resorbable cross-pins. The postoperative regimen included partial weight-bearing for 3 weeks and flexion limited to 90° for six weeks; an orthosis was not used. The mean follow-up duration was 29.5 months (24.3–38.5 months after the index procedure. The International Knee Documentation Committee (IKDC subjective score and examination form was assessed, as well as the Lysholm and Gillquist score and the Tegner activity index. The Rolimeter arthrometer was used to assess the anterior laxity of the knee. Results: Graft harvesting was possible in all cases

  9. Bone strength and muscle properties in postmenopausal women with and without a recent distal radius fracture.

    Science.gov (United States)

    Crockett, K; Arnold, C M; Farthing, J P; Chilibeck, P D; Johnston, J D; Bath, B; Baxter-Jones, A D G; Kontulainen, S A

    2015-10-01

    Distal radius (wrist) fracture (DRF) in women over age 50 years is an early sign of bone fragility. Women with a recent DRF compared to women without DRF demonstrated lower bone strength, muscle density, and strength, but no difference in dual-energy x-ray absorptiometry (DXA) measures, suggesting DXA alone may not be a sufficient predictor for DRF risk. The objective of this study was to investigate differences in bone and muscle properties between women with and without a recent DRF. One hundred sixty-six postmenopausal women (50-78 years) were recruited. Participants were excluded if they had taken bone-altering medications in the past 6 months or had medical conditions that severely affected daily living or the upper extremity. Seventy-seven age-matched women with a fracture in the past 6-24 months (Fx, n = 32) and without fracture (NFx, n = 45) were measured for bone and muscle properties using the nondominant (NFx) or non-fractured limb (Fx). Peripheral quantitative computed tomography (pQCT) was used to estimate bone strength in compression (BSIc) at the distal radius and tibia, bone strength in torsion (SSIp) at the shaft sites, muscle density, and area at the forearm and lower leg. Areal bone mineral density at the ultradistal forearm, spine, and femoral neck was measured by DXA. Grip strength and the 30-s chair stand test were used as estimates of upper and lower extremity muscle strength. Limb-specific between-group differences were compared using multivariate analysis of variance (MANOVA). There was a significant group difference (p lower leg, with the Fx group demonstrating 16 and 19% lower BSIc, 3 and 6% lower muscle density, and 20 and 21% lower muscle strength at the upper and lower extremities, respectively. There were no differences between groups for DXA measures. Women with recent DRF had lower pQCT-derived estimated bone strength at the distal radius and tibia and lower muscle density and strength at both extremities.

  10. Characterization of calcium and zinc spatial distributions at the fibrocartilage zone of bone-tendon junction by synchrotron radiation-based micro X-ray fluorescence analysis combined with backscattered electron imaging

    Science.gov (United States)

    Lu, Hongbin; Chen, Can; Wang, Zhanwen; Qu, Jin; Xu, Daqi; Wu, Tianding; Cao, Yong; Zhou, Jingyong; Zheng, Cheng; Hu, Jianzhong

    2015-09-01

    Tendon attaches to bone through a functionally graded fibrocartilage zone, including uncalcified fibrocartilage (UF), tidemark (TM) and calcified fibrocartilage (CF). This transition zone plays a pivotal role in relaxing load transfer between tendon and bone, and serves as a boundary between otherwise structurally and functionally distinct tissue types. Calcium and zinc are believed to play important roles in the normal growth, mineralization, and repair of the fibrocartilage zone of bone-tendon junction (BTJ). However, spatial distributions of calcium and zinc at the fibrocartilage zone of BTJ and their distribution-function relationship are not totally understood. Thus, synchrotron radiation-based micro X-ray fluorescence analysis (SR-μXRF) in combination with backscattered electron imaging (BEI) was employed to characterize the distributions of calcium and zinc at the fibrocartilage zone of rabbit patella-patellar tendon complex (PPTC). For the first time, the unique distributions of calcium and zinc at the fibrocartilage zone of the PPTC were clearly mapped by this method. The distributions of calcium and zinc at the fibrocartilage zone of the PPTC were inhomogeneous. A significant accumulation of zinc was exhibited in the transition region between UF and CF. The highest zinc content (3.17 times of that of patellar tendon) was found in the TM of fibrocartilage zone. The calcium content began to increase near the TM and increased exponentially across the calcified fibrocartilage region towards the patella. The highest calcium content (43.14 times of that of patellar tendon) was in the transitional zone of calcified fibrocartilage region and the patella, approximately 69 μm from the location with the highest zinc content. This study indicated, for the first time, that there is a differential distribution of calcium and zinc at the fibrocartilage zone of PPTC. These observations reveal new insights into region-dependent changes across the fibrocartilage zone of

  11. Failure load of patellar tendon grafts at the femoral side: 10- versus 20-mm-bone blocks

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan); M.J.N. Niggebrugge (Marnix); J.A.N. Verhaar (Jan)

    2009-01-01

    textabstractThe aim of the study was to investigate whether use of short bone blocks is safe in anterior cruciate ligament (ACL) reconstruction. Our hypothesis was that the smaller 10-mm-length bone blocks will fail at lower loads than 20-mm-bone blocks. Ten paired human cadaver knees were randomly

  12. BMP9-Induced Osteogenetic Differentiation and Bone Formation of Muscle-Derived Stem Cells

    Directory of Open Access Journals (Sweden)

    Li Xiang

    2012-01-01

    Full Text Available Efficient osteogenetic differentiation and bone formation from muscle-derived stem cells (MDSCs should have potential clinical applications in treating nonunion fracture healing or bone defects. Here, we investigate osteogenetic differentiation ability of MDSCs induced by bone morphogenetic protein 9 (BMP9 in vitro and bone formation ability in rabbit radius defects repairing model. Rabbit's MDSCs were extracted by type I collagenase and trypsin methods, and BMP9 was introduced into MDSCs by infection with recombinant adenovirus. Effects of BMP9-induced osteogenetic differentiation of MDSCs were identified with alkaline phosphatase (ALP activity and expression of later marker. In stem-cell implantation assay, MDSCs have also shown valuable potential bone formation ability induced by BMP9 in rabbit radius defects repairing test. Taken together, our findings suggest that MDSCs are potentiated osteogenetic stem cells which can be induced by BMP9 to treat large segmental bone defects, nonunion fracture, and/or osteoporotic fracture.

  13. Limb muscle sound speed estimation by ultrasound computed tomography excluding receivers in bone shadow

    Science.gov (United States)

    Qu, Xiaolei; Azuma, Takashi; Lin, Hongxiang; Takeuchi, Hideki; Itani, Kazunori; Tamano, Satoshi; Takagi, Shu; Sakuma, Ichiro

    2017-03-01

    Sarcopenia is the degenerative loss of skeletal muscle ability associated with aging. One reason is the increasing of adipose ratio of muscle, which can be estimated by the speed of sound (SOS), since SOSs of muscle and adipose are different (about 7%). For SOS imaging, the conventional bent-ray method iteratively finds ray paths and corrects SOS along them by travel-time. However, the iteration is difficult to converge for soft tissue with bone inside, because of large speed variation. In this study, the bent-ray method is modified to produce SOS images for limb muscle with bone inside. The modified method includes three steps. First, travel-time is picked up by a proposed Akaike Information Criterion (AIC) with energy term (AICE) method. The energy term is employed for detecting and abandoning the transmissive wave through bone (low energy wave). It results in failed reconstruction for bone, but makes iteration convergence and gives correct SOS for skeletal muscle. Second, ray paths are traced using Fermat's principle. Finally, simultaneous algebraic reconstruction technique (SART) is employed to correct SOS along ray paths, but excluding paths with low energy wave which may pass through bone. The simulation evaluation was implemented by k-wave toolbox using a model of upper arm. As the result, SOS of muscle was 1572.0+/-7.3 m/s, closing to 1567.0 m/s in the model. For vivo evaluation, a ring transducer prototype was employed to scan the cross sections of lower arm and leg of a healthy volunteer. And the skeletal muscle SOSs were 1564.0+/-14.8 m/s and 1564.1±18.0 m/s, respectively.

  14. Artistic versus rhythmic gymnastics: effects on bone and muscle mass in young girls.

    Science.gov (United States)

    Vicente-Rodriguez, G; Dorado, C; Ara, I; Perez-Gomez, J; Olmedillas, H; Delgado-Guerra, S; Calbet, J A L

    2007-05-01

    We compared 35 prepubertal girls, 9 artistic gymnasts and 13 rhythmic gymnasts with 13 nonphysically active controls to study the effect of gymnastics on bone and muscle mass. Lean mass, bone mineral content and areal density were measured by dual energy X-ray absorptiometry, and physical fitness was also assessed. The artistic gymnasts showed a delay in pubertal development compared to the other groups (partistic gymnasts had a 16 and 17 % higher aerobic power and anaerobic capacity, while the rhythmic group had a 14 % higher anaerobic capacity than the controls, respectively (all partistic gymnasts had higher lean mass (partistic and the rhythmic gymnasts (partistic group compared to the other groups. Lean mass strongly correlated with bone mineral content (r=0.84, partistic gymnastic participation is associated with delayed pubertal development, enhanced physical fitness, muscle mass, and bone density in prepubertal girls, eliciting a higher osteogenic stimulus than rhythmic gymnastic.

  15. Use of a strontium-enriched calcium phosphate cement in accelerating the healing of soft-tissue tendon graft within the bone tunnel in a rabbit model of anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Kuang, G M; Yau, W P; Lu, W W; Chiu, K Y

    2013-07-01

    We investigated whether strontium-enriched calcium phosphate cement (Sr-CPC)-treated soft-tissue tendon graft results in accelerated healing within the bone tunnel in reconstruction of the anterior cruciate ligament (ACL). A total of 30 single-bundle ACL reconstructions using tendo Achillis allograft were performed in 15 rabbits. The graft on the tested limb was treated with Sr-CPC, whereas that on the contralateral limb was untreated and served as a control. At timepoints three, six, nine, 12 and 24 weeks after surgery, three animals were killed for histological examination. At six weeks, the graft-bone interface in the control group was filled in with fibrovascular tissue. However, the gap in the Sr-CPC group had already been completely filled in with new bone, and there was evidence of the early formation of Sharpey fibres. At 24 weeks, remodelling into a normal ACL-bone-like insertion was found in the Sr-CPC group. Coating of Sr-CPC on soft tissue tendon allograft leads to accelerated graft healing within the bone tunnel in a rabbit model of ACL reconstruction using Achilles tendon allograft.

  16. Measurements of the static friction coefficient between bone and muscle tissues.

    Science.gov (United States)

    Shacham, Sharon; Castel, David; Gefen, Amit

    2010-08-01

    This study aimed at measuring the static coefficient of friction (mu) between bone and skeletal muscle tissues in order to support finite element (FE) modeling in orthopaedic and rehabilitation research, where such contact conditions need to be defined. A custom-made friction meter (FM) that employs the load cell and motion-controlled loading arm of a materials testing machine was designed for this study. The FM was used to measure mu between fresh ulna bones and extensor muscles surrounding the ulna, which were harvested from five young adult pigs. Mean bone-muscle mu were between 0.36 and 0.29, decreased with the increase in loads applied on the bone (p<0.05) and plateaued at a mean approximately 0.3 for loads exceeding 4 N. Hence, for FE modeling of bone-muscle contacts through which loads with magnitudes of kgs to 10s-of-kgs are transferred, assuming mu of approximately 0.3 appears to be appropriate.

  17. Creatine supplementation in the aging population: effects on skeletal muscle, bone and brain.

    Science.gov (United States)

    Gualano, Bruno; Rawson, Eric S; Candow, Darren G; Chilibeck, Philip D

    2016-08-01

    This narrative review aims to summarize the recent findings on the adjuvant application of creatine supplementation in the management of age-related deficits in skeletal muscle, bone and brain metabolism in older individuals. Most studies suggest that creatine supplementation can improve lean mass and muscle function in older populations. Importantly, creatine in conjunction with resistance training can result in greater adaptations in skeletal muscle than training alone. The beneficial effect of creatine upon lean mass and muscle function appears to be applicable to older individuals regardless of sex, fitness or health status, although studies with very old (>90 years old) and severely frail individuals remain scarce. Furthermore, there is evidence that creatine may affect the bone remodeling process; however, the effects of creatine on bone accretion are inconsistent. Additional human clinical trials are needed using larger sample sizes, longer durations of resistance training (>52 weeks), and further evaluation of bone mineral, bone geometry and microarchitecture properties. Finally, a number of studies suggest that creatine supplementation improves cognitive processing under resting and various stressed conditions. However, few data are available on older adults, and the findings are discordant. Future studies should focus on older adults and possibly frail elders or those who have already experienced an age-associated cognitive decline.

  18. Growth hormone mitigates loss of periosteal bone formation and muscle mass in disuse osteopenic rats.

    Science.gov (United States)

    Grubbe, M-C; Thomsen, J S; Nyengaard, J R; Duruox, M; Brüel, A

    2014-12-01

    Growth hormone (GH) is a potent anabolic agent capable of increasing both bone and muscle mass. The aim was to investigate whether GH could counteract disuse-induced loss of bone and muscle mass in a rat model. Paralysis was induced by injecting 4 IU Botox (BTX) into the muscles of the right hind limb. Sixty female Wistar rats, 14 weeks old, were divided into the following groups: baseline, controls, BTX, BTX+GH, and GH. GH was given at a dosage of 5 mg/kg/d for 4 weeks. Compared with controls, BTX resulted in lower periosteal bone formation rate (BFR/BS,-79%, Pbone mineral density (aBMD, -13%, Pbone volume (BV/TV, -26%, Pbone strength (-12%, Pbone strength was found. In addition, GH partly prevented loss of muscle mass (+29% vs. BTX, P<0.001), and tended to prevent loss of muscle CSA (+11%, P=0.064). In conclusion, GH mitigates disuse-induced loss of periosteal BFR/BS at the mid-femur and rectus femoris muscle mass.

  19. Skeletal muscle fat content is inversely associated with bone strength in young girls.

    Science.gov (United States)

    Farr, Joshua N; Funk, Janet L; Chen, Zhao; Lisse, Jeffrey R; Blew, Robert M; Lee, Vinson R; Laudermilk, Monica; Lohman, Timothy G; Going, Scott B

    2011-09-01

    Childhood obesity is an established risk factor for metabolic disease. The influence of obesity on bone development, however, remains controversial and may depend on the pattern of regional fat deposition. Therefore, we examined the associations of regional fat compartments of the calf and thigh with weight-bearing bone parameters in girls. Data from 444 girls aged 9 to 12 years from the Jump-In: Building Better Bones study were analyzed. Peripheral quantitative computed tomography (pQCT) was used to assess bone parameters at metaphyseal and diaphyseal sites of the femur and tibia along with subcutaneous adipose tissue (SAT, mm(2) ) and muscle density (mg/cm(3) ), an index of skeletal muscle fat content. As expected, SAT was positively correlated with total-body fat mass (r = 0.87-0.89, p  .05), except the distal tibia (β = 0.09, p = .03). In conclusion, skeletal muscle fat content of the calf and thigh is inversely associated with weight-bearing bone strength in young girls. Copyright © 2011 American Society for Bone and Mineral Research.

  20. Variation in the insertion of the palmaris longus tendon

    Science.gov (United States)

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

    2015-01-01

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

  1. Quantitative separation of bone and muscle radioactivity in small rodents using Dermestid beetles

    International Nuclear Information System (INIS)

    Walburg, H.E.; Eisele, G.R.; Mraz, F.R.

    1979-01-01

    The use of Dermestid beetles, which feed on dead animals, to separate muscle and bone radioactivity in small rodent carcasses was studied. Eviscerated carcasses of mice injected with 1μCi 95 Nb 48hr before killing were placed in jars with adult beetle larvae. Within 3 weeks the skeletons were completely free of muscle. Losses of radioactivity were acceptably small. The actual muscle activity was measured by counting activity in beetles, larvae and excreta, and compared with estimated values. Dermestid digestion has proved to be effective for small carcasses, where size precludes other methods of separation, and is in current use in studies of tissue localization of radionuclides. (author)

  2. Insulin Resistance Negatively Influences the Muscle-Dependent IGF-1-Bone Mass Relationship in Premenarcheal Girls.

    Science.gov (United States)

    Kindler, J M; Pollock, N K; Laing, E M; Jenkins, N T; Oshri, A; Isales, C; Hamrick, M; Lewis, R D

    2016-01-01

    IGF-1 promotes bone growth directly and indirectly through its effects on skeletal muscle. Insulin and IGF-1 share a common cellular signaling process; thus, insulin resistance may influence the IGF-1-muscle-bone relationship. We sought to determine the effect of insulin resistance on the muscle-dependent relationship between IGF-1 and bone mass in premenarcheal girls. This was a cross-sectional study conducted at a university research center involving 147 girls ages 9 to 11 years. Glucose, insulin, and IGF-1 were measured from fasting blood samples. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated from glucose and insulin. Fat-free soft tissue (FFST) mass and bone mineral content (BMC) were measured by dual-energy x-ray absorptiometry. Our primary outcome was BMC/height. In our path model, IGF-1 predicted FFST mass (b = 0.018; P = .001), which in turn predicted BMC/height (b = 0.960; P IGF-1 predicted BMC/height (b = 0.001; P = .002), but not after accounting for the mediator of this relationship, FFST mass. The HOMA-IR by IGF-1 interaction negatively predicted FFST mass (b = -0.044; P = .034). HOMA-IR had a significant and negative effect on the muscle-dependent relationship between IGF-1 and BMC/height (b = -0.151; P = .047). Lean body mass is an important intermediary factor in the IGF-1-bone relationship. For this reason, bone development may be compromised indirectly via suboptimal IGF-1-dependent muscle development in insulin-resistant children.

  3. The functional muscle-bone unit in children with cerebral palsy.

    Science.gov (United States)

    Duran, I; Schütz, F; Hamacher, S; Semler, O; Stark, C; Schulze, J; Rittweger, J; Schoenau, E

    2017-07-01

    Our results suggest that the prevalence of bone health deficits in children with CP was overestimated, when using only age- and height-adjusted bone mineral content (BMC) and areal bone mineral density (aBMD). When applying the functional muscle-bone unit diagnostic algorithm (FMBU-A), the prevalence of positive results decreased significantly. We recommend applying the FMBU-A when assessing bone health in children with CP. The prevalence of bone health deficits in children with cerebral palsy (CP) might be overestimated because age- and height-adjusted reference percentiles for bone mineral content (BMC) and areal bone mineral density (aBMD) assessed by dual-energy X-ray absorptiometry (DXA) do not consider reduced muscle activity. The aim of this study was to compare the prevalence of positive DXA-based indicators for bone health deficits in children with CP to the prevalence of positive findings after applying a functional muscle-bone unit diagnostic algorithm (FMBU-A) considering reduced muscle activity. The present study was a monocentric retrospective analysis of 297 whole body DXA scans of children with CP. The prevalence of positive results of age- and height-adjusted BMC and aBMD defined as BMC and aBMD below the P3 percentile and of the FMBU-A was calculated. In children with CP, the prevalence of positive results of age-adjusted BMC were 33.3% and of aBMD 50.8%. Height-adjusted results for BMC and aBMD were positive in 16.8 and 36.0% of cases. The prevalence of positive results applying the FMBU-A regarding BMC and aBMD were significantly (p BMC and aBMD (8.8 and 14.8%). Our results suggest that the prevalence of bone health deficits in children with CP was overestimated, when using age- and height-adjusted BMC and aBMD. When applying the FMBU-A, the prevalence decreased significantly. We recommend applying the FMBU-A when assessing bone health in children with CP.

  4. Assessment of the influence of body composition on bone mass in children and adolescents based on a functional analysis of the muscle-bone relationship.

    Science.gov (United States)

    Golec, Joanna; Chlebna-Sokół, Danuta

    2014-01-01

    The functional model of skeletal development considers the mechanical factor to be the most important skeletal modulant. The aim of the study was a functional analysis of the bone-muscle relationship in children with low and normal bone mass. The study involved 149 children with low and 99 children with normal bone mass (control group). All patients underwent a densitometry examination (DXA). Low bone mass was diagnosed if the Z-score was below values of Z-scores for all parameters in children with low bone mass as compared to the control group. Children with low bone mass had lower content of adipose and muscle tissue and a marked deficit of muscle tissue with regard to height (which according to mechanostat theory leads to lower muscle-generated strain on bones). This group of children had also lower TBBMC/LBM Z-scores, which indicates greater fracture susceptibility. 1. Functional analysis, which showed associations between bone and muscle tissues, can be useful for diagnosing and monitoring skeletal system disorders as well as making therapeutic decisions.2. The study emphasizes the role of proper nutrition and physical activities, which contribute to proper body composition, in the prevention of bone mineralization disorders in childhood and adolescence. 3. The study showed the inadequacy of the classic reference ranges used in interpreting DXA data in children and demonstrated the usefulness of continuous variables for that purpose.

  5. Skeletal muscle contraction in protecting joints and bones by absorbing mechanical impacts

    Science.gov (United States)

    Rudenko, O. V.; Tsyuryupa, S.; Sarvazyan, A.

    2016-09-01

    We have previously hypothesized that the dissipation of mechanical energy of external impact is a fundamental function of skeletal muscle in addition to its primary function to convert chemical energy into mechanical energy. In this paper, a mathematical justification of this hypothesis is presented. First, a simple mechanical model, in which the muscle is considered as a simple Hookean spring, is considered. This analysis serves as an introduction to the consideration of a biomechanical model taking into account the molecular mechanism of muscle contraction, kinetics of myosin bridges, sarcomere dynamics, and tension of muscle fibers. It is shown that a muscle behaves like a nonlinear and adaptive spring tempering the force of impact and increasing the duration of the collision. The temporal profiles of muscle reaction to the impact as functions of the levels of muscle contraction, durations of the impact front, and the time constants of myosin bridges closing, are obtained. The absorption of mechanical shock energy is achieved due to the increased viscoelasticity of the contracting skeletal muscle. Controlling the contraction level allows for the optimization of the stiffness and viscosity of the muscle necessary for the protection of the joints and bones.

  6. Tenomodulin is Required for Tendon Endurance Running and Collagen I Fibril Adaptation to Mechanical Load

    Directory of Open Access Journals (Sweden)

    Sarah Dex

    2017-06-01

    Full Text Available Tendons are dense connective tissues that attach muscles to bone with an indispensable role in locomotion because of their intrinsic properties of storing and releasing muscle- generated elastic energy. Tenomodulin (Tnmd is a well-accepted gene marker for the mature tendon/ligament lineage and its loss-of -function in mice leads to a phenotype with distinct signs of premature aging on tissue and stem/progenitor cell levels. Based on these findings, we hypothesized that Tnmd might be an important factor in the functional performance of tendons. Firstly, we revealed that Tnmd is a mechanosensitive gene and that the C-terminus of the protein co-localize with collagen I-type fibers in the extracellular matrix. Secondly, using an endurance training protocol, we compared Tnmd knockout mice with wild types and showed that Tnmd deficiency leads to significantly inferior running performance that further worsens with training. In these mice, endurance running was hindered due to abnormal response of collagen I cross-linking and proteoglycan genes leading to an inadequate collagen I fiber thickness and elasticity. In sum, our study demonstrates that Tnmd is required for proper tendon tissue adaptation to endurance running and aids in better understanding of the structural-functional relationships of tendon tissues.

  7. Molecular characterization and function of tenomodulin, a marker of tendons and ligaments that integrate musculoskeletal components

    Directory of Open Access Journals (Sweden)

    Chisa Shukunami, DDS, PhD

    2016-11-01

    Full Text Available Tendons and ligaments are dense fibrous bands of connective tissue that integrate musculoskeletal components in vertebrates. Tendons connect skeletal muscles to the bone and function as mechanical force transmitters, whereas ligaments bind adjacent bones together to stabilize joints and restrict unwanted joint movement. Fibroblasts residing in tendons and ligaments are called tenocytes and ligamentocytes, respectively. Tenomodulin (Tnmd is a type II transmembrane glycoprotein that is expressed at high levels in tenocytes and ligamentocytes, and is also present in periodontal ligament cells and tendon stem/progenitor cells. Tnmd is related to chondromodulin-1 (Chm1, a cartilage-derived angiogenesis inhibitor, and both Tnmd and Chm1 are expressed in the CD31− avascular mesenchyme. The conserved C-terminal hydrophobic domain of these proteins, which is characterized by the eight Cys residues to form four disulfide bonds, may have an anti-angiogenic function. This review highlights the molecular characterization and function of Tnmd, a specific marker of tendons and ligaments.

  8. A Novel Surgical Technique for Fixation of Recurrent Acromioclavicular Dislocations: AC Dog Bone Technique in Combination with Autogenous Semitendinosus Tendon Graft

    Directory of Open Access Journals (Sweden)

    Patrick Holweg

    2017-01-01

    Full Text Available Various surgical techniques have been described for the fixation of acromioclavicular (AC dislocations. However, recurrent dislocation is one of the main complications associated with the majority of these techniques. We report a case of postoperative AC joint redislocation. In order to overcome recurrent dislocation after revision surgery, a reconstruction of the conoid and trapezoid ligament with the use of a free tendon graft in combination with a FiberTape was provided within a novel surgical technique. After 12 months, the patient was very satisfied with the functional outcome. The patient achieved excellent results in the Constant (98 points, SPADI (0 points, and QuickDASH score (0 points. The described technique results in an anatomic reconstruction of the AC joint. The nonrigid nature of the intervention seems to restore the normal arthrokinematics by reconstructing the coracoclavicular ligaments with an autograft which is then protected by the AC Dog Bone artificial ligaments during the healing period. The arthroscopic approach to the AC joint with minimal exposure reduces the risks and complications of the intervention. This is the first case in literature that utilizes the artificial dog bone ligament securing the autograft in an anatomic AC reconstruction.

  9. Effect of Preoperative Fatty Degeneration of the Rotator Cuff Muscles on the Clinical Outcome of Patients With Intact Tendons After Arthroscopic Rotator Cuff Repair of Large/Massive Cuff Tears.

    Science.gov (United States)

    Ohzono, Hiroki; Gotoh, Masafumi; Nakamura, Hidehiro; Honda, Hirokazu; Mitsui, Yasuhiro; Kakuma, Tatsuyuki; Okawa, Takahiro; Shiba, Naoto

    2017-11-01

    Fatty degeneration of the rotator cuff muscles is associated not only with postoperative retear but also with postoperative muscle weakness; therefore, fatty changes in the muscles may affect the clinical outcome even in patients with these tears who have intact tendons after arthroscopic rotator cuff repair (ARCR). To evaluate the effect of fatty infiltration on the clinical outcome in patients with intact tendons after arthroscopic repair of large/massive cuff tears. Case-control study; Level of evidence, 3. One hundred fifty-five consecutive patients with large/massive rotator cuff tears underwent ARCR. Of these, 55 patients (mean ± SD age, 64.4 ± 9.1 years) in whom intact tendons after surgery were confirmed with magnetic resonance imaging at final follow-up (mean ± SD, 2.5 ± 1.4 years) were included in this study. Depending on their University of California Los Angeles (UCLA) score at the final follow-up, they were assigned to either the unsatisfactory group (score ≤27; n = 12) or the satisfactory group (score >27; n = 43). Various clinical parameters affecting the clinical outcome were examined through univariate and multivariate analyses. The UCLA score of all patients significantly improved from 18.1 ± 4.4 points preoperatively to 29.8 ± 4.5 points postoperatively ( P muscles, with area under the curve values of 0.79 (sensitivity 91% and specificity 51%) and 0.84 (sensitivity 100% and specificity 54%) in the infraspinatus and subscapularis, respectively. Preoperative fatty degeneration of the infraspinatus and/or subscapularis with Goutallier stage 2 or higher was significantly associated with worse outcome in patients with large/massive tears who had intact tendons after ARCR.

  10. Biomechanical, microvascular, and cellular factors promote muscle and bone regeneration.

    Science.gov (United States)

    Duda, Georg N; Taylor, William R; Winkler, Tobias; Matziolis, Georg; Heller, Markus O; Haas, Norbert P; Perka, Carsten; Schaser, Klaus-D

    2008-04-01

    It is becoming clear that the long-term outcome of complex bone injuries benefits from approaches that selectively target biomechanical, vascular, and cellular pathways. The typically held view of either biological or mechanical aspects of healing is oversimplified and does not correspond to clinical reality. The fundamental mechanisms of soft tissue regeneration most likely hold the key to understanding healing response.

  11. Rapid and reliable healing of critical size bone defects with genetically modified sheep muscle.

    Science.gov (United States)

    Liu, F; Ferreira, E; Porter, R M; Glatt, V; Schinhan, M; Shen, Z; Randolph, M A; Kirker-Head, C A; Wehling, C; Vrahas, M S; Evans, C H; Wells, J W

    2015-09-21

    Large segmental defects in bone fail to heal and remain a clinical problem. Muscle is highly osteogenic, and preliminary data suggest that autologous muscle tissue expressing bone morphogenetic protein-2 (BMP-2) efficiently heals critical size defects in rats. Translation into possible human clinical trials requires, inter alia, demonstration of efficacy in a large animal, such as the sheep. Scale-up is fraught with numerous biological, anatomical, mechanical and structural variables, which cannot be addressed systematically because of cost and other practical issues. For this reason, we developed a translational model enabling us to isolate the biological question of whether sheep muscle, transduced with adenovirus expressing BMP-2, could heal critical size defects in vivo. Initial experiments in athymic rats noted strong healing in only about one-third of animals because of unexpected immune responses to sheep antigens. For this reason, subsequent experiments were performed with Fischer rats under transient immunosuppression. Such experiments confirmed remarkably rapid and reliable healing of the defects in all rats, with bridging by 2 weeks and remodelling as early as 3-4 weeks, despite BMP-2 production only in nanogram quantities and persisting for only 1-3 weeks. By 8 weeks the healed defects contained well-organised new bone with advanced neo-cortication and abundant marrow. Bone mineral content and mechanical strength were close to normal values. These data demonstrate the utility of this model when adapting this technology for bone healing in sheep, as a prelude to human clinical trials.

  12. Gait analysis, bone and muscle density assessment for patients undergoing total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Benedikt Magnússon

    2012-12-01

    Full Text Available Total hip arthroplasty (THA is performed with or without the use of bone cement. Facing the lack of reliable clinical guidelines on decision making whether a patient should receive THA with or without bone cement, a joint clinical and engineering approach is proposed here with the objective to assess patient recovery developing monitoring techniques based on gait analysis, measurements of bone mineral density and structural and functional changes of quadriceps muscles. A clinical trial was conducted with 36 volunteer patients that were undergoing THA surgery for the first time: 18 receiving cemented implant and 18 receiving non-cemented implant. The patients are scanned with Computer Tomographic (CT modality prior-, immediately- and 12 months post-surgery. The CT data are further processed to segment muscles and bones for calculating bone mineral density (BMD. Quadriceps muscle density Hounsfield (HU based value is calculated from the segmented file on healthy and operated leg before and after THA surgery. Furthermore clinical assessment is performed using gait analysis technologies such as a sensing carpet, wireless electrodes and video. Patients undergo these measurements prior-, 6 weeks post - and 52 weeks post-surgery. The preliminary results indicate computational tools and methods that are able to quantitatively analyze patient’s condition pre and post-surgery: The spatial parameters such as step length and stride length increase 6 weeks post op in the patient group receiving cemented implant while the angle in the toe in/out parameter decrease in both patient groups.

  13. Mechanical and morphological properties of different muscle-tendon units in the lower extremity and running mechanics: effect of aging and physical activity.

    Science.gov (United States)

    Karamanidis, Kiros; Arampatzis, Adamantios

    2005-10-01

    The objectives of this work were (i) to investigate whether chronic endurance running is a sufficient stimulus to counteract the age-related changes in the mechanical and morphological properties of human triceps surae (TS) and quadriceps femoris (QF) muscle-tendon units (MTUs) by comparing runners and non-active subjects at different ages (young and old), (ii) to identify adaptational phenomena in running mechanics due to age-related changes in the mechanical and morphological properties of the TS and QF MTUs, and finally (iii) to examine whether chronic endurance-running exercise is associated with adaptational effects on running characteristics in old and young adults. The investigation was conducted on 30 old and 19 young adult males divided into two subgroups according to their running activity: endurance-runners vs non-active. To analyse the properties of the MTUs, all subjects performed isometric maximal voluntary (MVC) ankle plantarflexion and knee extension contractions at 11 different MTU lengths on a dynamometer. The activation of the TS and QF during MVC was estimated by surface electromyography. The gastrocnemius medialis and the vastus lateralis and their distal aponeuroses were visualized by ultrasonography at rest and during MVC, respectively. Ground reaction forces and kinematic data were recorded during running trials at 2.7 m s(-1). The TS and QF MTU capacities were reduced with aging (lower muscle strength and lower tendon stiffness). Runners and non-active subjects had similar MTU properties, suggesting that chronic endurance-running exercise does not counteract the age-related degeneration of the MTUs. Runners showed a higher mechanical advantage for the QF MTU while running (lower gear ratio) compared to non-active subjects, indicating a task-specific adaptation even at old age. Older adults reacted to the reduced capacities of their MTUs by increasing running safety (higher duty factor, lower flight time) and benefitting from a mechanical

  14. Quantification of Internal Stress-Strain Fields in Human Tendon: Unraveling the Mechanisms that Underlie Regional Tendon Adaptations and Mal-Adaptations to Mechanical Loading and the Effectiveness of Therapeutic Eccentric Exercise

    Science.gov (United States)

    Maganaris, Constantinos N.; Chatzistergos, Panagiotis; Reeves, Neil D.; Narici, Marco V.

    2017-01-01

    By virtue of their anatomical location between muscles and bones, tendons make it possible to transform contractile force to joint rotation and locomotion. However, tendons do not behave as rigid links, but exhibit viscoelastic tensile properties, thereby affecting the length and contractile force in the in-series muscle, but also storing and releasing elastic stain energy as some tendons are stretched and recoiled in a cyclic manner during locomotion. In the late 90s, advancements were made in the application of ultrasound scanning that allowed quantifying the tensile deformability and mechanical properties of human tendons in vivo. Since then, the main principles of the ultrasound-based method have been applied by numerous research groups throughout the world and showed that tendons increase their tensile stiffness in response to exercise training and chronic mechanical loading, in general, by increasing their size and improving their intrinsic material. It is often assumed that these changes occur homogenously, in the entire body of the tendon, but recent findings indicate that the adaptations may in fact take place in some but not all tendon regions. The present review focuses on these regional adaptability features and highlights two paradigms where they are particularly evident: (a) Chronic mechanical loading in healthy tendons, and (b) tendinopathy. In the former loading paradigm, local tendon adaptations indicate that certain regions may “see,” and therefore adapt to, increased levels of stress. In the latter paradigm, local pathological features indicate that certain tendon regions may be “stress-shielded” and degenerate over time. Eccentric exercise protocols have successfully been used in the management of tendinopathy, without much sound understanding of the mechanisms underpinning their effectiveness. For insertional tendinopathy, in particular, it is possible that the effectiveness of a loading/rehabilitation protocol depends on the topography

  15. Exercise and Regulation of Bone and Collagen Tissue Biology

    DEFF Research Database (Denmark)

    Kjaer, Michael; Jørgensen, Niklas Rye; Heinemeier, Katja

    2015-01-01

    The musculoskeletal system and its connective tissue include the intramuscular connective tissue, the myotendinous junction, the tendon, the joints with their cartilage and ligaments, and the bone; they all together play a crucial role in maintaining the architecture of the skeletal muscle, ensur...

  16. Tendon overuse syndrome: imaging diagnosis

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  17. Influence of Bone and Muscle Injuries on the Osteogenic Potential of Muscle Progenitors: Contribution of Tissue Environment to Heterotopic Ossification.

    Science.gov (United States)

    Molligan, Jeremy; Mitchell, Reed; Schon, Lew; Achilefu, Samuel; Zahoor, Talal; Cho, Young; Loube, Jeffery; Zhang, Zijun

    2016-06-01

    : By using surgical mouse models, this study investigated how the tissue environment influences the osteogenic potential of muscle progenitors (m-progenitors) and potentially contributes to heterotopic ossification (HO). Injury was induced by clamping the gluteus maximus and medius (group M) or osteotomy of greater trochanter (group O) on the right hip, as well as combined muscle injury and osteotomy of greater trochanter (group M+O). The gluteus maximus and medius of the operated hips were harvested at days 1, 3, 5, and 10 for isolation of m-progenitors. The cells were cultured in an osteogenic medium for 3 weeks, and osteogenesis was evaluated by matrix mineralization and the expression of osteogenesis-related genes. The expression of type I collagen, RUNX2 (runt-related transcription factor 2), and osteocalcin by the m-progenitors of group M+O was significantly increased, compared with groups M and O. Osteogenic m-progenitors in group O increased the expression of bone morphogenetic protein 2 and also bone morphogenetic protein antagonist differential screening-selected gene aberrative in neuroblastoma. On histology, there was calcium deposition mostly in the muscles of group M+O harvested at day 10. CD56, representing myogenic progenitors, was highly expressed in the m-progenitors isolated from group M (day 10), but m-progenitors of group M+O (day 10) exhibited the highest expression of platelet-derived growth factor receptor α (PDGFR-α), a marker of muscle-derived mesenchymal stem cells (M-MSCs). The expressions of PDGFR-α and RUNX2 were colocalized in osteogenic m-progenitors. The data indicate that the tissue environment simulated in the M+O model is a favorable condition for HO formation. Most likely, M-MSCs, rather than myogenic progenitors, in the m-progenitors participate in HO formation. The prevalence of traumatic heterotopic ossification (HO) is high in war injury. The pathogenesis of HO is still unknown. This study clarified the contribution of a

  18. Imaging and quantifying solute transport across periosteum: implications for muscle-bone crosstalk.

    Science.gov (United States)

    Lai, Xiaohan; Price, Christopher; Lu, Xin Lucas; Wang, Liyun

    2014-09-01

    Muscle and bone are known to act as a functional unit and communicate biochemically during tissue development and maintenance. Muscle-derived factors (myokines) have been found to affect bone functions in vitro. However, the transport times of myokines to penetrate into bone, a critical step required for local muscle-bone crosstalk, have not been quantified in situ or in vivo. In this study, we investigated the permeability of the periosteum, a major barrier to muscle-bone crosstalk by tracking and modeling fluorescent tracers that mimic myokines under confocal microscopy. Periosteal surface boundaries and tracer penetration within the boundaries were imaged in intact murine tibiae using reflected light and time-series xz confocal imaging, respectively. Four fluorescent tracers including sodium fluorescein (376Da) and dextrans (3kDa, 10kDa and 40kDa) were chosen because they represented a wide range of molecular weights (MW) of myokines. We found that i) murine periosteum was permeable to the three smaller tracers while the 40kDa could not penetrate beyond 40% of the outer periosteum within 8h, suggesting that periosteum is semi-permeable with a cut-off MW of approximately 40kDa, and ii) the characteristic penetration time through the periosteum (~60μm thick) increased with tracer MW and fit well with a relationship tcs=-4.43×10(4)-0.57×MWDa-4×10(4)-8.65×10(8)MWDa-4×10(4), from which, the characteristic penetration times of various myokines were extrapolated. To achieve effective muscle-bone crosstalk, likely signaling candidates should have shorter penetration time than their bioactive time, which we assumed to be 5 times of the molecule's half-lifetime in the body. Myokines such as PGE2, IGF-1, IL-15 and FGF-2 were predicted to satisfy this requirement. In summary, a novel imaging approach was developed and used to investigate the transport of myokine mimicking-tracers through the periosteum, enabling further quantitative studies of muscle-bone

  19. Reduced bone mass and muscle strength in male 5α-reductase type 1 inactivated mice.

    Directory of Open Access Journals (Sweden)

    Sara H Windahl

    Full Text Available Androgens are important regulators of bone mass but the relative importance of testosterone (T versus dihydrotestosterone (DHT for the activation of the androgen receptor (AR in bone is unknown. 5α-reductase is responsible for the irreversible conversion of T to the more potent AR activator DHT. There are two well established isoenzymes of 5α-reductase (type 1 and type 2, encoded by separate genes (Srd5a1 and Srd5a2. 5α-reductase type 2 is predominantly expressed in male reproductive tissues whereas 5α-reductase type 1 is highly expressed in liver and moderately expressed in several other tissues including bone. The aim of the present study was to investigate the role of 5α-reductase type 1 for bone mass using Srd5a1⁻/⁻ mice. Four-month-old male Srd5a1⁻/⁻ mice had reduced trabecular bone mineral density (-36%, p<0.05 and cortical bone mineral content (-15%, p<0.05 but unchanged serum androgen levels compared with wild type (WT mice. The cortical bone dimensions were reduced in the male Srd5a1⁻/⁻ mice as a result of a reduced cortical periosteal circumference compared with WT mice. T treatment increased the cortical periosteal circumference (p<0.05 in orchidectomized WT mice but not in orchidectomized Srd5a1⁻/⁻ mice. Male Srd5a1⁻/⁻ mice demonstrated a reduced forelimb muscle grip strength compared with WT mice (p<0.05. Female Srd5a1⁻/⁻ mice had slightly increased cortical bone mass associated with elevated circulating levels of androgens. In conclusion, 5α-reductase type 1 inactivated male mice have reduced bone mass and forelimb muscle grip strength and we propose that these effects are due to lack of 5α-reductase type 1 expression in bone and muscle. In contrast, the increased cortical bone mass in female Srd5a1⁻/⁻ mice, is an indirect effect mediated by elevated circulating androgen levels.

  20. Partial tear of the quadriceps tendon in a child

    International Nuclear Information System (INIS)

    Khanna, Geetika; El-Khoury, George

    2008-01-01

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

  1. A coincidental variation of the axillary artery: the brachioradial artery and the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle

    Directory of Open Access Journals (Sweden)

    Marek Konarik

    2014-09-01

    Full Text Available A case of anomalous terminal branching of the axillary artery was encountered and described in a left upper limb of a male cadaver. A series of 214 upper limbs of Caucasian race was dissected. A variant artery, stemming from the very end of the axillary artery followed a superficial course distally. It passed the cubital fossa, ran on the lateral side of the forearm as usual radial artery, crossed ventrally to the palm and terminated in the deep palmar arch. This vessel is a case of the brachioradial artery (incorrectly termed as the “radial artery with high origin”. Moreover, it was associated with another variation, concerning the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle. The anatomical knowledge of the axillary region is essential for radiodiagnostic, surgical and traumatologic procedures. The superficially located artery brings an elevated danger of heavy bleeding in all unexpected situations, its variant branching can cause problems in radial catheterization procedures and the anomalously coursing other arterial variant poses an elevated danger in surgical procedures concerning the surgical neck of humerus.

  2. Magnetic-resonance-imaging-based three-dimensional muscle reconstruction of hip abductor muscle volume in a person with a transfemoral bone-anchored prosthesis : A feasibility study

    NARCIS (Netherlands)

    Leijendekkers, Ruud A.; Marra, Marco A.; Ploegmakers, Marieke J.M.; Van Hinte, Gerben; Frölke, Jan Paul; Van De Meent, Hendrik; Staal, J. Bart; Hoogeboom, Thomas J.; Verdonschot, Nico

    2018-01-01

    Background: Persons with transfemoral amputation typically have severe muscle atrophy of the residual limb. The effect of bone-anchored prosthesis use on existing muscle atrophy is unknown. A potentially feasible method to evaluate this is magnetic resonance imaging (MRI)-based three-dimensional

  3. 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.

  4. ANATOMY OF BONE AND MUSCLE OF SCAPULA AND ARM OF Chrysocyon Brachyurus (CARNIVORA, CANIDAE

    Directory of Open Access Journals (Sweden)

    Saulo Gonçalves Pereira

    2016-10-01

    Full Text Available The maned wolf, Chrysocyon brachyurus - Illiger, 1815, is the largest canid of South America     and its found in the central region of the continent, preferably in open field biomes. It may reach between 20 and 33 kg and up to 125 cm. It is under threat of extinction. Anatomical knowledge is  of great importance to the completion of information about wild species and clinical, surgical, and conservationist implications. This study aimed to describe the bones and the bone accidents of the cingulate forelimb of brachial region and their respective muscles in maned wolf, through dissection procedures of animals preserved in 10% formalin solution. The animals belong to the didactic collection of the Laboratory of Education and Research on Wild Animals of UFU, and are the result of roadkill. The bones are scapula and humerus. There was no clavicula. The muscles are: M. deltoideus; M. supraspinatus; M. infraspinatus; M. teres major; M. teres minor; M. triceps brachii caput: laterale, accessorium, longum and mediale; M. anconeus; M. biceps; M. subscapularis; M.  coracobrachialis; M. tensor fasciae antebrachii; M. brachial. The scapula and arm have specific accidents; however, they are similar to domestic dogs. The humerus is straight. The muscles have some peculiarities. Keywords: anatomy; canids; maned wolf; muscles; osteology.

  5. Muscle as an osteoinductive niche for local bone formation with the use of a biphasic calcium sulphate/hydroxyapatite biomaterial

    DEFF Research Database (Denmark)

    Raina, D. B.; Gupta, A.; Petersen, M. M.

    2016-01-01

    Objectives: We have observed clinical cases where bone is formed in the overlaying muscle covering surgically created bone defects treated with a hydroxyapatite/calcium sulphate biomaterial. Our objective was to investigate the osteoinductive potential of the biomaterial and to determine if growth...... factors secreted from local bone cells induce osteoblastic differentiation of muscle cells. Materials and Methods: We seeded mouse skeletal muscle cells C2C12 on the hydroxyapatite/calcium sulphate biomaterial and the phenotype of the cells was analysed. To mimic surgical conditions with leakage of extra...

  6. A numerical study on stress distribution across the ankle joint: Effects of material distribution of bone, muscle force and ligaments.

    Science.gov (United States)

    Mondal, Subrata; Ghosh, Rajesh

    2017-09-01

    The goal of this study is to develop a realistic three dimensional FE model of intact ankle joint. Three dimensional FE model of the intact ankle joint was developed using computed tomography data sets. The effect of muscle force, ligaments and proper material property distribution of bone on stress distribution across the intact ankle joint was studied separately. Present study indicates bone material property, ligaments and muscle force have influence on stress distribution across the ankle joint. Proper bone material, ligaments and muscle must be considered in the computational model for pre-clinical analysis of ankle prosthesis.

  7. Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft

    Directory of Open Access Journals (Sweden)

    Seung Gee Kwon

    2012-07-01

    Full Text Available BackgroundCranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We propose using a reverse temporalis muscle flap and calvarial bone graft as an alternative option to a free flap for anterior cranial base reconstruction.MethodsBetween April 2009 and February 2012, cranial base reconstructions using an autologous calvarial split bone graft combined with a reverse temporalis muscle flap were performed in five patients. Medical records were retrospectively analyzed and postoperative computed tomography scans, magnetic resonance imaging, and angiography findings were examined to evaluate graft survival and flap viability.ResultsThe mean follow-up period was 11.8 months and the mean operation time for reconstruction was 8.4±3.36 hours. The defects involved the anterior cranial base, including the orbital roof and the frontal and ethmoidal sinus. All reconstructions were successful. Viable flap vascularity and bone survival were observed. There were no serious complications except for acceptable donor site depressions, which were easily corrected with minor procedures.ConclusionsThe reverse temporalis muscle flap could provide sufficient bulkiness to fill dead space and sufficient vascularity to endure infection. The calvarial bone graft provides a rigid framework, which is critical for maintaining the cranial base structure. Combined anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft could be a viable alternative to free tissue transfer.

  8. The diagnostic usefulness of densitometric examinations and radioisotopic indexes of bone metabolism and muscle perfusion in gout

    International Nuclear Information System (INIS)

    Tryniszewski, W.; Gadzicki, M.; Gorska-Chrzastek, M.; Maziarz, Z.; Rysz, J.

    2010-01-01

    Background: Gout affects joints and other organs and often impairs the body asymptomatically. The aim of this study was to determine to what extent gout correlates with the changes in bone system and muscle perfusion. The influence of gout on bone mineralization, bone metabolism and muscle perfusion were assessed. The correlation between these and the diagnostic usefulness of the methods applied are discussed. The study included 44 patients (ages 38 - 67) including 7 women (ages 59 - 67). Seventeen of the examined men were 35 -45 years of age. Of the 44 total patients, 5 were normal weight (11 %), 29 (66 %) were overweight and 10 (23 %) were obese. The disease duration was 5 - 10 years. Material/Methods: The patients were examined for gout by specialists. Biochemical and hormonal blood tests were performed on parameters that influence bone mineralization and rotation, and muscle perfusion. BMD, T-score and Z-score of femoral bone neck were obtained, and muscle perfusion was assessed. With own methods and programs the bone metabolism and muscle perfusion indicators were assigned. Results: In patients with gout, a decrease in BMD, together with the slowing of metabolic processes, was observed. When BMD increased, a decreased perfusion was observed. A strong positive correlation was observed between BMD and IBM (indicator of bone metabolism), and between BMI and the perfusion indicator. Improved perfusion caused the BMD and IBM to increase. IBM and BMD define the size of the disturbances and are important clinical parameters. Conclusions: The bone metabolism disorder, osteopenia and osteoporosis may be caused by the destructive influence of gout on the bone system. In patients with gout, bone mineralization and IBM disturbances occur much earlier than in those without gout. The increase of IBM reflects the pace of the metabolic processes in the bone system. These methods complete the diagnostics of bone systems in patients with gout. (authors)

  9. Closed reduction, internal fixation with quadratus femoris muscle pedicle bone grafting in displaced femoral neck fracture

    Directory of Open Access Journals (Sweden)

    Chaudhuri Sibaji

    2008-01-01

    Full Text Available Background: Management of femoral neck fracture is still considered as an unsolved problem. It is more evident in displaced fractures where this fracture is considered as some sort of vascular insult to the head of the femur. We have used closed reduction, internal fixation and quadratus femoris muscle pedicle bone grafting in fresh displaced femoral neck fractures. Materials and Methods: From April 1996 to December 2004 we operated 73 consecutive patients of displaced femoral neck fracture in the age group of 24 to 81 years, mean age being 54.6 years. The patients were operated within one week of injury, the mean delay being 3.6 days. Closed reduction internal fixation along with quadratus femoris muscle pedicle bone grafting was done in all cases. They were followed up for an average period of 5.6 years (range 2-11 years. Results: Results were assessed according to modified Harris Hip Scoring system and found to be excellent in 53, good in 12, fair in six and poor in two patients. Bony union occurred in 68 cases, no patient developed avascular necrosis (AVN till date. Conclusion: For fresh displaced femoral neck fracture in physiologically active patients closed reduction, internal fixation and quadratus femoris muscle pedicle bone grafting is a suitable option to secure union and prevent development of AVN.

  10. Muscle-Bone Crosstalk: Emerging Opportunities for Novel Therapeutic Approaches to Treat Musculoskeletal Pathologies.

    Science.gov (United States)

    Maurel, Delphine B; Jähn, Katharina; Lara-Castillo, Nuria

    2017-10-24

    Osteoporosis and sarcopenia are age-related musculoskeletal pathologies that often develop in parallel. Osteoporosis is characterized by a reduced bone mass and an increased fracture risk. Sarcopenia describes muscle wasting with an increasing risk of injuries due to falls. The medical treatment of both diseases costs billions in health care per year. With the impact on public health and economy, and considering the increasing life expectancy of populations, more efficient treatment regimens are sought. The biomechanical interaction between both tissues with muscle acting on bone is well established. Recently, both tissues were also determined as secretory endocrine organs affecting the function of one another. New exciting discoveries on this front are made each year, with novel signaling molecules being discovered and potential controversies being described. While this review does not claim completeness, it will summarize the current knowledge on both the biomechanical and the biochemical link between muscle and bone. The review will highlight the known secreted molecules by both tissues affecting the other and finish with an outlook on novel therapeutics that could emerge from these discoveries.

  11. Immunolocalization of Myostatin (GDF-8) Following Musculoskeletal Injury and the Effects of Exogenous Myostatin on Muscle and Bone Healing

    OpenAIRE

    Elkasrawy, Moataz; Immel, David; Wen, Xuejun; Liu, Xiaoyan; Liang, Li-Fang; Hamrick, Mark W.

    2012-01-01

    The time course and cellular localization of myostatin expression following musculoskeletal injury are not well understood; therefore, the authors evaluated the temporal and spatial localization of myostatin during muscle and bone repair following deep penetrant injury in a mouse model. They then used hydrogel delivery of exogenous myostatin in the same injury model to determine the effects of myostatin exposure on muscle and bone healing. Results showed that a “pool” of intense myostatin sta...

  12. Local Application of Gelatin Hydrogel Sheets Impregnated With Platelet-Derived Growth Factor BB Promotes Tendon-to-Bone Healing After Rotator Cuff Repair in Rats.

    Science.gov (United States)

    Tokunaga, Takuya; Ide, Junji; Arimura, Hitoshi; Nakamura, Takayuki; Uehara, Yusuke; Sakamoto, Hidetoshi; Mizuta, Hiroshi

    2015-08-01

    To determine whether the local application of platelet-derived growth factor BB (PDGF-BB) in hydrogel sheets would promote healing and improve histologic characteristics and biomechanical strength after rotator cuff (RC) repair in rats. To assess the effect of PDGF-BB on tendon-to-bone healing we divided 36 adult male Sprague-Dawley rats treated with bilateral surgery to repair the supraspinatus tendon at its insertion site into 3 groups: group 1 = suture-only group; group 2 = suture and gelatin hydrogel sheets impregnated with phosphate-buffered saline (PBS); and group 3 = suture and gelatin hydrogel sheets impregnated with PDGF-BB (0.5 μg). Semiquantitative histologic evaluation was carried out 2, 6, and 12 weeks later; cell proliferation was assessed 2 and 6 weeks postoperatively by immunostaining for proliferating cell nuclear antigen (PCNA), and biomechanical testing, including ultimate load to failure, stiffness, and ultimate stress to failure, was performed 12 weeks after the operation. At 2 weeks, the average percentage of PCNA-positive cells at the insertion site was significantly higher in group 3 (40.5% ± 2.4%) than in group 1 (32.1% ± 6.9%; P = .03) and group 2 (31.9% ± 3.7%; P = .02). At 2 and 6 weeks, the histologic scores were similar among the 3 groups. At 12 weeks, the histologic score was significantly higher in group 3 (10.3 ± 0.8) than in group 1 (8.5 ± 0.5; P = .002) or group 2 (8.8 ± 0.8; P = .009), whereas ultimate load to failure, stiffness, and ultimate load to stress (normal control population, 44.73 ± 9.75 N, 27.59 ± 4.32 N/mm, and 21.33 ± 4.65 N/mm(2), respectively) were significantly higher in group 3 (28.28 ± 6.28 N, 11.05 ± 2.37 N/mm, and 7.99 ± 2.13 N/mm(2), respectively) than in group 1 (10.44 ± 1.98 N, 4.74 ± 1.31 N/mm, and 3.28 ± 1.27 N/mm(2), respectively; all P repair in humans. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  13. A Novel Approach to Submandibular Gland Ptosis: Creation of a Platysma Muscle and Hyoid Bone Cradle

    Directory of Open Access Journals (Sweden)

    Robert Lukavsky

    2016-07-01

    Full Text Available Submandibular gland ptosis is a common impediment to obtaining superior surgical aesthetic results in neck lift surgery. Techniques for suspending the submandibular gland have been proposed, but these procedures have the drawbacks of disturbing the floor of the mouth mucosa and periosteum. We present an approach of submandibular gland suspension for the treatment of gland ptosis by employing a platysma and hyoid bone fascia cradle. Our technique was performed on cadaveric models. The platysma muscle and hyoid bone cradle for submandibular gland ptosis was created on the left side of the neck in two cadavers. A submental incision with sharp dissection was performed to raise a supraplatysmal flap. A subplatysmal plane was developed until the submandibular gland was identified. Sutures were used to pexy the platysma to the hyoid bone periosteum and deep cervical fascia, tightening the overlying muscle and in turn elevating the submandibular gland. Submandibular gland ptosis must be corrected in order to achieve exemplary aesthetic results. Our approach of creating a cradle with the platysma and hyoid bone avoids the potential complications of previously described sling procedures, while still maintaining the integrity of the gland and surrounding tissues.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Inferring Muscle-Tendon Unit Power from Ankle Joint Power during the Push-Off Phase of Human Walking: Insights from a Multiarticular EMG-Driven Model.

    Science.gov (United States)

    Honert, Eric C; Zelik, Karl E

    2016-01-01

    Inverse dynamics joint kinetics are often used to infer contributions from underlying groups of muscle-tendon units (MTUs). However, such interpretations are confounded by multiarticular (multi-joint) musculature, which can cause inverse dynamics to over- or under-estimate net MTU power. Misestimation of MTU power could lead to incorrect scientific conclusions, or to empirical estimates that misguide musculoskeletal simulations, assistive device designs, or clinical interventions. The objective of this study was to investigate the degree to which ankle joint power overestimates net plantarflexor MTU power during the Push-off phase of walking, due to the behavior of the flexor digitorum and hallucis longus (FDHL)-multiarticular MTUs crossing the ankle and metatarsophalangeal (toe) joints. We performed a gait analysis study on six healthy participants, recording ground reaction forces, kinematics, and electromyography (EMG). Empirical data were input into an EMG-driven musculoskeletal model to estimate ankle power. This model enabled us to parse contributions from mono- and multi-articular MTUs, and required only one scaling and one time delay factor for each subject and speed, which were solved for based on empirical data. Net plantarflexing MTU power was computed by the model and quantitatively compared to inverse dynamics ankle power. The EMG-driven model was able to reproduce inverse dynamics ankle power across a range of gait speeds (R2 ≥ 0.97), while also providing MTU-specific power estimates. We found that FDHL dynamics caused ankle power to slightly overestimate net plantarflexor MTU power, but only by ~2-7%. During Push-off, FDHL MTU dynamics do not substantially confound the inference of net plantarflexor MTU power from inverse dynamics ankle power. However, other methodological limitations may cause inverse dynamics to overestimate net MTU power; for instance, due to rigid-body foot assumptions. Moving forward, the EMG-driven modeling approach presented

  16. Inferring Muscle-Tendon Unit Power from Ankle Joint Power during the Push-Off Phase of Human Walking: Insights from a Multiarticular EMG-Driven Model.

    Directory of Open Access Journals (Sweden)

    Eric C Honert

    Full Text Available Inverse dynamics joint kinetics are often used to infer contributions from underlying groups of muscle-tendon units (MTUs. However, such interpretations are confounded by multiarticular (multi-joint musculature, which can cause inverse dynamics to over- or under-estimate net MTU power. Misestimation of MTU power could lead to incorrect scientific conclusions, or to empirical estimates that misguide musculoskeletal simulations, assistive device designs, or clinical interventions. The objective of this study was to investigate the degree to which ankle joint power overestimates net plantarflexor MTU power during the Push-off phase of walking, due to the behavior of the flexor digitorum and hallucis longus (FDHL-multiarticular MTUs crossing the ankle and metatarsophalangeal (toe joints.We performed a gait analysis study on six healthy participants, recording ground reaction forces, kinematics, and electromyography (EMG. Empirical data were input into an EMG-driven musculoskeletal model to estimate ankle power. This model enabled us to parse contributions from mono- and multi-articular MTUs, and required only one scaling and one time delay factor for each subject and speed, which were solved for based on empirical data. Net plantarflexing MTU power was computed by the model and quantitatively compared to inverse dynamics ankle power.The EMG-driven model was able to reproduce inverse dynamics ankle power across a range of gait speeds (R2 ≥ 0.97, while also providing MTU-specific power estimates. We found that FDHL dynamics caused ankle power to slightly overestimate net plantarflexor MTU power, but only by ~2-7%.During Push-off, FDHL MTU dynamics do not substantially confound the inference of net plantarflexor MTU power from inverse dynamics ankle power. However, other methodological limitations may cause inverse dynamics to overestimate net MTU power; for instance, due to rigid-body foot assumptions. Moving forward, the EMG-driven modeling

  17. Flexor digitorum profundus tendon anatomy in the forearm

    Directory of Open Access Journals (Sweden)

    Teoman Dogan

    2012-04-01

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

  18. A biomechanical comparison of tendon-bone interface motion and cyclic loading between single-row, triple-loaded cuff repairs and double-row, suture-tape cuff repairs using biocomposite anchors.

    Science.gov (United States)

    Barber, F Alan; Drew, Otis R

    2012-09-01

    To compare tendon-bone interface motion and cyclic loading in a single-row, triple-loaded anchor repair with a suture-tape, rip-stop, double-row rotator cuff repair. Using 18 human shoulders from 9 matched cadaveric pairs, we created 2 groups of rotator cuff repairs. Group 1 was a double-row, rip-stop, suture-tape construct. Group 2 was a single-row, triple-loaded construct. Before mechanical testing, the supraspinatus footprint was measured with calipers. A superiorly positioned digital camera optically measured the tendon footprint motion during 60° of humeral internal and external rotation. Specimens were secured at a fixed angle not exceeding 45° in reference to the load. After preloading, each sample was cycled between 10 N and 100 N for 200 cycles at 1 Hz, followed by destructive testing at 33 mm/s. A digital camera with tracking software measured the repair displacement at 100 and 200 cycles. Ultimate load and failure mode for each sample were recorded. The exposed anterior footprint border (6.5% ± 6%) and posterior footprint border (0.9% ± 1.7%) in group 1 were statistically less than the exposed anterior footprint border (30.3% ± 17%) and posterior footprint border (29.8% ± 14%) in group 2 (P = .003 and P row rotator cuff repair had greater footprint coverage, less rotational footprint displacement, and a greater mean ultimate failure load than the triple-loaded, single-row repair on mechanical testing. No double-row or single-row constructs showed 5 mm of displacement after the first 100 cycles. The most common failure mode for both constructs was suture tearing through the tendon. Differences in cuff fixation influence rotational tendon movement and may influence postoperative healing. Stronger repair constructs still fail at the suture-tendon interface. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  19. Internal fixation and muscle pedicle bone grafting in femoral neck fractures

    Directory of Open Access Journals (Sweden)

    Gupta A

    2008-01-01

    Full Text Available Background: The treatment of displaced intracapsular femoral neck fracture is still an unsolved problem. Non-union and avascular necrosis are the two main complications of this fracture, especially if patient presents late. Muscle pedicle bone grafting has been advocated to provide additional blood supply. We present analysis of our 32 cases of displaced femoral neck fracture treated by internal fixation and quadratus femoris based muscle pedicle bone grafting. Materials and Methods: Open reduction and internal fixation with muscle pedicle grafting was done in 32 patients. The age of patients varied from 14-62 years (average age 45 years with male to female ratio of 13:3. Twenty-nine fractures were more than three weeks old. All the cases were treated by Meyers′ procedure. The fracture was internally fixed after open reduction and then a muscle pedicle graft was applied. It was supplemented by cancellous bone graft in seven cases. Fixation was done by parallel cancellous lag screws ( n = 19, crossed Garden′s screws ( n = 7, parallel Asnis screws ( n = 5 and Moore′s pin ( n = 1.Quadratus femoris muscle pedicle graft was used in 32 cases. In the initial 12 cases the graft was fixed with circumferential proline sutures, but later, to provide a secure fixation, the graft was fixed with a cancellous screw ( n = 20. Postoperative full weight bearing was deferred to an average of 10 weeks. Results: Union was achieved in 26/29 (89.65% cases which could be followed for an average period of 3.4 years, (2-8.5 years with good functional results and had the ability to squat and sit cross-legged. Results were based on hip rating system given by Salvatti and Wilson. The results were excellent in 15 cases, good in four cases, fair in four cases and poor in six cases. Complications were avascular necrosis ( n = 2, transient foot drop ( n = 2, coxa-vara ( n = 1 and temporary loss of scrotal sensation ( n = 1. Conclusion: Muscle pedicle bone grafting with

  20. Repair of Traumatic Skeletal Muscle Injury with Bone-Marrow-Derived Mesenchymal Stem Cells Seeded on Extracellular Matrix

    Science.gov (United States)

    2010-06-02

    expressing full length dystrophin can complement Duchenne muscular dystrophy myotubes by cell fusion. Hum Mol Genet 15, 213, 2006. 52. Pittenger, M.F., et al... muscle , and vascular tissue, that are necessary for viable muscular regeneration after muscle defect injury.29–32 Cells from the bone marrow are known to...3,3-diaminobenzidine. Muscular infiltration into the ECM was further confirmed by immunofluorescent staining for the muscle -specific cyto- skeleton

  1. Increased palpation tenderness and muscle strength deficit in the prediction of tendon hypertrophy in symptomatic unilateral shoulder tendinopathy: an ultrasonographic study

    DEFF Research Database (Denmark)

    Joensen, J.; Couppe, C.; Bjordal, J.M.

    2009-01-01

    . The observer was blinded in the maximal pain-free isometric force test. Setting Outpatient physiotherapy clinic at Bergen University College, Norway. Participants Sixty-four patients with an exclusive, tentative diagnosis of unilateral shoulder tendinopathy. Main outcome measures Differences in maximal pain......-free isometric force, tendon pain pressure and tendon thickness measured by ultrasonography. Results This paper follows the STARD recommendations for papers on diagnostic accuracy. When cut-off values for within-subject side differences were selected at >= 0.8 mm for tendon thickness (TTdiff), >= 10 N...... for maximal pain-free isometric force (PFFdiff) and >= 0.6 kg for tendon pain pressure (PPTdiff), positive tests were found in 92% of patients. All three tests were sensitive for the detection of within-subject side differences with the selected cut-off values (TTdiff, n = 60/64; PPTdiff, n = 59/64 PFFdiff, n...

  2. Adipose, bone and muscle tissues as new endocrine organs: role of reciprocal regulation for osteoporosis and obesity development.

    Science.gov (United States)

    Migliaccio, Silvia; Greco, Emanuela A; Wannenes, Francesca; Donini, Lorenzo M; Lenzi, Andrea

    2014-01-01

    The belief that obesity is protective against osteoporosis has recently been revised. In fact, the latest epidemiologic and clinical studies show that a high level of fat mass, but also reduced muscle mass, might be a risk factor for osteoporosis and fragility fractures. Furthermore, increasing evidence seems to indicate that different components such as myokines, adipokines and growth factors, released by both fat and muscle tissues, could play a key role in the regulation of skeletal health and in low bone mineral density and, thus, in osteoporosis development. This review considers old and recent data in the literature to further evaluate the relationship between fat, bone and muscle tissue.

  3. 1H MR spectroscopy of skeletal muscle, liver and bone marrow

    International Nuclear Information System (INIS)

    Machann, Juergen; Stefan, Norbert; Schick, Fritz

    2008-01-01

    Proton magnetic resonance spectroscopy ( 1 H MRS) offers interesting metabolic information even from organs outside the brain. In the first part, applications in skeletal muscle for determination of intramyocellular lipids (IMCL), which are involved in the pathogenesis of insulin resistance, are described. Peculiarities of spectral pattern are discussed and studies for short-term regulation of IMCL, as dietary intervention, exercise and fasting are presented. The second part deals with quantification of small amounts of lipids in the liver (hepatic lipids, HL), which is also of increasing interest in the field of diabetes research. Recommendations for correct assessment of spectra in this 'moving organ' are given and the importance of HL is described by examples of a cohort at increased risk for type 2 diabetes. Regulation of HL is described on the basis of a few studies. The third part concentrates on spectral characterization of bone marrow. Peripheral bone marrow of adults consists mainly of fat, while central marrow regions in the pelvis, spinal column and breast bone (and the peripheral bone marrow of children as well) contribute to blood formation and show a variable composition of adipocytes (fat cells), interstitial fluid and water containing precursor cells for erythrocytes, leucocytes and thrombocytes. Adapted 1 H spectroscopic techniques allow a semi-quantitative analysis of bone marrow composition

  4. {sup 1}H MR spectroscopy of skeletal muscle, liver and bone marrow

    Energy Technology Data Exchange (ETDEWEB)

    Machann, Juergen [Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany)], E-mail: juergen.machann@med.uni-tuebingen.de; Stefan, Norbert [Department of Endocrinology, Metabolism and Pathobiochemistry, Eberhard-Karls University Tuebingen, 72076 Tuebingen (Germany); Schick, Fritz [Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany)

    2008-08-15

    Proton magnetic resonance spectroscopy ({sup 1}H MRS) offers interesting metabolic information even from organs outside the brain. In the first part, applications in skeletal muscle for determination of intramyocellular lipids (IMCL), which are involved in the pathogenesis of insulin resistance, are described. Peculiarities of spectral pattern are discussed and studies for short-term regulation of IMCL, as dietary intervention, exercise and fasting are presented. The second part deals with quantification of small amounts of lipids in the liver (hepatic lipids, HL), which is also of increasing interest in the field of diabetes research. Recommendations for correct assessment of spectra in this 'moving organ' are given and the importance of HL is described by examples of a cohort at increased risk for type 2 diabetes. Regulation of HL is described on the basis of a few studies. The third part concentrates on spectral characterization of bone marrow. Peripheral bone marrow of adults consists mainly of fat, while central marrow regions in the pelvis, spinal column and breast bone (and the peripheral bone marrow of children as well) contribute to blood formation and show a variable composition of adipocytes (fat cells), interstitial fluid and water containing precursor cells for erythrocytes, leucocytes and thrombocytes. Adapted {sup 1}H spectroscopic techniques allow a semi-quantitative analysis of bone marrow composition.

  5. Autologous implant of bone marrow mononuclear stem-cells as treatment for equine bicipital tendonitis: case report Implante autólogo de células mononucleares de médula ósea como tratamiento de tendinitis bicipital equina: reporte de caso clínico

    OpenAIRE

    BC Menarim; GA Fortini; PS Álvarez; J Gómez; CD Jarrín; A Ramírez; JS Galecio

    2012-01-01

    Bicipital bursitis in the horse, the inflammation of the bicipital tendon and its surrounding bursa, has been reported to represent a low percentage of lameness cause. However, it is the main cause of lameness associated to the shoulder region and it has been under diagnosed. Due to high recurrence in different types of tendon injuries, treatments aiming to re-establish tendon functionality have been a focus of research. The aim of this study is to report the implant of a bone marrow mononucl...

  6. Muscle strength and regional lean body mass influence on mineral bone health in young male adults.

    Science.gov (United States)

    Guimarães, Bianca Rosa; Pimenta, Luciana Duarte; Massini, Danilo Alexandre; Dos Santos, Daniel; Siqueira, Leandro Oliveira da Cruz; Simionato, Astor Reis; Dos Santos, Luiz Gustavo Almeida; Neiva, Cassiano Merussi; Pessôa Filho, Dalton Muller

    2018-01-01

    The relationship between muscle strength and bone mineral content (BMC) and bone mineral density (BMD) is supposed from the assumption of the mechanical stress influence on bone tissue metabolism. However, the direct relationship is not well established in younger men, since the enhancement of force able to produce effective changes in bone health, still needs to be further studied. This study aimed to analyze the influence of muscle strength on BMC and BMD in undergraduate students. Thirty six men (24.9 ± 8.6 y/o) were evaluated for regional and whole-body composition by dual energy X-ray absorptiometry (DXA). One repetition maximum tests (1RM) were assessed on flat bench-press (BP), lat-pull down (LPD), leg-curl (LC), knee extension (KE), and leg-press 45° (LP45) exercises. Linear regression modelled the relationships of BMD and BMC to the regional body composition and 1RM values. Measurements of dispersion and error (R2adj and standard error of estimate (SEE)) were tested, setting ρ at ≤0.05. The BMD mean value for whole-body was 1.12±0.09 g/cm2 and BMC attained 2477.9 ± 379.2 g. The regional lean mass (LM) in upper-limbs (UL) (= 6.80±1.21 kg) was related to BMC and BMD for UL (R2adj = 0.74, pBMC and BMD for LL (R2adj = 0.68, pBMC (R2adj = 0.47, pBMC (R2adj = 0.36, pBMC and BMD in young men, strengthening the relationship between force and LM, and suggesting both to parametrizes bone mineral health.

  7. Novel, non-steroidal, selective androgen receptor modulators (SARMs) with anabolic activity in bone and muscle and improved safety profile.

    Science.gov (United States)

    Rosen, J; Negro-Vilar, A

    2002-03-01

    A novel approach to the treatment of osteoporosis in men, and possibly women, is the development of selective androgen receptor modulators (SARMs) that can stimulate formation of new bone with substantially diminished proliferative activity in the prostate, as well as reduced virilizing activity in women. Over the last several years, we have developed a program to discover and develop novel, non-steroidal, orally-active selective androgen receptor modulators (SARMs) that provide improved therapeutic benefits and reduce risk and side effects. In recent studies, we have used a skeletally mature orchiectomized (ORX) male rat as an animal model of male hypogonadism for assessing the efficacy of LGD2226, a nonsteroidal, non-aromatizable, and non-5alpha-reducible SARM. We assessed the activity of LGD2226 on bone turnover, bone mass and bone strength, and also evaluated the effects exerted on classic androgen-dependent targets, such as prostate, seminal vesicles and muscle. A substantial loss of bone density was observed in ORX animals, and this loss was prevented by SARMs, as well as standard androgens. Biochemical markers of bone turnover revealed an early increase of bone resorption in androgen-deficient rats that was repressed in ORX animals treated with the oral SARM, LGD2226, during a 4-month treatment period. Differences in architectural properties and bone strength were detected by histomorphometric and mechanical analyses, demonstrating beneficial effects of LGD2226 on bone quality in androgen-deficient rats. Histomorphometric analysis of cortical bone revealed distinct anabolic activity of LGD2226 in periosteal bone. LGD2226 was able to prevent bone loss and maintain bone quality in ORX rats by stimulating bone formation, while also inhibiting bone turnover. LGD2226 also exerted anabolic activity on the levator ani muscle. Taken together, these results suggest that orally-active, non-steroidal SARMs may be useful therapeutics for both muscle and bone in elderly

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

    Science.gov (United States)

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

    1992-05-01

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

  9. Polymorphisms of muscle genes are associated with bone mass and incident osteoporotic fractures in Caucasians

    DEFF Research Database (Denmark)

    Harsløf, Torben; Frost, M; Nielsen, T L

    2013-01-01

    The interaction between muscle and bone is complex. The aim of this study was to investigate if variations in the muscle genes myostatin (MSTN), its receptor (ACVR2B), myogenin (MYOG), and myoD1 (MYOD1) were associated with fracture risk, bone mineral density (BMD), bone mineral content (BMC......), and lean body mass. We analyzed two independent cohorts: the Danish Osteoporosis Prevention Study (DOPS), comprising 2,016 perimenopausal women treated with hormone therapy or not and followed for 10 years, and the Odense Androgen Study (OAS), a cross-sectional, population-based study on 783 men aged 20......-29 years. Nine tag SNPs in the four genes were investigated. In the DOPS, individuals homozygous for the variant allele of the MSTN SNP rs7570532 had an increased risk of any osteoporotic fracture, with an HR of 1.82 (95 % CI 1.15-2.90, p = 0.01), and of nonvertebral osteoporotic fracture, with an HR of 2...

  10. Thompson Test in Achilles Tendon Rupture

    Directory of Open Access Journals (Sweden)

    Spencer Albertson

    2016-07-01

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

  11. Radiological Assessment of Bioengineered Bone in a Muscle Flap for the Reconstruction of Critical-Size Mandibular Defect

    Science.gov (United States)

    Al-Fotawei, Randa; Ayoub, Ashraf F.; Heath, Neil; Naudi, Kurt B.; Tanner, K. Elizabeth; Dalby, Matthew J.; McMahon, Jeremy

    2014-01-01

    This study presents a comprehensive radiographic evaluation of bone regeneration within a pedicled muscle flap for the reconstruction of critical size mandibular defect. The surgical defect (20 mm×15 mm) was created in the mandible of ten experimental rabbits. The masseter muscle was adapted to fill the surgical defect, a combination of calcium sulphate/hydroxyapatite cement (CERAMENT™ |SPINE SUPPORT), BMP-7 and rabbit mesenchymal stromal cells (rMSCs) was injected inside the muscle tissue. Radiographic assessment was carried out on the day of surgery and at 4, 8, and 12 weeks postoperatively. At 12 weeks, the animals were sacrificed and cone beam computerized tomography (CBCT) scanning and micro-computed tomography (µ-CT) were carried out. Clinically, a clear layer of bone tissue was identified closely adherent to the border of the surgical defect. Sporadic radio-opaque areas within the surgical defect were detected radiographically. In comparison with the opposite non operated control side, the estimated quantitative scoring of the radio-opacity was 46.6% ±15, the mean volume of the radio-opaque areas was 63.4% ±20. Areas of a bone density higher than that of the mandibular bone (+35% ±25%) were detected at the borders of the surgical defect. The micro-CT analysis revealed thinner trabeculae of the regenerated bone with a more condensed trabecular pattern than the surrounding native bone. These findings suggest a rapid deposition rate of the mineralised tissue and an active remodelling process of the newly regenerated bone within the muscle flap. The novel surgical model of this study has potential clinical application; the assessment of bone regeneration using the presented radiolographic protocol is descriptive and comprehensive. The findings of this research confirm the remarkable potential of local muscle flaps as local bioreactors to induce bone formation for reconstruction of maxillofacial bony defects. PMID:25226170

  12. Radiological assessment of bioengineered bone in a muscle flap for the reconstruction of critical-size mandibular defect.

    Directory of Open Access Journals (Sweden)

    Randa Al-Fotawei

    Full Text Available This study presents a comprehensive radiographic evaluation of bone regeneration within a pedicled muscle flap for the reconstruction of critical size mandibular defect. The surgical defect (20 mm × 15 mm was created in the mandible of ten experimental rabbits. The masseter muscle was adapted to fill the surgical defect, a combination of calcium sulphate/hydroxyapatite cement (CERAMENT™ |SPINE SUPPORT, BMP-7 and rabbit mesenchymal stromal cells (rMSCs was injected inside the muscle tissue. Radiographic assessment was carried out on the day of surgery and at 4, 8, and 12 weeks postoperatively. At 12 weeks, the animals were sacrificed and cone beam computerized tomography (CBCT scanning and micro-computed tomography (µ-CT were carried out. Clinically, a clear layer of bone tissue was identified closely adherent to the border of the surgical defect. Sporadic radio-opaque areas within the surgical defect were detected radiographically. In comparison with the opposite non operated control side, the estimated quantitative scoring of the radio-opacity was 46.6% ± 15, the mean volume of the radio-opaque areas was 63.4% ± 20. Areas of a bone density higher than that of the mandibular bone (+35% ± 25% were detected at the borders of the surgical defect. The micro-CT analysis revealed thinner trabeculae of the regenerated bone with a more condensed trabecular pattern than the surrounding native bone. These findings suggest a rapid deposition rate of the mineralised tissue and an active remodelling process of the newly regenerated bone within the muscle flap. The novel surgical model of this study has potential clinical application; the assessment of bone regeneration using the presented radiolographic protocol is descriptive and comprehensive. The findings of this research confirm the remarkable potential of local muscle flaps as local bioreactors to induce bone formation for reconstruction of maxillofacial bony defects.

  13. Nonoperative, dynamic treatment of acute achilles tendon rupture

    DEFF Research Database (Denmark)

    Barfod, Kristoffer Weisskirchner; Bencke, Jesper; Lauridsen, Hanne Bloch

    2015-01-01

    Acute Achilles tendon rupture alters the biomechanical properties of the plantar flexor muscle-tendon complex that can affect functional performance and the risk of repeat injury. The purpose of the present study was to compare the biomechanical properties of the plantar flexor muscle-tendon comp......Acute Achilles tendon rupture alters the biomechanical properties of the plantar flexor muscle-tendon complex that can affect functional performance and the risk of repeat injury. The purpose of the present study was to compare the biomechanical properties of the plantar flexor muscle...... in the terminal part of dorsiflexion was found in the non-weightbearing group. The altered stiffness and strength in the affected limb could affect the coordination of gait and running....

  14. Development of a subset of forelimb muscles and their attachment sites requires the ulnar-mammary syndrome gene Tbx3

    Directory of Open Access Journals (Sweden)

    Mary P. Colasanto

    2016-11-01

    Full Text Available In the vertebrate limb over 40 muscles are arranged in a precise pattern of attachment via muscle connective tissue and tendon to bone and provide an extensive range of motion. How the development of somite-derived muscle is coordinated with the development of lateral plate-derived muscle connective tissue, tendon and bone to assemble a functional limb musculoskeletal system is a long-standing question. Mutations in the T-box transcription factor, TBX3, have previously been identified as the genetic cause of ulnar-mammary syndrome (UMS, characterized by distinctive defects in posterior forelimb bones. Using conditional mutagenesis in mice, we now show that TBX3 has a broader role in limb musculoskeletal development. TBX3 is not only required for development of posterior forelimb bones (ulna and digits 4 and 5, but also for a subset of posterior muscles (lateral triceps and brachialis and their bone eminence attachment sites. TBX3 specification of origin and insertion sites appears to be tightly linked with whether these particular muscles develop and may represent a newly discovered mechanism for specification of anatomical muscles. Re-examination of an individual with UMS reveals similar previously unrecognized muscle and bone eminence defects and indicates a conserved role for TBX3 in regulating musculoskeletal development.

  15. Osteosynthesis of ununited femoral neck fracture by internal fixation combined with iliac crest bone chips and muscle pedicle bone grafting

    Directory of Open Access Journals (Sweden)

    D D Baksi

    2016-01-01

    Full Text Available Background: Ununited femoral neck fracture is seen commonly in developing countries due to delayed presentation or failure of primary internal fixation. Such fractures, commonly present with partial or total absorption of femoral neck, osteonecrosis of femoral head in 8-30% cases with upward migration of trochanter posing problem for osteosynthesis, especially in younger individuals. Several techniques for treatment of such conditions are described like osteotomies or nonvascularied cortical or cancellous bone grafting provided varying degrees of success in terms of fracture union but unsatisfactory long term results occurred due to varying incidence of avascular necrosis (AVN of femoral head. Moreover, in presence of AVN of femoral head neither free fibular graft nor cancellous bone graft is satisfactory. The vascularied bone grafting by deep circumflex iliac artery based on iliac crest bone grafting, free vascularied fibular grafting and muscle pedicle periosteal grafting showed high incidence of success rate. Osteosynthesis is the preferred treatment of choice in ununited femoral neck fracture in younger individuals. Materials and Methods: Of the 293 patients operated during the period from June 1977 to June 2009, 42 were lost to followup. Seven patients with gluteus medius muscle pedicle bone grafting (MPBG were excluded. Thus, out of 244 patients, 208 (85.3% untreated nonunion and 36 (14.7% following failure of primary internal fixation were available for studies. Time interval between the date of injury and operation in untreated nonunion cases was mean 6.5 months and in failed internal fixation cases was mean 11.2 months. Ages of the patients varied from 16 to 55 years. Seventy patients had partial and 174 had subtotal absorption of the femoral neck. Evidence of avascular necrosis (AVN femoral head was found histologically in 135 (54.3% and radiologically in 48 (19.7% patients. The patients were operated by open reduction of fracture

  16. Exercise enhance the ectopic bone formation of calcium phosphate biomaterials in muscles of mice.

    Science.gov (United States)

    Cheng, Lijia; Yan, Shuo; Zhu, Jiang; Cai, Peiling; Wang, Ting; Shi, Zheng

    2017-08-01

    To investigate whether exercise can enhance ectopic bone formation of calcium phosphate (Ca-P) biomaterials in muscles of mice. Firstly, ten transient receptor potential vanilloid subfamily member 1 (TRPV1) knockout mice (group KO) and ten C57BL/6 mice (group WT) were randomly chosen, 10μg Ca-P biomaterials were implanted into the thigh muscle pouch of each mouse which was far away from femur; after that, all animals were kept in open field for free exploration 5min, and the movement time and distance were automatically analyzed. Ten weeks later, the Ca-P samples were harvested for histological staining and immunochemistry. Secondly, the Ca-P biomaterials were implanted into the thigh muscle pouch of C57BL/6 mice the same as previous operation, and then randomly divided into two groups: running group and non-running group (n=10); in running group, all mice run 1h as a speed of 6m/h in a treadmill for 10weeks. Ten weeks later, the blood was collected to detect the interleukin-4 (IL-4) and IL-12 levels by enzyme linked immunosorbent assay (ELISA), and the samples were harvested for histological staining. In groups KO and WT, both the movement time and distance were significant higher in group KO than that in group WT (Pstronger athletic ability of mice, causing better osteoinductivity of Ca-P biomaterials both in TRPV1 -/- mice and running mice; according to this, we want to offer a proposal to patients who suffer from bone defects and artificial bone transplantation: do moderate exercise, don't convalesce all the time. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Effects of Ibuprofen and Resistance Training on Bone and Muscle: A Randomized Controlled Trial in Older Women.

    Science.gov (United States)

    Duff, Whitney R D; Chilibeck, Philip D; Candow, Darren G; Gordon, Julianne J; Mason, Riley S; Taylor-Gjevre, Regina; Nair, Bindu; Szafron, Michael; Baxter-Jones, Adam; Zello, Gordon A; Kontulainen, Saija A

    2017-04-01

    Resistance training with ibuprofen supplementation may improve musculoskeletal health in postmenopausal women. The study purpose was to determine the efficacy of resistance training and ibuprofen supplementation on bone and muscle properties in postmenopausal women. Participants (n = 90, 65.3 ± 4.9 yr) were randomly assigned to: supervised resistance training or stretching (placebo-exercise) with postexercise ibuprofen (400 mg) or placebo supplementation for 3 d·wk (9 months). Baseline and postintervention measurements included distal and shaft scans of the forearm and lower leg using peripheral quantitative computed tomography. Distal site outcomes included cross-sectional area, content, and density for total and trabecular bone, as well as estimated bone strength in compression. Shaft site outcomes included total bone area; cortical bone area, content, and density; estimated bone strength in torsion; and muscle area and density. Exercise-supplement-time interactions for total bone content at the distal radius (P = 0.009) and cortical density at the radius shaft (P = 0.038) were significant. Resistance training with ibuprofen decreased total bone content (-1.5%) at the distal radius in comparison to the resistance training (0.6%; P = 0.032) and ibuprofen alone (0.5%; P = 0.050). Change in cortical density at the radius shaft differed between the stretching with placebo and ibuprofen supplementation groups (-1.8% vs 1.1%; P = 0.050). Resistance training preserved muscle density in the lower leg more so than stretching (-3.1% vs -5.4%; P = 0.015). Ibuprofen consumed immediately after resistance training had a deleterious effect on bone mineral content at the distal radius, whereas resistance training or ibuprofen supplementation individually prevented bone loss. Resistance training prevented muscle density decline in the lower leg.

  18. Immunolocalization of Myostatin (GDF-8) Following Musculoskeletal Injury and the Effects of Exogenous Myostatin on Muscle and Bone Healing

    Science.gov (United States)

    Elkasrawy, Moataz; Immel, David; Wen, Xuejun; Liu, Xiaoyan; Liang, Li-Fang

    2012-01-01

    The time course and cellular localization of myostatin expression following musculoskeletal injury are not well understood; therefore, the authors evaluated the temporal and spatial localization of myostatin during muscle and bone repair following deep penetrant injury in a mouse model. They then used hydrogel delivery of exogenous myostatin in the same injury model to determine the effects of myostatin exposure on muscle and bone healing. Results showed that a “pool” of intense myostatin staining was observed among injured skeletal muscle fibers 12–24 hr postsurgery and that myostatin was also expressed in the soft callus chondrocytes 4 days following osteotomy. Hydrogel delivery of 10 or 100 µg/ml recombinant myostatin decreased fracture callus cartilage area relative to total callus area in a dose-dependent manner by 41% and 80% (pMyostatin treatment also decreased fracture callus total bone volume by 30.6% and 38.8% (pmyostatin yielding the greatest decrease in callus bone volume. Finally, exogenous myostatin treatment caused a significant dose-dependent increase in fibrous tissue formation in skeletal muscle. Together, these findings suggest that early pharmacological inhibition of myostatin is likely to improve the regenerative potential of both muscle and bone following deep penetrant musculoskeletal injury. PMID:22205678

  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. The Gambian Bone and Muscle Ageing Study: Baseline Data from a Prospective Observational African Sub-Saharan Study

    Directory of Open Access Journals (Sweden)

    Ayse Zengin

    2017-08-01

    Full Text Available The Gambian Bone and Muscle Ageing Study is a prospective observational study investigating bone and muscle ageing in men and women from a poor, subsistence farming community of The Gambia, West Africa. Musculoskeletal diseases, including osteoporosis and sarcopenia, form a major part of the current global non-communicable disease burden. By 2050, the vast majority of the world’s ageing population will live in low- and middle-income countries with an estimated two-fold rise in osteoporotic fracture. The study design was to characterise change in bone and muscle outcomes and to identify possible preventative strategies for fracture and sarcopenia in the increasing ageing population. Men and women aged ≥40 years from the Kiang West region of The Gambia were recruited with stratified sampling by sex and age. Baseline measurements were completed in 488 participants in 2012 who were randomly assigned to follow-up between 1.5 and 2 years later. Follow-up measurements were performed on 465 participants approximately 1.7 years after baseline measurements. The data set comprises a wide range of measurements on bone, muscle strength, anthropometry, biochemistry, and dietary intake. Questionnaires were used to obtain information on health, lifestyle, musculoskeletal pain, and reproductive status. Baseline cross-sectional data show preliminary evidence for bone mineral density and muscle loss with age. Men had greater negative differences in total body lean mass with age than women following adjustments for body size. From peripheral quantitative computed tomography scans, greater negative associations between bone outcomes and age at the radius and tibia were shown in women than in men. Ultimately, the findings from The Gambian Bone and Muscle Ageing Study will contribute to the understanding of musculoskeletal health in a transitioning population and better characterise fracture and sarcopenia incidence in The Gambia with an aim to the

  1. Administration of soluble activin receptor 2B increases bone and muscle mass in a mouse model of osteogenesis imperfecta

    Science.gov (United States)

    DiGirolamo, Douglas J.; Singhal, Vandana; Chang, Xiaoli; Lee, Se-Jin; Germain-Lee, Emily L.

    2015-01-01

    Osteogenesis imperfecta (OI) comprises a group of heritable connective tissue disorders generally defined by recurrent fractures, low bone mass, short stature and skeletal fragility. Beyond the skeletal complications of OI, many patients also report intolerance to physical activity, fatigue and muscle weakness. Indeed, recent studies have demonstrated that skeletal muscle is also negatively affected by OI, both directly and indirectly. Given the well-established interdependence of bone and skeletal muscle in both physiology and pathophysiology and the observations of skeletal muscle pathology in patients with OI, we investigated the therapeutic potential of simultaneous anabolic targeting of both bone and skeletal muscle using a soluble activin receptor 2B (ACVR2B) in a mouse model of type III OI (oim). Treatment of 12-week-old oim mice with ACVR2B for 4 weeks resulted in significant increases in both bone and muscle that were similar to those observed in healthy, wild-type littermates. This proof of concept study provides encouraging evidence for a holistic approach to treating the deleterious consequences of OI in the musculoskeletal system. PMID:26161291

  2. 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.

  3. Anatomical variation of radial wrist extensor muscles: a study in cadavers

    Directory of Open Access Journals (Sweden)

    Soubhagya Ranjan Nayak

    2008-01-01

    Full Text Available OBJECTIVE: The tendons of the extensor carpi radialis longus and brevis muscles are quite useful in tendon transfer, such as in correction of finger clawing and restoration of thumb opposition. Knowledge of additional radial wrist extensor muscle bellies with independent tendons is useful in the above-mentioned surgical procedures. METHODS: The skin, subcutaneous tissue, and antebrachial fascia of 48 (24 on the right side and 24 on left side male upper limb forearms were dissected. The following aspects were then analyzed: (a the presence of additional muscle bellies of radial wrist extensors, (b the origin and insertion of the additional muscle, and (c measurements of the muscle bellies and their tendons. RESULTS: Five out of 48 upper limbs (10.41% had additional radial wrist extensors; this occurred in 3 out of 24 left upper limbs (12.5% and 2 out of 24 right upper limbs (8.3%. In one of the right upper limbs, two additional muscles were found. The length and width of each additional muscle belly and its tendon ranged between 2 - 15cm by 0.35 - 6.4cm and 2.8 - 20.8cm by 0.2 0.5cm, respectively. The additional radial wrist extensor tendons in our study basically originated either from the extensor carpi radialis longus or brevis muscles and were inserted at the base of the 2nd or 3rd metacarpal bone. CONCLUSION: The present study will inform surgeons about the different varieties of additional radial wrist extensors and the frequency of their occurrence.

  4. In vitro biomechanical comparison of three different types of single- and double-row arthroscopic rotator cuff repairs: analysis of continuous bone-tendon contact pressure and surface during different simulated joint positions.

    Science.gov (United States)

    Grimberg, Jean; Diop, Amadou; Kalra, Kunal; Charousset, Christophe; Duranthon, Louis-Denis; Maurel, Nathalie

    2010-03-01

    We assessed bone-tendon contact surface and pressure with a continuous and reversible measurement system comparing 3 different double- and single-row techniques of cuff repair with simulation of different joint positions. We reproduced a medium supraspinatus tear in 24 human cadaveric shoulders. For the 12 right shoulders, single-row suture (SRS) and then double-row bridge suture (DRBS) were used. For the 12 left shoulders, DRBS and then double-row cross suture (DRCS) were used. Measurements were performed before, during, and after knot tying and then with different joint positions. There was a significant increase in contact surface with the DRBS technique compared with the SRS technique and with the DRCS technique compared with the SRS or DRBS technique. There was a significant increase in contact pressure with the DRBS technique and DRCS technique compared with the SRS technique but no difference between the DRBS technique and DRCS technique. The DRCS technique seems to be superior to the DRBS and SRS techniques in terms of bone-tendon contact surface and pressure. Copyright 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  5. Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes

    OpenAIRE

    Li, Guangyi; Yin, Jimin; Gao, Junjie; Cheng, Tak S; Pavlos, Nathan J; Zhang, Changqing; Zheng, Ming H

    2013-01-01

    Osteoarthritis (OA) is a major cause of disability in the adult population. As a progressive degenerative joint disorder, OA is characterized by cartilage damage, changes in the subchondral bone, osteophyte formation, muscle weakness, and inflammation of the synovium tissue and tendon. Although OA has long been viewed as a primary disorder of articular cartilage, subchondral bone is attracting increasing attention. It is commonly reported to play a vital role in the pathogenesis of OA. Subcho...

  6. Bone Morphogenetic Protein-Induced Msx1 and Msx2 Inhibit Myocardin-Dependent Smooth Muscle Gene Transcription▿

    OpenAIRE

    Hayashi, Ken'ichiro; Nakamura, Seiji; Nishida, Wataru; Sobue, Kenji

    2006-01-01

    During the onset and progression of atherosclerosis, the vascular smooth muscle cell (VSMC) phenotype changes from differentiated to dedifferentiated, and in some cases, this change is accompanied by osteogenic transition, resulting in vascular calcification. One characteristic of dedifferentiated VSMCs is the down-regulation of smooth muscle cell (SMC) marker gene expression. Bone morphogenetic proteins (BMPs), which are involved in the induction of osteogenic gene ex...

  7. Effect of tibial bone resection on the development of fast- and slow-twitch skeletal muscles in foetal sheep.

    Science.gov (United States)

    West, J M; Williams, N A; Luff, A R; Walker, D W

    2000-04-01

    To determine if longitudinal bone growth affects the differentiation of fast- and slow-twitch muscles, the tibial bone was sectioned at 90 days gestation in foetal sheep so that the lower leg was permanently without structural support. At 140 days (term is approximately 147 days) the contractile properties of whole muscles, activation profiles of single fibres and ultrastructure of fast- and slow-twitch muscles from the hindlimbs were studied. The contractile and activation profiles of the slow-twitch soleus muscles were significantly affected by tibial bone resection (TIBX). The soleus muscles from the TIBX hindlimbs showed: (1) a decrease in the time to peak of the twitch responses from 106.2 +/- 10.7 ms (control, n = 4) to 65.1 +/- 2.48 ms (TIBX, n = 5); (2) fatigue profiles more characteristic of those observed in the fast-twitch muscles: and (3) Ca2+ - and Sr2+ -activation profiles of skinned fibres similar to those from intact hindlimbs at earlier stages of gestation. In the FDL, TIBX did not significantly change whole muscle twitch contraction time, the fatigue profile or the Ca2+ - and Sr2+ -activation profiles of skinned fibres. Electron microscopy showed an increased deposition of glycogen in both soleus and FDL muscles. This study shows that the development of the slow-twitch phenotype is impeded in the absence of the physical support normally provided by the tibial bone. We suggest that longitudinal stretch is an important factor in allowing full expression of the slow-twitch phenotype.

  8. Implantation of silicon dioxide-based nanocrystalline hydroxyapatite and pure phase beta-tricalciumphosphate bone substitute granules in caprine muscle tissue does not induce new bone formation

    Directory of Open Access Journals (Sweden)

    Ghanaati Shahram

    2013-01-01

    Full Text Available Abstract Background Osteoinductive bone substitutes are defined by their ability to induce new bone formation even at heterotopic implantation sites. The present study was designed to analyze the potential osteoinductivity of two different bone substitute materials in caprine muscle tissue. Materials and methods One gram each of either a porous beta-tricalcium phosphate (β-TCP or an hydroxyapatite/silicon dioxide (HA/SiO2-based nanocrystalline bone substitute material was implanted in several muscle pouches of goats. The biomaterials were explanted at 29, 91 and 181 days after implantation. Conventional histology and special histochemical stains were performed to detect osteoblast precursor cells as well as mineralized and unmineralized bone matrix. Results Both materials underwent cellular degradation in which tartrate-resistant acid phosphatase (TRAP-positive osteoclast-like cells and TRAP-negative multinucleated giant cells were involved. The ß-TCP was completely resorbed within the observation period, whereas some granules of the HA-groups were still detectable after 180 days. Neither osteoblasts, osteoblast precursor cells nor extracellular bone matrix were found within the implantation bed of any of the analyzed biomaterials at any of the observed time points. Conclusions This study showed that ß-TCP underwent a faster degradation than the HA-based material. The lack of osteoinductivity for both materials might be due to their granular shape, as osteoinductivity in goat muscle has been mainly attributed to cylindrical or disc-shaped bone substitute materials. This hypothesis however requires further investigation to systematically analyze various materials with comparable characteristics in the same experimental setting.

  9. Tendon injury and repair - A perspective on the basic mechanisms of tendon disease and future clinical therapy

    NARCIS (Netherlands)

    Snedeker, J.G.; Foolen, J.

    2017-01-01

    Tendon is an intricately organized connective tissue that efficiently transfers muscle force to the bony skeleton. Its structure, function, and physiology reflect the extreme, repetitive mechanical stresses that tendon tissues bear. These mechanical demands also lie beneath high clinical rates of

  10. Comprehensive evaluation of finger flexor tendon entheseal soft tissue and bone changes by ultrasound can differentiate psoriatic arthritis and rheumatoid arthritis.

    Science.gov (United States)

    Tinazzi, Ilaria; McGonagle, Dennis; Zabotti, Alen; Chessa, Donatella; Marchetta, Antonio; Macchioni, Pierluigi

    2018-02-28

    To determine whether a detailed sonographic evaluation of the hand flexor tendon compartment could help differentiate between psoriatic arthritis (PsA) and rheumatoid arthritis (RA). Thirty-seven patients with PsA, 47 with RA and 10 healthy controls (HC) had flexor tendon (FT) compartment imaging of the dominant hand 2nd to 4th tendons using grey scale (GS) and power Doppler (PD) ultrasound (US) with evaluation for tenosynovitis, peri-tendinous lesions, soft tissue oedema and bony changes at FT insertions. 24/37 PsA and 19/47 RA cases had morning stiffness and 19/37 PsA and 10/47 RA had swollen and/or tender fingers. Tenosynovitis was more common in PsA (25/37) despite higher DAS28 scores in RA (25/37 versus 10/45; pthe insertional site was significantly more common in PsA (p=0.001). Considering a total inflammatory score per patient summing up the three modifications of the flexor tendon (tenosynovitis, peri-tendinous oedema and insertional enthesophytes) the difference between PsA and RA remained statistically significant (pthe growing body of literature that high resolution US of the hand FT compartment may help differentiate between RA and PsA, which needs assessment in the diagnostic setting.

  11. Mac-1low early myeloid cells in the bone marrow-derived SP fraction migrate into injured skeletal muscle and participate in muscle regeneration

    International Nuclear Information System (INIS)

    Ojima, Koichi; Uezumi, Akiyoshi; Miyoshi, Hiroyuki; Masuda, Satoru; Morita, Yohei; Fukase, Akiko; Hattori, Akihito; Nakauchi, Hiromitsu; Miyagoe-Suzuki, Yuko; Takeda, Shin'ichi

    2004-01-01

    Recent studies have shown that bone marrow (BM) cells, including the BM side population (BM-SP) cells that enrich hematopoietic stem cells (HSCs), are incorporated into skeletal muscle during regeneration, but it is not clear how and what kinds of BM cells contribute to muscle fiber regeneration. We found that a large number of SP cells migrated from BM to muscles following injury in BM-transplanted mice. These BM-derived SP cells in regenerating muscles expressed different surface markers from those of HSCs and could not reconstitute the mouse blood system. BM-derived SP/Mac-1 low cells increased in number in regenerating muscles following injury. Importantly, our co-culture studies with activated satellite cells revealed that this fraction carried significant potential for myogenic differentiation. By contrast, mature inflammatory (Mac-1 high ) cells showed negligible myogenic activities. Further, these BM-derived SP/Mac-1 low cells gave rise to mononucleate myocytes, indicating that their myogenesis was not caused by stochastic fusion with host myogenic cells, although they required cell-to-cell contact with myogenic cells for muscle differentiation. Taken together, our data suggest that neither HSCs nor mature inflammatory cells, but Mac-1 low early myeloid cells in the BM-derived SP fraction, play an important role in regenerating skeletal muscles

  12. 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.

  13. Quadriceps Tendon Autograft Medial Patellofemoral Ligament Reconstruction.

    Science.gov (United States)

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

    2018-06-01

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

  14. An Accurate and Dynamic Computer Graphics Muscle Model

    Science.gov (United States)

    Levine, David Asher

    1997-01-01

    A computer based musculo-skeletal model was developed at the University in the departments of Mechanical and Biomedical Engineering. This model accurately represents human shoulder kinematics. The result of this model is the graphical display of bones moving through an appropriate range of motion based on inputs of EMGs and external forces. The need existed to incorporate a geometric muscle model in the larger musculo-skeletal model. Previous muscle models did not accurately represent muscle geometries, nor did they account for the kinematics of tendons. This thesis covers the creation of a new muscle model for use in the above musculo-skeletal model. This muscle model was based on anatomical data from the Visible Human Project (VHP) cadaver study. Two-dimensional digital images from the VHP were analyzed and reconstructed to recreate the three-dimensional muscle geometries. The recreated geometries were smoothed, reduced, and sliced to form data files defining the surfaces of each muscle. The muscle modeling function opened these files during run-time and recreated the muscle surface. The modeling function applied constant volume limitations to the muscle and constant geometry limitations to the tendons.

  15. Comparative functional anatomy of hindlimb muscles and bones with reference to aquatic adaptation of the sea otter.

    Science.gov (United States)

    Mori, Kent; Suzuki, Satoshi; Koyabu, Daisuke; Kimura, Junpei; Han, Sung-Yong; Endo, Hideki

    2015-05-01

    Although the sea otter (Enhydra lutris) is a complete aquatic species, spending its entire life in the ocean, it has been considered morphologically to be a semi-aquatic animal. This study aimed to clarify the unique hindlimb morphology and functional adaptations of E. lutris in comparison to other Mustelidae species. We compared muscle mass and bone measurements of five Mustelidae species: the sea otter, Eurasian river otter (Lutra lutra), American mink (Neovison vison), Japanese weasel (Mustela itatsi) and Siberian weasel (M. sibirica). In comparison with the other 4 species, E. lutris possessed significantly larger gluteus, popliteus and peroneus muscles, but smaller adductor and ischiopubic muscles. The popliteus muscle may act as a medial rotator of the crus, and the peroneus muscle may act as an abductor of the fifth toe and/or the pronator of the foot. The bundles of the gluteus superficialis muscle of E. lutris were fused with those of the tensor fasciae latae muscle and gluteofemoralis muscles, and they may play a role in femur abduction. These results suggest that E. lutris uses the abducted femur, medially rotated crus, eversion of the ankle and abducted fifth digit or extended interdigital web as a powerful propulsion generator. Therefore, we conclude that E. lutris is a complete aquatic animal, possessing differences in the proportions of the hindlimb muscles compared with those in other semi-aquatic and terrestrial mustelids.

  16. Effects of sex steroids on bones and muscles: Similarities, parallels, and putative interactions in health and disease.

    Science.gov (United States)

    Carson, James A; Manolagas, Stavros C

    2015-11-01

    Estrogens and androgens influence the growth and maintenance of bones and muscles and are responsible for their sexual dimorphism. A decline in their circulating levels leads to loss of mass and functional integrity in both tissues. In the article, we highlight the similarities of the molecular and cellular mechanisms of action of sex steroids in the two tissues; the commonality of a critical role of mechanical forces on tissue mass and function; emerging evidence for an interplay between mechanical forces and hormonal and growth factor signals in both bones and muscles; as well as the current state of evidence for or against a cross-talk between muscles and bone. In addition, we review evidence for the parallels in the development of osteoporosis and sarcopenia with advancing age and the potential common mechanisms responsible for the age-dependent involution of these two tissues. Lastly, we discuss the striking difference in the availability of several drug therapies for the prevention and treatment of osteoporosis, as compared to none for sarcopenia. This article is part of a Special Issue entitled "Muscle Bone Interactions". Published by Elsevier Inc.

  17. How can we assess the burden of muscle, bone and joint conditions in rural Botswana

    DEFF Research Database (Denmark)

    Hondras, Maria; Myburgh, Corrie; Hartvigsen, Jan

    2015-01-01

    , organisational and clinical characteristics for the burden of living with and caring for people living with musculoskeletal conditions in rural Botswana. In this paper, we describe the community context, theoretical framework, and research methods to address the project aim with a qualitative study. METHODS......-participant and participant observations, and informal and in-depth interviews with villagers and healthcare providers. Villager interviews were typically conducted in Setswana with an interpreter. Audio recordings were transcribed verbatim in the language spoken with Setswana contextually translated into English. Computer......- and middle-income countries in Africa. Since 2011, World Spine Care, a nongovernmental organisation, has collaborated with the Botswana Ministry of Health to open spine care centres and to conduct research. The broad aim of the Muscle, Bone and Joint (MuBoJo) research project is to examine the sociocultural...

  18. Ontogeny of the Alligator Cartilago Transiliens and Its Significance for Sauropsid Jaw Muscle Evolution

    Science.gov (United States)

    Tsai, Henry P.; Holliday, Casey M.

    2011-01-01

    The cartilago transiliens is a fibrocartilaginous structure within the jaw muscles of crocodylians. The cartilago transiliens slides between the pterygoid buttress and coronoid region of the lower jaw and connects two muscles historically identified as m. pseudotemporalis superficialis and m. intramandibularis. However, the position of cartilago transiliens, and its anatomical similarities to tendon organs suggest the structure may be a sesamoid linking a single muscle. Incompressible sesamoids often form inside tendons that wrap around bone. However, such structures rarely ossify in reptiles and have thus far received scant attention. We tested the hypothesis that the cartilago transiliens is a sesamoid developed within in one muscle by investigating its structure in an ontogenetic series of Alligator mississippiensis using dissection, 3D imaging, and polarizing and standard light microscopy. In all animals studied, the cartilago transiliens receives collagen fibers and tendon insertions from its two main muscular attachments. However, whereas collagen fibers were continuous within the cartilaginous nodule of younger animals, such continuity decreased in older animals, where the fibrocartilaginous core grew to displace the fibrous region. Whereas several neighboring muscles attached to the fibrous capsule in older individuals, only two muscles had significant contributions to the structure in young animals. Our results indicate that the cartilago transiliens is likely a sesamoid formed within a single muscle (i.e., m. pseudotemporalis superficialis) as it wraps around the pterygoid buttress. This tendon organ is ubiquitous among fossil crocodyliforms indicating it is a relatively ancient, conserved structure associated with the development of the large pterygoid flanges in this clade. Finally, these findings indicate that similar tendon organs exist among potentially homologous muscle groups in birds and turtles, thus impacting inferences of jaw muscle homology

  19. Calcaneal tendon: imaging findings

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  20. 3D Modelling and monitoring of denervated muscle under Functional Electrical Stimulation treatment and associated bone structural changes

    Directory of Open Access Journals (Sweden)

    Paolo Gargiulo

    2011-03-01

    Full Text Available A novel clinical rehabilitation method for patients who have permanent and non recoverable muscle denervation in the legs was developed in the frame of the European Project RISE. The technique is based on FES and the project results shows, in these severely disabled patients, restoration of muscle tissue and function. This study propose novel methods based on image processing technique and medical modelling to monitor growth in denervated muscle treated with FES. Geometrical and structural changes in muscle and bone are studied and modelled. Secondary effects on the bone mineral density produced by the stimulation treatment and due the elicited muscle contraction are also investigated. The restoration process in DDM is an important object of discussion since there isn’t yet a complete understanding of the mechanisms regulating growth in denervated muscle. This study approaches the problem from a macroscopic point of view, developing 3-dimensional models of the whole stimulated muscles and following changes in volume, geometry and density very accurately. The method is based on the acquisition of high resolution Spiral CT scans from patients who have long-term flaccid paraplegia and the use of special image processing tools allowing tissue discriminations and muscle segmentation. Three patients were measured at different points of time during 4 years of electrical stimulation treatment. In this study is quantitatively demonstrated the influences of FES treatment on the different quadriceps bellies. The rectus femoris muscle is positioned in the middle of the quadriceps and responds (in general better to stimulation. In a patient with abundant adipose tissue surrounding the quadriceps, rectus femoris almost doubled the volume during the FES treatment while in the other bellies the changes measured were minimal. The analysis of the density shows clearly a restoration of the muscular structure in the growing muscle. The remarkable increase of

  1. Bone morphogenetic proteins regulate osteoprotegerin and its ligands in human vascular smooth muscle cells

    DEFF Research Database (Denmark)

    Knudsen, Kirsten Quyen Nguyen; Olesen, Ping; Ledet, Thomas

    2007-01-01

    The bone-related protein osteoprotegerin (OPG) may be involved in the development of vascular calcifications, especially in diabetes, where it has been found in increased amounts in the arterial wall. Experimental studies suggest that members of the TGF-superfamily are involved in the transformat......The bone-related protein osteoprotegerin (OPG) may be involved in the development of vascular calcifications, especially in diabetes, where it has been found in increased amounts in the arterial wall. Experimental studies suggest that members of the TGF-superfamily are involved...... in the transformation of human vascular smooth muscle cells (HVSMC) to osteoblast-like cells. In this study, we evaluated the effect of BMP-2, BMP-7 and transforming growth factor beta (TGF-beta1) on the secretion and mRNA expression of OPG and its ligands receptor activator of nuclear factor-kappabeta ligand (RANKL......) and TNF-related apoptosis-inducing ligand (TRAIL) in HVSMC. All three growth factors decreased OPG protein production significantly; these results were paralleled by reduced OPG mRNA expression. TRAIL mRNA levels were also decreased. RANKL mRNA expression declined when treated with TGF-beta1 but were...

  2. Quadriceps tendon autograft for arthroscopic knee ligament reconstruction: use it now, use it often.

    Science.gov (United States)

    Sheean, Andrew J; Musahl, Volker; Slone, Harris S; Xerogeanes, John W; Milinkovic, Danko; Fink, Christian; Hoser, Christian

    2018-04-28

    Traditional bone-patellar tendon-bone and hamstring tendon ACL grafts are not without limitations. A growing body of anatomic, biomechanical and clinical data has demonstrated the utility of quadriceps tendon autograft in arthroscopic knee ligament reconstruction. The quadriceps tendon autograft provides a robust volume of tissue that can be reliably harvested, mitigating the likelihood of variably sized grafts and obviating the necessity of allograft augmentation. Modern, minimally invasive harvest techniques offer the advantages of low rates of donor site morbidity and residual extensor mechanism strength deficits. New data suggest that quadriceps tendon autograft may possess superior biomechanical characteristics when compared with bone-patella tendon-bone (BPTB) autograft. However, there have been very few direct, prospective comparisons between the clinical outcomes associated with quadriceps tendon autograft and other autograft options (eg, hamstring tendon and bone-patellar tendon-bone). Nevertheless, quadriceps tendon autograft should be one of the primary options in any knee surgeon's armamentarium. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. The fly wheel exercise device (FWED): A countermeasure against bone loss and muscle atrophy

    Science.gov (United States)

    Hueser, Detlev; Wolff, Christian; Berg, Hans E.; Tesch, Per A.; Cork, Michael

    2008-01-01

    The flywheel exercise device (FWED) is planned for use as an in-flight exercise system, to demonstrate its efficacy as a countermeasure device to prevent muscle atrophy, bone loss and impairment of muscle function in human beings in response to long duration spaceflight. It is intended to be used on the International Space Station (ISS) and will be launched by the European cargo carrier, the automated transfer vehicle (ATV) in late 2005. The FWED is a non-gravity-dependent mechanical device based on the Yo-Yo principle, which provides resistance during coupled concentric and eccentric muscle actions, through the inertia of a spinning flywheel. Currently, the development of a FWED Flight and Ground Model is in progress and is due to be completed in May 2004. An earlier developed prototype is available that has been used for various ground studies. Our FWED design provides a maximum of built-in safety and support to the operation by one astronaut. This is achieved in particular by innovative mechanical design features and an easy, safe to use man-machine interface. The modular design is optimized for efficient set-up and maintenance operations to be performed in orbit by the crew. The mechanical subsystem of the FWED includes a μg disturbance suspension, which minimizes the mechanical disturbances of the exercising subject at the mechanical interface to the ISS. During the FWED operation the astronaut is guided through the exercises by the data management subsystem, which acquires sensor data from the FWED, calculates and displays real-time feedback to the subject, and stores all data on hard disk and personalized storage media for later scientific analysis.

  4. A passive exoskeleton with artificial tendons: design and experimental evaluation.

    Science.gov (United States)

    van Dijk, Wietse; van der Kooij, Herman; Hekman, Edsko

    2011-01-01

    We developed a passive exoskeleton that was designed to minimize joint work during walking. The exoskeleton makes use of passive structures, called artificial tendons, acting in parallel with the leg. Artificial tendons are elastic elements that are able to store and redistribute energy over the human leg joints. The elastic characteristics of the tendons have been optimized to minimize the mechanical work of the human leg joints. In simulation the maximal reduction was 40 percent. The performance of the exoskeleton was evaluated in an experiment in which nine subjects participated. Energy expenditure and muscle activation were measured during three conditions: Normal walking, walking with the exoskeleton without artificial tendons, and walking with the exoskeleton with the artificial tendons. Normal walking was the most energy efficient. While walking with the exoskeleton, the artificial tendons only resulted in a negligibly small decrease in energy expenditure. © 2011 IEEE

  5. About tendon tissue regeneration in experimental radiation disease

    Energy Technology Data Exchange (ETDEWEB)

    Popov, D; Trichkova, P

    1976-01-01

    Under the conditions of experimental acute radiation disease the authors study the tendon tissue regeneration after suture of the lateral part of the gastrocnemius muscle tendon. Tendon auto and alloplasty were applied. In four postoperative periods the histological features are described in details as well as the characteristic phenomena observed during the regeneration influenced to a considerable degree by the irradiation. Round cell infiltration, large necrotic zones, erythrocyte infiltrations as well as predominance of non-specific tendon regeneration long after the surgery characterize the recovery period of the traumatically damaged tendon, nevertheless that at the end there is real tendon regeneration even though in a longer period in comparison with the controls (non-irradiated animals).

  6. Tendon surveillance requirements - average tendon force

    International Nuclear Information System (INIS)

    Fulton, J.F.

    1982-01-01

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

  7. Curved bones: An adaptation to habitual loading.

    Science.gov (United States)

    Milne, Nick

    2016-10-21

    Why are long bones curved? It has long been considered a paradox that many long bones supporting mammalian bodies are curved, since this curvature results in the bone undergoing greater bending, with higher strains and so greater fracture risk under load. This study develops a theoretical model wherein the curvature is a response to bending strains imposed by the requirements of locomotion. In particular the radioulna of obligate quadrupeds is a lever operated by the triceps muscle, and the bending strains induced by the triceps muscle counter the bending resulting from longitudinal loads acting on the curved bone. Indeed the theoretical model reverses this logic and suggests that the curvature is itself a response to the predictable bending strains induced by the triceps muscle. This, in turn, results in anatomical arrangements of bone, muscle and tendon that create a simple physiological mechanism whereby the bone can resist the bending due to the action of triceps in supporting and moving the body. The model is illustrated by contrasting the behaviour of a finite element model of a llama radioulna to that of a straightened version of the same bone. The results show that longitudinal and flexor muscle forces produce bending strains that effectively counter strains due to the pull of the triceps muscle in the curved but not in the straightened model. It is concluded that the curvature of these and other curved bones adds resilience to the skeleton by acting as pre-stressed beams or strainable pre-buckled struts. It is also proposed that the cranial bending strains that result from triceps, acting on the lever that is the radioulna, can explain the development of the curvature of such bones. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  8. Comparative anatomy of rabbit and human achilles tendons with magnetic resonance and ultrasound imaging.

    Science.gov (United States)

    Doherty, Geoffrey P; Koike, Yoichi; Uhthoff, Hans K; Lecompte, Martin; Trudel, Guy

    2006-02-01

    We sought to describe the comparative anatomy of the Achilles tendon in rabbits and humans by using macroscopic observation, magnetic resonance imaging, and ultrasonography. The calcaneus-Achilles tendon-gastrocnemius-soleus complexes from 18 New Zealand white rabbits underwent ultrasound (US) and magnetic resonance (MR) imaging and gross anatomic sectioning; these results were compared with those from a cadaveric gastrocnemius-soleus-Achilles tendon-calcaneus specimen from a 68-y-old human male. The medial and lateral gastrocnemius muscle tendons merged 5.2 +/- 0.6 mm proximal to the calcaneal insertion macroscopically, at 93% of their course, different from the gastrocnemius human tendons, which merged at 23% of their overall course. The rabbit flexor digitorum superficialis tendon, corresponding to the flexor digitorum longus tendon in human and comparable in size with the gastrocnemius tendons, was located medial and anterior to the medial gastrocnemius tendon proximally and rotated dorsally and laterally to run posterior to the Achilles tendon-calcaneus insertion. In humans, the flexor digitorum longus tendon tracks posteriorly to the medial malleolus. The soleus muscle and tendon are negligible in the rabbit; these particular comparative anatomic features in the rabbit were confirmed on the MR images. Therefore the rabbit Achilles tendon shows distinctive gross anatomical and MR imaging features that must be considered when using the rabbit as a research model, especially for mechanical testing, or when generalizing results from rabbits to humans.

  9. MRI and gross anatomy of the iliopsoas tendon complex

    International Nuclear Information System (INIS)

    Polster, Joshua M.; Lee, Ho; Klika, Alison; Barsoum, Wael; Drake, Richard; Elgabaly, Mohamed

    2008-01-01

    The objective was to explain the anatomic basis of a longitudinal cleft of increased signal in the iliopsoas tendon seen on hip MR arthrograms. A prospective review of 20 MR hip arthrograms was performed using standard and fat-suppressed T1-weighted images to establish whether or not the cleft was composed of fatty tissue and to define the anatomy of the iliopsoas tendon complex. Three cadaver dissections of the hip region were then performed for anatomic correlation. Fourteen out of 20 MR hip arthrograms demonstrated a longitudinal cleft of increased T1 signal adjacent to the iliopsoas tendon, which suppressed on frequency selective fat-suppressed images, indicating fatty composition. Gross anatomic correlation demonstrated this fatty cleft to represent a fascial plane adjacent to the iliopsoas tendon, in one case separating the iliopsoas tendon medially from a thin intramuscular tendon within the lateral portion of the iliacus muscle. Also noted was a direct muscular insertion of the lateral portion of the iliacus muscle onto the anterior portion of the proximal femoral diaphysis in all 3 cadavers. The anatomy of the iliopsoas tendon complex is more complicated than typically illustrated and includes the iliopsoas tendon itself attaching to the lesser trochanter, the lateral portion of the iliacus muscle attaching directly upon the anterior portion of the proximal femoral diaphysis, and a thin intramuscular tendon within this lateral iliacus muscle that is separated from the iliopsoas tendon by a cleft of fatty fascia that accounts for the MRI findings of a cleft of increased T1 signal. (orig.)

  10. 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.

  11. Non-myogenic Contribution to Muscle Development and Homeostasis: The Role of Connective Tissues.

    Science.gov (United States)

    Nassari, Sonya; Duprez, Delphine; Fournier-Thibault, Claire

    2017-01-01

    Skeletal muscles belong to the musculoskeletal system, which is composed of bone, tendon, ligament and irregular connective tissue, and closely associated with motor nerves and blood vessels. The intrinsic molecular signals regulating myogenesis have been extensively investigated. However, muscle development, homeostasis and regeneration require interactions with surrounding tissues and the cellular and molecular aspects of this dialogue have not been completely elucidated. During development and adult life, myogenic cells are closely associated with the different types of connective tissue. Connective tissues are defined as specialized (bone and cartilage), dense regular (tendon and ligament) and dense irregular connective tissue. The role of connective tissue in muscle morphogenesis has been investigated, thanks to the identification of transcription factors that characterize the different types of connective tissues. Here, we review the development of the various connective tissues in the context of the musculoskeletal system and highlight their important role in delivering information necessary for correct muscle morphogenesis, from the early step of myoblast differentiation to the late stage of muscle maturation. Interactions between muscle and connective tissue are also critical in the adult during muscle regeneration, as impairment of the regenerative potential after injury or in neuromuscular diseases results in the progressive replacement of the muscle mass by fibrotic tissue. We conclude that bi-directional communication between muscle and connective tissue is critical for a correct assembly of the musculoskeletal system during development as well as to maintain its homeostasis in the adult.

  12. CT and MRI assessment and characterization using segmentation and 3D modeling techniques: applications to muscle, bone and brain

    Directory of Open Access Journals (Sweden)

    Paolo Gargiulo

    2014-03-01

    Full Text Available This paper reviews the novel use of CT and MRI data and image processing tools to segment and reconstruct tissue images in 3D to determine characteristics of muscle, bone and brain.This to study and simulate the structural changes occurring in healthy and pathological conditions as well as in response to clinical treatments. Here we report the application of this methodology to evaluate and quantify: 1. progression of atrophy in human muscle subsequent to permanent lower motor neuron (LMN denervation, 2. muscle recovery as induced by functional electrical stimulation (FES, 3. bone quality in patients undergoing total hip replacement and 4. to model the electrical activity of the brain. Study 1: CT data and segmentation techniques were used to quantify changes in muscle density and composition by associating the Hounsfield unit values of muscle, adipose and fibrous connective tissue with different colors. This method was employed to monitor patients who have permanent muscle LMN denervation in the lower extremities under two different conditions: permanent LMN denervated not electrically stimulated and stimulated. Study 2: CT data and segmentation techniques were employed, however, in this work we assessed bone and muscle conditions in the pre-operative CT scans of patients scheduled to undergo total hip replacement. In this work, the overall anatomical structure, the bone mineral density (BMD and compactness of quadriceps muscles and proximal femoral was computed to provide a more complete view for surgeons when deciding which implant technology to use. Further, a Finite element analysis provided a map of the strains around the proximal femur socket when solicited by typical stresses caused by an implant press fitting. Study 3 describes a method to model the electrical behavior of human brain using segmented MR images. The aim of the work is to use these models to predict the electrical activity of the human brain under normal and pathological

  13. Methods for histochemical demonstration of vascular structures at the muscle-bone interface from cryostate sections of demineralized tissue

    DEFF Research Database (Denmark)

    Kirkeby, S

    1981-01-01

    In tissue decalcified with MgNa2EDTA at a neutral pH activity for ATPase can used be for demonstration of the vascular structures at the muscle-bone interface. The GOMORI method for alkaline phosphatase is only of value, when fresh unfixed tissue is to be examined. The azo-dye method for alkaline...... phosphatase failed to give satisfactory results, and so did the alpha-amylase PAS method. 5'-nucleotidase activity is present in both capillaries and in cells lining the surfaces of bones, while larger blood vessels are poorly stained....

  14. A rare variation of the digastric muscle

    Science.gov (United States)

    KALNIEV, MANOL; KRASTEV, DIMO; KRASTEV, NIKOLAY; VIDINOV, KALIN; VELTCHEV, LUDMIL; APOSTOLOV, ALEXANDER; MILEVA, MILKA

    2013-01-01

    The digastric muscle is composed by two muscle bellies: an anterior and a posterior, joined by an intermediate tendon. This muscle is situated in the anterior region of the neck. The region between the hyoid bone and the mandible is divided by an anterior belly into two triangles: the submandibular situated laterally and the submental triangle which is located medially. We found that the anatomical variations described in the literature relate mainly to the anterior belly and consist of differences in shape and attachment of the muscle. During routine dissection in February 2013 in the section hall of the Department of Anatomy and Histology in Medical University – Sofia we came across a very interesting variation of the digastric muscle. The digastric muscles that presented anatomical variations were photographed using a Sony Cyber-shot DSC-T1 camera, with a Carl Zeiss Vario-Tessar lens. We found out bilateral variation of the digastric muscle in one cadaver. The anterior bellies were very thin and insert to the hyoid bone. Two anterior bellies connect each other and thus they formed a loop. The anatomical variations observed of our study related only to the anterior belly, as previously described by other authors. It is very important to consider the occurrence of the above mentioned variations in the digastric muscle when surgical procedures are performed on the anterior region of the neck. PMID:26527971

  15. Mineral distributions at the developing tendon enthesis.

    Science.gov (United States)

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

    2012-01-01

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

  16. Short-term, daily exposure to cold temperature may be an efficient way to prevent muscle atrophy and bone loss in a microgravity environment

    Science.gov (United States)

    Deng, Claudia; Wang, Ping; Zhang, Xiangming; Wang, Ya

    2015-04-01

    Microgravity induces less pressure on muscle/bone, which is a major reason for muscle atrophy as well as bone loss. Currently, physical exercise is the only countermeasure used consistently in the U.S. human space program to counteract the microgravity-induced skeletal muscle atrophy and bone loss. However, the routinely almost daily time commitment is significant and represents a potential risk to the accomplishment of other mission operational tasks. Therefore, development of more efficient exercise programs (with less time) to prevent astronauts from muscle atrophy and bone loss are needed. Consider the two types of muscle contraction: exercising forces muscle contraction and prevents microgravity-induced muscle atrophy/bone loss, which is a voluntary response through the motor nervous system; and cold temperature exposure-induced muscle contraction is an involuntary response through the vegetative nervous system, we formed a new hypothesis. The main purpose of this pilot study was to test our hypothesis that exercise at 4 °C is more efficient than at room temperature to prevent microgravity-induced muscle atrophy/bone loss and, consequently reduces physical exercise time. Twenty mice were divided into two groups with or without daily short-term (10 min × 2, at 12 h interval) cold temperature (4 °C) exposure for 30 days. The whole bodyweight, muscle strength and bone density were measured after terminating the experiments. The results from the one-month pilot study support our hypothesis and suggest that it would be reasonable to use more mice, in a microgravity environment and observe for a longer period to obtain a conclusion. We believe that the results from such a study will help to develop efficient exercise, which will finally benefit astronauts' heath and NASA's missions.

  17. Modified frontolateral partial laryngectomy operation: combined muscle-pedicle hyoid bone and thyrohyoid membrane flap in laryngeal reconstruction

    OpenAIRE

    Ouyang, Dian; Liu, Tian-Run; Chen, Yan-Feng; Wang, Jian

    2013-01-01

    Objective Laryngeal reconstruction is needed to preserve laryngeal function in patients who have undergone extensive vertical or frontal partial laryngectomy. However, the procedure remains a difficult challenge. Several reconstruction techniques have been described, but these techniques pose risks of complications such as laryngeal stenosis. This study aimed to evaluate the postoperative course and functional outcomes of a new technique that combined a muscle-pedicle hyoid bone and a thyrohy...

  18. Bone marrow stromal and vascular smooth muscle cells have chemosensory capacity via bitter taste receptor expression.

    Directory of Open Access Journals (Sweden)

    Troy C Lund

    Full Text Available The ability of cells to detect changes in the microenvironment is important in cell signaling and responsiveness to environmental fluctuations. Our interest is in understanding how human bone marrow stromal-derived cells (MSC and their relatives, vascular smooth muscle cells (VSMC, interact with their environment through novel receptors. We found, through a proteomics screen, that MSC express the bitter taste receptor, TAS2R46, a protein more typically localized to the taste bud. Expression was also confirmed in VSMCs. A prototypical bitter compound that binds to the bitter taste receptor class, denatonium, increased intracellular calcium release and decreased cAMP levels as well as increased the extracellular release of ATP in human MSC. Denatonium also bound and activated rodent VSMC with a change in morphology upon compound exposure. Finally, rodents given denatonium in vivo had a significant drop in blood pressure indicating a vasodilator response. This is the first description of chemosensory detection by MSC and VSMCs via a taste receptor. These data open a new avenue of research into discovering novel compounds that operate through taste receptors expressed by cells in the marrow and vascular microenvironments.

  19. Immunology Guides Skeletal Muscle Regeneration

    Directory of Open Access Journals (Sweden)

    F. Andrea Sass

    2018-03-01

    Full Text Available Soft tissue trauma of skeletal muscle is one of the most common side effects in surgery. Muscle injuries are not only caused by accident-related injuries but can also be of an iatrogenic nature as they occur during surgical interventions when the anatomical region of interest is exposed. If the extent of trauma surpasses the intrinsic regenerative capacities, signs of fatty degeneration and formation of fibrotic scar tissue can occur, and, consequentially, muscle function deteriorates or is diminished. Despite research efforts to investigate the physiological healing cascade following trauma, our understanding of the early onset of healing and how it potentially determines success or failure is still only fragmentary. This review focuses on the initial physiological pathways following skeletal muscle trauma in comparison to bone and tendon trauma and what conclusions can be drawn from new scientific insights for the development of novel therapeutic strategies. Strategies to support regeneration of muscle tissue after injury are scarce, even though muscle trauma has a high incidence. Based on tissue specific differences, possible clinical treatment options such as local immune-modulatory and cell therapeutic approaches are suggested that aim to support the endogenous regenerative potential of injured muscle tissues.

  20. Achilles tendon and sports

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  1. Skeletal Muscle-derived Hematopoietic Stem Cells: Muscular Dystrophy Therapy by Bone Marrow Transplantation

    OpenAIRE

    Asakura, Atsushi

    2012-01-01

    For postnatal growth and regeneration of skeletal muscle, satellite cells, a self-renewing pool of muscle stem cells, give rise to daughter myogenic precursor cells that contribute to the formation of new muscle fibers. In addition to this key myogenic cell class, adult skeletal muscle also contains hematopoietic stem cell and progenitor cell populations which can be purified as a side population (SP) fraction or as a hematopoietic marker CD45-positive cell population. These muscle-derived he...

  2. Anatomical and radiological observations of the sesamoid bone of the popliteus muscle in the adult dog and cat

    International Nuclear Information System (INIS)

    McCarthy, P.H.; Wood, A.K.W.

    1989-01-01

    In a random selection of 50 adult dogs (25 males and 25 females) and 50 adult cats (25 males and 25 females), the incidence of ossification of the sesamoid structure of the popliteus muscle was characterized through anatomical dissection and radiographic techniques. The incidence of ossification was 84% in the dogs and 100% in the cats. In both anatomical and radiologic studies, it was demonstrated that when the knee was fully extended, the sesamoid bone was adjacent to the caudodistal part of the articular surface of the lateral tibial condyle in both dogs and cats. When the knee was flexed, the sesamoid bone articulated progressively with the more craniodorsal part of the tibial articular surface and when full flexion is obtained, it articulated with the articular part of the lateral surface of the lateral meniscus. The probable functions of the sesamoid bone are discussed

  3. Inferior tendon graft to bone tunnel healing at the tibia compared to that at the femur after anterior cruciate ligament reconstruction

    International Nuclear Information System (INIS)

    Lui, P.P.Y.; Ho, G.; Shum, W.T.; Lee, Y.W.; Ho, P.Y.; Lo, W.N.; Lo, C.K.

    2010-01-01

    Tunnel widening after anterior cruciate ligament (ACL) reconstruction (ACLR) is commonly reported without a clear understanding of the mechanism. This study aimed to quantify the spatiotemporal change of the newly formed bone mass, bone tunnel diameter, and area along both bone tunnels using micro-computed tomography (μCT) and correlated the result with histology. ACLR was performed in 24 rabbits. At baseline and weeks 2, 6, and 12, the juxta-articular, middle, and exit segments of both tunnels were harvested for μCT and histological evaluation. μCT and histology revealed significant bone tunnel and graft-bone tunnel healing, respectively, only at week 6 after reconstruction. Despite this, the mean tunnel diameter and area remained relatively unchanged with time. The newly formed bone mass [new bone volume/total bone volume (BV/TV) ratio] and its bone mineral density (BMD) were both higher, whereas the mean tunnel diameter and area were significantly smaller at the femoral tunnel compared to those at the tibial tunnel at weeks 6 and 12 and at week 12, respectively. These were consistent with histological findings, which showed inferior graft remodeling and integration at the tibial tunnel at weeks 6 and 12. The BV/TV increased, whereas the mean tunnel diameter and area decreased toward the exit segment of both tunnels. However, whereas better histological healing occurred at the femoral exit segment, poorer graft remodeling and Sharpey's fiber formation occurred at the tibial exit segment. Poor healing was observed during the initial 6 weeks, particularly that of the tibia, after ACLR. Bone resorption was rapid during healing, resulting in unchanged tunnel diameter and area with time. (author)

  4. PERONEAL TENDON LESIONS IN ATHLETES (REVIEW

    Directory of Open Access Journals (Sweden)

    E. E. Achkasov

    2016-01-01

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

  5. Role of tissue-engineered artificial tendon in healing of a large Achilles tendon defect model in rabbits.

    Science.gov (United States)

    Moshiri, Ali; Oryan, Ahmad; Meimandi-Parizi, Abdolhamid

    2013-09-01

    Treatment of large Achilles tendon defects is technically demanding. Tissue engineering is an option. We constructed a collagen-based artificial tendon, covered it with a polydioxanon (PDS) sheath, and studied the role of this bioimplant on experimental tendon healing in vivo. A 2-cm tendon gap was created in the left Achilles tendon of rabbits (n = 120). The animals were randomly divided into 3 groups: control (no implant), treated with tridimensional-collagen, and treated with tridimensional-collagen-bidimensional-PDS implants. Each group was divided into 2 subgroups of 60 and 120 days postinjury (DPI). Another 50 pilot animals were used to study the host-implant interaction. Physical activity of the animals was scored and ultrasonographic and bioelectrical characteristics of the injured tendons were investigated weekly. After euthanasia, macro, micro, and nano morphologies and biophysical and biomechanical characteristics of the healing tendons were studied. Treatment improved function of the animals, time dependently. At 60 and 120 DPI, the treated tendons showed significantly higher maximum load, yield, stiffness, stress, and modulus of elasticity compared with controls. The collagen implant induced inflammation and absorbed the migrating fibroblasts in the defect area. By its unique architecture, it aligned the fibroblasts and guided their proliferation and collagen deposition along the stress line of the tendon and resulted in improved collagen density, micro-amp, micro-ohm, water uptake, and delivery of the regenerated tissue. The PDS-sheath covering amplified these characteristics. The implants were gradually absorbed and replaced by a new tendon. Minimum amounts of peritendinous adhesion, muscle atrophy, and fibrosis were observed in the treated groups. Some remnants of the implants were preserved and accepted as a part of the new tendon. The implants were cytocompatible, biocompatible, biodegradable, and effective in tendon healing and regeneration. This

  6. Evaluation of healthy muscle tissue by strain and shear wave elastography – Dependency on depth and ROI position in relation to underlying bone

    DEFF Research Database (Denmark)

    Ewertsen, Caroline; Carlsen, Jonathan Frederik; Christiansen, Iben Riishede

    2016-01-01

    and methods: Ten healthy volunteers (five males and five females) had their biceps brachii, gastrocnemius, and quadriceps muscle examined with strain- and shear wave elastography at three different depths and in regions located above bone and beside bone. Strain ratios were averaged from cine-loops of 10 s...

  7. Is increase in bone mineral content caused by increase in skeletal muscle mass/strength in adult patients with GH-treated GH deficiency? A systematic literature analysis

    DEFF Research Database (Denmark)

    Klefter, O.; Feldt-Rasmussen, U.

    2009-01-01

    to a muscle modulating effect, and if treatment with GH would primarily increase muscle mass and strength with a secondary increase in BMD/BMC, thus supporting the present physiological concept that mass and strength of bones are mainly determined by dynamic loads from the skeletal muscles. METHOD: We...... performed a systematic literature analysis, including 51 clinical trials published between 1996 and 2008, which had studied the development in muscle mass, muscle strength, BMD, and/or BMC in GH-treated adult GHD patients. RESULTS: GH therapy had an anabolic effect on skeletal muscle. The largest increase...... in muscle mass occurred during the first 12 months of therapy. Most trials measuring BMD/BMC reported significant increases from baseline values. The significant increases in BMD/BMC occurred after 12-18 months of treatment, i.e. usually later than the increases in muscle parameters. Only seven trials...

  8. Is increase in bone mineral content caused by increase in skeletal muscle mass/strength in adult patients with GH-treated GH deficiency?

    DEFF Research Database (Denmark)

    Klefter, Oliver; Feldt-Rasmussen, Ulla

    2009-01-01

    to a muscle modulating effect, and if treatment with GH would primarily increase muscle mass and strength with a secondary increase in BMD/BMC, thus supporting the present physiological concept that mass and strength of bones are mainly determined by dynamic loads from the skeletal muscles. METHOD: We...... performed a systematic literature analysis, including 51 clinical trials published between 1996 and 2008, which had studied the development in muscle mass, muscle strength, BMD, and/or BMC in GH-treated adult GHD patients. RESULTS: GH therapy had an anabolic effect on skeletal muscle. The largest increase...... in muscle mass occurred during the first 12 months of therapy. Most trials measuring BMD/BMC reported significant increases from baseline values. The significant increases in BMD/BMC occurred after 12-18 months of treatment, i.e. usually later than the increases in muscle parameters. Only seven trials...

  9. Enhancement of rotator cuff tendon-bone healing with fibroblast growth factor 2 impregnated in gelatin hydrogel sheets in a rabbit model.

    Science.gov (United States)

    Tokunaga, Takuya; Karasugi, Tatsuki; Arimura, Hitoshi; Yonemitsu, Ryuji; Sakamoto, Hidetoshi; Ide, Junji; Mizuta, Hiroshi

    2017-10-01

    Application of fibroblast growth factor 2 (FGF-2) may improve the healing response after rotator cuff (RC) surgical repair. This study aimed to determine whether FGF-2-impregnated gelatin hydrogel sheet (GHS) incorporation into the bony trough on the greater tuberosity facilitates healing after RC surgical repair in rabbits. We assigned 120 adult male Japanese white rabbits treated with unilateral surgery for supraspinatus tendon repair into the following groups: suture-only group (suture); suture and GHS with phosphate-buffered saline (carrier); suture and GHS with 3 µg of FGF-2 (F3); and suture and GHS with 30 µg of FGF-2 (F30). The effect of FGF-2 was assessed using histologic, biomechanical, and microcomputed tomography evaluations at 2, 6, and 12 weeks. At 12 weeks, loose fibrovascular tissues emerged at the repair site in the suture and carrier groups and dense tendon-like tissues in the F3 and F30 groups, which demonstrated significantly higher ultimate load-to-failure and stress-to-failure at 12 weeks than that in the suture and carrier groups. Microcomputed tomography imaging showed ectopic calcification formation in some specimens from each group. Appearances or frequencies were similar among groups. The histologic and biomechanical effects of FGF-2 on RC healing were obvious at ≥6 weeks postoperatively. FGF-2-impregnated GHS incorporation into the bony trough on the greater tuberosity before RC surgical repair is feasible and results in histologic and biomechanical improvements during RC healing in rabbits. No detrimental effect on ectopic calcification was observed. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  10. Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review

    OpenAIRE

    Rio, Ebonie; Kidgell, Dawson; Moseley, G Lorimer; Gaida, Jamie; Docking, Sean; Purdam, Craig; Cook, Jill

    2015-01-01

    Tendinopathy can be resistant to treatment and often recurs, implying that current treatment approaches are suboptimal. Rehabilitation programmes that have been successful in terms of pain reduction and return to sport outcomes usually include strength training. Muscle activation can induce analgesia, improving self-efficacy associated with reducing one's own pain. Furthermore, strength training is beneficial for tendon matrix structure, muscle properties and limb biomechanics. However, curre...

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Comparative expression analyses of bone morphogenetic protein 4 (BMP4) expressions in muscles of tilapia and common carp indicate that BMP4 plays a role in the intermuscular bone distribution in a dose-dependent manner.

    Science.gov (United States)

    Su, Shengyan; Dong, Zaijie

    2018-01-01

    Intermuscular bones in fish negatively influence both meet processing and attractiveness to consumers. Tilapia (Oreochromis niloticus) and common carp (Cyprinus carpio) are both major farmed fish species globally, but whereas the former does not possess intermuscular bones, the latter does. Therefore, these two species might present a good model to study the genetic control of distribution of intermuscular bones in fish. Bone morphogenetic protein 4 (BMP4) gene is associated with tissue ossification and bone regeneration in mammals, but in fish its role in ossification remains understudied. To study the relationship between BMP4 and bone distribution in fish, we determined the expression of BMP4 in muscle tissues of common carp and tilapia on transcriptional and translational levels. As the gene has been merely predicted in silico from the genome of common carp, we have cloned and characterized it. The gene (GenBank: HQ446455) contains one intron and two exons, which encode a 400-amino acid protein with high homology to other known BMP4 protein sequences. Phylogenetic analysis showed that common carp clustered within the Cypriniformes clade (zebrafish was the closest ortholog) and tilapia within the Percomorpha clade. Using microCT scanning, we confirmed that intermuscular bones could be observed only in common carp (none in tilapia), but only in dorsal and caudal muscles (none in the ventral muscle). Expression levels of BMP4 in the muscles of common carp were in agreement with this observation both on transcriptional (qPCR) and translational (immunohistochemistry) level: higher in dorsal and caudal muscles, and lower in the ventral muscle. In tilapia, expression of BMP4 gene was also detectable in all three muscles, but expression levels in all three muscles were comparable to the one observed in the ventral muscle of carp, i.e., very low. Therefore, among the six studied muscles, the expression of BMP4 was high only in the two that possess intermuscular bones

  13. Containment structure tendon investigation

    International Nuclear Information System (INIS)

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

    1983-01-01

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

  14. Sport-Specific Capacity to Use Elastic Energy in the Patellar and Achilles Tendons of Elite Athletes.

    Science.gov (United States)

    Wiesinger, Hans-Peter; Rieder, Florian; Kösters, Alexander; Müller, Erich; Seynnes, Olivier R

    2017-01-01

    Introduction: During running and jumping activities, elastic energy is utilized to enhance muscle mechanical output and efficiency. However, training-induced variations in tendon spring-like properties remain under-investigated. The present work extends earlier findings on sport-specific profiles of tendon stiffness and cross-sectional area to examine whether years of distinct loading patterns are reflected by tendons' ability to store and return energy. Methods: Ultrasound scans were performed to examine the morphological features of knee extensor and plantar flexor muscle-tendon units in elite ski jumpers, distance runners, water polo players, and sedentary controls. Tendon strain energy and hysteresis were measured with combined motion capture, ultrasonography, and dynamometry. Results: Apart from the fractional muscle-to-tendon cross-sectional area ratio being lower in the knee extensors of ski jumpers (-31%) and runners (-33%) than in water polo players, no difference in the considered muscle-tendon unit morphological features was observed between groups. Similarly, no significant difference in tendon energy storage or energy return was detected between groups. In contrast, hysteresis was lower in the patellar tendon of ski jumpers (-33%) and runners (-30%) compared to controls, with a similar trend for the Achilles tendon (significant interaction effect and large effect sizes η 2 = 0.2). Normalized to body mass, the recovered strain energy of the patellar tendon was ~50% higher in ski jumpers than in water polo players and controls. For the Achilles tendon, recovered strain energy was ~40% higher in ski jumpers and runners than in controls. Discussion: Advantageous mechanical properties related to tendon spring-like function are observed in elite athletes whose sport require effective utilization of elastic energy. However, the mechanisms underpinning the better tendon capacity of some athletes to retain elastic energy could not be ascribed to intrinsic or

  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. Biomechanics Analysis of Pressure Ulcer Using Damaged Interface Model between Bone and Muscle in the Human Buttock

    Science.gov (United States)

    Slamet, Samuel Susanto; Takano, Naoki; Tanabe, Yoshiyuki; Hatano, Asako; Nagasao, Tomohisa

    This paper aims at building up a computational procedure to study the bio-mechanism of pressure ulcer using the finite element method. Pressure ulcer is a disease that occurs in the human body after 2 hours of continuous external force. In the very early stage of pressure ulcer, it is found that the tissues inside the body are damaged, even though skin surface looks normal. This study assumes that tension and/or shear strain will cause damage to loose fibril tissue between the bone and muscle and that propagation of damaged area will lead to fatal stage. Analysis was performed using the finite element method by modeling the damaged fibril tissue as a cutout. By varying the loading directions and watching both tensile and shear strains, the risk of fibril tissue damage and propagation of the damaged area is discussed, which may give new insight for the careful nursing for patients, particularly after surgical treatment. It was found that the pressure ulcer could reoccur for a surgical flap treatment. The bone cut and surgical flap surgery is not perfect to prevent the bone-muscle interfacial damage.

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

    Science.gov (United States)

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

    2003-12-01

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

  18. Tendon 'turnover lengthening' technique.

    Science.gov (United States)

    Cerovac, S; Miranda, B H

    2013-11-01

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

  19. Neglected ruptured flexor carpi ulnaris tendon mimics a soft tissue tumor in the wrist.

    Science.gov (United States)

    Rau, Chi-Lun; Yen, Tze-Hsun; Wu, Lien-Chen; Huang, Yi-You; Jaw, Fu-Shan; Liou, Tsan-Hon

    2014-04-01

    A wrist mass is rarely caused by a ruptured tendon in the forearm. The common pathologies are ganglia, tendon tenosynovitis, and giant cell tumors of tendon sheaths. Less common causes are nerve sheath tumors, vascular lesions, or an accessory muscle belly. The authors investigated a case of neglected ruptured flexor carpi ulnaris tendon that mimics a mass in the wrist. To the authors' knowledge, this is the first case report in relevant literature. During investigation, the high-resolution musculoskeletal ultrasound suggested a soft tissue tumor or a ruptured flexor carpi ulnaris tendon. The magnetic resonance imaging scan indicated an accessory flexor carpi ulnaris muscle belly. The diagnosis of ruptured flexor carpi ulnaris tendon was confirmed by surgical exploration. This case indicates that ultrasound may be better suited than magnetic resonance imaging in evaluating a wrist mass for its accuracy, availability, and portability.

  20. Associations of dietary patterns with bone mass, muscle strength and balance in a cohort of Australian middle-aged women.

    Science.gov (United States)

    Wu, Feitong; Wills, Karen; Laslett, Laura L; Oldenburg, Brian; Jones, Graeme; Winzenberg, Tania

    2017-10-01

    Influences of dietary patterns on musculoskeletal health are poorly understood in middle-aged women. This cross-sectional analysis from a cohort of 347 women (aged 36-57 years) aimed to examine associations between dietary patterns and musculoskeletal health outcomes in middle-aged women. Diet was measured by the Cancer Council of Victoria FFQ. Total body bone mineral content (TB BMC), femoral neck and lumbar spine bone density (dual-energy X-ray absorptiometry), lower limbs muscle strength (LMS) and balance tests (timed up and go test, step test, functional reach test (FRT) and lateral reach test) were also measured. Exploratory factor analysis was used to identify dietary patterns and scores for each pattern generated using factor loadings with absolute values ≥0·20. Associations between food pattern scores and musculoskeletal outcomes were assessed using multivariable linear regression. Three dietary patterns were identified: 'Healthy' (high consumption of a plant-based diet - vegetables, legumes, fruit, tomatoes, nuts, snacks, garlic, whole grains and low intake of high-fat dairy products), 'high protein, high fat' (red meats, poultry, processed meats, potatoes, cruciferous and dark-yellow vegetables, fish, chips, spirits and high-fat dairy products) and 'Processed foods' (high intakes of meat pies, hamburgers, beer, sweets, fruit juice, processed meats, snacks, spirits, pizza and low intake of cruciferous vegetables). After adjustment for confounders, Healthy pattern was positively associated with LMS, whereas Processed foods pattern was inversely associated with TB BMC and FRT. The associations were not significant after accounting for multiple comparisons. There were no associations with any other outcomes. These results suggest that maintaining a healthy diet could contribute to bone acquisition, muscle strength and balance in adult life. However, while they provide some support for further investigating dietary strategies for prevention of age

  1. Muscle strength and areal bone mineral density at the hip in women: a cross-sectional study.

    Science.gov (United States)

    Pasco, Julie A; Holloway, Kara L; Brennan-Olsen, Sharon L; Moloney, David J; Kotowicz, Mark A

    2015-05-24

    Muscle strengthening exercises are promoted for building and maintaining a healthy skeleton. We aimed to investigate the relationship between muscle strength and areal bone mineral density (BMD) at the hip in women aged 26-97 years. This cross-sectional study utilises data from 863 women assessed for the Geelong Osteoporosis Study. Measures of hip flexor and abductor strength were made using a hand-held dynamometer (Nicholas Manual Muscle Tester). The maximal measure from three trials on each leg was used for analyses. BMD was measured at the hip using dual energy x-ray absorptiometry (DXA; Lunar DPX-L). Total lean mass, body fat mass and appendicular lean mass were determined from whole body DXA scans. Linear regression techniques were used with muscle strength as the independent variable and BMD as the dependent variable. Models were adjusted for age and indices of body composition. Measures of age-adjusted hip flexor strength and hip abductor strength were positively associated with total hip BMD. For each standard deviation (SD) increase in hip flexor strength, the increase in mean total hip BMD (SD) was 10.4 % (p = 0.009). A similar pattern was observed for hip abductor strength, with an increase in mean total hip BMD of 22.8 % (p = 0.025). All associations between hip muscle strength and total hip BMD were independent of height, but were nullified after adjusting for appendicular lean mass or total lean mass. There was a positive association observed between muscle strength and BMD at the hip. However, this association was explained by measures of lean mass.

  2. The effect of acute exercise on collagen turnover in human tendons

    DEFF Research Database (Denmark)

    Mørch, Lina Steinrud; Pingel, Jessica; Boesen, Mikael

    2013-01-01

    Mechanical loading of human tendon stimulates collagen synthesis, but the relationship between acute loading responses and training status of the tendon is not clear. We tested the effect of prolonged load deprivation on the acute loading-induced collagen turnover in human tendons, by applying...... the contra-lateral leg was used habitually. Following the procedure both Achilles tendons and calf muscles were loaded with the same absolute load during a 1-h treadmill run. Tissue collagen turnover was measured by microdialysis performed post-immobilization but pre-exercise around both Achilles tendons...... and compared to values obtained by 72-h post-exercise. Power Doppler was used to monitor alterations in intratendinous blood flow velocity of the Achilles tendon and MRI used to quantitate changes in tendon cross-section area. Acute loading resulted in an increased collagen synthesis 72 h after the run in both...

  3. Isolated tear of the tendon to the medial head of gastrocnemius presenting as a painless lump in the calf

    OpenAIRE

    Watura, Christopher; Harries, William

    2009-01-01

    We report on a case of isolated tear of the medial head of gastrocnemius tendon. The patient presented with a painless lump in the right calf and denied any prior history of trauma or strain to the leg. A longitudinal split of the tendon was demonstrated at ultrasound and magnetic resonance imaging (MRI). There were no other abnormalities and the gastrocnemius muscle was normal. There are no reports in the literature of isolated gastrocnemius tendon tear. To date the calf muscle complex injur...

  4. Achilles tendon healing

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  5. High-frequency, low-magnitude vibration does not prevent bone loss resulting from muscle disuse in mice following botulinum toxin injection.

    Science.gov (United States)

    Manske, Sarah L; Good, Craig A; Zernicke, Ronald F; Boyd, Steven K

    2012-01-01

    High-frequency, low-magnitude vibration enhances bone formation ostensibly by mimicking normal postural muscle activity. We tested this hypothesis by examining whether daily exposure to low-magnitude vibration (VIB) would maintain bone in a muscle disuse model with botulinum toxin type A (BTX). Female 16-18 wk old BALB/c mice (N = 36) were assigned to BTX-VIB, BTX-SHAM, VIB, or SHAM. BTX mice were injected with BTX (20 µL; 1 U/100 g body mass) into the left hindlimb posterior musculature. All mice were anaesthetized for 20 min/d, 5 d/wk, for 3 wk, and the left leg mounted to a holder. Through the holder, VIB mice received 45 Hz, ± 0.6 g sinusoidal acceleration without weight bearing. SHAM mice received no vibration. At baseline and 3 wk, muscle cross-sectional area (MCSA) and tibial bone properties (epiphysis, metaphysis and diaphysis) were assessed by in vivo micro-CT. Bone volume fraction in the metaphysis decreased 12 ± 9% and 7 ± 6% in BTX-VIB and BTX-SHAM, but increased in the VIB and SHAM. There were no differences in dynamic histomorphometry outcomes between BTX-VIB and BTX nor between VIB and SHAM. Thus, vibration did not prevent bone loss induced by a rapid decline in muscle activity nor produce an anabolic effect in normal mice. The daily loading duration was shorter than would be expected from postural muscle activity, and may have been insufficient to prevent bone loss. Based on the approach used in this study, vibration does not prevent bone loss in the absence of muscle activity induced by BTX.

  6. High-frequency, low-magnitude vibration does not prevent bone loss resulting from muscle disuse in mice following botulinum toxin injection.

    Directory of Open Access Journals (Sweden)

    Sarah L Manske

    Full Text Available High-frequency, low-magnitude vibration enhances bone formation ostensibly by mimicking normal postural muscle activity. We tested this hypothesis by examining whether daily exposure to low-magnitude vibration (VIB would maintain bone in a muscle disuse model with botulinum toxin type A (BTX. Female 16-18 wk old BALB/c mice (N = 36 were assigned to BTX-VIB, BTX-SHAM, VIB, or SHAM. BTX mice were injected with BTX (20 µL; 1 U/100 g body mass into the left hindlimb posterior musculature. All mice were anaesthetized for 20 min/d, 5 d/wk, for 3 wk, and the left leg mounted to a holder. Through the holder, VIB mice received 45 Hz, ± 0.6 g sinusoidal acceleration without weight bearing. SHAM mice received no vibration. At baseline and 3 wk, muscle cross-sectional area (MCSA and tibial bone properties (epiphysis, metaphysis and diaphysis were assessed by in vivo micro-CT. Bone volume fraction in the metaphysis decreased 12 ± 9% and 7 ± 6% in BTX-VIB and BTX-SHAM, but increased in the VIB and SHAM. There were no differences in dynamic histomorphometry outcomes between BTX-VIB and BTX nor between VIB and SHAM. Thus, vibration did not prevent bone loss induced by a rapid decline in muscle activity nor produce an anabolic effect in normal mice. The daily loading duration was shorter than would be expected from postural muscle activity, and may have been insufficient to prevent bone loss. Based on the approach used in this study, vibration does not prevent bone loss in the absence of muscle activity induced by BTX.

  7. Neck Muscle Moment Arms Obtained In-Vivo from MRI: Effect of Curved and Straight Modeled Paths.

    Science.gov (United States)

    Suderman, Bethany L; Vasavada, Anita N

    2017-08-01

    Musculoskeletal models of the cervical spine commonly represent neck muscles with straight paths. However, straight lines do not best represent the natural curvature of muscle paths in the neck, because the paths are constrained by bone and soft tissue. The purpose of this study was to estimate moment arms of curved and straight neck muscle paths using different moment arm calculation methods: tendon excursion, geometric, and effective torque. Curved and straight muscle paths were defined for two subject-specific cervical spine models derived from in vivo magnetic resonance images (MRI). Modeling neck muscle paths with curvature provides significantly different moment arm estimates than straight paths for 10 of 15 neck muscles (p straight lines to model muscle paths can lead to overestimating neck extension moment. However, moment arm methods for curved paths should be investigated further, as different methods of calculating moment arm can provide different estimates.

  8. Lateral luxation of the superficial digital flexor tendon from the calcaneal tuber in two horses

    International Nuclear Information System (INIS)

    Meagher, D.M.; Aldrete, A.V.

    1989-01-01

    Lateral luxation of the superficial digital flexor tendon from the calcaneal tuber occurs in horses as a result of tearing or rupture of the medial retinaculum of the tendon. This report describes the repair of this condition in 2 Thoroughbred race horses, using a surgical technique in which 2 cancellous bone screws were placed in the calcaneus lateral to the tendon, along with suturing the medial retinaculum

  9. Achilles tendon repair

    Science.gov (United States)

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

  10. Low dose PTH improves metaphyseal bone healing more when muscles are paralyzed.

    Science.gov (United States)

    Sandberg, Olof; Macias, Brandon R; Aspenberg, Per

    2014-06-01

    Stimulation of bone formation by PTH is related to mechanosensitivity. The response to PTH treatment in intact bone could therefore be blunted by unloading. We studied the effects of mechanical loading on the response to PTH treatment in bone healing. Most fractures occur in the metaphyses, therefor we used a model for metaphyseal bone injury. One hind leg of 20 male SD rats was unloaded via intramuscular botulinum toxin injections. Two weeks later, the proximal unloaded tibia had lost 78% of its trabecular contents. At this time-point, the rats received bilateral proximal tibiae screw implants. Ten of the 20 rats were given daily injections of 5 μg/kg PTH (1-34). After two weeks of healing, screw fixation was measured by pull-out, and microCT of the distal femur cancellous compartment was performed. Pull-out force provided an estimate for cancellous bone formation after trauma. PTH more than doubled the pull-out force in the unloaded limbs (from 14 to 30 N), but increased it by less than half in the loaded ones (from 30 to 44 N). In relative terms, PTH had a stronger effect on pull-out force in unloaded bone than in loaded bone (p=0.03). The results suggest that PTH treatment for stimulation of bone healing does not require simultaneous mechanical stimulation. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Lack of tissue renewal in human adult Achilles tendon is revealed by nuclear bomb 14C

    Science.gov (United States)

    Heinemeier, Katja Maria; Schjerling, Peter; Heinemeier, Jan; Magnusson, Stig Peter; Kjaer, Michael

    2013-01-01

    Tendons are often injured and heal poorly. Whether this is caused by a slow tissue turnover is unknown, since existing data provide diverging estimates of tendon protein half-life that range from 2 mo to 200 yr. With the purpose of determining life-long turnover of human tendon tissue, we used the 14C bomb-pulse method. This method takes advantage of the dramatic increase in atmospheric levels of 14C, produced by nuclear bomb tests in 1955–1963, which is reflected in all living organisms. Levels of 14C were measured in 28 forensic samples of Achilles tendon core and 4 skeletal muscle samples (donor birth years 1945–1983) with accelerator mass spectrometry (AMS) and compared to known atmospheric levels to estimate tissue turnover. We found that Achilles tendon tissue retained levels of 14C corresponding to atmospheric levels several decades before tissue sampling, demonstrating a very limited tissue turnover. The tendon concentrations of 14C approximately reflected the atmospheric levels present during the first 17 yr of life, indicating that the tendon core is formed during height growth and is essentially not renewed thereafter. In contrast, 14C levels in muscle indicated continuous turnover. Our observation provides a fundamental premise for understanding tendon function and pathology, and likely explains the poor regenerative capacity of tendon tissue.—Heinemeier, K. M., Schjerling, P., Heinemeier, J., Magnusson, S. P., Kjaer, M. Lack of tissue renewal in human adult Achilles tendon is revealed by nuclear bomb 14C. PMID:23401563

  12. Improved Achilles tendon healing by early mechanical loading in a rabbit model.

    Science.gov (United States)

    Wang, Jihong; Jiang, Dianming; Wen, Shuzheng; Jing, Shangfei; Fan, Dongsheng; Hao, Zengtao; Han, Chaoqian

    2015-01-01

    To investigate the structure and the attachment strength of a healing tendon-bone interface and the role of mechanical loading in tendon healing. Sixty rabbits underwent unilateral detachment and repair of the Achilles tendon. Thirty animals were immobilized (Group A), and the others wereallowed loadingimmediately postoperatively (Group B). Animals were sacrificed at 4 weeks and evaluated for histological and biomechanical testing. Statistical analysis was performed with an independent t test with significance set at P = 0.05. The ultimate stress was greater in group B (4.598 ± 1.321 N/mm(2)) compared with the control group (3.388 ± 0.994 N/mm(2)) (P tendon-to-bone interface with a larger area of chondrocytes was found in group B (P tendon-to-bone interface.

  13. Protein-containing nutrient supplementation following strength training enhances the effect on muscle mass, strength, and bone formation in postmenopausal women

    DEFF Research Database (Denmark)

    Holm, Lars; Olesen, Jens L; Matsumoto, Keitaro

    2008-01-01

    .0 +/- 1.4%); nutrient group: 0.953 +/- 0.051 to 0.978 +/- 0.043 g/mm(3) (3.8 +/- 3.4%)] when adjusted for age, body mass index, and BMD at inclusion. Bone formation displayed an interaction (P increased osteocalcin at 24 wk in the nutrient group. In conclusion, we report...... that nutrient supplementation results in superior improvements in muscle mass, muscle strength, femoral neck BMD, and bone formation during 24 wk of strength training. The observed differences following such a short intervention emphasize the significance of postexercise nutrient supply on musculoskeletal......We evaluated the response of various muscle and bone adaptation parameters with 24 wk of strength training in healthy, early postmenopausal women when a nutrient supplement (protein, carbohydrate, calcium, and vitamin D) or a placebo supplement (a minimum of energy) was ingested immediately...

  14. Protein-containing nutrient supplementation following strength training enhances the effect on muscle mass, strength, and bone formation in postmenopausal women

    DEFF Research Database (Denmark)

    Holm, Lars; Olesen, J.L.; Matsumoto, K.

    2008-01-01

    .4%); nutrient group: 0.953 ± 0.051 to 0.978 ± 0.043 g/mm3 (3.8 ± 3.4%)] when adjusted for age, body mass index, and BMD at inclusion. Bone formation displayed an interaction (P increased osteocalcin at 24 wk in the nutrient group. In conclusion, we report that nutrient supplementation...... results in superior improvements in muscle mass, muscle strength, femoral neck BMD, and bone formation during 24 wk of strength training. The observed differences following such a short intervention emphasize the significance of postexercise nutrient supply on musculoskeletal maintenance.......We evaluated the response of various muscle and bone adaptation parameters with 24 wk of strength training in healthy, early postmenopausal women when a nutrient supplement (protein, carbohydrate, calcium, and vitamin D) or a placebo supplement (a minimum of energy) was ingested immediately...

  15. Tendinitis of the Temporalis muscle: Differential diagnosis and treatment. A Case Report.

    Directory of Open Access Journals (Sweden)

    Veronica Iturriaga.

    2016-03-01

    Full Text Available Introduction: The temporalis muscle plays an essential role in mastication and is actively involved in the mandibular closing movement. It is covered by a fibroelastic fascia that forms its tendon. Tendinitis is a degenerative and inflammatory process, which originates in the tendon-bone junction. Signs and symptoms such as swelling, pain, tenderness on palpation, limitation of movement and mouth opening are frequently associated with other temporomandibular disorders and not with tendinitis as a causal factor. Objective: To describe a clinical case identifying the diagnostic process and management of tendinitis of the temporalis muscle. Case report: A 30-year old male patient who sought treatment after continuous squeezing pain in the zygomatic and bilateral temporal regions with increased pain during mouth opening and mandibular function. The patient referred pain in the insertion region of the tendon of the temporalis muscle. Pain was removed after using anesthesia, consequently confirming the diagnosis of tendinitis of the temporalis muscle. Primary management measures were performed and then peritendinous corticosteroids were administered. The patient did not refer spontaneous or functional pain during check-up. Conclusion: Tendinitis of the temporalis muscle is a common condition, although frequently underdiagnosed. A good differential diagnosis must be performed to avoid confusion with other common conditions such as odontogenic pain, sinusitis, arthralgia, myofascial pain and migraine. Management depends on the type of tendinitis. It usually occurs in conjunction with other types of TMD or facial pain, so it is important to know the different clinical characteristics of pathologies with similar manifestations.

  16. Changes in muscle fiber contractility and extracellular matrix production during skeletal muscle hypertrophy.

    Science.gov (United States)

    Mendias, Christopher L; Schwartz, Andrew J; Grekin, Jeremy A; Gumucio, Jonathan P; Sugg, Kristoffer B

    2017-03-01

    Skeletal muscle can adapt to increased mechanical loads by undergoing hypertrophy. Transient reductions in whole muscle force production have been reported during the onset of hypertrophy, but contractile changes in individual muscle fibers have not been previously studied. Additionally, the extracellular matrix (ECM) stores and transmits forces from muscle fibers to tendons and bones, and determining how the ECM changes during hypertrophy is important in understanding the adaptation of muscle tissue to mechanical loading. Using the synergist ablation model, we sought to measure changes in muscle fiber contractility, collagen content, and cross-linking, and in the expression of several genes and activation of signaling proteins that regulate critical components of myogenesis and ECM synthesis and remodeling during muscle hypertrophy. Tissues were harvested 3, 7, and 28 days after induction of hypertrophy, and nonoverloaded rats served as controls. Muscle fiber specific force (sF o ), which is the maximum isometric force normalized to cross-sectional area, was reduced 3 and 7 days after the onset of mechanical overload, but returned to control levels by 28 days. Collagen abundance displayed a similar pattern of change. Nearly a quarter of the transcriptome changed over the course of overload, as well as the activation of signaling pathways related to hypertrophy and atrophy. Overall, this study provides insight into fundamental mechanisms of muscle and ECM growth, and indicates that although muscle fibers appear to have completed remodeling and regeneration 1 mo after synergist ablation, the ECM continues to be actively remodeling at this time point. NEW & NOTEWORTHY This study utilized a rat synergist ablation model to integrate changes in single muscle fiber contractility, extracellular matrix composition, activation of important signaling pathways in muscle adaption, and corresponding changes in the muscle transcriptome to provide novel insight into the basic

  17. Modified frontolateral partial laryngectomy operation: combined muscle-pedicle hyoid bone and thyrohyoid membrane flap in laryngeal reconstruction

    International Nuclear Information System (INIS)

    Ouyang, Dian; Liu, Tian-Run; Chen, Yan-Feng; Wang, Jian

    2013-01-01

    Laryngeal reconstruction is needed to preserve laryngeal function in patients who have undergone extensive vertical or frontal partial laryngectomy. However, the procedure remains a difficult challenge. Several reconstruction techniques have been described, but these techniques pose risks of complications such as laryngeal stenosis. This study aimed to evaluate the postoperative course and functional outcomes of a new technique that combined a muscle-pedicle hyoid bone and a thyrohyoid flap during laryngeal reconstruction after tumor resection. Four patients underwent extensive vertical partial or frontal partial laryngectomy for cancer. After tumor resection, laryngeal reconstruction was performed using the proposed technique. Postoperative recovery time, complications, and oncologic results were evaluated. The four patients were successfully treated with the proposed technique. No dyspnea, dysphagia, or death occurred during the postoperative course. Decannulation was performed after a median of 3 days. The average postoperative hospital stay was 7 days. Short-term postoperative functional recovery was normal. No laryngeal stenosis or tumor recurrence was observed in any of the four patients after a follow-up period of more than 24 months. The combination of the muscle-pedicle hyoid bone and the thyrohyoid flap is a reliable procedure for laryngeal reconstruction after extensive vertical partial or frontal partial laryngectomy

  18. Supraspinatus Intramuscular Calcified Hematoma or Necrosis Associated with Tendon Tear

    Directory of Open Access Journals (Sweden)

    Alexandre Lädermann

    2015-01-01

    Full Text Available Introduction. Rotator cuff intramuscular calcification is a rare condition usually caused by heterotopic ossification and myositis ossificans. Case Presentation. We describe a patient with voluminous calcified mass entrapped in supraspinatus muscle associated with corresponding tendon tear. Histological examination corresponded to a calcified hematoma or necrosis. Patient was surgically managed with open excision of the calcified hematoma and rotator cuff arthroscopic repair. At 6 months, supraspinatus muscle was healed, and functional outcome was good. Discussion and Conclusion. We hypothesized that supraspinatus intramuscular calcified hematoma was responsible for mechanical stress on the tendon. This association has never been described.

  19. Myostatin inhibits osteoblastic differentiation by suppressing osteocyte-derived exosomal microRNA-218: A novel mechanism in muscle-bone communication.

    Science.gov (United States)

    Qin, Yiwen; Peng, Yuanzhen; Zhao, Wei; Pan, Jianping; Ksiezak-Reding, Hanna; Cardozo, Christopher; Wu, Yingjie; Divieti Pajevic, Paola; Bonewald, Lynda F; Bauman, William A; Qin, Weiping

    2017-06-30

    Muscle and bone are closely associated in both anatomy and function, but the mechanisms that coordinate their synergistic action remain poorly defined. Myostatin, a myokine secreted by muscles, has been shown to inhibit muscle growth, and the disruption of the myostatin gene has been reported to cause muscle hypertrophy and increase bone mass. Extracellular vesicle-exosomes that carry microRNA (miRNA), mRNA, and proteins are known to perform an important role in cell-cell communication. We hypothesized that myostatin may play a crucial role in muscle-bone interactions and may promote direct effects on osteocytes and on osteocyte-derived exosomal miRNAs, thereby indirectly influencing the function of other bone cells. We report herein that myostatin promotes expression of several bone regulators such as sclerostin (SOST), DKK1, and RANKL in cultured osteocytic (Ocy454) cells, concomitant with the suppression of miR-218 in both parent Ocy454 cells and derived exosomes. Exosomes produced by Ocy454 cells that had been pretreated with myostatin could be taken up by osteoblastic MC3T3 cells, resulting in a marked reduction of Runx2, a key regulator of osteoblastic differentiation, and in decreased osteoblastic differentiation via the down-regulation of the Wnt signaling pathway. Importantly, the inhibitory effect of myostatin-modified osteocytic exosomes on osteoblast differentiation is completely reversed by expression of exogenous miR-218, through a mechanism involving miR-218-mediated inhibition of SOST. Together, our findings indicate that myostatin directly influences osteocyte function and thereby inhibits osteoblastic differentiation, at least in part, through the suppression of osteocyte-derived exosomal miR-218, suggesting a novel mechanism in muscle-bone communication. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

  20. Slack length of gastrocnemius medialis and Achilles tendon occurs at different ankle angles.

    Science.gov (United States)

    Hug, François; Lacourpaille, Lilian; Maïsetti, Olivier; Nordez, Antoine

    2013-09-27

    Although muscle-tendon slack length is a crucial parameter used in muscle models, this is one of the most difficult measures to estimate in vivo. The aim of this study was to determine the onset of the rise in tension (i.e., slack length) during passive stretching in both Achilles tendon and gastrocnemius medialis. Muscle and tendon shear elastic modulus was measured by elastography (supersonic shear imaging) during passive plantarflexion (0° and 90° of knee angle, 0° representing knee fully extended, in a random order) in 9 participants. The within-session repeatability of the determined slack length was good at 90° of knee flexion (SEM=3.3° and 2.2° for Achilles tendon and gastrocnemius medialis, respectively) and very good at 0° of knee flexion (SEM=1.9° and 1.9° for Achilles tendon and gastrocnemius medialis, respectively). The slack length of gastrocnemius medialis was obtained at a significantly lower plantarflexed angle than for Achilles tendon at both 0° (Pslack can be experimentally determined using supersonic shear imaging. The slack length of gastrocnemius medialis and Achilles tendon occurred at different joint angles. Although reporting this result is crucial to a better understanding of muscle-tendon interactions, further experimental investigations are required to explain this result. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Biomechanical and immunohistochemical analysis of high hydrostatic pressure-treated Achilles tendons

    International Nuclear Information System (INIS)

    Diehl, P.; Steinhauser, E.; Gollwitzer, H.; Heister, C.; Schauwecker, J.; Schmitt, M.; Milz, S.; Mittelmeier, W.

    2006-01-01

    Reconstruction of bone defects caused by malignant tumors is carried out in different ways. At present, tumor-bearing bone segments are devitalized mainly by extracorporeal irradiation or autoclaving, but both methods have substantial disadvantages. In this regard, high hydrostatic pressure (HHP) treatment of the bone is a new, advancing technology that has been used in preclinical testing to inactivate normal cells and tumor cells without altering the biomechanical properties of the bone. The aim of this study was to examine the biomechanical and immunohistochemical properties of tendons after exposure to HHP and to evaluate whether preservation of the bony attachment of tendons and ligaments is possible. For this, 19 paired Achilles tendons were harvested from both hindlimbs of 4-month-old pigs. After preparation, the cross-sectional area of each tendon was determined by magnetic resonance imaging (MRI). For each animal, one of the two tendons was taken at random and exposed to a pressure of 300 MPa (n=9) or 600 MPa (n=10). The contralateral tendon served as an untreated control. The biomechanical properties of the tendons remained unchanged with respect to the tested parameters: Young's modulus (MPa) and tensile strength (MPa). This finding is in line with immunohistochemical labeling results, as no difference in the labeling pattern of collagen I and versican was observed when comparing the HHP group (at 600 MPa) to the untreated control group. We anticipate that during orthopedic surgery HHP can serve as a novel, promising methodical approach to inactivate Achilles tendon and bone cells without altering the biomechanical properties of the tendons. This should allow one to preserve the attachment of tendon and ligaments to the devitalized bone and to facilitate functional reconstruction. (author)

  2. An advanced glycation endproduct (AGE)-rich diet promotes accumulation of AGEs in Achilles tendon

    DEFF Research Database (Denmark)

    Skovgaard, Dorthe; Svensson, Rene B; Scheijen, Jean

    2017-01-01

    Advanced Glycation Endproducts (AGEs) accumulate in long-lived tissue proteins like collagen in bone and tendon causing modification of the biomechanical properties. This has been hypothesized to raise the risk of orthopedic injury such as bone fractures and tendon ruptures. We evaluated the rela......Advanced Glycation Endproducts (AGEs) accumulate in long-lived tissue proteins like collagen in bone and tendon causing modification of the biomechanical properties. This has been hypothesized to raise the risk of orthopedic injury such as bone fractures and tendon ruptures. We evaluated...... the relationship between AGE content in the diet and accumulation of AGEs in weight-bearing animal Achilles tendon. Two groups of mice (C57BL/6Ntac) were fed with either high-fat diet low in AGEs high-fat diet (HFD) (n = 14) or normal diet high in AGEs (ND) (n = 11). AGE content in ND was six to 50-fold higher...... than HFD The mice were sacrificed at week 40 and Achilles and tail tendons were carefully excised to compare weight and nonweight-bearing tendons. The amount of the AGEs carboxymethyllysine (CML), methylglyoxal-derived hydroimidazolone (MG-H1) and carboxyethyllysine (CEL) in Achilles and tail tendon...

  3. Elongamento do enxerto de tendões do músculo grácial e semitendinoso humanos: estudo realizado em cadáveres de adultos jovens Graft semitendinosus and gracilis human muscle tendons elongation: a study carried out on young adult human cadavers

    Directory of Open Access Journals (Sweden)

    Sérgio Rocha Piedade

    2005-01-01

    Full Text Available Na cirurgia de reconstrução do ligamento cruzado anterior do joelho, os enxertos de tendões autólogos são a principal opção como substitutos ligamentares. Entretanto, uma das razões da falha da reconstrução ligamentar com tecidos moles é o estiramento ou elongamento do enxerto com o tempo. Neste trabalho, foram ensaiados oito tendões do músculo grácil e oito do músculo semitendinoso humanos, obtidos de quatro cadáveres do sexo masculino, com idade média de 24,5 anos. Cada tendão foi submetido a uma deformação relativa constante de 2,5% durante 600 s, com registro contínuo do relaxamento de força. A seguir, o tendão retornava ao seu comprimento inicial e era mantido num período de repouso de 300 s. Após este intervalo, um segundo ensaio, semelhante ao primeiro, era realizado. A velocidade de carregamento empregada foi de 10% do comprimento inicial do corpo de prova por segundo. Foram obtidos valores de força inicial, com 300 s e 600 s nos dois ensaios. A análise estatística sugere um comportamento mecânico mais uniforme para o tendão do músculo semitendinoso quando comparado ao tendão do músculo grácil.In the anterior cruciate ligament knee surgery reconstruction, autologous tendons graft remains as a main option as substitutive ligaments. However time effect on graft elongation is the main reason of ligament reconstruction failure. Traction tests have been performed on eight gracilis as well as on eight semitendinosus human muscles tendons obtained from four male cadavers at an average of 24.5 years. Each tendon specimen has been submitted to a deformation of 2.5% of its initial length for a time interval of 600 s with continuous recording of the corresponding force relaxation. The tendon specimen was then kept at rest for 300 s as soon as it returned to its initial length. The same specimen was then submitted to a similar test. Deformation rate for both tests was 10% of its initial length per second. Initial

  4. Engaging Stem Cells for Customized Tendon Regeneration

    Directory of Open Access Journals (Sweden)

    Hatim Thaker

    2012-01-01

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

  5. Biomarkers of skeletal muscle and bone regeneration-adaptation to neurorehabilitation training strategies

    OpenAIRE

    Kern, Helmut; Carraro, Ugo; Marcante, Andrea; Baba, Alfonc; Piccione, Francesco; Esser, Karyn A.; Dyar, Kenneth A.; Ciciliot, Stefano; Tagliazucchi, Guidantonio Malagoli; Pallafacchina, Giorgia; Tothova, Jana; Argentini, Carla; Agatea, Lisa; Abraham, Reimar; Ahdesm?ki, Miika

    2016-01-01

    Functional recovery after peripheral nerve injury is reduced when axon growth is misdirected to reinnervate muscles other than their original targets.1-3 Here we review the effects of chronic electrical muscle stimulation (EMS) following peripheral nerve injury in rat, canine, and equine models of peripheral nerve injury. Specifically, we examine whether EMS accelerates reinnervation of muscular targets and if these targets are appropriately reinnervated by their original axons following nerv...

  6. Normal bone mineral content but unfavourable muscle/fat ratio in Klinefelter syndrome

    DEFF Research Database (Denmark)

    Aksglaede, L.; Mølgaard, Christian; Skakkebaek, N.E.

    2008-01-01

    OBJECTIVE: To evaluate body composition and bone mineral content (BMC) in children and adolescents with Klinefelter syndrome (KS). DESIGN: Retrospective cross-sectional study. SETTING: Tertiary endocrine clinic at the University Hospital, Copenhagen. PATIENTS: Eighteen untreated boys with KS...

  7. Phylogenetic patterns and correlation of key structures for jumping: bone crests and cross-sectional areas of muscles in Leptodactylus (Anura, Leptodactylidae).

    Science.gov (United States)

    Ponssa, María Laura; Fratani, Jéssica; Abdala, Virginia

    2018-05-01

    Anurans are characterized by their saltatory mode of locomotion, which is associated with a specific morphology. The coordinated action of the muscles and bones of the pelvic girdle is key to the transmission of the force of the hindlimbs to the axial skeleton during jumping. Two features are critical for optimal locomotory performance: the cross-sectional area of muscle and the bone crest attachment sites. The first character is a proxy of the force exerted by the muscle, whereas the crests are muscle attachments sites related to muscle force. The provisory relationship between these features has previously been identified and bone crest size can be used to infer the magnitude and, therefore, muscle force in fossils records. In this work, we explore the correlation between the cross-sectional area of essential muscles to the jumping mechanism (longissimus dorsi, extensor iliotibialis B, tenuissimus, puboischiofemoralis internus B, coccygeo-sacralis and coccygeo-iliacus) and the bone crests where these muscles are inserted (dorsal tubercle, dorsal crest and urostylar crest) in species of the genus Leptodactylus. This genus, along with other leptodactylids, exhibits a diversity of locomotor modes, including jumping, hopping, swimming and burrowing. We therefore analyzed the morphometric variation in the two features, cross-sectional area and bone crest area, expecting a correlation with different locomotor types. Our results showed: (i) a correlation between the urostylar crest and the cross-sectional area of the related muscles; (ii) that the bone crest surface area of urostyle and ilium and the cross-sectional area of the corresponding muscles can be utilized to infer locomotor faculties in leptodactylid frogs; and (iii) that the evolution of both characters demonstrates a general tendency from lower values in leptodactylid ancestors to higher values in the Leptodactylus genus. The results attest to the importance of the comparison of current ecological and

  8. [Achilles tendon rupture].

    Science.gov (United States)

    Thermann, H; Hüfner, T; Tscherne, H

    2000-03-01

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

  9. Region specific patella tendon hypertrophy in humans following resistance training

    DEFF Research Database (Denmark)

    Kongsgaard, M.; Reitelseder, S; Pedersen, T.G.

    2007-01-01

    AIM: To examine if cross-sectional area (CSA) differs along the length of the human patellar tendon (PT), and if there is PT hypertrophy in response to resistance training. METHODS: Twelve healthy young men underwent baseline and post-training assessments. Maximal isometric knee extension strength...... (MVC) was determined unilaterally in both legs. PT CSA was measured at the proximal-, mid- and distal PT level and quadriceps muscle CSA was measured at mid-thigh level using magnetic resonance imaging. Mechanical properties of the patellar tendons were determined using ultrasonography. Subsequently....... CONCLUSIONS: To our knowledge, this study is the first to report tendon hypertrophy following resistance training. Further, the data show that the human PT CSA varies along the length of the tendon....

  10. Improved healing of transected rabbit Achilles tendon after a single injection of cartilage-derived morphogenetic protein-2.

    Science.gov (United States)

    Forslund, Carina; Aspenberg, Per

    2003-01-01

    Achilles tendon ruptures in humans might be treated more efficiently with the help of a growth factor. Cartilage-derived morphogenetic protein-2 has been shown to induce formation of tendon-like tissue. Cartilage-derived morphogenetic protein-2 has a positive effect on mechanical parameters for tendon healing in a rabbit model with Achilles tendon transection. Controlled laboratory study. The right Achilles tendon of 40 rabbits was transected without tendon suture. Cartilage-derived morphogenetic protein-2 (10 micro g) or vehicle control (acetate buffer) was injected locally 2 hours postoperatively. All tendons were tested biomechanically at 8 and 14 days, and treated tendons were histologically and radiographically evaluated at 56 days. At 14 days, both failure load and stiffness of treated tendons were increased by 35%. The treated tendons had significantly larger callus size at 8 and 14 days. Histologic and radiographic examination showed no signs of ossification in the treated tendons after 56 days. A single injection of cartilage-derived morphogenetic protein-2 led to a stronger and stiffer tendon callus than that in the controls without inducing bone formation. Similar results from a larger animal model would suggest a possible future use of cartilage-derived morphogenetic protein-2 in the treatment of human Achilles tendon ruptures.

  11. Características morfológicas, histoquímicas e imunoistoquímicas dos tendões dos músculos semitendíneo e grácil: estudo comparativo entre os sexos Morphologic, histochemical, and immunohistochemical characteristics of the tendons of the semitendinosus and gracilis muscles: comparative study between men and women

    Directory of Open Access Journals (Sweden)

    Edgard dos Santos Pereira Júnior

    2008-05-01

    Full Text Available OBJETIVO: Comparar, entre os sexos, as características morfológicas, histoquímicas e imunoistoquímicas dos tendões dos músculos semitendíneo e grácil a serem utilizados como auto-enxerto nas cirurgias de reconstrução do ligamento cruzado anterior. MÉTODOS: Amostras dos tendões dos músculos semitendíneo e grácil de 36 pacientes (36 joelhos foram avaliadas. As idades variaram de 15 a 46 anos, com média de 29,3 anos. Com relação à cor, 33 pacientes eram brancos e três não brancos. Quanto ao lado, eram 23 joelhos direitos e 13 esquerdos. Os pacientes foram divididos em dois grupos, sexo masculino (n = 20 e feminino (n = 16. As amostras dos tendões foram submetidas à análise histológica, histoquímica e imunoistoquímica. RESULTADOS: Não se observaram diferenças estatisticamente significantes em relação à idade, ao sexo, à cor, ao lado, ao processo inflamatório, à vascularização, e à alcianofilia entre os grupos avaliados. Houve aumento da celularidade nos tendões do músculo semitendíneo em relação aos tendões do músculo grácil (sexo masculino p = 0,03 e sexo feminino p = 0,22. Pôde-se observar tendência nas mulheres à maior presença de calcificações dos tendões dos músculos semitendíneo e grácil (p = 0,06 e p = 0,09, e ao aumento da degeneração das fibras colágenas dos tendões do músculo semitendíneo (p = 0,06. Em relação à presença de receptores de estrógeno nos tendões dos músculos semitendíneo e grácil, observou-se aumento do número de receptores nos pacientes do sexo masculino. CONCLUSÃO: Observaram-se, entre os sexos, diferenças morfológicas, histoquímicas e imunoistoquímicas no tendão do músculo semitendíneo entre o tendão dos músculos grácil e semitendíneo no sexo masculino.OBJECTIVE: To compare the morphologic, histochemical, and immunohistochemical characteristics of the tendons of the semitendinosus and the gracilis muscles to be used as autograft in anterior

  12. The hamstring muscle complex

    NARCIS (Netherlands)

    van der Made, A. D.; Wieldraaijer, T.; Kerkhoffs, G. M.; Kleipool, R. P.; Engebretsen, L.; van Dijk, C. N.; Golanó, P.

    2015-01-01

    The anatomical appearance of the hamstring muscle complex was studied to provide hypotheses for the hamstring injury pattern and to provide reference values of origin dimensions, muscle length, tendon length, musculotendinous junction (MTJ) length as well as width and length of a tendinous

  13. Normal tendon sheath of the second to fifth fingers as seen on oblique views

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, E.

    1984-01-01

    Oblique views of the fingers, using a low kilovolt technique, show a portion of the tendon sheaths which can be regarded as representative of the entire sheath. Because of the varying obliquity of each finger, this proportion differs in the fingers. With increasing age the projected portion of the sheath becomes smaller because it is covered by increasing bone formation in the insertion of the tendon sheat. Normal values have been obtained for adults according to their decades; from these, quite minor degrees of tendon sheat thickening can be determined. In camptodactyly of the fifth finger, which is not uncommon, the tendon sheat may be widened in the absence of a tenosynovitis.

  14. Effect of pulsed electric field treatment on hot-boned muscles of different potential tenderness.

    Science.gov (United States)

    Suwandy, Via; Carne, Alan; van de Ven, Remy; Bekhit, Alaa El-Din A; Hopkins, David L

    2015-07-01

    In this study, the effect of pulsed electric field (PEF) treatment and ageing on the quality of beef M. longissimus lumborum (LL) and M. semimembranosus (SM) muscles was evaluated, including the tenderness, water loss and post-mortem proteolysis. Muscles were obtained from 12 steers (6 steers for each muscle), removed from the carcasses 4 hour postmortem and were treated with pulsed electric field within 2h. Six different pulsed electric fie