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The present study aimed to evaluate the new heterologous fibrin biopolymer associated, or not, with photobiomodulation therapy for application in tendon injuries, considered a serious and common orthopedic problem. Thus, 84 Rattus norvegicus had partial transection of the calcaneus tendon (PTCT) and were randomly divided into: control (CG); heterologous fibrin biopolymer (HFB); photobiomodulation (PBM); heterologous fibrin biopolymer + photobiomodulation (HFB + PBM). The animals received HFB immediately after PTCT, while PBM (660 nm, 40 mW, 0.23 J) started 24 h post injury and followed every 24 h for 7, 14, and 21 days. The results of the edema volume showed that after 24 h of PTCT, there was no statistical difference among the groups. After 7, 14, and 21 days, it was observed that the treatment groups were effective in reducing edema when compared to the control. The HFB had the highest edema volume reduction after 21 days of treatment. The treatment groups did not induce tissue necrosis or infections on the histopathological analysis. Tenocyte proliferation, granulation tissue, and collagen formation were observed in the PTCT area in the HFB and HFB + PBM groups, which culminated a better repair process when compared to the CG in the 3 experimental periods. Interestingly, the PBM group revealed, in histological analysis, major tendon injury after 7 days; however, in the periods of 14 and 21 days, the PBM had a better repair process compared to the CG. In the quantification of collagen, there was no statistical difference between the groups in the 3 experimental periods. The findings suggest that the HFB and PBM treatments, isolated or associated, were effective in reducing the volume of the edema, stimulating the repair process. However, the use of HFB alone was more effective in promoting the tendon repair process. Thus, the present study consolidates previous studies of tendon repair with this new HFB. Future clinical trials will be needed to validate this proposal. [ABSTRACT FROM AUTHOR]

Abstract The increasing incidence of calcaneal tendon ruptures has substantially impacted orthopedic care and costs related to its treatment and prevention. Primarily motivated by the increasing of life expectancy, the growing use of tenotoxic drugs and erratic access to physical activity, this injury accounts for considerable morbidity regardless of its outcome. In recent years, the evolution of surgical and rehabilitation techniques gave orthopedists better conditions to decide the most appropriate conduct in acute tendon rupture. Although still frequent due to their high neglect rate, Achilles chronic ruptures currently find simpler and more biological surgical options, being supported by a new specialty-focused paradigm.

Calcaneal tendon (CT) is the strongest tendon in the human body, with a great capacity to support load. CT is vulnerable to repetitive strain injuries since it receives too much load, responsible for 18% of all injuries in sports. Diagnostic ultrasound (US) is a cheap, dynamic and fast technique for assessing tendon tissues, which can be associated with clinical tests for the diagnosis of tendinopathies. Considering that the symmetry of the organism is related to good general health, the aim of this study was to evaluate the morphology and clinical aspects of CT in individuals with and without CT tendinopathy. 28 individuals participated in the study: 15 in the control group (CG) and 13 in the tendinopathy group (TG). The participants underwent specific CT assessments: US examination, palpation and clinical tests. The subjects of the CG had an average of 0.407 cm and 0.389 cm for CT thickness (right CT and left CT), and no abnormalities were shown that would indicate inflammation in the US images and in clinical tests. In the TG individuals, the CT thickness values were higher, reaching up to 0.563 cm, in addition to showing changes in the US images for inflammation. The difference in CT thickness among members of the individuals in CG was 10%, while in the GT it was 22%. By the results, it is suggested that differences in CT thickness greater than 20% indicate the presence of tendinopathy, confirmed by the findings in the ultrasound images and by the positive results of the palpation and clinical tests. [ABSTRACT FROM AUTHOR]

OBJETIVO: O objetivo do estudo foi avaliar o efeito, nas propriedades mecânicas, do arranjo de reparo com material de sutura, no tendão calcâneo de rato, na ausência de processo de cicatrização. MÉTODO: Foram utilizados 12 ratos machos da linhagem Wistar. Os animais foram submetidos à colocação de ponto de sutura tipo Kessler modificado no tendão calcâneo. Os sacrifícios foram realizados nos períodos imediato e com seis semanas de pós-operatório. As propriedades mecânicas estudadas foram: carga máxima, tensão na carga máxima e módulo de elasticidade. O tendão contralateral foi usado como controle. RESULTADOS: A análise estatística indicou que, em relação aos períodos estudados, os valores das propriedades mecânicas não apresentaram diferenças significativas. Em relação ao controle, isto é, tendão contralateral sem sutura, os resultados demonstram que, com seis semanas de pós-operatório, houve queda dos valores do módulo de elasticidade, enquanto a carga máxima e a tensão na carga máxima não apresentaram variações significativas. CONCLUSÃO: A colocação de material de sutura em tendão extrassinovial não lesado provocou queda do módulo de elasticidade, porém não interferiu na carga máxima e na tensão na carga máxima após seis semanas de pós-operatório.OBJECTIVE: The aim of this study was to evaluate the effects on the mechanical properties of rats' calcaneus tendons, of repair arrangements using suture material in the absence of any healing process. METHOD: Twelve male Wistar rats were used. They were subjected to placement of a modified Kessler suture stitch in the calcaneus tendon. The sacrifices were performed immediately after and six weeks after the operation. The mechanical properties studied were maximum load, tension in the maximum load and module of elasticity. The contralateral tendon was used as a control. RESULTS: The statistical analysis showed that for the times studied, the values for mechanical properties did not present any significant differences. In relation to the control, i.e. the contralateral tendon without a suture, the results demonstrated that, six weeks after the operation, the values for the modulus of elasticity were lower, whereas there were no significant variations in maximum load or tension at maximum load. CONCLUSION: Placement of suture material on an extrasynovial tendon without lesions decreased the modulus of elasticity, but it did not interfere with the maximum load or tension at maximum load, six weeks after the operation.

In man the calaneous tendon (CT) is the most voluminous and resistent tendon in the body: its insertion is a vital element of the foot joint mechanism as well as in a number of disorders that affect talocrural and calcaneal regions. For the present study 120 lower members (60 right and 60 left) of tormolized cadavers, adult subjects of both sexes were used. Posterior surface of the leg was disected from the joint line of the knee to the lower part of the calcaneal removing precalcaneus adipose tissue, exposing the CT. We observed that in 62 cases (51.67%) the CT was formed exclusively by fusion of aponeurosis of the gastrocnemius and soleus muscles. In 38 cases (31.67%) tendon of the plantar muscle contributes to the partial formation of the CT, and fully integrated in 20 cases (16.66%). Width of the CT at the soleus muscle belly end, was 12.88 mm ± 2.0 in men and 11.55 mm ± 1.6 women and density at the same level was 4.29 mm ± 0.64 in men and 4.36 mm ± 0.64 in women. Width of the CT at the posterosuperior border of the calcaneal was 17.98 mm ± 17 in men, and 17.06 mm ± 1.53 in women. CT density at the same level was 3.79 mm ± 0.61 in men and 3.93 mm ± 0.67 in women. Distance between posterosupcrior border of the calcaneal and starting point of the inserted portion of the CT was 10.99 mm ± 2.11 in men and 10.84 ± 2.71 in women. Length of the inserted portion of the CT was 17.78 mm ± 2.4 in men and 17.66 mm ± 4.75 in women. Width of the CT at the insertion level in the calcaneus bone was 28.77 mm ± 2.53 in men and 27.21 mm ± 2.93 in women. Insertional CT tendinopathy is a chronic condition in some cases requiring surgical debridement of the tendon. Therefore, knowledge of morphological aspects of the CT and its insertion is important at the time of surgical procedures of the talocrural region. [ABSTRACT FROM AUTHOR]

The article discusses research which was conducted to investigate whether reducing load transmission to the Achilles tendon by gastrocnemius lengthening would be effective in treating noninsertional Achilles tendinopathy. Researchers evaluated 14 patients. They found that the technique was effective in treating chronic Achilles noninsertional tendinopathy.

The increasing incidence of calcaneal tendon ruptures has substantially impacted orthopedic care and costs related to its treatment and prevention. Primarily motivated by the increasing of life expectancy, the growing use of tenotoxic drugs and erratic access to physical activity, this injury accounts for considerable morbidity regardless of its outcome. In recent years, the evolution of surgical and rehabilitation techniques gave orthopedists better conditions to decide the most appropriate conduct in acute tendon rupture. Although still frequent due to their high neglect rate, Achilles chronic ruptures currently find simpler and more biological surgical options, being supported by a new specialty-focused paradigm., Competing Interests: Conflito de Interesses Os autores declaram não haver conflito de interesses., (Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Objective: The aim of this study was to evaluate the effects on the mechanical properties of rats' calcaneus tendons, of repair arrangements using suture material in the absence of any healing process., Method: Twelve male Wistar rats were used. They were subjected to placement of a modified Kessler suture stitch in the calcaneus tendon. The sacrifices were performed immediately after and six weeks after the operation. The mechanical properties studied were maximum load, tension in the maximum load and module of elasticity. The contralateral tendon was used as a control., Results: The statistical analysis showed that for the times studied, the values for mechanical properties did not present any significant differences. In relation to the control, i.e. the contralateral tendon without a suture, the results demonstrated that, six weeks after the operation, the values for the modulus of elasticity were lower, whereas there were no significant variations in maximum load or tension at maximum load., Conclusion: Placement of suture material on an extrasynovial tendon without lesions decreased the modulus of elasticity, but it did not interfere with the maximum load or tension at maximum load, six weeks after the operation.