Erica Domeij Arverud1, Olof Persson-Lindell2, Fredrik Sundquist2, Fausto Labruto3, Gunnar Edman4, Paul W Ackermann2. 1. Department of Orthopedic Surgery, Danderyd Hospital, Stockholm, Sweden. 2. Department of Orthopedic Surgery, Karolinska University Hospital, Stockholm, Sweden. 3. Section of Diagnostic Imaging, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. 4. Department of Neurobiology, Care Sciences, and Society, Centre of Family Medicine (CeFAM), Karolinska Institutet, Stockholm, Sweden.
Abstract
INTRODUCTION: Achilles tendon (AT) rupture exhibits a prolonged healing process with varying clinical outcome. Reduced blood flow to the AT has been considered an underlying factor to AT rupture (ATR) and impaired healing. In vivo measurements using laser Doppler flowmetry (LDF) may be a viable method to assess blood flow in healthy and healing AT. METHODS: 29 persons were included in the study; 9 being ATR patients and 20 healthy subjects without any prior symptoms from the AT. Invasive LDF was used to determine the post-occlusive reactive hyperemia (PORH) in the paratenon after 15 minutes of occlusion of the lower extremities. ATR patients were examined two weeks post-operatively. RESULTS: LDF-assessments demonstrated a significantly different (p < 0.001) PORH response in the healing- versus intact- and control AT. In the healing AT, a slow, flattened PORH was observed compared to a fast, high peak PORH in intact, healthy AT. CONCLUSION: in vivo LDF appears to be a feasible method to assess alterations in blood flow in healing and intact AT. The healing ATs capability to react to an ischemic period is clearly impaired, which may be due to the trauma at injury and/or surgery or degenerative changes in the tendon.
INTRODUCTION:Achilles tendon (AT) rupture exhibits a prolonged healing process with varying clinical outcome. Reduced blood flow to the AT has been considered an underlying factor to AT rupture (ATR) and impaired healing. In vivo measurements using laser Doppler flowmetry (LDF) may be a viable method to assess blood flow in healthy and healing AT. METHODS: 29 persons were included in the study; 9 being ATR patients and 20 healthy subjects without any prior symptoms from the AT. Invasive LDF was used to determine the post-occlusive reactive hyperemia (PORH) in the paratenon after 15 minutes of occlusion of the lower extremities. ATR patients were examined two weeks post-operatively. RESULTS: LDF-assessments demonstrated a significantly different (p < 0.001) PORH response in the healing- versus intact- and control AT. In the healing AT, a slow, flattened PORH was observed compared to a fast, high peak PORH in intact, healthy AT. CONCLUSION: in vivo LDF appears to be a feasible method to assess alterations in blood flow in healing and intact AT. The healing ATs capability to react to an ischemic period is clearly impaired, which may be due to the trauma at injury and/or surgery or degenerative changes in the tendon.
Authors: Katarina Nilsson-Helander; Karin Grävare Silbernagel; Roland Thomeé; Eva Faxén; Nicklas Olsson; Bengt I Eriksson; Jon Karlsson Journal: Am J Sports Med Date: 2010-08-27 Impact factor: 6.202
Authors: Md Abdul Alim; Erica Domeij-Arverud; Gunnar Nilsson; Gunnar Edman; Paul W Ackermann Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-07-01 Impact factor: 4.342