Ben Hickey1,2, Justin Lee1, Jo Stephen1,3, Jarrod Antflick1, James Calder1,3. 1. Fortius Clinic, London, England, UK. 2. Wrexham Maelor Hospital, Wrexham, Wales. 3. The Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, UK.
Abstract
PURPOSE: Open plantaris tendon excision and ventral paratendinous stripping is a recognised treatment option in selected patients with non-insertional Achilles tendinopathy. The aim of this study was to develop a minimally invasive outpatient technique of ultrasound guided plantaris tendon release (UPTR). METHODS: A 19 gauge needle, 15 gauge scalpel blade, hook knife (Smith and Nephew, Boston, MA, USA) and a beaver blade (Arthrex, Naples, FL, USA), were used under ultrasound guidance to identify and divide the plantaris tendon in 12 cadaveric legs. Specimens were dissected to identify whether division of the plantaris tendon had been successful. UPTR was subsequently performed on patients. RESULTS: The 15 gauge scalpel blade, hook knife (Smith and Nephew, Boston, MA, USA) and beaver blade (Arthrex, Naples, FL, USA) were all able to cut the plantaris tendon. However, on dissection the hook knife (Smith and Nephew, Boston MA) caused less damage to surrounding structures. Subsequently, the plantaris tendon was successfully divided in three patients using UPTR technique without complication. CONCLUSION: UPTR is a viable technique for treating plantaris related non-insertional Achilles tendinopathy.
PURPOSE: Open plantaris tendon excision and ventral paratendinous stripping is a recognised treatment option in selected patients with non-insertional Achilles tendinopathy. The aim of this study was to develop a minimally invasive outpatient technique of ultrasound guided plantaris tendon release (UPTR). METHODS: A 19 gauge needle, 15 gauge scalpel blade, hook knife (Smith and Nephew, Boston, MA, USA) and a beaver blade (Arthrex, Naples, FL, USA), were used under ultrasound guidance to identify and divide the plantaris tendon in 12 cadaveric legs. Specimens were dissected to identify whether division of the plantaris tendon had been successful. UPTR was subsequently performed on patients. RESULTS: The 15 gauge scalpel blade, hook knife (Smith and Nephew, Boston, MA, USA) and beaver blade (Arthrex, Naples, FL, USA) were all able to cut the plantaris tendon. However, on dissection the hook knife (Smith and Nephew, Boston MA) caused less damage to surrounding structures. Subsequently, the plantaris tendon was successfully divided in three patients using UPTR technique without complication. CONCLUSION: UPTR is a viable technique for treating plantaris related non-insertional Achilles tendinopathy.
Authors: Maayke N van Sterkenburg; Gino M M J Kerkhoffs; C Niek van Dijk Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-05-04 Impact factor: 4.342