Showing papers in "Sports Medicine and Arthroscopy Review in 2000"
85 citations
TL;DR: Tendon pathology has become particularly relevant only in the last few years, principally for two reasons: the diffusion of competitive sports at a high level and different approach to tendon problems since there is a better knowledge on the physiopathology and molecular structure of tendons.
Abstract: Tendons disorders can be disabling. Tendon pathology has become particularly relevant only in the last few years, principally for two reasons:
The diffusion of competitive sports at a high level
Different approach to tendon problems since there is a better knowledge on the physiopathology and molecular structure of tendons
75 citations
55 citations
TL;DR: In insertional tendinopathy, the pre-Achilles bursa is removed, together with the lateral and medial outgrowth of bone and cartilage of the posterior border of the calcaneus, as is done with Haglund deformity, thus preventing further impingement of the tendon insertion.
Abstract: Summary: Achilles tendinopathy is one of the most common overuse problems in running athletes. When conservative management is unsuccessful, surgery is indicated to increase the likelihood that the patient will return to high levels of sporting activity. Circulatory, metabolic, and mechanical factors are involved in the pathogenesis of the tendinopathy. In surgery for chronic paratendinopathy, we use different techniques depending on the extension of the adhesions and the thickening of the paratenon, removing the fibrotic rinds of the fascia and the hypertrophic parts of the paratenon, taking care not to disturb the mesotendon. In paratendinopathy associated with tendinopathy of the main body of the tendon and in isolated tendinopathy of the main body of the tendon, we free the tendon from fibrotic adhesions and remove the degenerated nodules. Longitudinal tenotomies are performed to try to re-establish tendon nutrition, or at least to cause tendon scarring. Moreover, to improve the blood supply in tendons with extensive degeneration, we have started to place a bundle of soleus muscle within the tendon itself. In insertional tendinopathy, the pre-Achilles bursa is removed, together with the lateral and medial outgrowth of bone and cartilage of the posterior border of the calcaneus, as is done with Haglund deformity, thus preventing further impingement of the tendon insertion.
38 citations
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14 citations
TL;DR: Achilles tendon ruptures became increasingly common in the latter half of the 20th century and the treatment choice should incorporate the patient's needs, desires, objectives, and functional goals to assure an optimal result.
Abstract: Achilles tendon ruptures became increasingly common in the latter half of the 20th century. Once the diagnosis is made, the patient's goals and objectives should be clearly stated. The treatment choice should incorporate the patient's needs, desires, objectives, and functional goals to assure an optimal result.
13 citations
TL;DR: Clinical results at preliminary 1- to 2-year follow-ups are very encouraging and further studies will be needed to confirm long-term efficacy of monopolar thermal energy application in the ankle.
Abstract: Thermal energy delivery systems, such as the monopolar radiofrequency (RF) systems, have growing applications in orthopedics These systems are approved for both high-power and low-power applications Basic science studies have shown that controlled thermal energy application results in structural changes in the collagen of ligamentous tissue that translates to shrinkage of the ligaments A fibroblastic response follows that thickens the treated tissue and promotes new collagen in-growth Current uses of thermal energy in the ankle include the treatment of lateral capsule and ligamentous laxity, via temperature-controlled low-power RF energy The procedure is technically easy to perform and the complication rate is low Clinical results at preliminary 1- to 2-year follow-ups are very encouraging Other applications of lowpower energy include the treatment of mild injuries of the articular cartilage and debridement of synovitis after syndesmosis sprains High-power applications include ablation of fibrosis, loose bodies, diseased synovium, and debridement of soft tissue impingement lesions Although these results of monopolar thermal energy application in the ankle are preliminary, the patient satisfaction rate has been very high Further studies will be needed to confirm long-term efficacy of these procedures
TL;DR: The mini-open technique has more aspects of a cuff repair performed through the arthroscope leaving a few steps to be done open.
Abstract: Open shoulder procedures require a deltoid release for proper exposure. Arthroscopic techniques have progressed so that minimally invasive techniques give similar outcomes as more formal open procedures with less risk of morbidity. Arthroscopically assisted open rotator cuff repair offers advantages over open procedures with some diagnostic and decompression performed with the arthroscope. The mini-open technique has more aspects of a cuff repair performed through the arthroscope leaving a few steps to be done open. The modern use of arthroscopic techniques for minimally invasive rotator cuff surgery coupled with advances in rehabilitation is discussed.