Article

Early microcirculatory responses after experimental tenotomy are
critical to the healing of tendons and their ultimate tensile strength. The
effects of changes in microcirculation on the outcomes of tendon healing,
however, have not been determined. OBJECTIVES: To assess microcirculation values
in injured Achilles tendons in the first 3 months after surgical repair and to
correlate the inter-limb microcirculatory changes with functional outcomes at 3
and 6 months after surgery. DESIGN: Case-control study. SETTING: A university
sports physiotherapy laboratory. PARTICIPANTS: Thirteen subjects (median age: 45
years; range: 34.8-51.9 years) with a repaired Achilles tendon were recruited.
METHODS OR INTERVENTION: Surgical repair. MAIN OUTCOME MEASUREMENTS: Measurements
were obtained at 1, 2, 3, and 6 months after surgery. Bilateral measurements of
tendon microcirculation (total hemoglobin [THb] and oxygen saturation [StO2])
were recorded at the first 3 time points, whereas outcome measures of a Taiwan
Chinese version of the Victorian Institute of Sport Assessment Scale-Achilles
questionnaire, one-leg hopping distance, the star excursion balance test, and the
heel raise index were conducted at the third and fourth time points. Correlations
between the inter-limb microcirculatory changes, eg, between the measurements at
2 months and 1 month (2-1) after surgery, at 3 months and 2 months (3-2) after
surgery, and at 3 months and 1 month (3-1) after surgery, and the outcome
measures were investigated. RESULTS: Compared with the noninjured tendons, the
repaired Achilles demonstrated greater THb (at 1, 2, and 3 months; P = .017,
.008, and .012 respectively) and StO2 (at 3 months; P = .017). Furthermore, the
THb2-1 and THb3-2, StO2 2-1, and StO2 3-2 showed correlations with the heel raise
index, differences in the star excursion balance test and one-leg hopping
distance between the noninjured leg and injured leg, and Taiwan Chinese version
of the Victorian Institute of Sport Assessment Scale-Achilles questionnaire
scores (rho -0.921 to 0.855). CONCLUSIONS: Changes in the inter-limb
microcirculation shortly after Achilles repair were correlated with subsequent
symptoms and functional symmetry. LEVEL OF EVIDENCE: III.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS