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Achilles tendon injury

Tendon elongation and soleus muscle fine structure in rabbit after different therapies

Summary

Unilateral tenotomy of the Achilles tendon was carried out in 60 rabbits. The limb was then either mobilized directly or immobilized for 10 to 35 days using a plaster usually after tendon suture. In certain cases the plaster was removed early (on the 7th or 16th day) and the animals were than allowed to use this leg.

Separation between tendon ends was apparent from steel markers, placed close to each cut end of the tendon and examined by X-ray. The separation curve was biphasic and both the first and the inactive phase reflected the degree of tension over the tendon suture. However, during the second separation phase, which began between the 17th and 21st day, the separation gradually reached the same level in all groups. Enzyme histochemistry and electron microscopy revealed severe degenerative changes in immobilized and in shortened muscles. Furthermore, a gradual shift in fibre type characteristics from type 1 slow-twitch fibres towards type 2 fast-twitch fibres occurred. Rapid recovery followed removal of the plaster.

The findings indicated that both degenerative and regenerative processes and adaptive processes had been initiated in all experimental muscles when the tendon continuity was broken. The adaptive processes progressed gradually during the five-week post-operative period and might have been responsible for the second phase of the tendon end separation. The fibre adaptation, i.e. the transformation, may be accounted for by changes in structure of the myofibrils and composition of the myosin molecules.

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References

  • Billeter R, Weber H, Lutz H, Howald H, Eppenberger HM, Jenny E (1980) Myosin types in human skeletal muscle fibers. Histochemistry 65:249–259

    Google Scholar 

  • Bergljung L (1968) Vascular reactions after tendon suture and tendon transplantation. A micrograph study in the rabbits. Scand J Plast Reconstr Surg, Suppl 4:7–63

    Google Scholar 

  • Booth FW, Seider MJ (1979) Recovery of skeletal muscle after 3 mo of hindlimb immobilization in rats. J Appl Physiol: Respirat Environ Exercise Physiol 47:435–439

    Google Scholar 

  • Carlson BM (1973) The regeneration of skeletal muscle: a review. Am J Anat 137:119–150

    Google Scholar 

  • Cowan RR, Courtemanche AD (1959) An experimental study of tendon suturing techniques. Canad J Surg 2:373–380

    Google Scholar 

  • Dubowitz V, Brooke MH (1973) Muscle biopsy: A modern approach, Saunders, London

  • Edgerton VR, Barnard RJ, Peter JB, Maier A, Simpson DR (1975) Properties of immobilized hind-limb muscles of the Galago senegalensis. Exp Neurol 46:115–131

    Google Scholar 

  • Ejeskär A (1981) Elongation in profundus tendon repair — a clinical and radiological study. Scand J Plastic Reconstr Surg (in press)

  • Fugl-Meyer AR, Nordin G, Sjöström M, Wählby L (1979) Achilles tendon injury. 5. A model for isokinetic strength training using biofeedback. Scand J Rehab Med 1:37–44

    Google Scholar 

  • Goldspink DF (1977) The influence of immobilization and stretch on protein turn over of rat skeletal muscle. J Physiol, London, 264:267–282

    Google Scholar 

  • Hayat A, Tardieu C, Tabary JC, Tabary C (1978) Effects of denervation on the reduction of sarcomere number in cat soleus muscle immobilized in shortened position during seven days. J Physiol, Paris, 74:563–567

    Google Scholar 

  • Hoh JFY, Yeoh GPS (1979) Rabbit skeletal myosin isoenezymes from fetal, fast-twitch and slow-twitch muscles. Nature 280:321–322

    Google Scholar 

  • Huet de la Tour E, Tabary JC, Tabary C, Tardieu C (1979) The respective roles of muscle length and muscle tension in sarcomere number adaptation of guinea-pig soleus muscle. J Physiol, Paris, 75:589–592

    Google Scholar 

  • Lutz H, Weber H, Billeter R, Jenny E (1979) Fast and slow myosin within single skeletal muscle fibers of adult rabbits. Nature 281:142–144

    Google Scholar 

  • Nyström B, Holmlund D (1982) Separation of tendon ends after tendon suturing with varying suture techniques and suture materials. Scand J Plast Reconstr Surg (in press)

  • Rubinstein N, Mabuchi K, Pepe F, Salmons S, Gergely J, Sreter F (1978) Use of type specific antimyosins to demonstrate the transformation of individual fibers in chronically stimulated rabbit fast muscles. J Cell Biol 79:252–261

    Google Scholar 

  • Schmitt HP (1976) Measurements of volontary muscle fiber cross sections: A comparative study of different possible methods. Microscopia Acta 77:427–440

    Google Scholar 

  • Smart GW, Taunton JE, Clement DB (1980) Achilles tendon disorders in runners — a review. Med Sci Sports exercise 12:231–243

    Google Scholar 

  • Sjöström M, Wählby L, Fugl-Meyer A (1979) Achilles tendon injury. 3. Structure of rabbit soleus muscles after immobilization at different positions. Acta Chir Scand 145:509–521

    Google Scholar 

  • Studitsky AN (1974) The neural factor in the development of transplanted muscles. In: Exploratory concepts in muscular dystrophy. II. Control mechanism in development and related neuromuscular diseases (AT Milhorst ed), Excerpta Medica, Amsterdam, p 351

    Google Scholar 

  • Tabary JC, Tabary C, Tardieu C, Tardieu G, Goldspink G (1972) Physiological and structural changes in the cat's soleus muscle due to immobilization at different lengths by plaster casts. J Physiol 224:231–244

    Google Scholar 

  • Tomanek RJ, Lund DD (1974) Degeneration of different types of skeletal muscle fibres. II. Immobilization. J Anat 118:531–541

    Google Scholar 

  • Wählby L, Dahlbäck L-O, Sjöström M (1978) Achilles tendon injury. II. Structure of tenotomized rabbit crural muscles after primary and delayed tendon suture. Acta Chir Scand 144:359–369

    Google Scholar 

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Supported by grants from the Swedish Medical Research Council of the Swedish Sports Federation

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Sjöström, M., Nyström, B. Achilles tendon injury. Vichows Archiv A Pathol Anat 399, 177–189 (1983). https://doi.org/10.1007/BF00619578

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  • DOI: https://doi.org/10.1007/BF00619578

Key words

  • Achilles tendon
  • Tendon injuries
  • Muscles
  • Myofibrils
  • Ultrastructure