preview

Achilles Tenon Injury

Better Essays

Unlike many other orthopedic injuries, Achilles tendon injuries are not fully understood, which results in heavily deliberated treatment procedures. Patients often have an unpredictable outcome with respect to return to function. Over the previous fifty years, the evolution of repair surgery for the Achilles tendon has been slow and minimal; furthermore, surgical repair is unpredictable and surrounded by complications5. Regarding surgical versus non-surgical procedures, there are existing studies that propose that conservative treatment not involving surgery give results comparable to surgical repair as long as patients undergo early rehabilitative protocols as well. However, it must be noted that the same studies discuss that the re-rupture …show more content…

Within each treatment group, some of the collected tissue samples were evaluated with histology and others were used for biomechanical testing. To examine and analyze the histology results the researchers developed an JNB Tendon Repair Histologic Scoring Scale because no scale previously existed to cover the proper variables5. Ranging from zero to three, zero being normal and three being the most disorganized poorly healed tissue, the core grades cellularity, collagen fiber organization, vascularity, cell shape, cartilage surrounding suture site, and granulation tissue. As seen in Table 1, Group 4, surgically repaired and receiving doxycycline, showed the lowest histology score at the first time point and more importantly retained a low score at the second collection time point, unlike the other groups5. Since Group 2, unrepaired and receiving doxycycline, showed a high histology score at both time points, it can be concluded that the primary, suture repair is more efficient than conservative repair5. Also when comparing Group 3 - surgically repaired and not receiving doxycycline to Group 4, Group 3 experiences a massive jump in histology score; this demonstrates the effective performance of doxycycline to help with tendon repair5. Regarding biomechanical function, the researchers tested the equilibrium tensile modulus - the …show more content…

For example, the study involving doxycycline discussed earlier was merely a pilot study and, therefore, is supposed to be regarded as a preliminary analysis. This study is meant to provide important information to orient more specific future research studies. As is the case with many biomedical research studies, this experiment is done using non-human subjects to avoid unknown, potentially harmful results to be projected on humans. This fact adds to the mystery surrounding the Achilles tendon; although rats are a good model system for humans, there is a great amount of generalizability done when transferring the data and results from rats to be interpreted for humans. In terms of procedure, noteworthy discrepancies exist in the discussed study. For example, the administration of doxycycline to the rats started one day prior to the induced tendon laceration5. This is a distortion of reality because in humans we do not know when we will receive an injury to our Achilles tendon. Furthermore, the injury to the tendon in the rats was surgically induced using a knife5. Again, this is unrealistic for humans because Achilles tendon injuries do not occur naturally by way of knife but rather are usually traumatic and do not yield the same clean cut that was obtained in this study. This is important to note because the way the injury was induced could impact the healing process

Get Access