N Maffulli

..This article outlines the stages of tendon healing, and reviews the possible strategies for optimizing tendon healing and repair, such as cytokine therapy, gene therapy, and tissue engineering...

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..Several techniques for the reconstruction of chronic tears of the Achilles tendon have been described, but the superiority of one technique over the others has not been demonstrated...

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..Research More and better scientific evidence is necessary to use augmentation of rotator cuff repairs in routine clinical practice...

..Area timely for developing research ACS can lead to enhancement of tissue regeneration and to reduction of degenerative mechanisms...

..Less-extensive and gentler exposure and dissection of deep soft tissues could reduce the times of recovery and rehabilitation after Achilles tendon reconstruction...

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..We recommend to reconstruct the ACL paying attention to avoid irreversible damage to the epiphyseal growth plates of the lower femur and upper tibia...

..This systematic literature review synthesizes the current findings of the effects of pre-cooling on endurance exercise performance, providing guidance for clinical practice and further research...

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..Post-operative stiffness negatively affects surgical outcomes leading to a substantial comorbidity and to the failure of surgical treatment. Also, a stiff shoulder could commonly be concomitant with an rotator cuff tear (RCT)...

..Anterior cruciate ligament (ACL) rupture is the most common surgically treated ligament injury. Many efforts have been taken to reconstruct it as anatomically as possible to restore knee stability and, possibly, prevent knee osteoarthritis...

..This review aims to establish what effect weightlifting has on the systolic and diastolic function of the left ventricular (LV)...

..The long-term biological consequences of exposure to Co-Cr particles and ions remain largely unknown...

..To assess histological changes and possible differences in the quadriceps of patients undergoing open repair of the tendon after spontaneous rupture, and subjects with no history of tendon pathology...

..An engaging Hill-Sachs lesion is a defect of the humeral head, large enough to cause locking of the humeral head against the anterior corner of the glenoid rim when the arm is at 90° of abduction and more than 30° of external rotation...

..In this review, we discuss the theories of pathogenesis behind CT. Better understanding of the pathogenesis is essential for development of effective treatment modalities and for improvement of clinical outcomes...

..The elongated structure must be shortened to restore effective push off. We report the results of a longitudinal study using Z-shortening of ruptured Achilles tendons that healed in continuity but were elongated...

..However, no definitive data on the superiority of DB reconstruction have been shown when compared with single-bundle (SB) ACL reconstruction...

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..Using the Coleman methodology score, we show that the methods used in obtaining and reporting clinical findings and intervention results could be improved. Where possible, we suggest improvements...

..Although there have been some studies investigating the effectiveness of adductor longus tenotomy, none have investigated bilateral adductor tenotomy for unilateral tendinopathy...

..Chronic tears of the Achilles tendon can result in substantial loss of function. Those tears with a tendon gap of up to 6.5 cm can be treated surgically with use of an autologous peroneus brevis tendon graft...

..The purpose of this study is to report the long-term results of reconstruction of such chronic Achilles tendon ruptures with use of a free autologous gracilis tendon graft...

..The co-implantation of ECs with MSCs is more intriguing when we take into account the vast array of complex reciprocal interactions between ECs and MSCs...

..Further research is required to fully elucidate the role of the TREK-1 ion channel in intervertebral disc cells...

..We prompt researchers to undertake appropriately powered level I studies with adequate and relevant outcome measures and clinically appropriate follow up...

..In the USA, 10 million people over 50 suffer from osteoporosis. In these patients, 1.5 million annual fractures have been registered, and 50% of these are vertebral compression...

..Greater trochanteric pain syndrome (GTPS) is a debilitating condition characterized by lateral hip pain located at or around the greater trochanter...

..Recently, structured training programs for sports injury prevention ("The 11" and "The 11+") have been validated in soccer. The FIFA 11+ program has not been evaluated in basketball...

..Little is known about therapeutic ultrasound (TUS) to diagnose bone stress injuries...

..Areas timely for developing research Research in this field could lead to better understanding of mechanisms behind aseptic osteolysis, and improve the results of THA...

..Although the clinical and functional outcomes of patients undergoing knee arthroplasty have widely been investigated, there is little information on the postoperative sport activity status...

..Our study provides a detailed structural characterization of the newly formed tissue in an experimental model of tibial lengthening in sheep and may be useful for further investigations on callotasis...

..Aim of the study was the assessment of training and especially detraining on the patellar tendon (PT) and its enthesis...

..In particular it is not clear whether surgery gives better outcomes than non-surgical management. Currently there is much variation in the use of surgery and a lack of good quality evidence to inform this decision...

..Non-surgical approaches have been developed to enhance nerve recovery, which are complementary to surgery and are an adjunct to the reinnervation process...

..Active prevention measures are the main weapon to decrease the (re-)injury rate and to increase athletic performance...

..The medial patellofemoral ligament (MPFL) is the primary passive restraint to lateral patellar dislocation and there is increasing awareness of its role in recurrent lateral patellar instability...

..Physical stimulation therapies are currently available to enhance fracture healing...

..Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence...

..Future randomized controlled trials are required to address the issue of the comparison between open versus minimally invasive AT surgery...

..Stiffness, infection and failure of repair are the more frequent complications reported...

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..1-3.2 years). Patients having the osteotomy had similar AOFAS and FAOS scores with less operating time and earlier discharge. Less operative time may benefit the patients, and earlier discharge has financial implications for the hospital...

..We performed a retrospective review of prospectively collected data study to evaluate the results of percutaneous repair of an acute AT rupture in elite athletes...

..New minimally invasive techniques for the management of this condition, including endoscopy are also reported...

..Several reconstruction procedures have been proposed to manage recurrent dislocation of the superior tibiofibular joint...

..Studies of higher levels of evidence, concentrating on large adequately powered randomized trials, should be conducted to help answer these questions...

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..Randomized controlled trials are necessary to better clarify the best therapeutic options for the management of tendinopathy...

..The aim of this study is to evaluate the results of percutaneous repair of an acute AT rupture in diabetic patients...

..To assess whether benefits from sports participation outweigh the risks, future research should involve questionnaires regarding the health-related quality of life in former athletes, to be compared with the general population...

..A less-invasive technique to reconstruct chronic Achilles tendon rupture with transfer of the tendon of peroneus brevis is suitable in patients with a tendon gap less than 6 cm...

..However, the optimal management is controversial...

..Important to this research is meticulous documentation of injuries on injury report forms that include age-appropriate designations of the type of injury and accurate determination of exposure-based injury rates...

..Although several therapeutic options are routinely used, very few well-conducted randomised prospective, placebo, controlled trials have been performed to assist in choosing the best evidence-based management...

..Using this approach, a wide exposure of the insertion of the Achilles tendon is possible, preserving the integrity of the skin overlying the site most prone to wound breakdown...

..This is a safe, reliable procedure for patients with recurrent dislocation of the patella resulting from an imbalance of soft tissue tension around the patella, but with a normally sited patella and normal trochlea...

..PSOCT has the potential to explore in situ and in-depth pathological change associated with Achilles tendon rupture, and could help to delineate abnormalities in tendinopathic samples in vivo...

..Reconstruction of the Achilles tendon using peroneus brevis has been widely reported. Classically, these procedures involve relatively long surgical wounds in a relatively hypovascular area which is susceptible to wound breakdown...

..To study the effects of early weight bearing following acute repair of ruptured Achilles tendon...

..After the removal of the tibial or femoral Ilizarov frames, the ROM of the knee tended to return to prelengthening values...

..The aim of this study was to assess the functional outcome of patients who had undergone elbow arthroscopy, evaluating the correlation between three elbow scoring systems and the patients' subjective perception of satisfaction..

..Many techniques have been developed for the reconstruction of the Achilles tendon in chronic tears. In presence of a large gap (greater than 6 centimetres), tendon augmentation is required...

..Further prevention strategies need to be developed to reduce the risk of wrong-site surgery...

..05). Doppler signal in Achilles tendinopathy may decrease immediately after activities that load the calf muscle and increase heart rate, suggesting that this activity should be avoided prior to imaging to avoid false negative results...

..Prospective studies on asymptomatic athletes are needed to define the predictive value of US signs of Achilles tendinopathy in the development of symptoms in the long-term...

..The macroscopic and ultrasonographic appearance of the operated tendon remained abnormal, but this was not associated with any overt clinical disturbance..

..If the fragment is seen to be significantly displaced it may have resulted from avulsion by important structures such as the medial collateral ligament and open reduction is required to stabilise the elbow...

..Re-rupture and complication rates were comparable to published rates. CONCLUSION: Treatment should be individualised according to the demands and health of the patient...

..It can be effectively used in an environment that can provide ordinary paediatric medical care and general orthopaedic expertise. The outcomes compare with supracondylar fractures treated surgically in specialist centres...

..This study investigated the temporal sequence in greyscale abnormalities as well as the relationship between greyscale abnormalities, Doppler flow and pain...

..However, strength deficit and muscle atrophy are not prevented...

..5 cm. Compared with acute injuries, chronic injuries are associated with a higher rate of postoperative infection and more prolonged recovery...

..Patients with a neglected rupture are at a slightly greater risk of post-operative complications and may never fully recover their ankle plantar flexion strength...

..Allografts and synthetic grafts are also employed. There are no comparative studies and no randomized controlled trials to guide clinicians toward an evidence-based approach to management...

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..Achilles tendinopathy is understood to be a failed healing response. Operative management is utilised following the failure of non-operative methods...

..Sports physicians should be able to identify both conditions early in their presentation, but still hold a high index of suspicion for these problems in athletes who have an acute exacerbation of ongoing tendinopathy...

..A variation in expression of these genes could be characteristic of this form tendinopathy, since an increased level of these genes has not been detected in other forms of tendon lesions...

..Heterogeneous echogenicity with a parallel shape may be a physiological phase and may develop into heterogeneous echogenicity with a spindle shape that is more likely to be pathological...

..Measures should be taken to modify the present structure of competitive sport to avoid the possible deleterious effects of intensive physical activity on children...

..With a perforation rate of 43%, the surgeons were significantly more at risk of glove perforation than the other members of the operating team...

..This in turn has led to a massive expansion in search of modified surgical therapies and various adjuvant therapies, which could prevent adhesion formation without compromising digital function...

..Recurrent peroneal tendon subluxation is uncommon...

..This article presents a minimally invasive distal metatarsal osteotomy technique, requiring no custom instrumentation. The operation is performed under direct vision and without fluoroscopy...

..Innovations in surgical techniques and other modalities need to be tested with adequately powered human trials, before their potential benefit in clinical practice is accepted...

..This article gives an up-to-date account on our personal views of managing complications following Achilles tendon rupture, tendinopathy, and delayed rupture...

..Although ankle fractures and an Achilles tendon rupture are relatively frequent in isolation, their association in the same injury is uncommon...

..We present our current method of percutaneous repair which permits a less invasive approach to the tendon, accurate opposition of the tendon ends, and minimises the chance of sural nerve injury...

..Because of individual sport cultures and different sport habits in different countries, national epidemiologic studies are of importance in each individual country...

..e., very close in time) bilateral ruptures of her Achilles tendons with no obvious predisposing factors. She was treated using a percutaneous technique and six months following surgery has returned to her normal activities...

..Achilles tendinopathy is prevalent in athletes, but can also affect sedentary patients. We studied the effects of eccentric exercises in sedentary non-athletic patients with Achilles tendinopathy...

..difficile-associated diarrhoea. We advocate the use of the new regimen as an alternative to multiple-dose cephalosporin antibiotics for the prevention of C. difficile infection in this group of high-risk patients...

..Future research and randomised controlled trials should address the issues that this investigation has raised...

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