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    Surgical treatment of achilles tendon ruptures: the comparison of open and percutaneous methods in a rabbit model
    (TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2014) Yilmaz, Guney; Doral, Mahmut Nedim; Turhan, Egemen; Donmez, Gurhan; Atay, Ahmet Ozgur; Kaya, Defne
    BACKGROUND: This study was intended to investigate the healing properties of open and percutaneous techniques in a rabbit model and compare histological, electron microscopical, and biomechanical findings of the healed tendon between the groups. METHODS: Twenty-six rabbits were randomly assigned to two groups of thirteen rabbits each. Percutaneous tenotomy of the Achilles tendon (AT) was applied through a stab incision on the right side 1.5 cm above the calcaneal insertion in all animals. Using the same Bunnell suture, the first group was repaired with the open and the second group was repaired with the percutaneous method. ATs were harvested at the end of eight weeks for biomechanical and histological evaluation. RESULTS: When the sections were evaluated for fibrillar density under electron microscopy, it was noted that fibrils were more abundant in the percutaneous repair group. The tendon scores in the percutaneous group were less than the open group indicating closer histological morphology to normal. The difference was not significant (p=0.065). The mean force to rupture the tendon was 143.7 +/- 9.5 N in percutaneous group and 139.2 +/- 8.2 N in the open group. The difference was not significant (p=0.33). CONCLUSION: Percutaneous techniques provide as good clinical results as the open techniques do. The healing tendon shows better findings in histological and electron microscopical level with percutaneous technique.
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    Women with patellofemoral pain syndrome have quadriceps femoris volume and strength deficiency
    (SPRINGER, 2011) Kaya, Defne; Citaker, Seyit; Kerimoglu, Ulku; Atay, Ozgur Ahmet; Nyland, John; Callaghan, Michael; Yakut, Yavuz
    The aim of this study was to assess muscle torque, total volume, and cross-sectional area, and lower limb function of the quadriceps muscle in women with unilateral patellofemoral pain syndrome (PFPS). Twenty-four women with unilateral patellofemoral pain participated in the study, with each subject acting as their own internal control by using the unaffected limb. quadriceps muscle torque was measured with the Isomed 2000(A (R)). The total volume and cross-sectional area (CSA) of the quadriceps muscle were measured by using magnetic resonance imaging. Lower limb function was assessed by hop and step-down tests. There was a significant difference in the total volume (P < 0.05) and in the cross-sectional area (P < 0.05) of the quadriceps muscle between affected and unaffected sides. There was a significant difference in the peak torque of the quadriceps muscle at 60A degrees/s between affected and unaffected sides (P < 0.05). There were significant correlations between quadriceps largest CSA and volume on the affected side (P < 0.05) and on the unaffected side (P < 0.05). There were significant negative correlations between the smallest CSA and the peak torque at 180A degrees/s (P < 0.05) and at 60A degrees/s (P < 0.05) on the affected side. Decreased torque, total volume, and CSA of the quadriceps muscle are presented in unilateral with PFPS although cause or effect cannot be established. Large prospective longitudinal studies are needed to detect the changes in the muscle structure and to establish whether these features are a cause of PFPS.