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Abstract

Background

Neovascularisation can be detected qualitatively by Power Doppler in Achilles tendinopathy. Quantitative data regarding tendon microcirculation have not been established and may be substantial.

Purpose

To assess the microcirculation of the Achilles tendon and the paratendon in healthy volunteers as well as in athletes with either midportion or insertional tendinopathy.

Study Design

Cohort study; Level of evidence, 2.

Methods

In 66 physically active volunteers, parameters of Achilles tendon and paratendon microcirculation, such as tissue oxygen saturation, relative postcapillary venous filling pressures, and microcirculatory blood flow, were determined at rest at 2-mm and 8-mm tissue depths. Forty-one patients never had Achilles pain (25 men, 27 ± 8 years), 14 patients had insertional pain (7 men, 29 ± 8 years), and 11 patients had midportion tendinopathy (7 men, 38 ± 13 years, not significant).

Results

Achilles tendon diameter 2 cm and 6 cm proximal to the insertion was increased in symptomatic tendons. Compared with the uninvolved opposite tendon, deep microcirculatory blood flow was significantly elevated at insertional (160 ± 79 vs 132 ± 42, P<. 05) as well as in midportion tendinopathy (150 ± 74 vs 119 ± 34, P<. 05). The microcirculation in the uninvolved opposite tendon and the normal athlete controls were not significantly different from each other (132 ± 42 insertional asymptomatic vs 119 ± 34 mid-portion vs 120 ± 48 healthy tendon). Insertional paratendon deep microcirculatory flow was elevated in all groups, whereas tissue oxygen saturation and relative postcapillary venous filling pressures were not significantly different.

Conclusion

Microcirculatory blood flow is significantly elevated at the point of pain in insertional and midportion tendinopathy. Postcapillary venous filling pressures are increased at both the midportion Achilles tendon and the midportion paratendon, whereas tissue oxygen saturation is not different among the studied groups. We found no evidence of an abnormal microcirculation of the asymptomatic limb in Achilles tendinopathy.

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Information

Published In

Article first published: January 2006
Issue published: January 2006

Keywords

  1. Achilles tendon
  2. tendinopathy
  3. Doppler
  4. pain
  5. microcirculation

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© 2006 American Orthopaedic Society for Sports Medicine.
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History

Issue published: January 2006
Published online: August 30, 2017
PubMed: 16219947

Authors

Affiliations

Karsten Knobloch, MD*
Trauma Surgery, Medical School Hannover, Hannover, Germany
Robert Kraemer
Trauma Surgery, Medical School Hannover, Hannover, Germany
Artur Lichtenberg, MD
Cardiothoracic Surgery, Medical School Hannover, Hannover, Germany
Michael Jagodzinski, MD
Trauma Surgery, Medical School Hannover, Hannover, Germany
Thomas Gossling, MD
Trauma Surgery, Medical School Hannover, Hannover, Germany
Martinus Richter, MD PhD
Trauma Surgery, Medical School Hannover, Hannover, Germany
Johannes Zeichen, MD PhD
Trauma Surgery, Medical School Hannover, Hannover, Germany
Tobias Hufner, MD PhD
Trauma Surgery, Medical School Hannover, Hannover, Germany
Christian Krettek, MD PhD
Trauma Surgery, Medical School Hannover, Hannover, Germany

Notes

*
Trauma Surgery, Medical School Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, (e-mail: [email protected])

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