You are here

Home » Content

Aşil Tendon Rüptürlerinin Onarımı Sonrası Devamlı Pasif Hareketin Etkisi

The Effect Of Continuous Passive Motion After Repair Of Achilles Tendon Ruptures

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Aims: Traditional treatment of surgically repaired achilles tendons includes complete immobilization of the joint in rigid casts for 8 to 10 weeks. It is well-known that immobilization has a detrimental effect on tendon healing. The aim of this study was to determine the beneficial effect of limited immobilization and early passive motion on both macroscopical and histological recovery following repair of disected Achilles tendons in rabbits. Material and Methods: In 20 adult rabbits after their achilles tendons were surgically transected, we repaired them with modified Kessler technique. The second 10 rabbits were also held in cast immobilization, but in the postoperative second day their bi-valve casts were removed, and the rabbits were led to the Continuous Passive Motion device for 4 hours each day for 6 weeks. All the animals were kept in cast immoblization in cage. All rabbits were sacrified at the end of 6 weeks and their healed tendon tissue were examined according to macroscopical and histological aspects. Results:On macroscopical evaluation, adhesions in the operation area, periarticular atrophy, and the ROM of the ankle joint were better in CPM group than the immobilized group. On histological evaluation, we found 70% regular collagen bundle alignment in CPM group, compared to 20% in immobilized group. The results on hyalinization and inflamatory infiltration were not significantly different in either group. Conclusion:On the basis of the results of this investigation, following achilles tendon repair the utilization of continous controlled passive motion has benifical effects on tendon healing.
Bookmark/Search this post with
Abstract (Original Language): 
Amaç: Aşil tendon yırtıklarının cerrahi onarımı sonrası klasik tedavide eklemin 8-10 hafta süre ile immobilizasyonu uygulanmaktadır. Uzun süreli immobilizasyonun tendon iyileşmesi üzerine zararlı etkisi daha önce bir çok çalışmada gösterilmiştir. Bu nedenle son zamanlarda aşil tendon yırtıklarının cerrahi onarımı sonrası agresif fonksiyonel tedavi protokolleri yaygınlaşmaktadır. Biz, bu çalışmada, tavşanlarda aşil tendon rüptürünün onarımı sonrası erken post-operatif dönemde devamlı pasif hareket (DPH) ve aralıklı immobilizasyon uygulanmasının makroskopik ve histolojik bulgularını değerlendirmeyi amaçladık. Gereç ve Yöntem: 20 erişkin tavşanın aşil tendonları cerrahi olarak kesildikten sonra modifiye Kessler tekniği ile onarıldı. Ameliyat sonrası dönemde 10 tavşan alçı içerisinde 6 hafta immobilize edilirken diğer 10 tavşana 6 hafta süresince her gün 4 saat devamlı pasif hareket (DPH) uygulandı. Bu gruptaki tavşanlar pasif hareket uygulanmadığı zamanlarda alçı içerisinde immobilize edilerek kafeslerine yerleştirildi. Tüm tavşanlar 6. haftanın sonunda öldürülerek onarım dokusu makroskopik ve histolojik olarak değerlendirildi. Bulgular: Makroskopik muayenede, onarım dokusundaki yapışıklıklar, adale atrofisi ve ayakbileği ekleminin hareket genişliği bakımından sonuçlar DPH grubunda immobilizasyon grubuna göre daha iyiydi. Histolojik muayenede, hyalinizasyon ve iltihabi infiltrasyon bakımından gruplar arasında anlamlı fark yoktu. Ancak kollajen demet dizilimi DPH grubunda %70 düzenli saptanırken immobilize grupta %20 idi. Sonuç: Bu deneysel çalışmanın sonucunda, aşil tendon rüptürlerinin onarımı sonrası erken kontrollü pasif hareket vermenin tendon iyileşmesi üzerinde yararlı etkiye sahip olacağı kanısına varıldı
FULL TEXT (PDF): 
PDF icon arastirmax-asil-tendon-rupturlerinin-onarimi-sonrasi-devamli-pasif-hareketin-etkisi.pdf
  • 2
62-66
  • Turkish

REFERENCES

References: 

1. Wills C., Washburn S.,Caiozzo V. Achilles tendon rupture. A review of the literature comparing surgical versus non-surgical treatment. Clin. Orthop. 1986, 207: 156-63.
2. Stephen E. Stein and AC. Leukens. Closed treatment of Achilles tendon ruptures. Orth North Am. 1976, 7(1), 241-46.
3. Charles A. Soma, MD, Bert R. Mandelbaum, MD. Repair of acute Achilles tendon ruptures. Orth. Clin. North Am. 1995, 4, 239-40.
4. Booth FW, Physiologic and biomechanical effects of immobilization on muscle. Clin Orthop 1987, 219:15-20.
5. Haggmark T, Liedberg H, Erickson E. Calf muscle atrophy and muscle function after non operative vs operative treatment of Achilles tendon ruptures. Clin Orthop. 1986, 9: 160-64;
6. Gelberman RH, Menon J, Gonsalves M, Akeson WH. The effects of mobilization on the vascularization of healing flexor tendons in dogs. Clin Orthop. 1980, 153;
283-89.
7. Mandelbaum BR, Myerson MS, Forster R. Achilles tendon ruptures: A new method of repair, early range of motion, and functional rehabilitation. Am j Sports
Med 1995,23: 392-395.
8. Curtis RC, Delee JC. Reconstruction of the anterior cruciate ligament with freeze dried fascia lata allografts in dogs. Am J Sports Med 1985 13: 408-14.
9. Nistor L. Surgical and nonsurgical treatment of Achilles rupture . A prospective randomized study. J Bone Joint Surg 1981,63. A: 394-9.
10. Inglis A E,Scott WN, Sculco TP. Ruptures of the tendo achilles. An objective assesment of surgical and non-surgical treatment. J Bone Joint Surg.1976, 58A:
990-3.
11. Peppels WRJ, Plasmans CMT, Sloof TJH. The course of healing of tendons and
ligaments. Acta Orthop Scand 1983,54: 952-955.
12. Carter TR, Fowler Pj, Blokker C, Functional postopertive treatment of Achilles tendon repair. AmJ. Sports Med. 1992, 459-62.
13. A Sölveborn, A Mogers. Immediate free ankle motion after surgical repair of Achilles tendon ruptures. Am J Sports Med. 1994,Vol 22(5); 607-610.
14. R B Salter, O C. The Biologic Concept of Continous Passive Motion of Snovial
joints. Clin Orthop and Rel Res 1989, Number 242(5), 12-25.

Thank you for copying data from http://www.arastirmax.com