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  1. Fulltext Palmaris longus tendon absence in pre-clinical medical students of Universiti Malaysia Sabah
    Navin Ravi, Elvira Effie Juis, Michelle Maria Vincent, Rasyidah Shokri, Vinooshana R. Kannan, Izzudin Madin, et al.
    Borneo Journal of Medical Sciences, 2019;14(1):73-79.
    MyJurnal
    Palmaris longus (PL) tendon is regularly used in reconstructive surgeries as a donor tendon because it is observed as an accessory muscle and has little practical use to the human hands. It is only found in mammals. For example, the orangutan has PL but it is absent variable in the higher class of apes such as gorillas and chimpanzees. The absence of PL in humans appears to be hereditary, but the genetic transmission is unclear. The main objective of this study is to determine the prevalence of PL tendon absence in pre-clinical medical students of UMS and to compare the lack between gender and ethnic groups. By using standard Schaffer’s test, we examined the presence or absence of PL tendon among the first and second-year medical students of UMS. Four additional tests, Thompson’s test, Mishra’s test I, and II, Pushpakumar’s tests were used to determine whether PL present or not. A total of 134 volunteers were examined, and 91.8% were right-handed, and 8.2% were left-handed. The overall absence (bilateral and unilateral) of PL tendon was 23.9%, whereas unilateral absent was 17.9%, and bilateral absent was 6.0%. The high prevalence of absence of PL tendon among females 25.5% compared to males 20.0%. Chinese and Indian have a higher incidence of PL tendon absence followed by Kadazandusun and Malay. In this study, there were different figures for each ethnic group. The prevalence of absence of PL varies depending on the populations.
    Matched MeSH terms: Tendons
  2. Fulltext Current Update of Collagen Nanomaterials-Fabrication, Characterisation and Its Applications: A Review
    Lo S, Fauzi MB
    Pharmaceutics, 2021 Feb 28;13(3).
    PMID: 33670973 DOI: 10.3390/pharmaceutics13030316
    Tissue engineering technology is a promising alternative approach for improvement in health management. Biomaterials play a major role, acting as a provisional bioscaffold for tissue repair and regeneration. Collagen a widely studied natural component largely present in the extracellular matrix (ECM) of the human body. It provides mechanical stability with suitable elasticity and strength to various tissues, including skin, bone, tendon, cornea and others. Even though exogenous collagen is commonly used in bioscaffolds, largely in the medical and pharmaceutical fields, nano collagen is a relatively new material involved in nanotechnology with a plethora of unexplored potential. Nano collagen is a form of collagen reduced to a nanoparticulate size, which has its advantages over the common three-dimensional (3D) collagen design, primarily due to its nano-size contributing to a higher surface area-to-volume ratio, aiding in withstanding large loads with minimal tension. It can be produced through different approaches including the electrospinning technique to produce nano collagen fibres resembling natural ECM. Nano collagen can be applied in various medical fields involving bioscaffold insertion or fillers for wound healing improvement; skin, bone, vascular grafting, nerve tissue and articular cartilage regeneration as well as aiding in drug delivery and incorporation for cosmetic purposes.
    Matched MeSH terms: Tendons
  3. Splinting after Carpal Tunnel Release: Does it really Matter?
    Shalimar A, Nor-Hazla MH, Arifaizad A, Jamari S
    Malays Orthop J, 2015 Jul;9(2):41-46.
    PMID: 28435609 MyJurnal DOI: 10.5704/MOJ.1507.011
    Splinting of the wrist after carpal tunnel release (CTR) has been practised by many surgeons especially in North America. The main reason was to prevent possible adverse events of bowstringing of flexor tendons and the median nerve, pillar pain, entrapment of the median nerve in scar tissue and wound dehiscence. Studies on the effect of splinting after standard CTR have had dismal results. The duration of splinting in standard CTR has been either too long (for 2-4 weeks) or too short (48 hours only). The aim of our study was to compare the effects of post-operative splinting for a duration of one week with no splinting.

    METHODS: All 30 of our patients underwent a standardized limited open CTR by a designated surgeon. Post operatively, they were randomized into a splinted (n=16) and a nonsplinted (n=14) group. The splint was kept for a week. Patients were reviewed at regular intervals of one week, two months and six months. At each follow up, these patients were clinically assessed for the following outcome measures: VAS (visual analogue score), 2PD (two-point discrimination), pinch grip, grip, Abductor Pollicis Brevis (APB)) power and completion of the Boston questionnaire.

    RESULTS: All patients presented with significant improvement in the postoperative evaluation in the analyzed parameters within each group. However, there was no significant difference between the two groups for any of the outcome measurements at sequential and at final follow-up.

    CONCLUSION: We conclude that wrist splinting in the immediate post-operative period has no advantage when compared with the unsplinted wrist after a limited open carpal tunnel release.

    Matched MeSH terms: Tendons
  4. Studies of the chemical composition of a healing skin wound in rats, and of the concentrations of some constituents of tissues distant from the healing wound
    Candlish J, Chandra N
    Biochem. J., 1967 Mar;102(3):767-73.
    PMID: 16742493
    1. A skin lesion was made in rats by dorsal incision and the insertion of a polythene tube. 2. Over a period of 25 days after wounding, assays were performed for ascorbic acid, DNA, hydroxyproline, methionine, tryptophan, tyrosine and free amino acids in the lesion tissue. 3. The neutral-salt-soluble proteins of the lesion tissue were fractionated on DEAE-Sephadex, with the separation of fibrinogen and gamma-globulin from a serum protein fraction. 4. Over a period of 20 days after wounding, in wounded rats and in controls, assays were conducted for: ascorbic acid in lens and liver, hydroxyproline, soluble protein, methionine and water in muscle and tendon, and free amino acids in muscle. 5. Relative to controls there was a decrease in lens and liver ascorbic acid, a rise in tendon hydroxyproline, a rise in muscle free amino acids, a fall in muscle protein and a rise in tendon and muscle water.
    Matched MeSH terms: Tendons
  5. Fulltext Four nucleotide deletions of exon 47 in Dystrophin gene: a case report of a Kelantanese Duchenne Muscular Dystrophy patient
    Fatimah Azman, Rose Adzrianee Adnan, Norhafizah Che Abdul Razak, Nazihah Mohd Yunus, Sarina Sulong, Rozita Abdullah, et al.
    Journal of Biomedical and Clinical Sciences, 2017;2(202):11-13.
    MyJurnal
    Muscular dystrophy is a group of diseases that result in progressive muscle weakness and atrophy. Duchenne Muscular Dystrophy (DMD) is classified as dystrophinopathy and is an X-linked recessive disease. It is caused by alterations in the dystrophin gene at Xp21.2 encoding 79 exons [1]. It is characterised by progressive muscle wasting that begins at 3 to 5 years, delay in motor development and eventually wheelchair confinement followed by premature death at about 30 years from cardiac or respiratory complications [2]. Genetic etiology of cases of DMD in Malaysia are still scarcely reported. Here, we report the genetic cause in the case of an 11-year-old Kelantanese Malay boy who has progressive muscle weakness since 5 years old. He has difficulty in getting up from sitting and supine position also in climbing up stairs until 1st floor. He has a strong family history of DMD and musculoskeletal problems. His younger brother was diagnosed with DMD by molecular analysis and his maternal uncle died at the age of 16 with musculoskeletal problems but was never investigated. Physical examination revealed no dysmorphic features, positive Gower sign with absent tounge fasciculation. On neurological examination, tendon reflexes and muscle tone for limbs were normal. Muscle power for bilateral upper limbs were normal, however, bilateral lower limbs showed slight reduction in muscle power with calf hypertrophy.
    Matched MeSH terms: Tendons
  6. Fulltext Genetic researches among malaysian familial hypercholesterolaemic population
    Al-Khateeb, A, Al-Talib, H
    JUMMEC, 2016;19(2):1-11.
    MyJurnal
    Background:
    Familial hypercholesterolaemia (FH) is one of the most frequent inherited metabolic disorders that can lead
    to a risk of premature cardiovascular disease. Publications on FH are mainly from western patients as there is
    little research on Asians, including Malaysians. The aim of this review is to provide an up-to- date information
    on Malaysian studies on FH genotyping and its relation to the phenotype of the affected patients.
    Method:
    A search was conducted for data from online databases on FH in Malaysia.
    Results:
    The mutation spectrum for FH among Malaysian patients was extremely broad. The gene variants were located
    mainly in the low-density lipoprotein receptor (LDLR) and apolipoprotein B-100 (APOB-100) genes rather than
    in the proprotein convertase subtilisin kexin type 9 (PCSK9) gene. The exon 9 and 14 were the hotspots in the
    LDLR gene. The most frequent mutation was p.Cys255Ser, at 12.5%, followed by p.Arg471Gly, at 11%, and the
    most common single nucleotide polymorphism (SNP) was c.1060+7 T>C at 11.7%. The LDLR gene variants were
    more common compared to the APOB-100 gene variants, while variants in the PCSK9 gene were very few.
    Phenotype-genotype associations were identified. Subjects with LDLR and APOB-100 genes mutations had a
    higher frequency of cardiovascular disease, a family history of hyperlipidaemia and tendon xanthoma and a
    higher low-density lipoprotein cholesterol (LDL-C) level than non-carriers.
    Conclusion:
    Research on Malaysian familial hypercholesterolaemic patients by individual groups is encouraging. However,
    more extensive molecular studies on FH on a national scale, with a screening of the disease-causing mutations
    together with a comprehensive genotype-phenotype association study, can lead to a better outcome for
    patients with the disease.
    Matched MeSH terms: Tendons
  7. Fulltext Abdominal flap: a reconstructive option for hand defect in rural setting
    Sinnasamy, Shankari, B Mohd Shakir, Vijayashingam, Naveen, Mustaqim Afifi @ Apipi, Prakash, Doddaballapur Ramaiah
    Borneo Journal of Medical Sciences, 2018;12(3):63-67.
    MyJurnal
    Reconstruction of hand injury is the challenge for the surgeon especially in rural settings. This case report is about a 10-year-old boy, who sustained large degloving wound of dorsum of right hand with extensor tendon injury following a road traffic accident. We performed a staged abdominal flap with tensor fascia lata graft for tendon reconstruction as microsurgery facilities was not available. Post-operatively he was subjected to physiotherapy and he has a functional right hand. This case report aimed to highlight abdominal flap as reconstructive option as compared to skin grafting which is reproducible with limited resources. Besides that, overall exposure to all surgical options is of paramount importance in the training of trainees to equip them with skills to serve in rural setting.
    Matched MeSH terms: Tendons
  8. The use of an aberrant flexor carpi ulnaris tendon with an ulnar artery island forearm flap for reconstruction of a dorsal defect of the hand
    Jeyaratnam TS, Ahmad TS, Kassim NM
    Hand Surg, 2001 Jul;6(1):99-102.
    PMID: 11677671
    Matched MeSH terms: Tendons/surgery
  9. Fulltext Recombinant human adiponectin as a potential protein for treating diabetic tendinopathy promotes tenocyte progenitor cells proliferation and tenogenic differentiation in vitro
    Rothan HA, Suhaeb AM, Kamarul T
    Int J Med Sci, 2013;10(13):1899-906.
    PMID: 24324367 DOI: 10.7150/ijms.6774
    Adiponectin is an adipocyte-secreting hormone that increases cell sensitivity to insulin. It has been previously demonstrated that this hormone protects against Type II Diabetes and, is found to concurrently promote cell proliferation and differentiation. It is postulated that diabetic patients who suffer from tendinopathy may benefit from using adiponectin, which not only improves the metabolism of diabetic ridden tenocytes but also promotes progenitor cell proliferation and differentiation in tendons. These changes may result in tendon regeneration, which, in diabetic tendinopathy, is difficult to treat. Considering that such findings have yet to be demonstrated, a study was thus conducted using diabetic ridden human tenocyte progenitor cells (TPC) exposed to recombinant adiponectin in vitro. TPC were isolated from tendons of diabetic patients and exposed to 10 μg/ml adiponectin. Cell proliferation rate was investigated at various time points whilst qPCR were used to determine the tenogenic differentiation potential. The results showed that adiponectin significantly reduced blood glucose in animal models. The proliferation rate of adiponectin-treated TPCs was significantly higher at 6, 8 and 10 days as compared to untreated cells (p<0.05). The levels of tenogenic genes expression (collagen I, III, tenomodulin and scleraxis) were also significantly upregulated; whilst the osteogenic (Runx2), chondrogenic (Sox9) and adipogenic (PPARУγ) gene expressions remained unaltered. The results of this study suggest that adiponectin is a potential promoter that not only improves diabetic conditions, but also increases tendon progenitor cell proliferation and differentiation. These features supports the notion that adiponectin may be potentially beneficial in treating diabetic tendinopathy.
    Matched MeSH terms: Tendons/drug effects; Tendons/pathology
  10. Fulltext Identification of Pathways Mediating Growth Differentiation Factor5-Induced Tenogenic Differentiation in Human Bone Marrow Stromal Cells
    Tan SL, Ahmad TS, Ng WM, Azlina AA, Azhar MM, Selvaratnam L, et al.
    PLoS One, 2015;10(11):e0140869.
    PMID: 26528540 DOI: 10.1371/journal.pone.0140869
    To date, the molecular signalling mechanisms which regulate growth factors-induced MSCs tenogenic differentiation remain largely unknown. Therefore, a study to determine the global gene expression profile of tenogenic differentiation in human bone marrow stromal cells (hMSCs) using growth differentiation factor 5 (GDF5) was conducted. Microarray analyses were conducted on hMSCs cultures supplemented with 100 ng/ml of GDF5 and compared to undifferentiated hMSCs and adult tenocytes. Results of QuantiGene® Plex assay support the use and interpretation of the inferred gene expression profiles and pathways information. From the 27,216 genes assessed, 873 genes (3.21% of the overall human transcriptome) were significantly altered during the tenogenic differentiation process (corrected p<0.05). The genes identified as potentially associated with tenogenic differentiation were ARHGAP29, CCL2, integrin alpha 8 and neurofilament medium polypeptides. These genes, were mainly associated with cytoskeleton reorganization (stress fibers formation) signaling. Pathway analysis demonstrated the potential molecular pathways involved in tenogenic differentiation were: cytoskeleton reorganization related i.e. keratin filament signaling and activin A signaling; cell adhesion related i.e. chemokine and adhesion signaling; and extracellular matrix related i.e. arachidonic acid production signaling. Further investigation using atomic force microscopy and confocal laser scanning microscopy demonstrated apparent cytoskeleton reorganization in GDF5-induced hMSCs suggesting that cytoskeleton reorganization signaling is an important event involved in tenogenic differentiation. Besides, a reduced nucleostemin expression observed suggested a lower cell proliferation rate in hMSCs undergoing tenogenic differentiation. Understanding and elucidating the tenogenic differentiation signalling pathways are important for future optimization of tenogenic hMSCs for functional tendon cell-based therapy and tissue engineering.
    Matched MeSH terms: Tendons/cytology; Tendons/metabolism*
  11. High incidence and treatment of flexor carpi radialis tendinitis after trapeziectomy and abductor pollicis longus suspensionplasty for basal joint arthritis
    Low TH, Hales PF
    J Hand Surg Eur Vol, 2014 Oct;39(8):838-44.
    PMID: 24051478 DOI: 10.1177/1753193413506150
    We reviewed the incidence and treatment of flexor carpi radialis tendinitis in 77 patients (81 thumbs) who had trapeziectomy and abductor pollicis longus suspensionplasty for thumb carpometacarpal joint arthritis. Eighteen patients, 20 wrists (25%) had flexor carpi radialis tendinitis. The onset was 2-10 months (mean 4.7) after surgery. Two cases had preceding trauma. Eight cases (40%) responded to splinting and steroid injection. Ten patients, 12 wrists (60%) underwent surgery after failing non-operative treatment. Eleven wrists had frayed or partially torn flexor carpi radialis tendon and one had a complete tendon rupture with pseudotendon formation. Flexor carpi radialis tenotomy and pseudotendon excision were performed. All operated patients obtained good pain relief initially post-operatively. However, the pain recurred in two patients after 8 months. One required a local steroid injection for localized tenderness at the site of the proximal tendon stump. The other patient required a revision operation for scaphotrapezoid impingement. Both obtained complete pain relief. Our study has shown a high incidence of flexor carpi radialis tendinitis following trapeziectomy and abductor pollicis longus suspensionplasty. Patients should be warned about this potential complication.

    Study a collaboration between Malaysia and Australia
    Matched MeSH terms: Tendons/surgery*
  12. Long-term results of tibialis posterior tendon transfer for drop-foot
    Yeap JS, Birch R, Singh D
    Int Orthop, 2001;25(2):114-8.
    PMID: 11409449
    Twelve patients with drop-foot secondary to sciatic or common peroneal nerve palsy treated with transfer of the tibialis posterior tendon were followed-up for a mean of 90 (24-300) months. In 10 patients the results were 'excellent' or 'good'. In 11 patients grade 4 or 5 power of dorsiflexion was achieved, although the torque, as measured with a Cybex II dynamometer, and generated by the transferred tendon, was only about 30% of the normal side. Seven patients were able to dorsiflex their foot to the neutral position and beyond. The results appeared to be better in men under 30 years of age with common peroneal palsies. A painful flatfoot acquired in adulthood does not appear to be a significant long-term complication despite the loss of a functioning tibialis posterior tendon.
    Matched MeSH terms: Tendons/transplantation*
  13. Prevalence of Absence of Palmaris Longus and Its Association with Gender, Hand Dominance and Absence of FDS Tendon to Little Finger Among Malay Population
    Yong MW, Yusof N, Rampal L, Arumugam M
    J Hand Surg Asian Pac Vol, 2017 Dec;22(4):484-489.
    PMID: 29117832 DOI: 10.1142/S021881041750054X
    BACKGROUND: Palmaris Longus is being widely used in reconstructive, plastic and cosmetic surgeries due to its long tendon. It is the most readily available source for tendon grafting. The objective of this study was to determine the prevalence of absence of Palmaris Longus and its association with gender, hand dominance and absence of FDS (flexor digitorum superficialis) tendon to little finger among Malay population.

    METHODS: An analytical cross sectional study design was used and a self-administered proforma was distributed for data collection. 1239 Malay secondary school children in Putrajaya were tested for absence of Palmaris Longus using Schaffer's test. 4 additional tests namely Thompson's test, Mishra's test I, Mishra's test II and Pushpakumar's 'two-finger sign' method were used to confirm its absence in respondents with negative Schaffer's test. Function of Flexor Digitorum Superficialis tendon to little finger was determined by flexing PIP of little finger while hyperextend the other fingers.

    RESULTS: The prevalence of absence of Palmaris Longus was 11.7%. Left side absence of Palmaris Longus was much common. There was a significant association between absence of Palmaris Longus with gender in which female had higher prevalence of absence of Palmaris Longus than male.

    CONCLUSIONS: In conclusion, the prevalence of absence of Palmaris Longus in Malay population was lower than Indian but higher than Chinese population. Females had higher prevalence of absence of Palmaris Longus and no association can be found with hand dominance and absence of Flexor Digitorum Superficialis tendon to little finger.

    Matched MeSH terms: Tendons/abnormalities*
  14. Fulltext New clinical sign of cervical myelopathy: Wazir hand myelopathy sign
    Wazir NN, Kareem BA
    Singapore Med J, 2011 Jan;52(1):47-9.
    PMID: 21298241
    Cervical spondylotic myelopathy (CSM) represents a spectrum of pathologies with progressive compression of the spinal cord. The clinical signs and symptoms play a key role in diagnosis. The characteristic hand myelopathy signs are of significant clinical importance. The aim of this descriptive study was to report a relatively easy to elicit new hand myelopathy sign. The basis for this is finger and wrist flexor disinhibition, which is used for the spinal specificity of cord compression at or above the C5/6 level.
    Matched MeSH terms: Tendons/pathology
  15. Fulltext Preliminary Study of In Vitro Three-Dimensional Skin Model Using an Ovine Collagen Type I Sponge Seeded with Co-Culture Skin Cells: Submerged versus Air-Liquid Interface Conditions
    Fauzi MB, Rashidbenam Z, Bin Saim A, Binti Hj Idrus R
    Polymers (Basel), 2020 Nov 25;12(12).
    PMID: 33255581 DOI: 10.3390/polym12122784
    Three-dimensional (3D) in vitro skin models have been widely used for cosmeceutical and pharmaceutical applications aiming to reduce animal use in experiment. This study investigate capability of ovine tendon collagen type I (OTC-I) sponge suitable platform for a 3D in vitro skin model using co-cultured skin cells (CC) containing human epidermal keratinocytes (HEK) and human dermal fibroblasts (HDF) under submerged (SM) and air-liquid interface (ALI) conditions. Briefly, the extracted OTC-I was freeze-dried and crosslinked with genipin (OTC-I_GNP) and carbodiimide (OTC-I_EDC). The gross appearance, physico-chemical characteristics, biocompatibility and growth profile of seeded skin cells were assessed. The light brown and white appearance for the OTC-I_GNP scaffold and other groups were observed, respectively. The OTC-I_GNP scaffold demonstrated the highest swelling ratio (~1885%) and water uptake (94.96 ± 0.14%). The Fourier transformation infrared demonstrated amide A, B and I, II and III which represent collagen type I. The microstructure of all fabricated sponges presented a similar surface roughness with the presence of visible collagen fibers and a heterogenous porous structure. The OTC-I_EDC scaffold was more toxic and showed the lowest cell attachment and proliferation as compared to other groups. The micrographic evaluation revealed that CC potentially formed the epidermal- and dermal-like layers in both SM and ALI that prominently observed with OTC-I_GNP compared to others. In conclusion, these results suggest that OTC_GNP could be used as a 3D in vitro skin model under ALI microenvironment.
    Matched MeSH terms: Tendons
  16. Fulltext Carpal tunnel syndrome in pregnancy : is there really oedema in the carpal tunnel?
    Mohamed Faizal Sikkandar, Shalimar Abdullah, Rajesh Singh, Parminder Singh Gill, Nur Azuatul Akmal Kamaludin, Tan Jin Aun, et al.
    Malaysian Journal of Medicine and Health Sciences, 2020;16(1):191-195.
    MyJurnal
    Introduction: Compression of the median nerve in pregnancy is thought to be due to fluid retention within the carpal tunnel space. We aim to discover the cause of carpal tunnel syndrome (CTS) in pregnancy using high resonance ul- trasonography. Methods: This is a cross-sectional study where obstetric patients were screened for CTS and subjected to a non invasive ultrasonic imaging. Results: A total of 63 patients were seen with 25 diagnosed to have CTS (39.7%) and 38 patients had none (60.3%) based on a screening tool. Age ranged from 20-42 years old with the highest range in the 28-30 year old group (34.9%). In patients with CTS, the cross sectional area of the median nerve inside the tunnel was a mean of 0.908 cm ie larger, while non-CTS patients had a mean of 0.797 cm inside the tunnel. The transverse carpal ligament (TCL) measured a mean of 0.0988 cm in the CTS group (ie thinner) and 0.1058 cm in the non-CTS group. Median nerve mobility at equal to or less than one tendon width was 80% in pregnant women with CTS and 92.1% for those without. No fluid was present within the carpal tunnel of all patients. The results were sta- tistically not significant. Conclusion: Ultrasonographic evidence in pregnant women with CTS shows a larger median nerve, a more mobile median nerve and a less thick transverse carpal ligament. There is absence of fluid retention and synovitis ruling out extrinsic compression of the median nerve as cause of CTS in pregnancy.
    Matched MeSH terms: Tendons
  17. Fulltext Acute Retropharyngeal Calcific Tendonitis as a Rare Cause of Odynophagia and Neck Pain
    Singh PKM, Noor MIM, Jaafar R, Ahmad A, Mohamad I
    Medeni Med J, 2021;36(1):75-79.
    PMID: 33828894 DOI: 10.5222/MMJ.2021.37539
    Retropharyngeal calcific tendonitis (RCT) is an aseptic inflammatory process of the superior oblique tendons of the longus colli muscle caused by the deposition of calcium hydroxyapatite crystals. We reported a 23-year-old woman who presented with a sudden onset of neck pain with odynophagia after waking up from sleep. Physical examination showed paracervical point tenderness with limited neck movement in all directions. Prior to surgery, further imaging was requested to aid in diagnosis, which in turn revealed RCT. It is important to be aware that RCT presentation may mimic other severe conditions such as retropharyngeal space abscess or meningitis.
    Matched MeSH terms: Tendons
  18. Fulltext Knee pain during Islamic prayer after anterior cruciate ligament reconstruction using hamstring and bone patellar tendon autograft
    Ahmed N, Shihabudin M.T, Ab Rahman S
    IIUM Medical Journal Malaysia, 2020;19(1):31-36.
    MyJurnal
    Introduction: Hamstring tendon (HT) and bone patellar tendon bone (BPTB) are the commonly used
    autograft in an anterior cruciate ligament reconstruction surgery. The BPTB is said to have more incidence of
    anterior knee pain compared to HT. The study aimed to compare the severity of knee pain during Islamic
    prayer kneeling. Methods: A cross sectional cohort analysis of patients undergoing ACL reconstruction surgery
    using BPTB with HT autografts was conducted to determine differences in postoperative pain while kneeling
    and ability to pray in normal position. Kneeling during prayer and the ability to sit while performing prayer
    were assessed at 3rd, 4th, 5th and 6th month. Results: There were no significant differences in mean pain score
    while kneeling at 3rd, 4th, 5th and 6th month. The mean difference of patient’s ability to perform normal
    prayers for BPTB (3.56+1.16) and HT (3.30+1.05) was found insignificant. The average number of patients in
    both groups was able to pray between 3 to 4 months post operatively as full range of motion of knee is
    allowed within this period. Total 49 patients (BPTB 23, HT 26) out of 60 were able to pray normally within 4
    months post-operation. Mostly delayed due to anterior knee pain. Conclusion: There is no different in term of
    knee pain during kneeling while performing Islamic prayer between those who had their ACL reconstructed
    either using BPTB or HT autograft.
    Matched MeSH terms: Hamstring Tendons
  19. Heel Pad Reconstruction With Medial Plantar Flap
    Langat AS, Wan Sulaiman WA, Mat Johar SFN
    Cureus, 2021 Mar 19;13(3):e13987.
    PMID: 33884238 DOI: 10.7759/cureus.13987
    The heel of the foot is covered by highly specialized thick, glabrous skin containing fibroadipose tissue with numerous fibrous septae traversing the subcutaneous tissue, which acts as a shock-absorbent and prevents shearing of the skin. The loss of heel pad would cause interruption of the propelling function of the foot during walking. Therefore, heel pad reconstruction is an important procedure for wound closure in the acute phase and also functional reconstruction in delayed cases. We report a case of heel pad deformity in a patient who presented to us with left heel pain and inability to fully bear weight, which has caused her walking difficulty, following a road traffic accident. She sustained a degloving injury of the left foot and an open fracture of left calcaneum with ruptured Tendon Achilles in which the wound was initially addressed with failed reverse sural flap and the wound was allowed to heal by secondary intention. Delayed heel reconstruction was carried out with a propeller medial plantar flap and split skin graft. Postoperatively, the patient had improved functional and esthetic outcome.
    Matched MeSH terms: Tendons
  20. Fulltext Single-Bundle Versus Double-Bundle Arthroscopic Anterior Cruciate Ligament Reconstruction: Comparison of Long-Term Functional Outcomes
    Anandan V, Goh TC, Zamri KS
    Cureus, 2020 Dec 23;12(12):e12243.
    PMID: 33500862 DOI: 10.7759/cureus.12243
    Objective To compare long-term functional results of ACL reconstruction with a single bundle (SB) and double bundle (DB). Methods Sixty patients who underwent ACL reconstructions from January 2007 to December 2008 were retrospectively evaluated (30 SB and 30 DB ACL reconstructions). Clinical and functional outcomes were measured pre- and postoperatively in terms of anterior drawer test, Lachman's test, pivot shift test, KT1000 side-to-side difference, range of motion, International Knee Documentation Committee Scoring, Lysholm knee scoring scale (LKS), and Tegner activity level scale. The period of follow-up was 10 years. Results Clinical outcome measured showed that anterior drawer test result were equally normal for both groups (93.3%; p > 0.995); however, the Lachman test was 76.7% in the DB group and 56.7% in the SB group (p > 0.100), the pivot shift was 83% in the DB group and 50% in the SB group (p < 0.001), and KT1000 was 76.7% in the DB group and 56.7% in the SB group (p > 0.100). Regarding the functional outcome, it favored the DB group of patients, with the LKS being statistically significant (p < 0.007) and the Tegner activity level scale p-value being <0.001 Conclusions DB ACL reconstruction produces better rotational stability and gives superior functional outcome in terms of return to pre-injury activity level in comparison to SB reconstruction. DB ACL reconstruction using hamstring tendon autograft produces better functional results at 10 years follow-up.
    Matched MeSH terms: Hamstring Tendons
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