- Email: [email protected]
All Those Worms
Treatment of Acute and Chronic Tendon Rupture and Tendinopathy
Preface A l l T h o s e Wo r m s
Selene G. Parekh, MD, MBA, FAOA Editor
Dating back to the time of Homer, man has been intrigued by tendons. Achilles, the most popular and well known of the lot, has been a hot topic of debate for years. Treatment of acute to chronic issues, nonop versus surgical care, open versus percutaneous, the use of adjunctive treatments or not, and so much more have been argued. Many countries are not afforded the luxury of fancy tools that allow surgeons to help our patients. In this issue, we touch on the current state of many of these topics and have authors who discuss their implant-free methods of handling these issues in their own country. Advances in peroneal tendon treatment have evolved as well. We have come a long way from the times of offering only repairs or tenodeses. Now we have options for allografts, tendon transfers, and the use of adjuncts as well. Fibular osteotomies can be performed in a variety of ways. Some of the authors in this issue will elucidate and expand on these treatment algorithms. Such insight will also be given in this issue to the often neglected anterior tibial tendon. Although we don’t see these abnormalities as frequently, anterior tibial tendon issues can lead to significant morbidity. The advances from both the Achilles and the peroneals can be applied to the anterior tibial tendon. Since the time I have been in practice, I have been intrigued by tendons. Looking like worms, and even more so if they are completely torn on an MRI, these are structures on which we have struggled to provide clear guidelines for care. From the general orthopedist to the sports medicine surgeons, to the traumatologists, tendon abnormalities are diagnosed and treated by many of us. In recent years, the understanding of the basic science behind these abnormalities is expanding and it is hoped will one day allow us to intervene and treat tendinopathies long before surgery is required. While reading this issue, you will find the latest thoughts on the process, diagnosis, and treatment of tendon abnormalities. Keep in mind that as our knowledge evolves,
Foot Ankle Clin N Am 22 (2017) xv–xvi https://doi.org/10.1016/j.fcl.2017.09.001 1083-7515/17/ª 2017 Published by Elsevier Inc.
foot.theclinics.com
xvi
Preface
so too will our treatments. In the end, it is about returning our patients to function in the most efficient manner. Selene G. Parekh, MD, MBA, FAOA North Carolina Orthopaedic Clinic Department of Orthopaedic Surgery Fuqua School of Business Duke University 3609 SW Durham Drive Durham, NC 27707, USA E-mail address: [email protected]
Preface A l l T h o s e Wo r m s
Selene G. Parekh, MD, MBA, FAOA Editor
Dating back to the time of Homer, man has been intrigued by tendons. Achilles, the most popular and well known of the lot, has been a hot topic of debate for years. Treatment of acute to chronic issues, nonop versus surgical care, open versus percutaneous, the use of adjunctive treatments or not, and so much more have been argued. Many countries are not afforded the luxury of fancy tools that allow surgeons to help our patients. In this issue, we touch on the current state of many of these topics and have authors who discuss their implant-free methods of handling these issues in their own country. Advances in peroneal tendon treatment have evolved as well. We have come a long way from the times of offering only repairs or tenodeses. Now we have options for allografts, tendon transfers, and the use of adjuncts as well. Fibular osteotomies can be performed in a variety of ways. Some of the authors in this issue will elucidate and expand on these treatment algorithms. Such insight will also be given in this issue to the often neglected anterior tibial tendon. Although we don’t see these abnormalities as frequently, anterior tibial tendon issues can lead to significant morbidity. The advances from both the Achilles and the peroneals can be applied to the anterior tibial tendon. Since the time I have been in practice, I have been intrigued by tendons. Looking like worms, and even more so if they are completely torn on an MRI, these are structures on which we have struggled to provide clear guidelines for care. From the general orthopedist to the sports medicine surgeons, to the traumatologists, tendon abnormalities are diagnosed and treated by many of us. In recent years, the understanding of the basic science behind these abnormalities is expanding and it is hoped will one day allow us to intervene and treat tendinopathies long before surgery is required. While reading this issue, you will find the latest thoughts on the process, diagnosis, and treatment of tendon abnormalities. Keep in mind that as our knowledge evolves,
Foot Ankle Clin N Am 22 (2017) xv–xvi https://doi.org/10.1016/j.fcl.2017.09.001 1083-7515/17/ª 2017 Published by Elsevier Inc.
foot.theclinics.com
xvi
Preface
so too will our treatments. In the end, it is about returning our patients to function in the most efficient manner. Selene G. Parekh, MD, MBA, FAOA North Carolina Orthopaedic Clinic Department of Orthopaedic Surgery Fuqua School of Business Duke University 3609 SW Durham Drive Durham, NC 27707, USA E-mail address: [email protected]