High intratendinous lactate levels in painful chronic Achilles tendinosis.: An investigation using microdialysis technique

被引:68
作者
Alfredson, H [1 ]
Bjur, D
Thorsen, K
Lorentzon, R
Sandström, P
机构
[1] Umea Univ, Dept Surg & Perioperat Sci, Sports Med Unit, S-90187 Umea, Sweden
[2] Natl Inst Working Life, Dept Musculoskeletal Res, S-90187 Umea, Sweden
基金
瑞典研究理事会;
关键词
Achilles pain; microdialysis; lactate;
D O I
10.1016/S0736-0266(02)00021-9
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
In this investigation the microdialysis technique was used to study the concentrations of lactate in Achilles tendons with painful chronic tendinosis and in normal pain-free tendons. In four patients (mean age 40.7 years) with a painful thickening localized at the 2-6 cm level in the Achilles tendon (chronic Achilles tendinosis) and in five controls (mean age 37.2 years) with normal Achilles tendons, the local concentrations of lactate were registered under resting conditions. All tendons were examined using ultrasonography. In the tendons with tendinosis the painful thickening corresponded to a widened tendon and structural tendinosis changes. Normal tendons showed no widening and a normal structure. A standard microdialysis catheter was inserted into the Achilles tendon under local anesthesia. Samplings were done every 15 min during a 4 h period. The results showed significantly higher mean concentrations of lactate in tendons with tendinosis compared to normal tendons (2.15 mmol/l vs. 1.14 mmol/l). The lactate concentrations in the tendons with tendinosis were stable. and approximately twofold higher than in the normal tendons during the whole 4 h investigation period. In conclusion, the higher concentrations of lactate in Achilles tendons with painful tendinosis indicate that there arc anaerobic conditions in the area with tendinosis. The importance of this finding for the pathogenesis and pain mechanisms in this chronic condition needs to be further investigated. (C) 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.
引用
收藏
页码:934 / 938
页数:5
相关论文
共 24 条
[1]   In situ microdialysis in tendon tissue:: high levels of glutamate, but not prostaglandin E2 in chronic Achilles tendon pain [J].
Alfredson, H ;
Thorsen, K ;
Lorentzon, R .
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 1999, 7 (06) :378-381
[2]   In vivo investigation of ECRB tendons with microdialysis technique - no signs of inflammation but high amounts of glutamate in tennis elbow [J].
Alfredson, H ;
Ljung, BO ;
Thorsen, K ;
Lorentzon, R .
ACTA ORTHOPAEDICA SCANDINAVICA, 2000, 71 (05) :475-479
[3]   In vivo microdialysis and immunohistochemical analyses of tendon tissue demonstrated high amounts of free glutamate and glutamate NMDAR1 receptors, but no signs of inflammation, in Jumper's knee [J].
Alfredson, H ;
Forsgren, S ;
Thorsen, K ;
Lorentzon, R .
JOURNAL OF ORTHOPAEDIC RESEARCH, 2001, 19 (05) :881-886
[4]   Glutamate NMDAR1 receptors localised to nerves in human Achilles tendons.: Implications for treatment? [J].
Alfredson, H ;
Forsgren, S ;
Thorsen, K ;
Fahlström, M ;
Johansson, H ;
Lorentzon, R .
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2001, 9 (02) :123-126
[5]   Chronic Achilles tendinosis - Recommendations for treatment and prevention [J].
Alfredson, H ;
Lorentzon, R .
SPORTS MEDICINE, 2000, 29 (02) :135-146
[6]   COMPENSATION FOR INTRINSIC MUSCLE-STIFFNESS BY SHORT-LATENCY REFLEXES IN HUMAN TRICEPS SURAE MUSCLES [J].
ALLUM, JHJ ;
MAURITZ, KH .
JOURNAL OF NEUROPHYSIOLOGY, 1984, 52 (05) :797-818
[7]   BLOOD-FLOW IN THE HUMAN ACHILLES-TENDON ASSESSED BY LASER-DOPPLER FLOWMETRY [J].
ASTROM, M ;
WESTLIN, N .
JOURNAL OF ORTHOPAEDIC RESEARCH, 1994, 12 (02) :246-252
[8]  
ASTROM M, 1994, CLIN ORTHOP RELAT R, P166
[9]  
BOUSHEL R, 2000, J PHYSL, V524, P1305
[10]  
DARIMONT C, 1994, INT J OBESITY, V18, P783