Jason Wong - Academia.edu (original) (raw)

Papers by Jason Wong

Journal of Visualized Experiments, 2021

In this paper, we present an in vitro and in situ protocol to repair a tendon gap of up to 1.5 cm... more In this paper, we present an in vitro and in situ protocol to repair a tendon gap of up to 1.5 cm by filling it with engineered collagen graft. This was performed by developing a modified suture technique to take the mechanical load until the graft matures into the host tissue.

Current Transplantation Reports, 2020

Purpose of ReviewSkin provides a window into the health of an individual. Using transplanted skin... more Purpose of ReviewSkin provides a window into the health of an individual. Using transplanted skin as a monitor can provide a powerful tool for surveillance of rejection in a transplant. The purpose of this review is to provide relevant background to the role of skin in vascularized transplantation medicine.Recent FindingsDiscrete populations of T memory cells provide distributed immune protection in skin, and cycle between skin, lymph nodes, and blood. Skin-resident TREGcells proliferate in response to inflammation and contribute to long-term VCA survival in small animal models. Early clinical studies show sentinel flap rejection to correlate well with facial VCA skin rejection, and abdominal wall rejection demonstrates concordance with visceral rejection, but further studies are required.SummaryThis review focuses on the immunology of skin, skin rejection in vascularized composite allografts, and the recent advances in monitoring the health of transplanted tissues using distant “se...

Muscle Ligaments and Tendons Journal, 2019

Frontiers in surgery, 2018

Surgical robots have the potential to provide surgeons with increased capabilities, such as remov... more Surgical robots have the potential to provide surgeons with increased capabilities, such as removing physiologic tremor, scaling motion and increasing manual dexterity. Several surgical specialties have subsequently integrated robotic surgery into common clinical practice. Plastic and reconstructive microsurgical procedures have not yet benefitted significantly from technical developments observed over the last two decades. Several studies have successfully demonstrated the feasibility of utilising surgical robots in plastic surgery procedures, yet limited work has been done to identify and analyse current barriers that have prevented wide-scale adaptation of surgical robots for microsurgery. Therefore, a systematic review using PubMed, MEDLINE, Embase and Web of Science databases was performed, in order to evaluate current state of surgical robotics within the field of reconstructive microsurgery and their limitations. Despite the theoretical potential of surgical robots, current ...

Developmental biology, Mar 15, 2018

Arterial vasculature distributes blood from early embryonic development and provides a nutrient h... more Arterial vasculature distributes blood from early embryonic development and provides a nutrient highway to maintain tissue viability. Atherosclerosis, peripheral artery diseases, stroke and aortic aneurysm represent the most frequent causes of death and are all directly related to abnormalities in the function of arteries. Vascular intervention techniques have been established for the treatment of all of these pathologies, yet arterial surgery can itself lead to biological changes in which uncontrolled arterial wall cell proliferation leads to restricted blood flow. In this review we describe the intricate cellular composition of arteries, demonstrating how a variety of distinct cell types in the vascular walls regulate the function of arteries. We provide an overview of the developmental origin of arteries and perivascular cells and focus on cellular dynamics in arterial repair. We summarize the current knowledge of the molecular signaling pathways that regulate vascular smooth mus...

Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 2017

The use of pedicled perforator flaps provides an alternative to free tissue transfer for lower li... more The use of pedicled perforator flaps provides an alternative to free tissue transfer for lower limb reconstruction. We use computer-aided image analysis to investigate the versatility of pedicled perforator flaps for the reconstruction of lower limb defects. Between April 2007 and April 2011, a case series of 61 patients with wounds of the lower extremity from knee to ankle were reconstructed with pedicled perforator flaps. We performed 16 pedicled reverse-flow anterolateral thigh (RF-ALT) flaps, 8 pedicled medial sural artery perforator (MSAP) flaps, 26 pedicled peroneal artery perforator (PAP) flaps, and 11 pedicled posterior tibial artery perforator (PTAP) flaps. Digital planimetry of defects covered was analyzed and the "efficiency" of each flap was calculated, which allowed the assessment of the merits of each flap in the management of lower limb defects. Flaps healed primarily in 82% of cases (50/61). Approximately 50% of the secondary donor sites required skin graft...

Plastic and reconstructive surgery, 2016

After reading this article, the participant should be able to: 1. Appreciate the variation and ev... more After reading this article, the participant should be able to: 1. Appreciate the variation and evolution of flexor tendon management 2. Know how to assess the patient who presents with a flexor tendon laceration. 3. Understand the biology of repairing flexor tendon lacerations. 4. Appreciate the technical challenges in flexor tendon repair relating to different zones. 5. Understand the rationale of postoperative hand therapy. 6. Have an overview of the types of secondary tendon surgery. Flexor tendon injury constitutes a considerable trauma workload for hand surgeons, and a vast amount of research is dedicated toward improving outcomes in tendon repair. This Continuing Medical Education article aims to provide an up-to-date evidence-based outline of flexor tendon surgery in the hand. The authors reviewed the literature on flexor tendon repairs to include a balanced overview of the experimental and clinical research. For each section, the best levels of evidence were assessed in the ...

Experimental Dermatology, 2015

The skin is often viewed as a static barrier that protects the body from the outside world. Empha... more The skin is often viewed as a static barrier that protects the body from the outside world. Emphasis on studying the skin's architecture and biomechanics in the context of restoring skin movement and function is often ignored. It is fundamentally important that if skin is to be modelled or developed, we do not only focus on the biology of skin but also aim to understand its mechanical properties and structure in living dynamic tissue. In this review, we describe the architecture of skin and patterning seen in skin as viewed from a surgical perspective and highlight aspects of the microanatomy that have never fully been realized and provide evidence or concepts that support the importance of studying living skin's dynamic behaviour. We highlight how the structure of the skin has evolved to allow the body dynamic form and function, and how injury, disease or ageing results in a dramatic changes to the microarchitecture and changes physical characteristics of skin. Therefore, a...

The Journal of sports medicine and physical fitness, 2003

To study the effects of early weight bearing following acute repair of ruptured Achilles tendon. ... more To study the effects of early weight bearing following acute repair of ruptured Achilles tendon. Using a comparative longitudinal study design, following repair of an Achilles tendon rupture, patients in Group 1 were immobilised with their ankle in gravity equinus, were encouraged to weight bear on the operated limb as soon as possible to full weight bearing, and received a single a cast change at 2 weeks, when the ankle was immobilised in a plantigrade position. Patients in Group 2 were immobilised with their ankle in full equinus, and received a cast change at 2 weeks, when the ankle was immobilised in mid equinus, and at 4 weeks, when the ankle was immobilised in a plantigrade position. They were advised to weight bear 4 weeks from the operation. Patients in Group 1 attended less outpatient visits, completely discarded their crutches at an average of 2.5 weeks from the operation (Group 2: average of 5.7 weeks from the operation), (p=0.013), and a greater proportion of them were s...

The American journal of sports medicine

There is no consensus on the best method for management of acute Achilles tendon ruptures. Indivi... more There is no consensus on the best method for management of acute Achilles tendon ruptures. Individual preferences, drawn from experience and study, determine whether treatment is operative or nonoperative. Our goal was to review the literature to try to determine what management method was the most popular and effective. We wanted to ascertain the best results in terms of complication rates and patient outcomes. Retrospective review of retrospectively and prospectively collected data. We analyzed 125 articles in peer-reviewed journals for year of publication, patient numbers, sex, management method, follow-up complications, and patient satisfaction. Each article was graded using a validated methods score. Methods, patient satisfaction, and complication rates were correlated with the year each article was published. Skin-healing complications were lowest in conservatively managed patients (3 of 578, 0.5%) and highest in open repair and immobilized patients (543 of 3718, 14.6%). Gener...

Plastic and Reconstructive Surgery, 2014

he management of flexor tendon injuries remains one of the most published topics in hand surgery,... more he management of flexor tendon injuries remains one of the most published topics in hand surgery, with the numbers of publications on this subject seeing a year-onyear increase (Fig. 1). The perfect repair and outcome continue to evade us, 1 despite the flexor tendon repair being one of the earliest skills acquired as a hand surgeon in either plastic or orthopedic surgery training. 2 New tendon repairs and hand therapy regimens are reported regularly. Occasionally, there is an announcement of a new treatment modality that promises hope for this clinical conundrum, but this rarely becomes part of standard practice. Over the past 50 years, there have been many innovations, but overall outcomes have not changed dramatically. For example, the best series published in the 1970s showed that a two-strand repair with simple circumferential suture and a Kleinert type rehabilitation regimen had a 5 percent rupture rate, with 75 percent of patients achieving good to excellent functional outcomes in 28 zone II injuries. 3 This compares favorably with more recent studies showing that a four-strand repair and early active mobilization regimen had a 5 percent rupture rate, with 71 percent achieving good to excellent outcomes in 73 cases. 4 Real paradigm shifts in this area require us to rethink the whole process of flexor tendon biology Disclosure: Neither author has a financial interest in any of the products or devices mentioned in this article.

Journal of Plastic, Reconstructive & Aesthetic Surgery, 2008

... Titre du document / Document title. Key points in technique : Split thickness skin grafting t... more ... Titre du document / Document title. Key points in technique : Split thickness skin grafting to bare skull as a single stage procedure. Auteur(s) / Author(s). FOONG Deborah PS ; BABAR Ahmed Z. ; MCGROUTHER Duncan A. ; WONG Jason ; Revue / Journal Title. ...

Journal of Plastic, Reconstructive & Aesthetic Surgery, 2010

No abstract is available. To read the body of this article, please view the Full Text online. ...... more No abstract is available. To read the body of this article, please view the Full Text online. ... © 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved. ... Visit SciVerse ScienceDirect to see if you have access via your ...

European Journal of Vascular and Endovascular Surgery, 2003

Background: the variability of venous reflux patterns complicate the management of venous disease... more Background: the variability of venous reflux patterns complicate the management of venous disease. Our study investigates specific variations in venous anatomy and patterns of reflux in varying clinical situations. Methods: prospective analysis of 464 legs in 355 patients was performed by complete duplex venous mapping of both primary and recurrent varicose veins. Hand Held Doppler (HHD) and Duplex Ultrasonography (Duplex US) observations in the popliteal fossa were compared in a subgroup of 89 patients with primary varicose veins. Distribution of venous system disease was correlated with clinical severity in a subgroup of 117 affected legs which was representative of the overall study group. Results: sapheno-femoral junction (SFJ) incompetence predominated in both primary and recurrent varicose veins. Only 21% of primary legs and 25% of recurrent legs had sapheno-popliteal junction (SPJ) incompetence. SPJ incompetence was present in only 42% of cases where reflux in the popliteal region on HHD had been demonstrated. A proportion of both primary and recurrent varicose veins had evidence of deep venous incompetence (DVI). Sixty-four percent of primary leg ulcer patients had superficial incompetence alone. In patients with recurrent varicosities and ulceration, 57% had SPJ incompetence, 64% multiple sites and 50% DVI. Conclusion: the complex variations of varicose vein anatomy and functional pathology in the lower limb are currently best assessed by complete whole-leg venous duplex mapping.

Clinics in Sports Medicine, 2003

Certain similarities can clearly be appreciated between Achilles and patellar tendon ruptures. Bo... more Certain similarities can clearly be appreciated between Achilles and patellar tendon ruptures. Both are strong tendons that transmit force bridging at least one joint of the lower limb. When healthy, both require massive forces to be disrupted, and both can be weakened through certain systemic disease processes, steroids, and fluoroquinones. Both allow for a variety of innovative management possibilities that ultimately lend themselves to individual surgical preference. We feel that, although surgical management plays an important role in restoring continuity in knee extension and in plantar flexion, functional outcome inevitably relies on patient motivation and a well-established physiotherapy regime. Sports physicians should be able to identify both conditions early in their presentation, but still hold a high index of suspicion for these problems in athletes who have an acute exacerbation of ongoing tendinopathy.

Clinics in Sports Medicine, 2003

Over the course of the last two decades, athletes have received increased demands on their perfor... more Over the course of the last two decades, athletes have received increased demands on their performance. This has determined an increase in the risk of acute and overuse sport injuries, as they are required to train more often, more intensely and for longer. Until the recent past, sports and physical activities involved mainly young and middle-aged people. Today, with an increase in leisure time, a greater number of individuals spend time practicing recreational or competitive sports [1,2]. During physical exercise, much stress and force are exerted on the tendon, increasing the risk of injury. In repetitive hopping in place, a force of about 4000 N has been measured in the Achilles tendon. The force measured from the Achilles tendon is about twice the ground-reaction force. In hopping, most of the elastic energy is stored in the tendon itself. The contribution of the elastic energy in hopping is about 40% of the total mechanical work [3]. This implies that the tendon plays an important role as an active element of the muscle-tendon unit during sport. This article is divided into separate but interconnected parts. First we discuss tendinopathy from a histopathological viewpoint. We then describe the basic epidemiological issues facing physicians when dealing with such conditions. Some forms of tendinopathies are discussed, but we stress that these are not detailed, in-depth descriptions, and that the conditions selected, though representative, are only a small cross-section of clinically relevant tendinopathies

Cochrane Database of Systematic Reviews, 2016

Nasal decontamination for the prevention of surgical site infection in Staphylococcus aureus carr... more Nasal decontamination for the prevention of surgical site infection in Staphylococcus aureus carriers.

Journal of Visualized Experiments, 2021

In this paper, we present an in vitro and in situ protocol to repair a tendon gap of up to 1.5 cm... more In this paper, we present an in vitro and in situ protocol to repair a tendon gap of up to 1.5 cm by filling it with engineered collagen graft. This was performed by developing a modified suture technique to take the mechanical load until the graft matures into the host tissue.

Current Transplantation Reports, 2020

Purpose of ReviewSkin provides a window into the health of an individual. Using transplanted skin... more Purpose of ReviewSkin provides a window into the health of an individual. Using transplanted skin as a monitor can provide a powerful tool for surveillance of rejection in a transplant. The purpose of this review is to provide relevant background to the role of skin in vascularized transplantation medicine.Recent FindingsDiscrete populations of T memory cells provide distributed immune protection in skin, and cycle between skin, lymph nodes, and blood. Skin-resident TREGcells proliferate in response to inflammation and contribute to long-term VCA survival in small animal models. Early clinical studies show sentinel flap rejection to correlate well with facial VCA skin rejection, and abdominal wall rejection demonstrates concordance with visceral rejection, but further studies are required.SummaryThis review focuses on the immunology of skin, skin rejection in vascularized composite allografts, and the recent advances in monitoring the health of transplanted tissues using distant “se...

Muscle Ligaments and Tendons Journal, 2019

Frontiers in surgery, 2018

Surgical robots have the potential to provide surgeons with increased capabilities, such as remov... more Surgical robots have the potential to provide surgeons with increased capabilities, such as removing physiologic tremor, scaling motion and increasing manual dexterity. Several surgical specialties have subsequently integrated robotic surgery into common clinical practice. Plastic and reconstructive microsurgical procedures have not yet benefitted significantly from technical developments observed over the last two decades. Several studies have successfully demonstrated the feasibility of utilising surgical robots in plastic surgery procedures, yet limited work has been done to identify and analyse current barriers that have prevented wide-scale adaptation of surgical robots for microsurgery. Therefore, a systematic review using PubMed, MEDLINE, Embase and Web of Science databases was performed, in order to evaluate current state of surgical robotics within the field of reconstructive microsurgery and their limitations. Despite the theoretical potential of surgical robots, current ...

Developmental biology, Mar 15, 2018

Arterial vasculature distributes blood from early embryonic development and provides a nutrient h... more Arterial vasculature distributes blood from early embryonic development and provides a nutrient highway to maintain tissue viability. Atherosclerosis, peripheral artery diseases, stroke and aortic aneurysm represent the most frequent causes of death and are all directly related to abnormalities in the function of arteries. Vascular intervention techniques have been established for the treatment of all of these pathologies, yet arterial surgery can itself lead to biological changes in which uncontrolled arterial wall cell proliferation leads to restricted blood flow. In this review we describe the intricate cellular composition of arteries, demonstrating how a variety of distinct cell types in the vascular walls regulate the function of arteries. We provide an overview of the developmental origin of arteries and perivascular cells and focus on cellular dynamics in arterial repair. We summarize the current knowledge of the molecular signaling pathways that regulate vascular smooth mus...

Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 2017

The use of pedicled perforator flaps provides an alternative to free tissue transfer for lower li... more The use of pedicled perforator flaps provides an alternative to free tissue transfer for lower limb reconstruction. We use computer-aided image analysis to investigate the versatility of pedicled perforator flaps for the reconstruction of lower limb defects. Between April 2007 and April 2011, a case series of 61 patients with wounds of the lower extremity from knee to ankle were reconstructed with pedicled perforator flaps. We performed 16 pedicled reverse-flow anterolateral thigh (RF-ALT) flaps, 8 pedicled medial sural artery perforator (MSAP) flaps, 26 pedicled peroneal artery perforator (PAP) flaps, and 11 pedicled posterior tibial artery perforator (PTAP) flaps. Digital planimetry of defects covered was analyzed and the "efficiency" of each flap was calculated, which allowed the assessment of the merits of each flap in the management of lower limb defects. Flaps healed primarily in 82% of cases (50/61). Approximately 50% of the secondary donor sites required skin graft...

Plastic and reconstructive surgery, 2016

After reading this article, the participant should be able to: 1. Appreciate the variation and ev... more After reading this article, the participant should be able to: 1. Appreciate the variation and evolution of flexor tendon management 2. Know how to assess the patient who presents with a flexor tendon laceration. 3. Understand the biology of repairing flexor tendon lacerations. 4. Appreciate the technical challenges in flexor tendon repair relating to different zones. 5. Understand the rationale of postoperative hand therapy. 6. Have an overview of the types of secondary tendon surgery. Flexor tendon injury constitutes a considerable trauma workload for hand surgeons, and a vast amount of research is dedicated toward improving outcomes in tendon repair. This Continuing Medical Education article aims to provide an up-to-date evidence-based outline of flexor tendon surgery in the hand. The authors reviewed the literature on flexor tendon repairs to include a balanced overview of the experimental and clinical research. For each section, the best levels of evidence were assessed in the ...

Experimental Dermatology, 2015

The skin is often viewed as a static barrier that protects the body from the outside world. Empha... more The skin is often viewed as a static barrier that protects the body from the outside world. Emphasis on studying the skin's architecture and biomechanics in the context of restoring skin movement and function is often ignored. It is fundamentally important that if skin is to be modelled or developed, we do not only focus on the biology of skin but also aim to understand its mechanical properties and structure in living dynamic tissue. In this review, we describe the architecture of skin and patterning seen in skin as viewed from a surgical perspective and highlight aspects of the microanatomy that have never fully been realized and provide evidence or concepts that support the importance of studying living skin's dynamic behaviour. We highlight how the structure of the skin has evolved to allow the body dynamic form and function, and how injury, disease or ageing results in a dramatic changes to the microarchitecture and changes physical characteristics of skin. Therefore, a...

The Journal of sports medicine and physical fitness, 2003

To study the effects of early weight bearing following acute repair of ruptured Achilles tendon. ... more To study the effects of early weight bearing following acute repair of ruptured Achilles tendon. Using a comparative longitudinal study design, following repair of an Achilles tendon rupture, patients in Group 1 were immobilised with their ankle in gravity equinus, were encouraged to weight bear on the operated limb as soon as possible to full weight bearing, and received a single a cast change at 2 weeks, when the ankle was immobilised in a plantigrade position. Patients in Group 2 were immobilised with their ankle in full equinus, and received a cast change at 2 weeks, when the ankle was immobilised in mid equinus, and at 4 weeks, when the ankle was immobilised in a plantigrade position. They were advised to weight bear 4 weeks from the operation. Patients in Group 1 attended less outpatient visits, completely discarded their crutches at an average of 2.5 weeks from the operation (Group 2: average of 5.7 weeks from the operation), (p=0.013), and a greater proportion of them were s...

The American journal of sports medicine

There is no consensus on the best method for management of acute Achilles tendon ruptures. Indivi... more There is no consensus on the best method for management of acute Achilles tendon ruptures. Individual preferences, drawn from experience and study, determine whether treatment is operative or nonoperative. Our goal was to review the literature to try to determine what management method was the most popular and effective. We wanted to ascertain the best results in terms of complication rates and patient outcomes. Retrospective review of retrospectively and prospectively collected data. We analyzed 125 articles in peer-reviewed journals for year of publication, patient numbers, sex, management method, follow-up complications, and patient satisfaction. Each article was graded using a validated methods score. Methods, patient satisfaction, and complication rates were correlated with the year each article was published. Skin-healing complications were lowest in conservatively managed patients (3 of 578, 0.5%) and highest in open repair and immobilized patients (543 of 3718, 14.6%). Gener...

Plastic and Reconstructive Surgery, 2014

he management of flexor tendon injuries remains one of the most published topics in hand surgery,... more he management of flexor tendon injuries remains one of the most published topics in hand surgery, with the numbers of publications on this subject seeing a year-onyear increase (Fig. 1). The perfect repair and outcome continue to evade us, 1 despite the flexor tendon repair being one of the earliest skills acquired as a hand surgeon in either plastic or orthopedic surgery training. 2 New tendon repairs and hand therapy regimens are reported regularly. Occasionally, there is an announcement of a new treatment modality that promises hope for this clinical conundrum, but this rarely becomes part of standard practice. Over the past 50 years, there have been many innovations, but overall outcomes have not changed dramatically. For example, the best series published in the 1970s showed that a two-strand repair with simple circumferential suture and a Kleinert type rehabilitation regimen had a 5 percent rupture rate, with 75 percent of patients achieving good to excellent functional outcomes in 28 zone II injuries. 3 This compares favorably with more recent studies showing that a four-strand repair and early active mobilization regimen had a 5 percent rupture rate, with 71 percent achieving good to excellent outcomes in 73 cases. 4 Real paradigm shifts in this area require us to rethink the whole process of flexor tendon biology Disclosure: Neither author has a financial interest in any of the products or devices mentioned in this article.

Journal of Plastic, Reconstructive & Aesthetic Surgery, 2008

... Titre du document / Document title. Key points in technique : Split thickness skin grafting t... more ... Titre du document / Document title. Key points in technique : Split thickness skin grafting to bare skull as a single stage procedure. Auteur(s) / Author(s). FOONG Deborah PS ; BABAR Ahmed Z. ; MCGROUTHER Duncan A. ; WONG Jason ; Revue / Journal Title. ...

Journal of Plastic, Reconstructive & Aesthetic Surgery, 2010

No abstract is available. To read the body of this article, please view the Full Text online. ...... more No abstract is available. To read the body of this article, please view the Full Text online. ... © 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved. ... Visit SciVerse ScienceDirect to see if you have access via your ...

European Journal of Vascular and Endovascular Surgery, 2003

Background: the variability of venous reflux patterns complicate the management of venous disease... more Background: the variability of venous reflux patterns complicate the management of venous disease. Our study investigates specific variations in venous anatomy and patterns of reflux in varying clinical situations. Methods: prospective analysis of 464 legs in 355 patients was performed by complete duplex venous mapping of both primary and recurrent varicose veins. Hand Held Doppler (HHD) and Duplex Ultrasonography (Duplex US) observations in the popliteal fossa were compared in a subgroup of 89 patients with primary varicose veins. Distribution of venous system disease was correlated with clinical severity in a subgroup of 117 affected legs which was representative of the overall study group. Results: sapheno-femoral junction (SFJ) incompetence predominated in both primary and recurrent varicose veins. Only 21% of primary legs and 25% of recurrent legs had sapheno-popliteal junction (SPJ) incompetence. SPJ incompetence was present in only 42% of cases where reflux in the popliteal region on HHD had been demonstrated. A proportion of both primary and recurrent varicose veins had evidence of deep venous incompetence (DVI). Sixty-four percent of primary leg ulcer patients had superficial incompetence alone. In patients with recurrent varicosities and ulceration, 57% had SPJ incompetence, 64% multiple sites and 50% DVI. Conclusion: the complex variations of varicose vein anatomy and functional pathology in the lower limb are currently best assessed by complete whole-leg venous duplex mapping.

Clinics in Sports Medicine, 2003

Certain similarities can clearly be appreciated between Achilles and patellar tendon ruptures. Bo... more Certain similarities can clearly be appreciated between Achilles and patellar tendon ruptures. Both are strong tendons that transmit force bridging at least one joint of the lower limb. When healthy, both require massive forces to be disrupted, and both can be weakened through certain systemic disease processes, steroids, and fluoroquinones. Both allow for a variety of innovative management possibilities that ultimately lend themselves to individual surgical preference. We feel that, although surgical management plays an important role in restoring continuity in knee extension and in plantar flexion, functional outcome inevitably relies on patient motivation and a well-established physiotherapy regime. Sports physicians should be able to identify both conditions early in their presentation, but still hold a high index of suspicion for these problems in athletes who have an acute exacerbation of ongoing tendinopathy.

Clinics in Sports Medicine, 2003

Over the course of the last two decades, athletes have received increased demands on their perfor... more Over the course of the last two decades, athletes have received increased demands on their performance. This has determined an increase in the risk of acute and overuse sport injuries, as they are required to train more often, more intensely and for longer. Until the recent past, sports and physical activities involved mainly young and middle-aged people. Today, with an increase in leisure time, a greater number of individuals spend time practicing recreational or competitive sports [1,2]. During physical exercise, much stress and force are exerted on the tendon, increasing the risk of injury. In repetitive hopping in place, a force of about 4000 N has been measured in the Achilles tendon. The force measured from the Achilles tendon is about twice the ground-reaction force. In hopping, most of the elastic energy is stored in the tendon itself. The contribution of the elastic energy in hopping is about 40% of the total mechanical work [3]. This implies that the tendon plays an important role as an active element of the muscle-tendon unit during sport. This article is divided into separate but interconnected parts. First we discuss tendinopathy from a histopathological viewpoint. We then describe the basic epidemiological issues facing physicians when dealing with such conditions. Some forms of tendinopathies are discussed, but we stress that these are not detailed, in-depth descriptions, and that the conditions selected, though representative, are only a small cross-section of clinically relevant tendinopathies

Cochrane Database of Systematic Reviews, 2016

Nasal decontamination for the prevention of surgical site infection in Staphylococcus aureus carr... more Nasal decontamination for the prevention of surgical site infection in Staphylococcus aureus carriers.