Клинические исследования стопы и голеностопного сустава

Абстрактный

Achilles Tendon Rupture and Abnormal Lipid Profile: A Descriptive Clinical Laboratory and Histology Study

Loisel François, Hugo Kielwasser, Grégoire Faivre, Kantelip Bernadette, Obert Laurent

Introduction: Several human and animal studies have revealed a link between abnormal serum lipid levels and Achilles tendon rupture. However, clinicians have not detected macroscopic amounts of fatty tissue during the repair of ruptured tendons.
Material and Methods: A lipid profile and evaluation of tendon lipomatosis were performed in a group of 65 patients with Achilles tendon rupture recruited over a two-year period at two French hospitals. Cardiovascular and tendon rupture risk factors were inventoried.
Results: Ten patients had a history of hypercholesterolemia, seven of whom were undergoing statin treatment (15%). Two patients had known risk factors for tendon rupture (3%): one was taking inhaled corticosteroids and the other suffered from hyperuricemia. Total cholesterol was normal in 63% of cases; triglycerides were normal in 67% of cases and HDL cholesterol was normal in 54% of cases. If cardiovascular risk factors were taken into account, the portion of high-LDL cholesterol went from 17% to 23%, but this was not significant. Pathology analysis found four cases of tendon lipomatosis among the 36 collected samples (11%).
Discussion: Since this study did not include a control group, we cannot make any conclusions about the lack of relationship between abnormal lipid profile and tendon rupture. The prevalence of hypercholesterolemia in our study population was similar to that of the general population. Although high cholesterol levels have been implicated by some authors, cholesterol accumulation within the tendon is probably not directly responsible for weakening it; however, an increase in atheromatous plaque in tendon blood vessels may lead to hypoxia.