{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:14:27Z","timestamp":1783509267896,"version":"3.55.0"},"reference-count":22,"publisher":"MDPI AG","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3]]},"abstract":"\n Background<\/jats:title>\n In the Ponseti technique, the residual equinus deformity is corrected with percutaneous tenotomy. This experimental study aimed to compare the safety and effectiveness of a large-gauge needle, a corneal knife, and a No. 11 blade in percutaneous achillotomy performed in rats.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Ninety Achilles tendons of 45 Sprague-Dawley rats were analyzed, following division into three study groups. In the study, group I (needle), group II (corneal knife), and group III (No. 11 blade) were compared on the basis of bleeding, incision length, requirement for primary suture, range of motion, and resulting neurovascular injury at day 0. Moreover, the groups were compared in terms of range of motion, macroscopic and microscopic adhesions, and tenocyte morphology at days 21 and 42 postoperatively.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n On day 0, one suture was required in group III, whereas in groups I and II, no sutures were required. Postoperative bleeding was greater in group III and similar in groups I and II. Neurovascular injury was not observed in any of the groups. Three incomplete tenotomies were observed in group III and one incomplete tenotomy was observed in group II. Importantly, all tenotomies were complete in group I. In all groups, the range of motion was similar. The macroscopic adhesion score revealed high adhesion in group III (\n P<\/jats:italic>\n = .009). According to Tang's criteria, microscopic adhesion was significantly higher on day 21 in group III compared with the other groups (\n P<\/jats:italic>\n <0.001). No significant differences were observed in tenocyte morphology based on the Bonar criteria (\n P<\/jats:italic>\n = .850).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In the results obtained from this animal study, we observed less bleeding, less adhesion, and less incomplete tenotomy in the large-gauge needle and corneal knife groups compared with the No. 11 blade group during the percutaneous Achilles tenotomy performed in rats.<\/jats:p>\n <\/jats:sec>","DOI":"10.7547\/19-121","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T01:46:41Z","timestamp":1618883201000},"source":"Crossref","is-referenced-by-count":3,"title":["Comparison of Large-Gauge Needle, Corneal Knife, and No. 11 Blade for Percutaneous Achillotomy"],"prefix":"10.3390","volume":"111","author":[{"given":"Yakup","family":"Alpay","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timur","family":"Yildirim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deniz","family":"Akbulut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Cukurlu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suheyla Esra","family":"Ozkocer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cigdem","family":"Elmas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"i8750-7315-111-2-Article_10-b01","series-title":"J Foot Ankle Surg","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1053\/j.jfas.2004.05.012","article-title":"Percutaneous tendo-Achilles lengthening with a large-gauge needle: a modification of the Ponseti technique for correction of idiopathic clubfoot","volume":"43","author":"Minkowitz","year":"2004","unstructured":"Minkowitz\n B\n \n \n Finkelstein\n BI\n \n \n Bleicher\n M:\n \n \n Percutaneous tendo-Achilles lengthening with a large-gauge needle: a modification of the Ponseti technique for correction of idiopathic clubfoot.\n\t\t\t\t\tJ Foot Ankle Surg43: 263,\n\t\t\t\t\t2004.\n\t\t\t\t1528481710.1053\/j.jfas.2004.05.012"},{"key":"i8750-7315-111-2-Article_10-b02","series-title":"Congenital Clubfoot: Fundamentals of Treatment","author":"Ponseti","year":"1996","unstructured":"Ponseti\n IV:\n \n \n \n Congenital Clubfoot: Fundamentals of Treatment\n ,\n\t\t\t\t\tOxford University Press,\n\t\t\t\t\tNew York,\n\t\t\t\t\t1996."},{"key":"i8750-7315-111-2-Article_10-b03","series-title":"J Orthop Surg Hong Kong","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1177\/230949900901700115","article-title":"Conservative management of idiopathic clubfoot: Kite versus Ponseti method","volume":"17","author":"Sanghvi","year":"2009","unstructured":"Sanghvi\n AV\n \n \n Mittal\n VK:\n \n \n Conservative management of idiopathic clubfoot: Kite versus Ponseti method.\n\t\t\t\t\tJ Orthop Surg Hong Kong17: 67,\n\t\t\t\t\t2009.\n\t\t\t\t1939879710.1177\/230949900901700115"},{"key":"i8750-7315-111-2-Article_10-b04","series-title":"J Pediatr Orthop","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1097\/01241398-200407000-00002","article-title":"Bleeding complications following percutaneous tendoachilles tenotomy in the treatment of clubfoot deformity","volume":"24","author":"Dobbs","year":"2004","unstructured":"Dobbs\n MB\n \n \n Gordon\n JE\n \n \n Walton\n T\n \n :\n \n Bleeding complications following percutaneous tendoachilles tenotomy in the treatment of clubfoot deformity.\n\t\t\t\t\tJ Pediatr Orthop24: 353,\n\t\t\t\t\t2004.\n\t\t\t\t10.1097\/01241398-200407000-0000215205614"},{"key":"i8750-7315-111-2-Article_10-b05","series-title":"JAPMA","first-page":"414","article-title":"Mini-open technique for the Achilles tenotomy in correction of idiopathic clubfoot: a report of 25 cases","volume":"98","author":"Dogan","year":"2008","unstructured":"Dogan\n A\n \n \n Kalender\n AM\n \n \n Serame\n E\n \n :\n \n Mini-open technique for the Achilles tenotomy in correction of idiopathic clubfoot: a report of 25 cases.\n\t\t\t\t\tJAPMA98: 414,\n\t\t\t\t\t2008."},{"key":"i8750-7315-111-2-Article_10-b06","series-title":"J Clin Orthop Trauma","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.jcot.2013.12.001","article-title":"Use of keratome 1-0 for percutaneous tendo Achilles tenotomy for correction of equinus deformity in club foot","volume":"5","author":"Goyal","year":"2014","unstructured":"Goyal\n S\n \n \n Sangwan\n SS\n \n \n Gogna\n P\n \n :\n \n Use of keratome 1-0 for percutaneous tendo Achilles tenotomy for correction of equinus deformity in club foot.\n\t\t\t\t\tJ Clin Orthop Trauma5: 115,\n\t\t\t\t\t2014.\n\t\t\t\t10.1016\/j.jcot.2013.12.00125983483"},{"key":"i8750-7315-111-2-Article_10-b07","series-title":"J Orthop Case Rep","first-page":"35","article-title":"Percutaneous needle tenotomy for tendo-Achillis release in clubfoot: technical note","volume":"2","author":"Patwardhan","year":"2012","unstructured":"Patwardhan\n S\n \n \n Shyam\n A\n \n \n Sancheti\n P:\n \n \n Percutaneous needle tenotomy for tendo-Achillis release in clubfoot: technical note.\n\t\t\t\t\tJ Orthop Case Rep2: 35,\n\t\t\t\t\t2012.\n\t\t\t\t27298852"},{"key":"i8750-7315-111-2-Article_10-b08","series-title":"J Foot Ankle Res","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1186\/s13047-017-0231-4","article-title":"\u2018Fast cast' and \u2018needle tenotomy' protocols with the Ponseti method to improve clubfoot management in Bangladesh","volume":"10","author":"Evans","year":"2017","unstructured":"Evans\n A\n \n \n Chowdhury\n M\n \n \n Rana\n S\n \n :\n \n \u2018Fast cast' and \u2018needle tenotomy' protocols with the Ponseti method to improve clubfoot management in Bangladesh.\n\t\t\t\t\tJ Foot Ankle Res10: 49,\n\t\t\t\t\t2017.\n\t\t\t\thttp:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000414793200001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1186\/s13047-017-0231-429151894"},{"key":"i8750-7315-111-2-Article_10-b09","series-title":"J Pediatr Orthop","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1097\/BPO.0b013e3181653b6f","article-title":"Pseudoaneurysm after Ponseti percutaneous Achilles tenotomy: a case report","volume":"28","author":"Burghardt","year":"2008","unstructured":"Burghardt\n RD\n \n \n Herzenberg\n JE\n \n \n Ranade\n A:\n \n \n Pseudoaneurysm after Ponseti percutaneous Achilles tenotomy: a case report.\n\t\t\t\t\tJ Pediatr Orthop28: 366,\n\t\t\t\t\t2008.\n\t\t\t\t18362805http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000262286000016&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1097\/BPO.0b013e3181653b6f"},{"key":"i8750-7315-111-2-Article_10-b10","series-title":"Clin Orthop Relat Res","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1097\/00003086-200110000-00014","article-title":"Complications of Achilles and posterior tibial tendon surgeries","volume":"391","author":"Dalton","year":"2001","unstructured":"Dalton\n GP\n \n \n Wapner\n KL\n \n \n Hecht\n PJ:\n \n \n Complications of Achilles and posterior tibial tendon surgeries.\n\t\t\t\t\tClin Orthop Relat Res391: 133,\n\t\t\t\t\t2001.\n\t\t\t\t10.1097\/00003086-200110000-00014"},{"key":"i8750-7315-111-2-Article_10-b11","series-title":"J Child Orthop","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1007\/s11832-009-0207-4","article-title":"A comparison of percutaneous and mini-open techniques of Achilles tenotomy: an experimental study in rats","volume":"3","author":"Dogan","year":"2009","unstructured":"Dogan\n A\n \n \n UzumcugilZ\n O\n \n \n Sar\u0131sozen\n B\n \n :\n \n A comparison of percutaneous and mini-open techniques of Achilles tenotomy: an experimental study in rats.\n\t\t\t\t\tJ Child Orthop3: 485,\n\t\t\t\t\t2009.\n\t\t\t\t10.1007\/s11832-009-0207-419795145"},{"key":"i8750-7315-111-2-Article_10-b12","series-title":"J Surg Res","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/j.jss.2003.12.011","article-title":"Postoperative stiffness and adhesion formation around repaired and immobilized Achilles tenotomies are prevented using a model of heat shock protein induction","volume":"120","author":"Healy","year":"2004","unstructured":"Healy\n C\n \n \n Mulhall\n KJ\n \n \n Nelligan\n M\n \n :\n \n Postoperative stiffness and adhesion formation around repaired and immobilized Achilles tenotomies are prevented using a model of heat shock protein induction.\n\t\t\t\t\tJ Surg Res120: 225,\n\t\t\t\t\t2004.\n\t\t\t\t10.1016\/j.jss.2003.12.011"},{"key":"i8750-7315-111-2-Article_10-b13","series-title":"Clin Orthop Relat Res","first-page":"170","article-title":"The effect of the local corticosteroids on the healing and biomechanical properties of the partially injured tendon","volume":"163","author":"Kapetanos","year":"1982","unstructured":"Kapetanos\n G:\n \n \n The effect of the local corticosteroids on the healing and biomechanical properties of the partially injured tendon.\n\t\t\t\t\tClin Orthop Relat Res163: 170,\n\t\t\t\t\t1982."},{"key":"i8750-7315-111-2-Article_10-b14","series-title":"Clin Orthop Relat Res","first-page":"281","article-title":"Hyaluronic acid and its effect on postoperative adhesions in the rabbit flexor tendon. A preliminary look","volume":"206","author":"Thomas","year":"1986","unstructured":"Thomas\n SC\n \n \n Jones\n LC\n \n \n Hungerford\n DS:\n \n \n Hyaluronic acid and its effect on postoperative adhesions in the rabbit flexor tendon. A preliminary look.\n\t\t\t\t\tClin Orthop Relat Res206: 281,\n\t\t\t\t\t1986."},{"key":"i8750-7315-111-2-Article_10-b15","series-title":"J Hand Surg Am","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/0363-5023(94)90225-9","article-title":"Dorsal and circumferential sheath reconstructions for flexor sheath defect with concomitant bony injury","volume":"19","author":"Tang","year":"1994","unstructured":"Tang\n JB\n \n \n Ishii\n S\n \n \n Usui\n M\n \n :\n \n Dorsal and circumferential sheath reconstructions for flexor sheath defect with concomitant bony injury.\n\t\t\t\t\tJ Hand Surg Am19: 61,\n\t\t\t\t\t1994.\n\t\t\t\t772688210.1016\/0363-5023(94)90225-9"},{"key":"i8750-7315-111-2-Article_10-b16","series-title":"J Orthop Res","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1016\/j.orthres.2003.08.005","article-title":"Abnormal tenocyte morphology is more prevalent than collagen disruption in asymptomatic athletes' patellar tendons","volume":"22","author":"Cook","year":"2004","unstructured":"Cook\n JL\n \n \n Feller\n JA\n \n \n Bonar\n SF\n \n :\n \n Abnormal tenocyte morphology is more prevalent than collagen disruption in asymptomatic athletes' patellar tendons.\n\t\t\t\t\tJ Orthop Res22: 334,\n\t\t\t\t\t2004.\n\t\t\t\t10.1016\/j.orthres.2003.08.00515013093"},{"key":"i8750-7315-111-2-Article_10-b17","series-title":"Knee Surg Sports Traumatol Arthrosc","doi-asserted-by":"publisher","first-page":"2788","DOI":"10.1007\/s00167-019-05536-w","article-title":"Repair within the first 48 h in the treatment of acute Achilles tendon ruptures achieves the best biomechanical and histological outcomes","volume":"28","author":"Misir","year":"2020","unstructured":"Misir\n A\n \n \n Kizkapan\n TB\n \n \n Arikan\n Y\n \n :\n \n Repair within the first 48 h in the treatment of acute Achilles tendon ruptures achieves the best biomechanical and histological outcomes.\n\t\t\t\t\tKnee Surg Sports Traumatol Arthrosc28: 2788,\n\t\t\t\t\t2020.\n\t\t\t\thttp:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000565793400007&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1007\/s00167-019-05536-w"},{"key":"i8750-7315-111-2-Article_10-b18","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"837","DOI":"10.2106\/00004623-198264060-00005","article-title":"Arteriography in club foot","volume":"64","author":"Greider","year":"1982","unstructured":"Greider\n TD\n \n \n Siff\n SJ\n \n \n Gerson\n P\n \n :\n \n Arteriography in club foot.\n\t\t\t\t\tJ Bone Joint Surg Am.\n\t\t\t\t\t64: 837,\n\t\t\t\t\t1982.\n\t\t\t\t708571110.2106\/00004623-198264060-00005"},{"key":"i8750-7315-111-2-Article_10-b19","series-title":"J Pediatr Orthop","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1097\/01241398-199001000-00020","article-title":"Arterial abnormalities in talipes equinovarus as assessed by angiography and the Doppler technique","volume":"10","author":"Sodre","year":"1990","unstructured":"Sodre\n H\n \n \n Bruschini\n S\n \n \n Mestriner\n LA\n \n :\n \n Arterial abnormalities in talipes equinovarus as assessed by angiography and the Doppler technique.\n\t\t\t\t\tJ Pediatr Orthop10: 101,\n\t\t\t\t\t1990.\n\t\t\t\t240501910.1097\/01241398-199001000-00020"},{"key":"i8750-7315-111-2-Article_10-b20","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"599","DOI":"10.2106\/00004623-200403000-00022","article-title":"Absent posterior tibial artery associated with idiopathic clubfoot. A report of two cases","volume":"86","author":"Dobbs","year":"2004","unstructured":"Dobbs\n MB\n \n \n Gordon\n JE\n \n \n Schoenecker\n PL:\n \n \n Absent posterior tibial artery associated with idiopathic clubfoot. A report of two cases.\n\t\t\t\t\tJ Bone Joint Surg Am86: 599,\n\t\t\t\t\t2004.\n\t\t\t\t10.2106\/00004623-200403000-0002214996890"},{"key":"i8750-7315-111-2-Article_10-b21","series-title":"Arch Orthop Trauma Surg","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1007\/s00402-006-0267-6","article-title":"Neurovascular complications following percutaneous tendoachillis tenotomy for congenital idiopathic clubfoot","volume":"127","author":"Changulani","year":"2007","unstructured":"Changulani\n M\n \n \n Garg\n N\n \n \n Bruce\n CE:\n \n \n Neurovascular complications following percutaneous tendoachillis tenotomy for congenital idiopathic clubfoot.\n\t\t\t\t\tArch Orthop Trauma Surg127: 429,\n\t\t\t\t\t2007.\n\t\t\t\t10.1007\/s00402-006-0267-617216170http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000248109200006&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3"},{"key":"i8750-7315-111-2-Article_10-b22","series-title":"J Pediatr Orthop","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1097\/01241398-198509000-00014","article-title":"An electron microscopic study of the fascia from the medial and lateral sides of clubfoot","volume":"5","author":"Zimny","year":"1985","unstructured":"Zimny\n ML\n \n \n Willig\n SJ\n \n \n Roberts\n JM\n \n :\n \n An electron microscopic study of the fascia from the medial and lateral sides of clubfoot.\n\t\t\t\t\tJ Pediatr Orthop5: 577,\n\t\t\t\t\t1985.\n\t\t\t\t10.1097\/01241398-198509000-000144044817"}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/111\/2\/i8750-7315-111-2-article_10.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/japma\/article-pdf\/doi\/10.7547\/19-121\/2812816\/i8750-7315-111-2-article_10.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/111\/2\/i8750-7315-111-2-article_10.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/111\/2\/i8750-7315-111-2-article_10.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:18:12Z","timestamp":1783505892000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/111\/2\/19121"}},"subtitle":["An Experimental Study"],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":22,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.7547\/19-121","relation":{},"ISSN":["8750-7315"],"issn-type":[{"value":"8750-7315","type":"print"}],"subject":[],"published":{"date-parts":[[2021,3]]}}}