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Oh Snap! Osteopathic Treatment of Tendon Rupture with Link to Long Term Statin Use

Journal: The AAO Journal Date: 2024/06, 34(2):Pages: 18. doi: Subito , type of study: case report

Full text    (https://meridian.allenpress.com/aaoj/article/34/2/16/500954/LBORC-NUFA-Poster-Abstracts-2024-Students)

Keywords:

case report [726]
geriatrics [128]
male [831]
OMT [3796]
osteopathic manipulative treatment [3817]
tendon rupture [2]

Abstract:

Introduction/Background: Statins, the preferred medication for hyperlipidemia, tout minimal side effects. Used by over 90-million patients, their role in lifetime cardiovascular disease risk reduction supports interest in long-term therapy implications. Recent studies demonstrate induced tendon matrix disruption, clinical cases pose suspected relationships to significant ruptures, and a 104-patient retrospective study concludes 2-times greater risk of distal bicep tendon rupture. The availability/ efficacy of alternative medications accentuates the importance of physician awareness to preserve quality of life in at-risk patients. Case: An 86-year-old male experienced 2 successive rare tendinous ruptures. Regularly active, 60+ years removed from competitive sports, and without history of related trauma/surgery; he was without typical risk factors. His medications included unchanged, long-term pravastatin. After a “pop!” while lifting boxes, he was diagnosed in clinic with a semitendinosus rupture. Within 9 weeks, still rehabbing his injury, and again lifting boxes, he ruptured his latissimus dorsi. Therapy for both included strain-counterstrain and muscle energy techniques to rebalanced muscle groups and myofascial release to aid lymphatic clearance. Review of literature, prompted by this second rupture, indicated replacement of his statin with evolocumab. Methods/Results: Osteopathic Manipulative Treatment (OMT) expedited resolution of his ecchymosis/swelling and was documented via photographs. Replacement of his statin with evolocumab enabled return to activity without further ruptures. Discussion/Conclusion: This case study captures successive rare tendon ruptures, without classic risk factors, in the setting of chronic statin therapy. Limited to one patient, it provides an opportunity to update education regarding statins and illustrates the application of OMT in tendinopathy treatment. This case demonstrates the strong clinical application of functional medicine and osteopathic principles and emphasizes the need for further research into the long-term prevalence of tendinopathy with statin therapy.


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