Ruptured Tendons and Torned Ligaments

I did a quick Google search and it does seem that lupus, especially when treated with prednisone, seems to have a higher incidence of spontaneous tendon ruptures. Are you on prednisone? For a while? It's not a common occurrence, but it definitely happens!

Here is one article synopsis, and you can read the full thing if you want to...

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1237870

Another article popped up in my search about 2 women with SLE in their 40's who had ruptured Achilles tendons and both had been on prednisone at the time, both had a delay in diagnosis, but both had surgery to repair it. Have you seen a top notch specialist about your achilles tendon rupture to be sure it can't be fixed? Seems like an especially important tendon to have working to me!

In your shoes, I would probably get the surgery. Especially if the doctors are recommending it (get a second opinion if you want extra reassurance/information). It may not bother you much now, but it sounds like it will get worse over time and there could come a time when it is too late to fix.

Hi,

Lupus is a connective tissue disease and that can include the tendons. I know of at least 2 members on this forum that have had ankle problems related to their lupus. Here is a brief bit on lupus and tendons from The Lupus Book 3rd edition. The sentences are part of larger paragraphs with more detailed discussion.

"Only joints lined with Synovium can be involved in lupus. In active lupus , synovium grows and thickens as part of the inflammatory response. Synovium also lines the tendons and bursae. Inflammation of these structures may lead to deformity if ligaments or tendons rupture. pages 78-80"

I know that in the USA, in the past, Orthopedic Surgeons had a bad reputation. I can understand your concern over surgery. Is the orthopedic doctor you are seeing a referral from your rheumatologist? I would suggest getting a 2nd opinion preferably with a doctor familiar with connective tissue diseases. I would also discuss with your rheumatologist what can be done to better control your lupus since this is the 2nd incidence of tendon rupture that you are dealing with.

Let us know how things go.

Take care,
Karen

Thanks Karen and Maia for your reply.

I have been on prednisone for 35 years!! I have finally got it down to 2.5 mg every other day this past two months because I am supposely in remission....finally. Unfortunately, my body is fighting it. I am very tired, my body aches, no appetite (for once in my life) and now I discovered these torn lignaments in my shoulder. I think when I was on the higher dose of prednisone, it was hiding the pain.

As for my rupture achilles tendon, I saw three top orthos in LA. Two recommended not doing it and one said he could try but the chance of it working was questionable. I opted not doing it because I did not have six or more months of being in a cast and not be able to drive. At that time, I was going to China in less than two months to pick up my adopted daughter. I now walk with a slight limp and I cannot run. After two years, the pain in my achilles finally subsided.

As for my shoulder with the torn ligaments, if I can function, I can live with the mild pain, just like my leg. In the mean time, I am trying to find another shoulder ortho to see what my options are. Does anyone have a recommendation for a shoulder ortho in LA?

For now, how do I protect my other ligaments, tendons from degenerating?

Judy

Judy,

I was in a similar position just a few months ago... I rupture the pereneal brevis tendon in my ankle and slightly tore my achillies. I had the surgery to repair the ruptured tendon, but the achillies they said was not something that they could repair. Now the rupture is healing very nicely, but the tear is not. I am afraid that it is going to progress to a rupture because of the way it won't heal.

Looking back if I were in your shoes, I would probably look for that 2nd opinion, but maybe be leaning in the direction of surgery just to give it the best possibility of healing. As far as Orthos in the LA area, have you tried SCOI? They have many great doctors there. I can't give you a specific name, I have only used knee and ankle guys there.

Good luck in what ever you choose.


Nichole

Hi:

I have torn Rotator cuffs in both shoulders, torn flexor tendons in both elbows and bursitis in those places. I also have thickening on my hips lexor tendons.

I have a great ortho (in florida of course) and he refuses to perform the operation until they get my lupus more under control. He said that there was no point in repairing the tears, going through therapy, etc, just to have it hapen again due to the inflammation. I was not on prendisone until just recently and these are all pre-prendisone. I have been on cellcept for about 8 months.

Both Ortho and (new) Rhumy agree (Old rhumy said it was from walking my dog???) that this is all caused by the constant inflammation of the Lupus.

I Know this probably doen't help much, but I suggest, if your lupus is under control, that you get these repaired...otherwise you may have more trouble later on.

Stephanie