scholarly journals DEFICITS OF CALF MUSCLES STRENGTH AND RATE OF FORCE DEVELOPMENT AFTER ACHILLES TENDON RUPTURE

2019 ◽  
Vol 2 (8) ◽  
pp. 118
Author(s):  
Vaida Aleknavičiūtė - Ablonskė ◽  
Agnė Savenkovienė ◽  
Albertas Skurvydas
Keyword(s):  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Biomechanical Properties ◽  
Calf Muscle ◽  
Plantar Flexors ◽  
Adaptive Changes ◽  
Motor Strategy ◽  
Neural Factors ◽  
Muscle Changes

<p>The Achilles tendon is the thickest and the strongest tendon in the human body. Many studies, investigating biomechanical properties of plantar flexors muscle-tendon unit after ATR surgery, reported an incomplete calf muscle contractile functional recovery. However, these studies only investigated the plantar flexors muscle function failing to provide information about the adaptive changes in motor strategy. In fact, the development of adaptive changes in motor strategies, due to both mechanical and neural factors, may result in pathological musculoskeletal conditions over the long term. Understanding physiological calf muscle changes due to long-term immobilization may help prevent Achilles tendon re-rupture cases.</p>

Relationship between recovery of calf-muscle biomechanical properties and gait pattern following surgery for achilles tendon rupture

2007 ◽  
Vol 22 (2) ◽  
pp. 211-220 ◽  
Author(s):  
Romildo Don ◽  
Alberto Ranavolo ◽  
Angelo Cacchio ◽  
Mariano Serrao ◽  
Francesca Costabile ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Biomechanical Properties ◽  
Gait Pattern ◽  
Calf Muscle

scholarly journals Concomitant Partial Achilles Tendon Rupture and Lateral Luxation of the Superficial Digital Flexor Muscle Tendon in a Dog

VCOT Open ◽  
2021 ◽  
Vol 04 (01) ◽  
pp. e37-e40
Author(s):  
Hélène Dosseray ◽  
Claire Deroy-Bordenave
Keyword(s):  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Simultaneous Occurrence ◽  
Flexor Muscle ◽  
Screw Insertion ◽  
Superficial Digital Flexor Tendon ◽  
Fixation Screw ◽  
Pelvic Limb ◽  
The Right

AbstractThe aim of this study was to report a posttraumatic partial Achilles tendon (AT) rupture associated with lateral luxation of the superficial digital flexor tendon (SDFT) in a Whippet. This article is a brief communication. A Whippet was presented with posttraumatic plantigrade stance and non-load-bearing lameness of the right pelvic limb. The objective findings consisted in partial AT rupture and SDFT lateral luxation. Surgical treatment ensued: tenorrhaphy of the torn tendons and calcaneo-tibial screw insertion for tarsal immobilization, followed by suturing of the SDFT retinaculum. A casting bandage was employed for additional immobilization. Nonetheless, a bandage complication prompted the premature removal of the fixation screw and casting wrap. Complete functional recovery was achieved by the 20th postoperative week. The simultaneous occurrence of SDFT luxation and partial AT tear has not been reported in the literature before. The long-term postoperative functional outcome was highly satisfactory.

scholarly journals Management of Missed Traumatic Achilles Tendon Rupture in a Pediatric Patient: A Case Report

2021 ◽  
Vol 9 (4) ◽  
pp. 465-470
Author(s):  
Saad Andaloussi
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Skin Wound ◽  
Plantaris Tendon ◽  
First Case ◽  
Tendon Ruptures ◽  
Post Traumatic

BACKGROUND: Missed traumatic Achilles tendon ruptures in children are rarely reported in the literature. Various techniques have been described to reconstruct delayed Achilles tendon ruptures for adults, but the long-term consequences in the growing child are unknown. CLINICAL CASE: The article presents a clinical observation of a 8-year-old girl with missed rupture of the Achilles tendon operated 7 weeks after the trauma by end-to-end Kessler-type sutures augmented with the plantaris tendon. At 2-year follow-up, the patient was completely asymptomatic. DISCUSSION: A review of the literature shows that this is the third neglected pediatric case of post-traumatic Achilles tendon rupture. The first case concerns a 10-year-old boy treated successfully six weeks after the traumat by open surgical repair using the Bunnell sutures technique. The second patient was a 7-year-old girl, she was operated 8 weeks after the trauma with a termino-terminal tenorrhaphy using the Bunnell technique augmented with the plantaris tendon. CONCLUSIONS: Using the plantaris tendon to reinforce the Achilles tendon repair offers satisfactory results with minimal morbidity. Prognosis depends on the extent of tendon defect which determines the long-term functional outcome. Any skin wound that sits on the back of the leg requires a systematic and careful physical examination to check the integrity of the Achilles tendon.

scholarly journals The ultrasonographic dynamic heel-rise test of the Achilles tendon

2021 ◽  
Vol 21 (86) ◽  
pp. e260-e266
Author(s):  
Beata Ciszkowska-Łysoń ◽  
◽  
Urszula Zdanowicz ◽  
Robert Śmigielski ◽  
◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Dynamic Assessment ◽  
Healing Process ◽  
Achilles Tendon Rupture ◽  
Recovery Process ◽  
Biomechanical Properties ◽  
Resonance Imaging ◽  
Ultrasound Monitoring ◽  
And Function

The treatment of Achilles tendon rupture attempts to restore the primary anatomical structure and principal biomechanical properties of the damaged tendon. Postoperative clinical assessment of the healing progression and function monitoring may be difficult and require experience. Diagnostic imaging (ultrasonography and magnetic resonance imaging) helps monitor the healing process. In the following paper, we propose a heel-rise test – a dynamic assessment of the Achilles tendon performed under direct observation and ultrasound monitoring to establish the tension of the Achilles tendon. The test allows for a simple assessment of tendon function and may be safely repeated at any postoperative stage. It may be performed by a physician, radiologist and physiotherapist to monitor the recovery process following Achilles tendon damage.

Changes in Tendon Elongation and Muscle Atrophy Over Time After Achilles Tendon Rupture Repair: A Prospective Cohort Study on the Effects of Early Functional Mobilization

2020 ◽  
Vol 48 (13) ◽  
pp. 3296-3305 ◽  
Author(s):  
Susanna Aufwerber ◽  
Gunnar Edman ◽  
Karin Grävare Silbernagel ◽  
Paul W. Ackermann
Keyword(s):  
Patient Outcome ◽  
Cohort Study ◽  
Achilles Tendon ◽  
Muscle Atrophy ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Calf Muscle ◽  
Control Group ◽  
Tendon Elongation ◽  
Over Time

Background: Early functional mobilization (EFM) may improve patient outcome after Achilles tendon rupture (ATR). However, whether EFM affects patient outcome via changes in tendon elongation, thickening, or calf muscle atrophy is unknown. Purpose: To analyze differences in tendon and muscle morphology recovery over time between groups treated with EFM or standard treatment after ATR repair. Study Design: Cohort study; Level of evidence, 2. Methods: This prospective cohort study included 86 patients (20 women) with ATR repair who had a mean (SD) age of 39.3 (8.2) years and were part of a larger prospective randomized controlled trial. Patients were postoperatively randomized to immediate postoperative weightbearing and ankle motion (EFM group) or to immobilization in a below-knee plaster cast for 2 weeks (control group). Patient-reported and functional outcomes were assessed at 6 and 12 months with the Achilles Tendon Total Rupture Score and the heel-rise test for endurance. At 2 and 6 weeks and 6 and 12 months postoperatively, B-mode ultrasound imaging was performed to assess the length and cross-sectional area (CSA) of the Achilles tendon, the gastrocnemius CSA, as well as the thickness of soleus. Results: The Achilles Tendon Total Rupture Score for the EFM and control groups were 65.8 (18.7) and 56.8 (20.1; P = .045), respectively, at 6 months and 79.6 (15.8) and 78.9 (17.2; P = .87), respectively, at 12 months. At 2 weeks, tendon elongation was significantly more pronounced in the EFM group as compared with the control group (mean side-to-side difference, 1.88 cm vs 0.71 cm; P = .005). Subsequently, tendon elongation increased in the control group while it decreased in the EFM group so that at 6 and 12 months no significant differences between groups were found. Mean Achilles tendon elongation at 1 year was 1.73 (1.07) cm for the EFM group (n = 55) and 1.67 (0.92) cm for the control group (n = 27), with a mean difference of 0.06 cm (95% CI, 0.54 to –0.42; P = .80). Achilles tendon CSA and calf muscle atrophy displayed no significant differences between the groups; however, significant changes were demonstrated over time ( P ≤ .001) in both groups. Conclusion: EFM results in more Achilles tendon elongation at early healing, but this difference subsides over time. EFM does not seem to affect patient outcome via changes in tendon elongation, thickening, or calf muscle atrophy. Registration: NCT02318472 (ClinicalTrials.gov identifier).

Long-Term Results After Functional Nonoperative Treatment of Achilles Tendon Rupture

2006 ◽  
Vol 27 (3) ◽  
pp. 167-171 ◽  
Author(s):  
Tobias M. Hufner ◽  
Dirk B. Brandes ◽  
Hajo Thermann ◽  
Martinus Richter ◽  
Karsten Knobloch ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Treatment Protocol ◽  
Nonoperative Treatment ◽  
Long Term Results ◽  
Neutral Position ◽  
Return To Sports ◽  
Sports Activity ◽  
Tendon Ruptures

Background: Nonoperative treatment of complete Achilles tendon ruptures generally involves a long period of cast immobilization and is associated with frequent reruptures. Functional nonoperative treatment of complete Achilles tendon ruptures involves the use of a high-shaft boot with a 3-cm hindfoot elevation, in which physical therapy is begun after 3 weeks of wear. We reviewed our long-term results with this treatment protocol to determine its effectiveness. Methods: The indications for nonoperative treatment, defined by ultrasound, were a distance of 10 mm or less between the tendon ends with the ankle in neutral position and complete apposition of the tendon ends in 20 degrees of plantarflexion. From 1990 to 1996, 168 patients were treated; 125 (74%) were available for followup at a mean of 5.5 (2 to 12.7) years after the injury. Results: Good or excellent results were achieved in 92 (73.5%) with complete rehabilitation and return to sports activity at their pre-injury levels. Satisfactory (9%) and poor results (17.5%) were due to pain in the Achilles tendon region, a lengthened Achilles tendon, markedly reduced strength, or a marked reduction of calf size in 25 patients (76%). Eight patients (6.4%) sustained a rerupture. Conclusions: Functional nonoperative treatment achieved good results in patients who had precise sonographic evaluation and who were compliant. As a result of our study, we modified our protocol: (1) a repeat ultrasound examination is done by an experienced sonographer 2 to 5 days after the first to confirm the indications for nonoperative treatment, (2) the use of the 3-cm hindfoot elevation is extended from 6 to 8 weeks to provide a longer protection of the tendon, and (3) patients then wear shoes with 1-cm hindfoot elevation for another 3 months.

scholarly journals Effects of long-term athletic training on muscle morphology and tendon stiffness in preadolescence: association with jump performance

2020 ◽  
Vol 120 (12) ◽  
pp. 2715-2727
Author(s):  
Nikolaos Pentidis ◽  
Falk Mersmann ◽  
Sebastian Bohm ◽  
Erasmia Giannakou ◽  
Nickos Aggelousis ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Achilles Tendon ◽  
Muscle Hypertrophy ◽  
Muscle Thickness ◽  
Pennation Angle ◽  
Triceps Surae ◽  
Plantar Flexors ◽  
Tendon Stiffness ◽  
Jumping Performance

Abstract Purpose Evidence on training-induced muscle hypertrophy during preadolescence is limited and inconsistent. Possible associations of muscle strength and tendon stiffness with jumping performance are also not investigated. We investigated the thickness and pennation angle of the gastrocnemius medialis muscle (GM), as indicators for potential muscle hypertrophy in preadolescent athletes. Further, we examined the association of triceps surae muscle–tendon properties with jumping performance. Methods Eleven untrained children (9 years) and 21 similar-aged artistic gymnastic athletes participated in the study. Muscle thickness and pennation angle of the GM were measured at rest and muscle strength of the plantar flexors and Achilles tendon stiffness during maximum isometric contractions. Jumping height in squat (SJ) and countermovement jumps (CMJ) was examined using a force plate. We evaluated the influence of normalised muscle strength and tendon stiffness on jumping performance with a linear regression model. Results Muscle thickness and pennation angle did not differ significantly between athletes and non-athletes. In athletes, muscle strength was greater by 25% and jumping heights by 36% (SJ) and 43% (CMJ), but Achilles tendon stiffness did not differ between the two groups. The significant predictor for both jump heights was tendon stiffness in athletes and normalised muscle strength for the CMJ height in non-athletes. Conclusion Long-term artistic gymnastics training during preadolescence seems to be associated with increased muscle strength and jumping performance but not with training-induced muscle hypertrophy or altered tendon stiffness in the plantar flexors. Athletes benefit more from tendon stiffness and non-athletes more from muscle strength for increased jumping performance.

scholarly journals Use of ankle resting angle as a surrogate for tendon elongation in individuals following Achilles tendon rupture

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Heather Gotha ◽  
Jennifer Zellers ◽  
Karin Silbernagel
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Plantar Flexors ◽  
Cross Sectional ◽  
Tendon Length ◽  
Tendon Elongation ◽  
The Relationship

Category: Ankle, Sports Introduction/Purpose: Tendon elongation is associated with poor functional outcome in individuals after Achilles tendon rupture. While imaging modalities are reliable to measure Achilles tendon length, alternative time- and cost-effective measures are of interest. The resting angle of the ankle in prone both with knee extended1 and knee flexed2 have been used in the literature as surrogates for measuring Achilles elongation, however, their relationship to tendon length is not well-established. The purpose of this study is to validate the ankle resting angle as a measure of tendon elongation and examine the relationship of ankle resting angle to tendon elongation and calf strength. Methods: Individuals following unilateral Achilles tendon rupture, treated surgically, were included in this cross-sectional study. Individuals were excluded if they had deep wound infection or lumbar radiculopathy affecting the ankle plantar flexors. Ankle resting angle with knee extended and knee flexed to 90 degrees was measured using a digital inclinometer positioned on the lateral, plantar surface of the foot. Relative resting angle was calculated by subtracting the uninjured from the injured side. Tendon length to gastrocnemius was measured using B mode, extended field of view ultrasound imaging3 (tendon elongation = ruptured- uninjured). Calf strength was measured using the heel-rise test4. Limb symmetry indexes (LSI) were calculated (ruptured/uninjured sidex100) for total work performed on the heel-rise test. Results: Twenty-five individuals, a mean(SD) age of 44.2(13.6) years and mean(SD) of 22.5(39.1) months post-rupture, were included in this study. Mean(SD) relative resting angle with knee flexed was -5.4(6.4)° and mean (SD) relative resting angle with knee extended was -6.7(8.8)°. Mean(SD) tendon elongation was 1.56(1.20)cm. Mean(SD) heel-rise test work LSI was 45.8(23.8)%. Ankle resting angle with knee flexed related to elongation (r = -0.452, p = 0.027) and heel-rise test work LSI (r = 0.591, p=0.006). Ankle resting angle with knee extended related to elongation (r=-0.528, p=0.008) (Figure 1) but not heel-rise test work LSI. Conclusion: The results of this study suggest that ankle resting angle with knee extended and flexed are related to tendon elongation, however, calf strength also has a relationship to resting angle with knee flexed. This suggests that the ability of the calf to put passive tension on the foot is also a component of resting angle. The relationship between tendon elongation and resting angle with knee flexed may have been limited by methodological concerns, as tendon length was measured with the participant positioned with knees extended.

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