TY - JOUR
T1 - 1.7 cm elongated Achilles tendon did not alter walking gait kinematics 4.5 years after non-surgical treatment
AU - Kastoft, Rasmus
AU - Barfod, Kristoffer
AU - Bencke, Jesper
AU - Speedtsberg, Merete B
AU - Hansen, Sanja Bay
AU - Penny, Jeannette Ø
N1 - © 2022. The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
PY - 2022/10
Y1 - 2022/10
N2 - PURPOSE: The aim of the present study was to evaluate Achilles tendon length after non-surgical treatment of acute Achilles tendon rupture (aATR), and to evaluate indirect effects of possible persistent elongation on kinematics.METHODS: The study was performed as a cross-sectional study based on a population of patients from an RCT regarding non-operative treatment of aATR. Thirty-seven patients out of the 56 in the original RCT participated with at a follow up of 4-5 years after aATR. Primary outcome was Achilles tendon elongation. Additional outcomes were Achilles tendon resting angle (ATRA), calf circumference, passive ankle plantar and dorsiflexion and loading pattern. Foot pressure mapping was performed to measure plantar loading distribution pattern; medial and lateral forefoot peak pressure, heel peak pressure, medial versus lateral loading pattern and timing of heel lift during roll over process. The healthy leg was used as a control.RESULTS: The injured Achilles tendon was significantly elongated by 1.7 (SD 1.6) cm compared to the non-injured leg. A slight delay of 2.6% (SD 6.0) was measured in heel lift in the injured side compared to the non-injured leg. We found no significant difference in forefoot peak pressure, medial and lateral peak pressure as well as heel peak pressure, and no correlation was found between Achilles tendon length and pressure measurements. Finally, dorsiflexion was 1.9°(SD1.28) larger, ATRA 8.1°(SD6.7) larger, and calf circumference 1.6 cm (SD1.1) lower on the injured leg.CONCLUSION: The Achilles tendon was 1.7 cm elongated 4.5 years after the initial injury and significant changes in ATRA, calf circumference and passive dorsiflexion was present. Except for a slight delay in heel lift-off, kinematics during walking was symmetrical between injured and healthy leg, even with an elongated tendon on the injured leg. The clinical relevance of the Achilles tendon elongation is uncertain.LEVEL OF EVIDENCE: II.CLINICAL TRIALS IDENTIFIER: NCT02760784.
AB - PURPOSE: The aim of the present study was to evaluate Achilles tendon length after non-surgical treatment of acute Achilles tendon rupture (aATR), and to evaluate indirect effects of possible persistent elongation on kinematics.METHODS: The study was performed as a cross-sectional study based on a population of patients from an RCT regarding non-operative treatment of aATR. Thirty-seven patients out of the 56 in the original RCT participated with at a follow up of 4-5 years after aATR. Primary outcome was Achilles tendon elongation. Additional outcomes were Achilles tendon resting angle (ATRA), calf circumference, passive ankle plantar and dorsiflexion and loading pattern. Foot pressure mapping was performed to measure plantar loading distribution pattern; medial and lateral forefoot peak pressure, heel peak pressure, medial versus lateral loading pattern and timing of heel lift during roll over process. The healthy leg was used as a control.RESULTS: The injured Achilles tendon was significantly elongated by 1.7 (SD 1.6) cm compared to the non-injured leg. A slight delay of 2.6% (SD 6.0) was measured in heel lift in the injured side compared to the non-injured leg. We found no significant difference in forefoot peak pressure, medial and lateral peak pressure as well as heel peak pressure, and no correlation was found between Achilles tendon length and pressure measurements. Finally, dorsiflexion was 1.9°(SD1.28) larger, ATRA 8.1°(SD6.7) larger, and calf circumference 1.6 cm (SD1.1) lower on the injured leg.CONCLUSION: The Achilles tendon was 1.7 cm elongated 4.5 years after the initial injury and significant changes in ATRA, calf circumference and passive dorsiflexion was present. Except for a slight delay in heel lift-off, kinematics during walking was symmetrical between injured and healthy leg, even with an elongated tendon on the injured leg. The clinical relevance of the Achilles tendon elongation is uncertain.LEVEL OF EVIDENCE: II.CLINICAL TRIALS IDENTIFIER: NCT02760784.
KW - Achilles tendon length
KW - Achilles tendon resting angle
KW - Achilles tendon rupture
KW - ATRA
KW - Conservative
KW - Early weight-bearing
KW - Foot pressure mapping
KW - Non-operative
KW - Achilles Tendon/injuries
KW - Cross-Sectional Studies
KW - Gait
KW - Humans
KW - Treatment Outcome
KW - Tendon Injuries/surgery
KW - Walking
KW - Biomechanical Phenomena
KW - Ankle Injuries
KW - Rupture/surgery
KW - Syndactyly
UR - http://www.scopus.com/inward/record.url?scp=85125530056&partnerID=8YFLogxK
U2 - 10.1007/s00167-022-06874-y
DO - 10.1007/s00167-022-06874-y
M3 - Journal article
C2 - 35234975
SN - 0942-2056
VL - 30
SP - 3579
EP - 3587
JO - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
JF - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
IS - 10
ER -