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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 3/2015

01-03-2015 | Ankle

Long-term biomechanical outcomes after Achilles tendon ruptures

Authors: Claudio Rosso, Daniel M. Buckland, Caroline Polzer, Patrick Sadoghi, Reinhard Schuh, Lukas Weisskopf, Patrick Vavken, Victor Valderrabano

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2015

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Abstract

Purpose

The ideal treatment for Achilles tendon ruptures is still unknown. Biomechanical were correlated to radiological and clinical parameters to study outcomes.

Methods

In this retrospective, assessor-blinded multi-centre cohort study, 52 patients with unilateral Achilles tendon rupture were assessed, each at least 3 years after injury. Patients underwent open surgery, percutaneous surgery or non-surgical treatment of Achilles tendon rupture. Both legs underwent plantar pressure distribution and isokinetic measures. Demographic parameters, maximum calf circumference (MCC) and clinical scores (American Orthopaedic Foot and Ankle Society, Achilles tendon rupture score, Hannover) were also evaluated. Complications were not assessed.

Results

Peak plantar flexion torque (PPFT) was significantly weaker on the treated side compared to the untreated leg [80.4 ± 29.7 Nm (mean ± SD) vs. 92.1 ± 27.4 Nm, p < 0.0001]. PPFT and push-off force (POFF) were not different between treatment groups nor was there a leg difference in POFF alone. There was only a weak correlation of clinical scores and PPFT or POFF, respectively. MCC correlated significantly with both PPFT (R 2 = 0.21, p = 0.01) and POFF (R 2 = 0.29, p < 0.0001). POFF appeared to be a predictor of PPFT (R 2 = 0.31, p < 0.0001). Open surgery outperformed non-surgical treatment in terms of centre-of-pressure line (p = 0.007), torque per muscle volume (p = 0.04) and relative POFF per body weight (p = 0.02) and relative in side comparison (p = 0.03).

Conclusions

Clinical scores do not predict biomechanical outcomes. Clinically measured MCC is a good predictor of PPFT and POFF and can easily be used in clinical practice. Relative POFF in side comparison as well as per body weight favours surgical treatment.
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Metadata
Title
Long-term biomechanical outcomes after Achilles tendon ruptures
Authors
Claudio Rosso
Daniel M. Buckland
Caroline Polzer
Patrick Sadoghi
Reinhard Schuh
Lukas Weisskopf
Patrick Vavken
Victor Valderrabano
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2726-2

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