Dynamic subtendon analysis during walking in patients following surgically treated achilles tendon rupture : A pilot study

Titelangaben

Höpfl, Tanja ; Brand, Andreas ; Frisch, Michael ; Augat, Peter:
Dynamic subtendon analysis during walking in patients following surgically treated achilles tendon rupture : A pilot study.
2022
Veranstaltung: 12. Kongress der Deutschen Gesellschaft für Biomechanik (DGfB) , 28.-30. September 2022 , Köln.
(Veranstaltungsbeitrag: Kongress/Konferenz/Symposium/Tagung , Vortrag )

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Abstract

Background
The Achilles tendon (AT) is comprised of three subtendons originating from the gastrocnemius medialis, lateralis and soleus showing different collagen fibre displacements and inter-tendon sliding during walking1. Following rupture, impaired gait patterns and altered tendon properties are prevalent while it remains unclear to what extent individual subtendons are affected2. This pilot study aims to evaluate individual subtendon stretch-shortening patterns in the context of impaired walking after AT rupture.
Methods
11 patients (43 ± 12 years, BMI: 25.8 ± 2.9 kg/m², 21 ± 18 months post-surgery) and 11 controls (44 ± 12 years, BMI: 25.1 ± 2.5 kg/m²) were investigated using ultrasound and motion capture. Myotendinous junction displacements of individual subtendons were measured during level walking. Dynamic subtendon length and shortening at push-off as well as ankle joint kinematics and kinetics were analysed. Gait
parameters and subtendon shortening were compared using t- tests. Statistical parametric mapping was used to display differences throughout the gait cycle.
Results
Patients with AT rupture showed significant (p < 0.001) elongations in all subtendons during gait. Maximum shortening rates for all subtendons were reduced in patients, but did not reach significance. Reductions of
averaged subtendon shortening rates were highest (32%) for medial gastrocnemius, followed by soleus (18%) and lateral gastrocnemius (6%). A significant (p < 0.05) decrease in ankle biomechanics of up to 75% (plantar flexion angle), 19% (dorsal extension moment) and 29% (plantar flexion power) was also detected.
Conclusion
Increased subtendon lengths imply an impaired capability of individual muscles to transfer force via their tendon aspects towards the ankle joint. It might be further suspected that individual subtendons follow different morphomechanical recovery profiles after AT rupture.