Structure and Function of the Achilles Tendon and Plantarflexors 1 Year Following Achilles Tendon Rupture in the United Kingdom: A Cross-Sectional Study.

IF 2.2 3区医学 Q1 ORTHOPEDICS

Journal of Foot and Ankle Research Pub Date : 2026-03-01 DOI:10.1002/jfa2.70134

Samuel Briggs-Price, Jitendra Mangwani, Alexander Kilcran, Anchal Prasad, Reihaneh Salimian, Seth O'Neill

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引用次数: 0

Abstract

Background: Achilles tendon rupture (ATR) is the most common tendon rupture affecting the lower limb. This study investigates Achilles tendon structure, strength and function 1 year or more after ATR.

Methods: This cross-sectional study recruited individuals ≥ 12 months post ATR. Structure was assessed using ultrasound tissue characterisation (UTC) including cross-sectional area (CSA), aligned fibrillar structure (AFS), disorganised fibrillar structure (DFS) and echo type percentage. Strength was measured using maximal voluntary isometric contraction (MVIC) plantarflexor testing and the calf raise test. Patient-reported outcomes included the Achilles tendon rupture score (ATRS), EQ-5D-5L and general practice physical activity questionnaire (GPPAQ). Achilles tendon resting angle (ATRA) was used as an indirect measure of tendon elongation. The relationship between outcomes and time since ATR was analysed using linear regression adjusting for age, sex, ethnicity and body mass index (BMI). Between limb comparisons were made using paired t-tests.

Findings: Sixty participants (mean age 55.2 years and 78.5% male) were assessed at a mean of 6.8 years post ATR. The affected tendon showed a 62% larger cross-sectional area, with 28.7 mm² (16%) DFS compared to 7.3 mm² (7%) on the nonaffected side (p < 0.001). Linear regression showed decreasing AFS with time postinjury (p = 0.04); no significant associations were found for CSA or DFS. Significant deficits were observed in plantarflexor strength and function, with MVIC and calf raise work 18% and 40% lower in the affected limb (p < 0.001). ATRA indicated tendon elongation in the affected limb of 6.7° (p < 0.001). Median ATRS was 83, EQ-5D index was 0.95 and VAS was 85; 93% were physically active based on the GPPAQ.

Conclusion: Significant structural and functional deficits persist years after ATR, including increased tendon size, fibre disorganisation, reduced strength and tendon elongation. ATRS scores were consistent with previous nonsurgical immobilisation protocol outcomes in the United Kingdom. Longitudinal studies are needed to understand the trajectory of recovery following ATR.

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英国跟腱断裂1年后跟腱和跖屈肌的结构和功能：一项横断面研究

背景：跟腱断裂（ATR）是影响下肢最常见的肌腱断裂。本研究调查ATR术后1年或更长时间跟腱的结构、强度和功能。方法：这项横断面研究招募了ATR后≥12个月的个体。采用超声组织表征（UTC）评估结构，包括横截面积（CSA）、排列纤维结构（AFS）、无组织纤维结构（DFS）和回声型百分比。力量测量采用最大自主等距收缩（MVIC）跖屈肌测试和小腿抬高测试。患者报告的结果包括跟腱断裂评分（ATRS）、EQ-5D-5L和一般实践体力活动问卷（GPPAQ）。跟腱静息角（ATRA）作为跟腱伸长率的间接测量。使用线性回归分析ATR后结果与时间之间的关系，调整年龄、性别、种族和体重指数（BMI）。肢体间比较采用配对t检验。结果：60名参与者（平均年龄55.2岁，78.5%为男性）在ATR后平均6.8年接受评估。与未受影响侧的7.3 mm2（7%）相比，受影响侧的肌腱横截面积增加了62%，DFS为28.7 mm2 (16%) (p结论：ATR后显著的结构和功能缺陷持续数年，包括肌腱大小增加、纤维组织紊乱、强度和肌腱伸长降低。ATRS评分与英国以前的非手术固定方案结果一致。需要进行纵向研究来了解ATR后的恢复轨迹。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Foot and Ankle Research ORTHOPEDICS-

CiteScore

4.50

自引率

10.30%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Foot and Ankle Research, the official journal of the Australian Podiatry Association and The College of Podiatry (UK), is an open access journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. Journal of Foot and Ankle Research covers a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care. The journal encourages submissions from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care. The Australian Podiatry Association and the College of Podiatry (UK) have reserve funds to cover the article-processing charge for manuscripts submitted by its members. Society members can email the appropriate contact at Australian Podiatry Association or The College of Podiatry to obtain the corresponding code to enter on submission.