Persistent functional loss following ruptured Achilles tendon is associated with reduced gastrocnemius muscle fascicle length, elongated gastrocnemius and soleus tendon, and reduced muscle cross-sectional area
René B. Svensson
Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital and Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
Search for more papers by this authorChristian Couppé
Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital and Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Physical Therapy, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
Search for more papers by this authorAnne-Sofie Agergaard
Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital and Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Physical Therapy, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
Search for more papers by this authorChristian Ohrhammar Josefsen
Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital and Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
Search for more papers by this authorMikkel Holm Jensen
Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital and Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
Search for more papers by this authorKristoffer Weisskirchner Barfod
Department of Orthopedic Surgery, Sports Orthopedic Research Center–Copenhagen, Copenhagen University Hospital, Amager-Hvidovre, Denmark
Search for more papers by this authorJanus D. Nybing
Department of Radiology, Musculoskeletal Imaging Research Unit, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
Search for more papers by this authorPhilip Hansen
Department of Radiology, Musculoskeletal Imaging Research Unit, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
Search for more papers by this authorMichael Krogsgaard
Section for Sports Traumatology, Department of Orthopedic Surgery, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
Search for more papers by this authorCorresponding Author
S. Peter Magnusson
Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital and Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Physical Therapy, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
Correspondence
S. Peter Magnusson, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital, Bldg. 8, Nielsine Nielsens vej 11, Bispebjerg Bakke 23, DK-2400 Copenhagen, NV, Denmark.
Email: [email protected]
Search for more papers by this authorRené B. Svensson
Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital and Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
Search for more papers by this authorChristian Couppé
Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital and Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Physical Therapy, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
Search for more papers by this authorAnne-Sofie Agergaard
Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital and Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Physical Therapy, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
Search for more papers by this authorChristian Ohrhammar Josefsen
Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital and Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
Search for more papers by this authorMikkel Holm Jensen
Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital and Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
Search for more papers by this authorKristoffer Weisskirchner Barfod
Department of Orthopedic Surgery, Sports Orthopedic Research Center–Copenhagen, Copenhagen University Hospital, Amager-Hvidovre, Denmark
Search for more papers by this authorJanus D. Nybing
Department of Radiology, Musculoskeletal Imaging Research Unit, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
Search for more papers by this authorPhilip Hansen
Department of Radiology, Musculoskeletal Imaging Research Unit, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
Search for more papers by this authorMichael Krogsgaard
Section for Sports Traumatology, Department of Orthopedic Surgery, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
Search for more papers by this authorCorresponding Author
S. Peter Magnusson
Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital and Center for Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Physical Therapy, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
Correspondence
S. Peter Magnusson, Institute of Sports Medicine Copenhagen, Bispebjerg-Frederiksberg Hospital, Bldg. 8, Nielsine Nielsens vej 11, Bispebjerg Bakke 23, DK-2400 Copenhagen, NV, Denmark.
Email: [email protected]
Search for more papers by this authorFunding information
This study was supported by grants from Novo Nordisk research foundation, Lundbeck research foundation, Nordea Foundation (Center of Healthy Aging, University of Copenhagen), IOC Research Center Sports Medicine Copenhagen, and The Danish Medical Research Council.
Abstract
We examined muscle function, muscle architecture, and tendon length bilaterally in persons who experience a functional deficit 2 years after an Achilles tendon rupture. Eleven persons were investigated on the injured compared with the uninjured side 47 ± 7 months (mean ± SD) after a tendon rupture. Heel-rise data, plantar flexion strength, tendon resting angle 3D MRI-determined tendon length and muscle cross-sectional area, ultrasound-determined fascicle length, and pennation angle were obtained. The heel-rise test yielded reduced max height (32%), number of repetitions (54%), and work performed (61%), P < .001. Plantar flexion strength was impaired (P < .001) with the knee in extension (20%-42%) and flexion (29%-39%). Muscle cross-sectional area was reduced for both the soleus (36%) and gastrocnemius muscles (46%; P < .001). Both the soleus tendon (55%) and the gastrocnemius tendon (14%) were longer (P < .001), and the fascicle length of the medial gastrocnemius was substantially reduced (18%; P < .001). The difference in heel-rise height correlated to that of the gastrocnemius tendon elongation, r = .66, P < .05, but not soleus tendon elongation. These data show that a functional deficit after an Achilles tendon rupture is associated with an elongated soleus and gastrocnemius tendon along with a reduced soleus and gastrocnemius muscle cross-sectional area and gastrocnemius fascicle length.
CONFLICT OF INTEREST
The authors have nothing to disclose.
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