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DOS Kongressen 2016 ·
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Achilles Tendon Length, ATRS and Functional Outcomes
5 Years After Acute Achilles Tendon Rupture Treated
Conservatively
Rasmus Kastoft, Jesper Bencke, Kristoffer Barfod, Merete Speedtsberg, Rasmus
M. Søndergaard, Jeannette Ø. Penny
Dep of Orthopedic Surgery, Copenhagen University Hospital -Hvidovre; Laboratory
of Human Movement Analysis, Dep of Orthopaedic Surgery, Copenhagen University
Hospital -Hvidovre; Dep of Orthopedic Surgery, Epworth HealthCare, Melbourne -
Australia; Laboratory of Human Movement Analysis, Dep of Orthopaedic Surgery,
Copenhagen University Hospital -Hvidovre; Laboratory of Human Movement Analysis,
Dep of Orthopaedic Surgery, Copenhagen University Hospital -Hvidovre; Dep of
Orthopedic Surgery, Copenhagen University Hospital -Hvidovre
Background:
Achilles tendon rupture (ATR) may lead to significant functional deficits,
which mechanisms are poorly understood.
Purpose / Aim of Study:
Primary aim was to investigate if the Achilles tendon (AT) was
longer, muscles weaker in the injured leg 4- 5 years post injury. Secondary, to measure
foot pressure and to compare functional outcomes with patient reported Achilles Tendon
Total Rupture Score (ATRS).
Materials and Methods:
We invited all participants from a RCT, of conservatively
treated ATR with or without early weight bearing (E-WB, N-WB). Of the original 56,
37 patients participated - 19 from E-WB (1 re- rupture (RR)), and 18 from N-WB (2
RR). Time from injury to follow up was 4.5 years (4.1 to 5.1). AT length was measured
using ultrasound. Heel raise work was measured on a 10 degree inclining platform, and
the method validated. Foot pressure mapping was measured barefoot, using an EMED
platform (novel, DE). T-tests for limb comparisons and linear regression for ATRS cor-
relations were applied.
Findings / Results:
We found no differences in any of the variables between the E-WB
and N-WB groups. Including RR in the sample did not impact the results. Compared to
the healthy limb, the AT was an average of 1,8 (1,2-2,3) cm longer on the injured limb,
which produced 40% less work. A smaller calf circumference (p<0,001), larger dorsiflex-
tion (p=0,001), AT resting angle (p<0.001) and delayed heel lift off (p=0,02) was found
on the injured limb. Lower mean medial forefoot peak pressure in the injured limb was
approaching significance (p=0,08). ATRS could not be linked to AT length or total work
using linear regression.
Conclusions:
Conservatively treated ATR were approximately 1,8 cm longer than con-
trol limb. The injured limb was persistently weaker, and had delayed heel lift. ATRS does
not appear to correlate directly with AT length or loss of total work.
No conflicts of interest reported
90.