Can Weakness in End-Range Plantar Flexion After Achilles Tendon Repair Be Prevented?

Orthopaedic Journal of Sports Medicine
Karl F OrishimoStephen J Nicholas

Abstract

Disproportionate end-range plantar flexion weakness, decreased passive stiffness, and inability to perform a heel rise on a decline after Achilles tendon repair are thought to reflect increased tendon compliance or tendon lengthening. Since this was first noted, we have performed stronger repairs and avoided stretching into dorsiflexion for the first 12 weeks after surgery. Using stronger repairs and avoiding stretching into dorsiflexion would eliminate end-range plantar flexion weakness and normalize passive stiffness. Case series; Level of evidence, 4. Achilles repairs with epitendinous augmentation were performed on 18 patients. Plantar flexion torque, dorsiflexion range of motion (ROM), passive joint stiffness, and standing single-legged heel rise on a decline were assessed at 43 ± 24 months after surgery (range, 9 months to 8 years). Maximum isometric plantar flexion torque was measured at 20° and 10° of dorsiflexion, neutral position, and 10° and 20° of plantar flexion. Passive dorsiflexion ROM was measured with a goniometer. Passive joint stiffness was computed from the increase in passive torque from 10° to 20° of dorsiflexion. Tendon thickness was measured by use of digital calipers. Plantar flexion electromyographic (...Continue Reading

References

Sep 17, 2003·The American Journal of Sports Medicine·Nicola MaffulliRobert Bleakney
Feb 16, 2006·The American Journal of Sports Medicine·Michael J MullaneySteven J Lee
Sep 16, 2006·The American Journal of Sports Medicine·Jarmo KangasJuhana Leppilahti
Dec 25, 2007·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Karl F OrishimoSteven J Lee
Feb 11, 2009·The American Journal of Sports Medicine·Steven J LeeMalachy McHugh
May 5, 2009·The Journal of Bone and Joint Surgery. American Volume·Ari PajalaJuhana Leppilahti
May 3, 2011·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Nicklas OlssonKarin Grävare Silbernagel
Apr 14, 2012·International Journal of Sports Medicine·T HorstmannA Mündermann
May 18, 2012·The American Journal of Sports Medicine·Karin Grävare SilbernagelKurt Manal
Feb 6, 2013·Archives of Physical Medicine and Rehabilitation·Hsing-Kuo WangChing-Chuan Jiang
Apr 24, 2013·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Stephen M SuydamKarin Gravare Silbernagel
Apr 24, 2015·Scandinavian Journal of Medicine & Science in Sports·A N AgresS Manegold
Apr 27, 2017·Brazilian Journal of Physical Therapy·Pollyana R T BorgesJuliana M Ocarino
Sep 20, 2017·The Journal of Bone and Joint Surgery. American Volume·Juuso HeikkinenJuhana Leppilahti

❮ Previous
Next ❯

Citations

Nov 26, 2019·Orthopaedic Journal of Sports Medicine·Malachy P McHughStephen J Nicholas
Jan 24, 2021·Archives of Orthopaedic and Trauma Surgery·Markus WenningJochen Paul

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Scandinavian Journal of Medicine & Science in Sports
M M MoltubakkJ Bojsen-Møller
Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology
Michael R CarmontJon Karlsson
Applied Physiology, Nutrition, and Metabolism = Physiologie Appliquée, Nutrition Et Métabolisme
Jonathan D MillerEric M Mosier
© 2022 Meta ULC. All rights reserved