ACFAS Clinical Consensus Statement: Acute Achilles Tendon Pathology

Naldo, Jason; Agnew, Patrick; Brucato, Maryellen P.; Dayton, Paul; Shane, Amber M.

doi:10.1053/j.jfas.2020.02.006

Cited by 6 publications

(5 citation statements)

References 104 publications

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“…7 Rehabilitation after AT rupture is also performed in both conservative and surgical treatments. 11 Load management on the AT is important in rehabilitation. 8,12 Mechanical loading of the injured AT through exercise is a key factor in promoting the reparative and constructive processes of the tendon tissue.…”

Section: Introductionmentioning

confidence: 99%

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Hip and knee kinematics, center of pressure position, and ground reaction force are associated with Achilles tendon force during jump landing

Koshino,

Ishida,

Taniguchi

et al. 2023

Scandinavian Med Sci Sports

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PurposeJump‐landing exercises are often performed during the rehabilitation of Achilles tendon (AT) injuries. However, the factors that affect the AT force (ATF) during landing are unclear. This study aimed to determine the kinematics and ground reaction force (GRF) variables associated with the peak ATF during a drop vertical jump (DVJ).MethodsThe landing phase of DVJ was evaluated in 101 healthy participants (46 males, age: 21.2 ± 1.4 years old) using a three‐dimensional motion analysis system with two force plates. ATF was estimated from the ankle flexion angle and moment. Univariate and multivariate regression analyses were performed with the peak ATF as the dependent variable. The vertical GRF (VGRF), center of pressure (COP), forward trunk leaning, hip/knee/ankle joint angles at peak ATF, and sex were used as independent variables.ResultsIn the univariate regression analysis, larger VGRF (β = 0.813), more anterior COP position (β = 0.214), smaller knee flexion (β = −0.251) and adduction (β = −0.252), smaller hip flexion (β = −0.407), smaller forward trunk lean (β = −0.492), and male sex (β = −0.282) were significantly associated with a larger peak ATF. Multivariate analysis revealed that larger VGRF (β = 1.018), more anterior COP position (β = 0.320), a larger knee (β = 0.442), and smaller hip flexion (β = −0.205) were associated with the larger peak ATF.ConclusionsThe VGRF, COP position, and knee and hip flexion were independently associated with ATF. Modifying these factors may be useful in managing tendon loading during jump‐landing exercises.

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Section: Introductionmentioning

confidence: 99%

“…This is backed by strong evidence in the clinical practice guidelines 7 . Rehabilitation after AT rupture is also performed in both conservative and surgical treatments 11 . Load management on the AT is important in rehabilitation 8,12 .…”

Section: Introductionmentioning

confidence: 99%

Hip and knee kinematics, center of pressure position, and ground reaction force are associated with Achilles tendon force during jump landing

Koshino,

Ishida,

Taniguchi

et al. 2023

Scandinavian Med Sci Sports

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“…The overall incidence of ATR has been reported to range between 8 to 29 per 100,000 person‐years [10, 16, 22, 35, 40]. Clinical examination and medical history are usually enough to diagnose an acute ATR [20, 23, 27, 33]. However, as many as 25% of the acute ATRs are reported to be missed in the acute phase, either due to a misdiagnosis by the assessing physician or because of patient delay [9, 24, 25].…”

Section: Introductionmentioning

confidence: 99%

Patients with chronic Achilles tendon rupture have persistent limitations in patient-reported function and calf muscle function one year after surgical treatment – a case series

et al. 2022

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Purpose Evaluate the one-year postoperative outcomes in patients with Chronic Achilles tendon rupture. Methods Patients surgically treated for Chronic Achilles tendon rupture (n = 22, 14 males and 8 females, mean age 61 ± 15) were evaluated by Achilles tendon Total Rupture Score, The Physical Activity Scale, The Foot and Ankle Outcome Score, Calf muscle endurance test, counter movement jump, Hopping, ultrasound measurement of tendon length, Achilles Tendon Resting Angle, dorsi flexion range of motion and calf muscle circumference. Muscle function and tendon length outcomes on the injured side were compared with the healthy side. Results The patients scored a mean of 62 ± 26 on the Achilles tendon Total Rupture Score. Median scores on the injured compared with the healthy side were lower in heel-rise repetitions (20 vs 24 cm, p = 0.004), hel-rise height (8 vs 10 cm, p < 0.001), heel-rise total work (872 vs 1590 joule, p < 0.001) and hopping ratio (0.37 vs 0.48, p = 0.005). Median calf circumference was smaller (37 vs 38 cm, p = 0.001) and the mean tendon elongation greater on the injured side; Achilles tendon resting angle (55 vs 50°, p < 0.001) and ultrasound (22.4 vs 20.5 cm, p = 0.006). Conclusions At one year postoperatively, patients with chronic Achilles tendon rupture reported persistent limitations in subjective foot and ankle function. Heel-rise height and total work as well as hopping ratio were not recovered, and there was an elongation of the injured Achilles tendon compared with the healthy tendon. Level of evidence IV

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“…In addition, early weight-bearing and progressive physical therapy should be used both after surgical repair and at initiation of nonsurgical treatment. 9 Although the surgical treatment option is more prominent in terms of re-rupture, the treatment option should be determined on a case-by-case basis in terms of other complications. 10 The diagnosis of ATR is mainly based on a detailed history and physical Diagnostic Value of Lateral Ankle Radiography in Achilles Tendon Rupture examination findings.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Lateral Ankle Radiography in Achilles Tendon Rupture

Kokulu

Altunok

Sert

et al. 2022

Foot & Ankle Specialist

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Introduction: Achilles tendon rupture (ATR) is a common sports injury, but approximately 20% of acute ATR cases are misdiagnosed as ankle sprains at first presentation. This study aimed to investigate the diagnostic value of lateral ankle radiography in the diagnosis of acute ATR. Methods: This was a retrospective case-control study in which the lateral ankle radiographs of patients who presented to the emergency department between January 1, 2015 and December 31, 2019 were examined. The study included a total of 154 patients with acute ATR, who underwent lateral ankle radiography at the presentation and were surgically or magnetic resonance imaging (MRI) confirmed to have ATR in our hospital. The lateral ankle radiographs of the patients were examined by 2 clinicians blinded to clinical data for the following 3 findings: Kager’s fat pad sign, tibio-first metatarsal angle, and tibiocalcaneal angle. The same procedure was repeated for 308 controls who underwent lateral ankle radiography and were diagnosed with ankle sprain. Results: Kager’s fat pad sign was detected in 133 (86.4%) of the 154 patients with ATR and 26 (8.4%) of the 308 patients in the control group. The Kager’s fat pad sign, tibio-first metatarsal angle, and tibiocalcaneal angle sensitivity values for the diagnosis of ATR were 86.4%, 61.7%, and 65.6%, respectively, and their specificity values were 91.6%, 78.9%, and 56.2%, respectively. Interobserver reliability was determined to be good for all 3 radiographic findings. Conclusion: Clinicians should be particularly aware of Kager’s fat pad sign when examining lateral ankle radiographs for ankle injury. Levels of Evidence: Level IV: Case control study

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ACFAS Clinical Consensus Statement: Acute Achilles Tendon Pathology

Cited by 6 publications

References 104 publications

Hip and knee kinematics, center of pressure position, and ground reaction force are associated with Achilles tendon force during jump landing

Hip and knee kinematics, center of pressure position, and ground reaction force are associated with Achilles tendon force during jump landing

Patients with chronic Achilles tendon rupture have persistent limitations in patient-reported function and calf muscle function one year after surgical treatment – a case series

Diagnostic Value of Lateral Ankle Radiography in Achilles Tendon Rupture

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