The influence of aging on the insertion of the Achilles tendon: A magnetic resonance study

Pękala, Przemysław A.; Drzymała, Anna; Kaythampillai, Lourdes; Skinningsrud, Bendik; Mizia, Ewa; Rok, Tomasz; Wojciechowski, Wadim; Tomaszewski, Krzysztof A.

doi:10.1002/ca.23431

Cited by 7 publications

(11 citation statements)

References 31 publications

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“…Functional and structural changes to the calcaneal tendon, such as upper migration of the insertion, can be observed during life [ 20 ]. Macroscopic components of the adult enthesis organ [ 5 ] were identified in our study, possibly due to stimulation to maturity of the tendon primordium.…”

Section: Discussionmentioning

confidence: 99%

The twisted structure of the fetal calcaneal tendon is already visible in the second trimester

2020

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Introduction The progress in morphological science results from the greater possibilities of intra-pubic diagnosis and treatment of congenital disabilities, including the motor system. However, the structure and macroscopic development of the calcaneal tendon have not been investigated in detail. Studies on the adult calcaneal tendon showed that the calcaneal tendon is composed of twisted subtendons. This study aimed to investigate the internal structure of the fetal calcaneal tendon in the second trimester. Materials and methods Thirty-six fetuses fixed in 10% formaldehyde were dissected using the layer-by-layer method and a surgical microscope. Results The twisted structure of the calcaneal tendon was revealed in all specimens. The posterior layer of the calcaneal tendon is formed by the subtendon from the medial head of the gastrocnemius muscle. In contrast, the anterior layer is formed by the subtendon from the lateral head of the gastrocnemius muscle. The subtendon from the soleus muscle constitutes the anteromedial outline of the calcaneal tendon. The lateral outline of the calcaneal tendon is formed by the subtendon originating from the medial head of the gastrocnemius muscle. In contrast, the medial outline is formed by the subtendon from the soleus muscle. In most of the examined limbs, the plantaris tendon attached to the tuber calcanei was not directly connected to the calcaneal tendon. Conclusions The twisted structure of the subtendons of the fetal calcaneal tendon is already visible in the second trimester and is similar to that seen in adults.

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Section: Discussionmentioning

confidence: 99%

The twisted structure of the fetal calcaneal tendon is already visible in the second trimester

2020

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Section: Introductionmentioning

confidence: 99%

“…The Achilles tendon is the largest tendon in the body, formed by twisted subtendons from the triceps surae muscle complex [ 21 , 26 , 29 ]. The subtendon from the medial head of the gastrocnemius forms the posterior layer, the subtendon from the gastrocnemius's lateral head contributes to the anterior part while the soleus subtendon composes the central and medial part of the Achilles tendon [ 21 , 30 ]. Based on MR and anatomical studies, the tendon is divided into anatomical segments, including the intramuscular part, the free tendinous region, and most distally, the calcaneal part.…”

Section: Introductionmentioning

confidence: 99%

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The anatomical variant of high soleus muscle may predispose to tendinopathy: a preliminary MR study

Drakonaki¹,

Gataa

Szaro

2021

Surg Radiol Anat

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Purpose This study aimed to examine the anatomic variations at the level of the distal soleus musculotendinous junction and the possible association between the length of the free tendon and the development of symptomatic Achilles tendinopathy. Methods We retrospectively assessed 72 ankle MRI studies with findings of Achilles tendinopathy (study group, 26 females/46 males, mean age 52.6 ± 10.5 years, 30 right/42 left) and 72 ankle MRI studies with normal Achilles tendon (control group, 32 females/40 males, mean age 35.7 ± 13.7 years, 42 right/30 left side). We measured the distance from the lowest outline of the soleus myotendinous junction to the proximal outline of the Achilles tendon insertion (length of the free tendon, diameter a) and to the distal outline of the insertion (distance B). We also measured the maximum thickness of the free tendon (diameter c) and the distance between the levels of maximum thickness to the proximal outline of the Achilles tendon insertion (distance D). All measurements were assessed twice. Statistical analysis was performed using independent t test. Results Distances A and B were significantly larger in tendinopathic tendons (59.7 and 83.4 mm, respectively) than normal Achilles tendons (38.5 and 60.8 mm, respectively) (p = 0.001). Mean distance C was larger in tendinopathic than normal tendons (11.2 versus 4.9 mm). Distances C and D were significantly larger in males than females. There was no significant difference in the measurements between sides. Conclusion There is wide anatomical variation in the length of the free Achilles tendon. Tendinopathy may be associated with the thicker free part of the Achilles tendon. The anatomical variant of the high soleus musculotendinous junction resulting in a longer free Achilles tendon may be a predisposing factor to the development of tendinopathy.

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“…The AT commonly experiences tendinopathy and rupture. It has been proposed that torsion of the AT may alter its biomechanical properties and influence the pathophysiological mechanisms of Achilles tendinopathy (Pękala et al, 2020;Pękala, Henry, Ochała et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

The twisted structure of the rat Achilles tendon

et al. 2021

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The rat is frequently used as a model to study the characteristics, aetiology and pathology of the Achilles tendon. However, though the structure of the human Achilles tendon has been extensively investigated, the anatomical structure of the rat Achilles tendon remains unclear, which impedes the ability to use rats to study Achilles tendinopathy. The purpose of this study was to reveal the structure of the rat Achilles tendon and to explore its similarities with the human Achilles tendon through an anatomical dissection of 80 rat Achilles tendons (40 female, 40 male). This study found that the subtendons of the rat Achilles tendon originating from the triceps surae muscle were twisted, and each subtendon also had its own torsion. The extent of these two types of torsion could be very different between rats. Alterations in this torsion may result in distinct stress fields in the Achilles tendon, which may play a critical role in the pathogenesis of Achilles tendinopathy. This study provides an important basis to support the use of rats as model animals to investigate the characteristics of the human Achilles tendon and Achilles tendinopathy.

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The influence of aging on the insertion of the Achilles tendon: A magnetic resonance study

Cited by 7 publications

References 31 publications

The twisted structure of the fetal calcaneal tendon is already visible in the second trimester

The twisted structure of the fetal calcaneal tendon is already visible in the second trimester

The anatomical variant of high soleus muscle may predispose to tendinopathy: a preliminary MR study

The twisted structure of the rat Achilles tendon

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