Ultrasound measurements of Achilles tendon length using skin markings are more reliable than extended-field-of-view imaging

Brouwer, Espen Femmo; Myhrvold, Ståle Bergman; Benth, Jūratė Šaltytė; Hoelsbrekken, Sigurd Erik

doi:10.1007/s00167-017-4815-0

Cited by 13 publications

(18 citation statements)

References 19 publications

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“…Ultrasound is the most preferred method for diagnosing TC rupture and which is also commonly utilized in determining the TC morphometry [24,[33][34][35]40,41]. There is usually a high variability in the TC dimension when measurement is obtained from images acquired using ultrasound.…”

Section: Discussionmentioning

confidence: 99%

“…Similar to Liem et al [32], Ebeling et al [33] and Kumar et al [27], the superior aspect of the calcaneal tuberosity was used as the reference point from which all measurements were taken in order to reduce variability in the measurements. Also for repeatability, the distal width and circumference ( Figure 1b) were measured 2 cm from the reference point [32,33] while the proximal width was determined at the lowest level of the musculotendinous junction of the gastrocnemius [24,34,35]. Due to ease of access, visibility and without cutting the TC that may compromise measuring its actual length, the medial and lateral lengths of the tendon (Figure 1a) were considered to be the actual length of the TC which is a slight modification to the measurements by Kumar et al [27].…”

Section: Measurementsmentioning

confidence: 99%

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Morphometric profile of tendocalcaneus of South Africans of European ancestry using a cadaveric approach

2021

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Background: Tendocalcaneus is a strong tendon that is vital for bipedalism in humans. Despite its tremendous strength, the tendocalcaneus is prone to damage and degeneration causing mobility problems and pain. Morphometric dimension of the tendocalcaneus is of benefit to the surgical repair and reconstruction of the damaged tendon. Cadaveric approach provides a realistic method for determining tendocalcaneus morphometry and as at present only two cadaveric studies on Indian population is available. Thus this study presents data on tendocalcaneus morphometry in South Africans of European ancestry using a cadaveric approach. Materials and methods: A total of 66 lower limbs (32 left and 34 right legs) sourced from 49 male and female cadavers were used. After careful dissection of the posterior aspect of leg, the medial and lateral length, distal width, distal circumference and proximal width of the tendocalcaneus were measured. 2 Results: The data showed a high degree of reproducibility indicating that the measurements obtained using cadaveric approach were precise and accurate. There was no difference in measurements between the sides. Measurements in the males were generally higher than in the females. Strong associations were observed between the paired measurements of the medial and lateral tendon length and between the distal width and distal circumference. Conclusions: The data obtained will be useful in predicting tendocalcaneus size during the surgical reconstruction of the tendocalcaneus.

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Section: Discussionmentioning

confidence: 99%

Section: Measurementsmentioning

confidence: 99%

Morphometric profile of tendocalcaneus of South Africans of European ancestry using a cadaveric approach

2021

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“…The measurements are preformed the same way; they have the same distal landmark but the proximal landmark differs. CALM has shown good reliability and is recommended over other measurements of elongation [17,20,21]. The measure is performed as described by Barfod et al but with the feet of the patient (laying in the prone position) hanging free of the table instead of with 10°degrees of plantar flexion in the ankle joints as originally described [16,21].…”

Section: Secondary Outcome Measuresmentioning

confidence: 99%

Individualized treatment for acute Achilles tendon rupture based on the Copenhagen Achilles Rupture Treatment Algorithm (CARTA): a study protocol for a multicenter randomized controlled trial

Hansen

Vestermark

Hölmich

et al. 2020

Trials

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Background: An individualized treatment algorithm (Copenhagen Achilles Rupture Treatment Algorithm (CARTA)) based on the ultrasonographic appearance of an acute Achilles tendon rupture has been developed aiming to select the correct patients for operative and non-operative treatment. The objective of this study is to investigate if this individualized treatment algorithm gives a better functional outcome than treating all patients either operatively or non-operatively per default. Methods/design: This study is conducted as a multicenter, three-armed randomized controlled trial. Participants are included from four hospitals in Denmark and randomized 1:1:1 to one of three parallel groups: 1) Intervention group-participants are treated according to an individualized treatment algorithm; 2) Control group Aparticipants are treated non-operatively; 3) Control group B-participants are treated operatively. The individualized treatment algorithm for the intervention group is based on an ultrasonographic examination; tendon overlap and elongation below 7% is to be treated non-operatively, while no tendon overlap and/or elongation above 7% will be treated operatively. Over a period of 3 years, 300 participants will be included. The primary outcome is the heelrise work test at 12 months post-injury. Secondary outcomes are tendon elongation, the Achilles tendon Total Rupture Score (ATRS), the rate of re-ruptures, and other complications. The primary analysis will be conducted as an intention-to-treat analysis.

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“…The measurements are preformed the same way, they have the same distal landmark, but differs upon the proximal landmark. CALM has shown good reliability and is recommended over other measurements of elongation (17,20,21). The measure is performed as described by Barfod et al but with the feet of the patient (laying in prone position) hanging free of the table instead of 10 degrees of plantar flexion in the ankle joints as originally described (16,21).…”

Section: Secondary Outcome Measuresmentioning

confidence: 99%

Individualized treatment for acute Achilles tendon rupture based on the Copenhagen Achilles Rupture Treatment Algorithm (CARTA): a study protocol for a multicenter randomized controlled trial

Hansen

Vestermark

Hölmich

et al. 2020

Preprint

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Background: An individualized treatment algorithm (Copenhagen Achilles Rupture Treatment Algorithm - CARTA) based on the ultrasonographic appearance of an acute Achilles tendon rupture has been developed aiming to select the correct patients for operative and non-operative treatment. The objective of this study is to investigate if this individualized treatment algorithm gives a better functional outcome than treating all patients either operatively or non-operatively per default. Methods: This study is conducted as a multicenter three-armed randomized controlled trial. Participants are included from four hospitals in Denmark and randomized 1:1:1 to one of three parallel groups: 1) Intervention group: Participants are treated according to an individualized treatment algorithm, 2) Control group A: Participants are treated non-operative, 3) Control group B: Participants are treated operative. The individualized treatment algorithm for the intervention group is based on an ultrasonographic examination; tendon overlap and elongation below 7% is to be treated non-operative, while no tendon overlap and and/or elongation above 7% will be treated operative. 300 participants will be included over a period of 3 years. The primary outcome is the heel-rise work test at 12 months post-injury. Secondary outcomes are tendon elongation, the Achilles tendon Total Rupture Score (ATRS), the rate of re-ruptures and other complications. The primary analysis will be conducted as intention-to-treat analysis.Discussion: This trial will indicate if treatment of acute Achilles tendon rupture can be individualized based on the elongation and tendon overlap. It is hypothesized that different patients will benefit from different treatment instead of offering all the same treatment. Trial registration: ClinicalTrials.gov Identifier: NCT03525964. Registered 16 May 2018.

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Ultrasound measurements of Achilles tendon length using skin markings are more reliable than extended-field-of-view imaging

Abstract: III.

Cited by 13 publications

References 19 publications

Morphometric profile of tendocalcaneus of South Africans of European ancestry using a cadaveric approach

Morphometric profile of tendocalcaneus of South Africans of European ancestry using a cadaveric approach

Individualized treatment for acute Achilles tendon rupture based on the Copenhagen Achilles Rupture Treatment Algorithm (CARTA): a study protocol for a multicenter randomized controlled trial

Individualized treatment for acute Achilles tendon rupture based on the Copenhagen Achilles Rupture Treatment Algorithm (CARTA): a study protocol for a multicenter randomized controlled trial

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