Lower material stiffness in rupture-repaired Achilles tendon during walking: transmission-mode ultrasound for post-surgical tendon evaluation

Wulf, Mathias, Shanker, Mihir, Schuetz, Michael, Lutz, Michael, Langton, Christian M., Hooper, Sue L., Smeathers, James E., Brauner, Torsten and Wearing, Scott C. (2017) Lower material stiffness in rupture-repaired Achilles tendon during walking: transmission-mode ultrasound for post-surgical tendon evaluation. Knee Surgery, Sports Traumatology, Arthroscopy, . doi:10.1007/s00167-017-4624-5

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Author Wulf, Mathias
Shanker, Mihir
Schuetz, Michael
Lutz, Michael
Langton, Christian M.
Hooper, Sue L.
Smeathers, James E.
Brauner, Torsten
Wearing, Scott C.
Title Lower material stiffness in rupture-repaired Achilles tendon during walking: transmission-mode ultrasound for post-surgical tendon evaluation
Journal name Knee Surgery, Sports Traumatology, Arthroscopy   Check publisher's open access policy
ISSN 1433-7347
0942-2056
Publication date 2017-06-28
Year available 2017
Sub-type Article (original research)
DOI 10.1007/s00167-017-4624-5
Open Access Status Not yet assessed
Total pages 8
Place of publication Heidelberg, Germany
Publisher Springer
Language eng
Abstract Purpose: This cross-sectional study used transmission-mode ultrasound to evaluate dynamic tendon properties during walking in surgically repaired and contralateral Achilles tendon (AT), with a median (range) post-operative period of 22 (4–58) months. It was hypothesised that the axial transmission speed of ultrasound (TSOU) during walking would be slower, indicating lower material stiffness in repaired compared with contralateral AT. Methods: Ten patients [median (range) age 47 (37–69) years; height 180 (170–189) cm; weight 93 (62–119) kg], who had undergone open surgical repair of the AT and were clinically recovered according to their treating clinicians, walked barefoot on a treadmill at self-selected speed (1.0 ± 0.2 m/s). Synchronous measures of TSOU, sagittal ankle motion, vertical ground reaction force (GRF), and spatiotemporal gait parameters were recorded during 20 s of steady-state walking. Paired t tests were used to evaluate potential between-limb differences in TSOU, GRF, ankle motion, and spatiotemporal gait parameters. Results: TSOU was significantly lower (≈175 m/s) in the repaired than in the contralateral AT over the entire gait cycle (P < 0.05). Sagittal ankle motion was significantly greater (≈3°) in the repaired than in the contralateral limb (P = 0.036). There were no significant differences in GRF or spatiotemporal parameters between limbs. Conclusions: Repaired AT was characterised by a lower TSOU, reflecting a lower material stiffness in the repaired tendon than in the contralateral tendon. A lower material stiffness may underpin greater ankle joint motion of the repaired limb during walking and long-term deficits in the muscle-tendon unit reported with AT repair. Treatment and rehabilitation approaches that focus on increasing the material stiffness of the repaired AT may be clinically beneficial. Transmission-mode ultrasound would seem useful for quantifying tendon properties post AT rupture repair and may have the potential to individually guide rehabilitation programmes, thereby aiding safer return to physical activity. Level of evidence: II.
Keyword Biomechanics
Gait analysis
Locomotion
Speed of sound
Tendon healing
Tendon rupture
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
Faculty of Medicine
 
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Created: Wed, 02 May 2018, 23:09:48 EST by Mihir Shanker on behalf of Faculty of Medicine