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Long-term outcomes of muscle volume and Achilles tendon length after Achilles tendon ruptures

Rosso, Claudio ; Vavken, Patrick ; Polzer, Caroline ; Buckland, Daniel ; Studler, Ueli ; Weisskopf, Lukas ; Lottenbach, Marc ; Müller, Andreas ; Valderrabano, Victor

In: Knee Surgery, Sports Traumatology, Arthroscopy, 2013, vol. 21, no. 6, p. 1369-1377

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    Titre
    • Long-term outcomes of muscle volume and Achilles tendon length after Achilles tendon ruptures
    Auteur
    • Rosso, Claudio. Orthopaedic Department, University Hospital Basel and University of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
    • Vavken, Patrick. Orthopaedic Department, University Hospital Basel and University of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
    • Polzer, Caroline. Orthopaedic Department, University Hospital Basel and University of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
    • Buckland, Daniel. Orthopaedic Department, University Hospital Basel and University of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
    • Studler, Ueli. Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland
    • Weisskopf, Lukas. Rennbahn Clinic, Muttenz, Switzerland
    • Lottenbach, Marc. Cantons Hospital Fribourg, Fribourg, Switzerland
    • Müller, Andreas. Orthopaedic Department, University Hospital Basel and University of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
    • Valderrabano, Victor. Orthopaedic Department, University Hospital Basel and University of Basel, Spitalstrasse 21, 4031, Basel, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Knee Surgery, Sports Traumatology, Arthroscopy, 2013, vol. 21, no. 6, p. 1369-1377. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:320782
    Summary
    Purpose: The best treatment for Achilles tendon (AT) ruptures remains controversial. Long-term follow-up with radiological and clinical measurements is needed. Methods: In this retrospective multicentre cohort study, patients (n=52) were assessed at a mean of 91months follow-up after unilateral AT rupture treated by open, percutaneous or conservative (non-surgical) treatment. Demographic parameters, time off work, maximum calf circumference and clinical scores (ATRS, Hannover, AOFAS) were evaluated. Muscle volume and cross-sectional area of the calf and AT length were measured on MR images and were compared between groups and to each patient's healthy contralateral leg. Results: Reduced muscle volume was found across all groups with a higher muscle volume in the conservative (729.9±130.3cm3) compared to the percutaneous group (675.9±207.4cm3, p=0.04). AT length was longer in the affected leg (198.4±24.1 vs. 180.6±25.0mm, p<0.0001) without difference in subgroup analysis. Clinically measured ankle dorsiflexion showed poor correlation with AT length (R 2=0.07, p=0.008). Muscle volume strongly correlated with the cross-sectional area (R 2=0.6, p<0.0001) but showed a weak correlation with the Hannover score (R 2=0.08, p=0.048). Maximum calf circumference correlated with muscle volume (R 2=0.42, p<0.0001). Conclusions: No significant difference between the treatment groups was found in muscle volume, AT length, clinical measures or days off work. Cross-sectional area and maximum calf circumference are cost-effective measurements and a good approximation of muscle volume and can thus be used in a clinical setting while clinical dorsiflexion should not be used. Level of evidence: III