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

Journal Article (Journal Article;Multicenter Study)

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 91 months 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 ± 130.3 cm(3)) compared to the percutaneous group (675.9 ± 207.4 cm(3), p = 0.04). AT length was longer in the affected leg (198.4 ± 24.1 vs. 180.6 ± 25.0 mm, 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.

Full Text

Duke Authors

Cited Authors

  • Rosso, C; Vavken, P; Polzer, C; Buckland, DM; Studler, U; Weisskopf, L; Lottenbach, M; Müller, AM; Valderrabano, V

Published Date

  • June 2013

Published In

Volume / Issue

  • 21 / 6

Start / End Page

  • 1369 - 1377

PubMed ID

  • 23370984

Electronic International Standard Serial Number (EISSN)

  • 1433-7347

Digital Object Identifier (DOI)

  • 10.1007/s00167-013-2407-1


  • eng

Conference Location

  • Germany