Gökay Eken1, Abdulhamit Misir2, Cem Tangay3, Teoman Atici4, Nevzat Demirhan5, Nadir Sener6. 1. Bursa Acibadem Hospital, Orthopedics and Traumatology Department, FSM Bulvarı, Sumer Sokak No:1 16110 Nilufer Bursa, Turkey. Electronic address: gokay_eken@yahoo.com. 2. Basaksehir Pine and Sakura City Hospital, Başakşehir Olimpiyat Bulvarı Yolu, 34480 Başakşehir, İstanbul, Turkey. Electronic address: misirabdulhamitmd@gmail.com. 3. Bursa Acibadem Hospital, Orthopedics and Traumatology Department, FSM Bulvarı, Sumer Sokak No:1 16110 Nilufer Bursa, Turkey. Electronic address: cem.tangay@acibadem.com. 4. Uludag University Faculty of Medicine, Orthopedics and Traumatology Department, 16059 Gorukle Nilufer Bursa, Turkey. Electronic address: teoman@uludag.edu.tr. 5. Bursa Acibadem Hospital, Radiology Department, FSM Bulvarı, Sumer Sokak No:1, Nilufer, Bursa, Turkey. Electronic address: nevzat.demirhan@acibadem.com. 6. Bursa Acibadem Hospital, Orthopedics and Traumatology Department, FSM Bulvarı, Sumer Sokak No:1 16110 Nilufer Bursa, Turkey. Electronic address: nadir.sener@acibadem.com.
Abstract
OBJECTIVES: Muscle atrophy is one of the most common problems after Achilles tendon repair. The aim of this study was to evaluate the effect of gastrosoleus muscle atrophy and fatty infiltration on clinical, and functional outcomes after Achilles tendon repair. MATERIAL AND METHODS: A total of 46 patients (mean age = 39.3 ± 7.4 years) who underwent open Achilles tendon repair were included in the study. During the clinical evaluation of muscle atrophy, ipsilateral and contralateral calf circumference (CC), maximum heel rise (HR), and ankle range of motion measurements were recorded. Functional outcomes were assessed via The Achilles tendon Total Rupture Score (ATRS), the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and the Leppilahti score. Muscle volume (MV), cross-sectional area (CSA), and percent of fatty infiltration (FI) were measured via magnetic image resonance. RESULTS: The functional outcome scores were excellent: ATRS = 98.1 ± 2.2; AOFAS = 97.3 ± 4.1; Leppilahti score = 95.8 ± 5.1. There were significant differences detected between injured and non-injured legs regarding CC, HR, MV, CSA, and FI. Additionally, there were significant negative correlations between CSA and MV loss with all functional outcome scores. FI was correlated with only the AOFAS ankle-hindfoot score. CONCLUSIONS: Significant muscle atrophy was measured after a mean follow-up period of 7.4 (range 2.0-12.6) years post-surgery and negatively correlated with clinical outcomes. CC is an easy and cost-effective measurement method to predict MV during the follow-up of Achilles tendon repairs.
OBJECTIVES:Muscle atrophy is one of the most common problems after Achilles tendon repair. The aim of this study was to evaluate the effect of gastrosoleus muscle atrophy and fatty infiltration on clinical, and functional outcomes after Achilles tendon repair. MATERIAL AND METHODS: A total of 46 patients (mean age = 39.3 ± 7.4 years) who underwent open Achilles tendon repair were included in the study. During the clinical evaluation of muscle atrophy, ipsilateral and contralateral calf circumference (CC), maximum heel rise (HR), and ankle range of motion measurements were recorded. Functional outcomes were assessed via The Achilles tendon Total Rupture Score (ATRS), the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and the Leppilahti score. Muscle volume (MV), cross-sectional area (CSA), and percent of fatty infiltration (FI) were measured via magnetic image resonance. RESULTS: The functional outcome scores were excellent: ATRS = 98.1 ± 2.2; AOFAS = 97.3 ± 4.1; Leppilahti score = 95.8 ± 5.1. There were significant differences detected between injured and non-injured legs regarding CC, HR, MV, CSA, and FI. Additionally, there were significant negative correlations between CSA and MV loss with all functional outcome scores. FI was correlated with only the AOFAS ankle-hindfoot score. CONCLUSIONS: Significant muscle atrophy was measured after a mean follow-up period of 7.4 (range 2.0-12.6) years post-surgery and negatively correlated with clinical outcomes. CC is an easy and cost-effective measurement method to predict MV during the follow-up of Achilles tendon repairs.
Authors: Lara Gil-Melgosa; Jorge Grasa; Ainhoa Urbiola; Rafael Llombart; Miguel Susaeta Ruiz; Verónica Montiel; Cristina Ederra; Begoña Calvo; Mikel Ariz; Purificación Ripalda-Cemborain; Felipe Prosper; Carlos Ortiz-de-Solórzano; Juan Pons-Villanueva; Ana Pérez Ruiz Journal: Biomedicines Date: 2021-12-23