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Alterations in structure of the muscle-tendon unit and gait pattern after percutaneous repair of Achilles tendon rupture with the Dresden instrument
Authors:Sebastian Manegold  Serafim Tsitsilonis  Tobias Gehlen  Sebastian Kopf  Georg N. Duda  Alison N. Agres
Affiliation:1. Charité — University Medicine Berlin, Center for Musculoskeletal Surgery, Campus Virchow Clinic, Augustenburger Platz 1, 13353, Berlin, Germany;2. Berlin-Brandenburg Center for Regenerative Therapies/BSRT, Charité — University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
Abstract:BackgroundFunctional deficits after Achilles tendon (AT) ruptures are observed. The relationship between musculotendinous structural alterations and functional outcome is not clear.MethodsKinematic analyses (level walking, stair climbing), patient-reported outcome measures (PROMs), calf atrophy (maximum calf circumference (MCC)), and AT length were evaluated in patients after percutaneous AT repair with the Dresden instrument (n = 20 min. follow-up: 24 months).ResultsPatients achieved good results in PROMs. However, MCC decreased significantly and AT length increased significantly postoperatively. Side-to-side MCC differences over 2 cm resulted in significantly lower PROMs. AT lengthening correlated with increased dorsiflexion and decreased plantarflexion.ConclusionCalf atrophy and AT lengthening after minimally invasive AT repair resulted in inferior ankle kinematics and PROMs.
Keywords:Corresponding author: Charité — University Medicine Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany.  Achilles tendon rupture  Gait analysis  Tendon lengthening  Muscle atrophy  Functional deficits  Minimally invasive Achilles tendon repair
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