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Bota O, Heinzinger LM, Herzog B, Disch AC, Amlang M, Flößel P, Dragu A, Taqatqeh F. Evaluation of the ankle function after Achilles tendon resection: a retrospective clinical study. Arch Orthop Trauma Surg 2024; 144:1243-1257. [PMID: 38231207 PMCID: PMC10896776 DOI: 10.1007/s00402-023-05177-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 12/06/2023] [Indexed: 01/18/2024]
Abstract
INTRODUCTION The Achilles tendon is the strongest tendon in the human body and has the function of plantar ankle flexion. When the tendon is exposed, the peritendineum has been breached and the thick avascular tendon colonized with bacteria, a complete resection of the tendon may be indicated to achieve infection control and facilitate wound closure. The Achilles tendon reconstruction is not mandatory, as the plantar flexion of the ankle joint is assumed by the remaining flexor hallucis longus, flexor digitorum longus and tibialis posterior muscles. Our study aimed to evaluate the impact of Achilles tendon resection without reconstruction on leg function and quality of life. MATERIAL AND METHODS We retrospectively evaluated all patients who were treated with an Achilles tendon resection between January 2017 and June 2022 in our quaternary institution. After evaluating the data, the patients who survived and were not amputated were contacted for re-evaluation, which included isokinetic strength measurement of both ankle joints, evaluation of the ankle range of motion and collection of several functional scores. RESULTS Thirty patients were included in the retrospective study, with a mean age of 70.3 years, including 11 women and 19 men. The most frequent cause of the infection was leg ulcer (43.3%), followed by open tendon suture (23.3%). No tendon reconstruction was performed. Fifteen patients could be gained for reevaluation. The average difference in ankle flexion torque on the injured side compared to the healthy side at 30 degrees/second was 57.49% (p = 0.003) and at 120 degrees/second was 53.13% (p = 0.050) while the difference in power was 45.77% (p = 0.025) at 30 degrees/second and 38.08% (p = 0.423) at 120 degrees/second. The follow-up time was between 4 and 49 months and a positive correlation could be determined between the time elapsed from surgery and the ankle joint strength. There was a significant loss of range of motion on the operated side compared to the healthy side: 37.30% for plantar flexion, 24.56% for dorsal extension, 27.79% for pronation and 24.99% for supination. The average Lepillhati Score was 68.33, while the average American Orthopedic Foot and Ankle Score was 74.53. CONCLUSION The complete Achilles tendon resection leaves the patient with satisfactory leg function and an almost normal gait. Especially in elderly, multimorbid patients, straightforward tendon resection and wound closure provide fast infection control with acceptable long-term results. Further prospective studies should compare the ankle function and gait in patients with and without Achilles tendon reconstruction after complete resection.
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Affiliation(s)
- Olimpiu Bota
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
- Department of Plastic Surgery, First Surgical Clinic, Emergency County Hospital Cluj-Napoca, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Leona M Heinzinger
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Bianka Herzog
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Alexander C Disch
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
- University Center for Orthopedics, Trauma and Plastic Surgery, Section Sports Medicine and Rehabilitation, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Michael Amlang
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Philipp Flößel
- University Center for Orthopedics, Trauma and Plastic Surgery, Section Sports Medicine and Rehabilitation, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Adrian Dragu
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Feras Taqatqeh
- University Center for Orthopedics, Trauma and Plastic Surgery, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
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Mallada NP, Beltrán MJM, Nuño MAS, Ribeiro ASF, Villa IDM, Molina CM, Tabares AME, Santamaría AP, Sánchez HL. Biomechanical Factors Predisposing to Knee Injuries in Junior Female Basketball Players. Sports (Basel) 2024; 12:60. [PMID: 38393280 PMCID: PMC10891574 DOI: 10.3390/sports12020060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/18/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
This cross-sectional observational study aims to determine isokinetic normality data at different speeds, and isometric data of ankle and knee joints, in healthy basketball players aged 15-16 years old. The participants were recruited through non-probabilistic convenience sampling. Sociodemographic, anthropometric, and biomechanical variables were collected. The study involved 42 participants. Right-leg dominance was higher in women (85.7%) than in men (78.6%). Men had a higher weight, height, and body mass index compared to women. Statistically significant differences were observed between sex and height (p < 0.001). Significant differences were found between sexes in knee flexor and extensor strength at different isokinetic speeds (30°, 120°, and 180°/s), except for the maximum peak strength knee flexion at 180°/s in the right leg. In the ankle, the variables inversion, eversion, and work strength values at different isokinetic speeds and full RoM, by sex, were not significantly different, except for the right (p = 0.004) and the left (p = 0.035) ankle full RoM. The study found lower knee extensor strength in women, indicating the need to improve knee flexor/extensor strength in women to match that of men, as seen in other joints. The results can guide the development of preventive and therapeutic interventions for lower limb injuries in basketball players.
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Affiliation(s)
- Néstor Pérez Mallada
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
- Institute for Research in Technology (IIT), ICAI School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain
| | - María Jesús Martínez Beltrán
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
| | - María Ana Saenz Nuño
- Institute for Research in Technology (IIT), ICAI School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain
| | - Ana S F Ribeiro
- Nursing Department, Faculty of Nursing, Physical Therapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
| | | | | | - Ana María Echeverri Tabares
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
| | - Andrés Paramio Santamaría
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
| | - Hugo Lamas Sánchez
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
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Islamoglu I, Çebi M, Tosun FC. The bone mineral density and isokinetic knee strength in amputee soccer players. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230100. [PMID: 37585984 PMCID: PMC10427187 DOI: 10.1590/1806-9282.20230100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/20/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVE The aim of this study was to examine the isokinetic knee strength, H/Q ratio (%), and bone mineral density values between amputees (n=14; amputee soccer players) and healthy football players (n=14; non-amputee soccer players). METHODS A total of 28 amputee soccer players and non-amputee soccer players participated in the study. An isokinetic dynamometer was used to determine the knee flexion/extension forces of the dominant legs of the athletes at 60, 180, and 240°/s. Bone mineral density scans were performed using dual-energy X-ray absorptiometry. RESULTS H/Q ratio and 60º/s flexion and 180 and 240º/s flexion/extension strength (p<0.05) were found to be high (180º/s, p=0.03; 240º/s, p=0.048) in the non-amputee soccer player group. Accordingly, the bone mineral density values of the lumbar vertebra, femoral neck, proximal metaphysis of the femur (p<0.01), tibia/fibula proximal metaphysis, and tibia/fibula distal metaphysis (p<0.05) were found to be high. A correlation was observed between the 60º/s knee extension strength and tibia/fibula diaphyseal bone mineral density (p=0.025; r=0.594) and tibia/fibula distal metaphysis bone mineral density (p=0.017; r=0.623) values in the amputee soccer players group. The Z-scores of the amputee soccer players and non-amputee soccer players were in the expected range according to age (>-2). CONCLUSION The bone mineral density, H/Q ratio, and all measured angular velocities of isokinetic strength were high in non-amputee soccer players. This finding made us think that lower extremity amputation may also be associated with losing strength. However, it was observed that the relationship between strength and bone mineral density in amputee athletes might vary according to different angular velocities. It is recommended that isokinetic strength measurement can be evaluated together with bone mineral density in athletes.
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Affiliation(s)
- Izzet Islamoglu
- Ondokuz Mayıs University, Faculty of Yasar Dogu Sports Sciences – Samsun, Turkey
| | - Mehmet Çebi
- Ondokuz Mayıs University, Faculty of Yasar Dogu Sports Sciences – Samsun, Turkey
| | - Fevziye Canbaz Tosun
- Ondokuz Mayıs University, Faculty of Medicine, Department of Nuclear Medicine – Samsun, Turkey
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