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Altered patterns of displacement within the Achilles tendon following surgical repair
Karolinska Institute, Stockholm, Sweden.
Karolinska Institute, Stockholm, Sweden.
KTH Royal Institute of Technology, Huddinge, Sweden.
KTH Royal Institute of Technology, Huddinge, Sweden.
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2017 (English)In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 25, no 6, 1857-1865 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: Ultrasound speckle tracking was used to compare tendon deformation patterns between uninjured and surgically repaired Achilles tendons at 14–27-month follow-up. The hypothesis was that the non-homogenous displacement pattern previously described in uninjured tendons, where displacement within deep layers of the tendons exceeds that of superficial layers, is altered following tendon rupture and subsequent surgical repair. Methods: In the first part of this study, an in-house-developed block-matching speckle tracking algorithm was evaluated for assessment of displacement on porcine flexor digitorum tendons. Displacement data from speckle tracking were compared to displacement data from manual tracking. In the second part of the study, eleven patients with previous unilateral surgically treated Achilles tendon rupture were investigated using ultrasound speckle tracking. The difference in superficial and deep tendon displacement was assessed. Displacement patterns in the surgically repaired and uninjured tendons were compared during passive motion (Thompson’s squeeze test) and during active ankle dorsiflexion. Results: The difference in peak displacement between superficial and deep layers was significantly (p < 0.01) larger in the uninjured tendons as compared to the surgically repaired tendons both during Thompson’s test (−0.7 ± 0.2 mm compared to −0.1 ± 0.1 mm) and active dorsiflexion (3.3 ± 1.1 mm compared to 0.3 ± 0.2 mm). The evaluation of the speckle tracking algorithm showed correlations of r ≥ 0.89 between displacement data acquired from speckle tracking and the reference displacement acquired from manual tracking. Speckle tracking systematically underestimated the magnitude of displacement with coefficients of variation of less than 11.7%. Conclusions: Uninjured Achilles tendons display a non-uniform displacement pattern thought to reflect gliding between fascicles. This pattern was altered after a mean duration of 19 ± 4 months following surgical repair of the tendon indicating that fascicle sliding is impaired. This may affect modulation of the action between different components of the triceps surae, which in turn may affect force transmission and tendon elasticity resulting in impaired function and risk of re-rupture. © 2016, The Author(s).

Place, publisher, year, edition, pages
Springer Verlag , 2017. Vol. 25, no 6, 1857-1865 p.
Keyword [en]
Achilles tendon ; Deformation pattern ; Rupture Surgical repair ; Speckle tracking
National Category
Natural Sciences
Identifiers
URN: urn:nbn:se:ri:diva-30049DOI: 10.1007/s00167-016-4394-5Scopus ID: 2-s2.0-85006944716OAI: oai:DiVA.org:ri-30049DiVA: diva2:1119461
Available from: 2017-07-04 Created: 2017-07-04 Last updated: 2017-07-04Bibliographically approved

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