Quantifying the effects of achilles tendon lengthening surgery: An intraoperative approach

Frontiers in Physiology

Physiology

Marco Götze¹  Stefanos Tsitlakidis¹  Sébastien Hagmann¹  Elena Brendecke²  Filiz Ates³ 

[1] Clinic of Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany;Clinic of Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany;Institute of Structural Mechanics and Dynamics in Aerospace Engineering, University of Stuttgart, Stuttgart, Germany;Institute of Structural Mechanics and Dynamics in Aerospace Engineering, University of Stuttgart, Stuttgart, Germany;

关键词: triceps surae;    idiopathic foot deformity;    in vivo;    muscle lengthening surgery;    cerebral palsy;   

DOI  :  10.3389/fphys.2023.1143292

 received in 2023-01-12, accepted in 2023-02-23,  发布年份 2023

来源: Frontiers

【 摘 要 】

Achilles tendon lengthening (ATL) is frequently used in the treatment of foot deformities. However, there is currently no objective method to determine the optimal muscle length during surgery. We developed an intraoperative approach to evaluate the passive and active forces of the triceps surae muscle group before and after ATL and aimed to test the following hypotheses: 1) the ankle passive range of motion (ROM) increases, 2) passive muscle forces decrease post-ATL, and 3) forces measured from patients with non-neurological and neurological conditions demonstrate different characteristics. Passive forces at various ankle joint positions were measured in ten patients (11.3 ± 3.0 years old) pre- and post-ATL using a force transducer attached to the Achilles tendon. In six patients, active isometric forces were measured by stimulating the triceps surae supramaximally. Passive forces decreased by 94.3% (p < 0.0001), and ROM increased by 89.4% (p < 0.0001) post-ATL. The pre-ATL passive forces were 70.8% ± 15.1% lower in patients with idiopathic foot deformities than in patients with neurological conditions (p < 0.001). The peak active force of 209.8 ± 114.3 N was achieved at an ankle angle of 38.3° ± 16.0°, where the passive force was 6.3 ± 6.7 N. The inter-individual variability was substantial in both groups. In conclusion, the hypotheses posed were supported. The present findings suggest that muscle passive and active force production as well as the inter-individual variability should be considered when planning further treatment.

【 授权许可】

Unknown   
Copyright © 2023 Brendecke, Tsitlakidis, Götze, Hagmann and Ates.