Long-term biomechanical outcomes after Achilles tendon ruptures

Purpose: The ideal treatment for Achilles tendon ruptures is still unknown. Biomechanical were correlated to radiological and clinical parameters to study outcomes. Methods: In this retrospective, assessor-blinded multi-centre cohort study, 52 patients with unilateral Achilles tendon rupture were assessed, each at least 3years after injury. Patients underwent open surgery, percutaneous surgery or non-surgical treatment of Achilles tendon rupture. Both legs underwent plantar pressure distribution and isokinetic measures. Demographic parameters, maximum calf circumference (MCC) and clinical scores (American Orthopaedic Foot and Ankle Society, Achilles tendon rupture score, Hannover) were also evaluated. Complications were not assessed. Results: Peak plantar flexion torque (PPFT) was significantly weaker on the treated side compared to the untreated leg [80.4±29.7Nm (mean±SD) vs. 92.1±27.4Nm, p<0.0001]. PPFT and push-off force (POFF) were not different between treatment groups nor was there a leg difference in POFF alone. There was only a weak correlation of clinical scores and PPFT or POFF, respectively. MCC correlated significantly with both PPFT (R 2=0.21, p=0.01) and POFF (R 2=0.29, p<0.0001). POFF appeared to be a predictor of PPFT (R 2=0.31, p