Affiliations: [a] Medical Clinic, Department of Sports Medicine,
University of Tübingen, Germany | [b] BG Orthopedic Surgery Clinic, University of
Tübingen, Germany
Note: [] Department of Sports Medicine, Medical Clinic and Policlinic
Eberhard-Karls-University of Tübingen, Hölderlinstr.11, 72074 Tübingen,
Germany. Tel.: +49 7071 2986493; Fax: +49 7071 295162; E-mail:
thomas.horstmann@med.uni-tuebingen.de
Abstract: Achilles tendon repair with following immobilisation causes atrophy
of the calf musculature. The aim of this study was the long term evaluation of
the strength and strength endurance deficit ten years after the injury. 63
patients (48 male, 15 female) were tested 10.8 years after achilles tendon
rupture repair and subsequent 6-week immobilisation. The test was made in the
eccentric (60^{\circ}/s), isometric and concentric
(60^{\circ}/s, 180^{\circ}/s) mode for
plantarflexion and dorsiflexion with a Lido Active dynamometer. The mean peak
torque of the best 3 of 5 movements and the work over 1 minute
(180^{\circ}/s) were evaluated for plantarflexion and
dorsiflexion. The circumference of the calf musculature and the range of motion
of the ankle (ROM) were measured. Differences to the non-operated side were
assessed with the Wilcoxon matched pairs test and adjusted with the Bonferroni
method. The mean peak torque in all modes showed no statistically significant
difference between the operated and non-operated legs ten years after
immobilisation. The work over 1 minute was markedly reduced for the operated
leg in plantarflexion (516 J operated versus 634 J non-operated, p<
0.001). The circumference of the calf musculature
(-1.1 cm) and the ROM
(-3.5
^{\circ} plantarflexion,
-1.9
^{\circ} dorsiflexion) were also
reduced (p< 0.001). It seems that a selective atrophy of the
slow twitch fibers is relevant for the durable loss of musculature and the
weakened calf musculature in the strength endurance test. Early remobilization
should be chosen after reconstruction of the achilles tendon, and more strength
endurance training must be done at the end of the rehabilitation.
