Abstract
Insertional Achilles tendinopathy (IAT) is caused by traction force of the tendon. The effectiveness of the suture bridge technique in correcting it is unknown. We examined the moment arm in patients with IAT before and after surgery using the suture bridge technique, in comparison to that of healthy individuals. We hypothesized that the suture bridge method influences the moment arm length. An IAT group comprising 10 feet belonging to 8 patients requiring surgical treatment for IAT were followed up postoperatively and compared with a control group comprising 15 feet of 15 healthy individuals with no ankle complaints or history of trauma or surgery. The ratio of the moment arm (MA) length/foot length was found to be statistically significant between the control group, the IAT group preoperatively and the IAT group postoperatively (p < 0.01). Despite no significant difference in the force between the control and preoperative IAT groups, a significantly higher force to the Achilles tendon was observed in the IAT group postoperatively compared to the other groups (p < 0.05). This study demonstrates that a long moment arm may be one of the causes of IAT, and the suture bridge technique may reduce the Achilles tendon moment arm.
Highlights
The Achilles tendon, attached to the posterior process of the calcaneus, is the largest and strongest tendon in the body
We examined the moment arm in patients with Insertional Achilles tendinopathy (IAT) before and after undergoing the suture bridge technique compared to that of healthy individuals
The Achilles tendon moment arm was significantly longer in patients with IAT
Summary
The Achilles tendon, attached to the posterior process of the calcaneus, is the largest and strongest tendon in the body It is composed of the gastrocnemius muscle, originating from the condyle of the femur, and the soleus muscle, originating from the upper tibia. The gastrocnemius and soleus muscles, collectively known as the triceps surae, flex the ankle joint during gait. The length of the MA is known to change depending on the angles of plantarflexion and dorsiflexion of the ankle joint, which is different in each individual [2,3,4]. The length of the MA of the triceps surae has been reported to change depending on the angle of plantar- and dorsiflexion of the ankle joint [5,6,7]. It has been reported that motion does not cause any change in the length of the MA [8,9], and that the plantarflexion moment length, from the plantarflexion region to the dorsiflexion region, is different in each individual, with little change caused by motion [2,3,4]
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