Muscle fascicle and sarcomere adaptation in response to Achilles tendon elongation in an animal model.

Abstract

Permanent loss of muscle function seen after an Achilles tendon rupture may partly be explained by tendon elongation and accompanying shortening of the muscle. Muscle fascicle length shortens, serial sarcomere number is reduced, and the sarcomere length is unchanged after Achilles tendon transection (ATT) and these changes are mitigated with suturing. Controlled laboratory study. Two groups of rats underwent ATT on one side with a contralateral control (CTRL): A) ATT with 3 mm removal of the Achilles tendon and no suturing (substantial tendon elongation), and B) ATT with suture repair (minimal tendon elongation). The operated limb was immobilized for 2 weeks to reduce load. Four weeks after surgery the rats were euthanized, and hindlimbs were analyzed for tendon length, gastrocnemius medialis (GM) muscle mass, length, fascicle length, sarcomere number and length. No differences were observed between the groups, and in both groups the Achilles tendon length was longer (15.2%, P<0.001), GM muscle mass was smaller (17.5%, P<0.001), and muscle length was shorter (8.2%, P<0.001) on the ATT compared to CTRL side. GM fascicle length was shorter (11.2%, P<0.001), and sarcomere number was lower (13.8%, P<0.001) on the ATT side in all regions. Sarcomere length was greater in the proximal (5.8%, P<0.001) and mid (4.2%, P=0.003), but not distal region on the ATT side. In this animal model, regardless of suturing, ATT resulted in tendon elongation, loss of muscle mass and length and reduced serial sarcomere number, which resulted in an "overshoot" lengthening of the sarcomeres.