title: Plantarflexion torque following reconstruction of Achilles tendinosis or rupture with flexor hallucis longus augmentation.
abstract: Nine patients treated surgically for Achilles tendon rupture (7 patients) or tendinosis (2 patients) with primary repair or debridement and augmentation with the flexor hallucis longus muscle-tendon unit were evaluated at a mean of 19 months postoperative. Subjective evaluation revealed a high level of satisfaction. All patients returned to work and only two patients reported limitation in their recreational activities. The mean post-operative AOFAS Ankle-Hindfoot Score was 90 points. Four patients reported mild occasional pain and one patient complained of moderate daily pain. Motion assessment showed a 20% increase in the hallux MTP dorsiflexion compared to the non-operative side (p = 0.045). No difference in ankle motion was noted. Cybex II+ dynamic evaluation of plantarflexion peak torque was complete on both extremities. The torque deficit on the reconstructed extremity was 20% (p = 0.01) at 120 degrees per second and 26% (p = 0.003) at 30 degrees per second. There is no significant difference between the torque deficit recorded for patients with Achilles rupture and those with Achilles tendinosis. A trend toward improved torque production with longer follow up was observed.
authors.affiliation: Department of Orthopaedic Surgery, Wayne State University, Detroit, MI 48201, USA.
authors.forename: M T
authors.initials: MT
authors.lastname: Monroe
authors.forename: D J
authors.initials: DJ
authors.lastname: Dixon
authors.forename: T C
authors.initials: TC
authors.lastname: Beals
authors.forename: G
authors.initials: G
authors.lastname: Pomeroy
authors.forename: D L
authors.initials: DL
authors.lastname: Crowley
authors.forename: A
authors.initials: A
authors.lastname: Manoli
mesh_terms: D000125:Achilles Tendon / Q000601:surgery*; D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology; D003646:Debridement; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000503:physiopathology*; D006214:Hallux / Q000503:physiopathology; D006365:Heel / Q000503:physiopathology; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000503:physiopathology; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000637:transplantation*; D009135:Muscular Diseases / Q000601:surgery*; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D011998:Recreation; D012422:Rupture, Spontaneous; D013710:Tendons / Q000637:transplantation*; D019415:Torque; D016896:Treatment Outcome