title: Deficits in heel-rise height and achilles tendon elongation occur in patients recovering from an Achilles tendon rupture.
abstract: BACKGROUND
  Whether an Achilles tendon rupture is treated surgically or not, complications such as muscle weakness, decrease in heel-rise height, and gait abnormalities persist after injury.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate if side-to-side differences in maximal heel-rise height can be explained by differences in Achilles tendon length.
  
  
  METHODS
  Case series; level of evidence, 4.
  
  
  METHODS
  Eight patients (mean [SD] age of 46 [13] years) with acute Achilles tendon rupture and 10 healthy subjects (mean [SD] age of 28 [8] years) were included in the study. Heel-rise height, Achilles tendon length, and patient-reported outcome were measured 3, 6, and 12 months after injury. Achilles tendon length was evaluated using motion analysis and ultrasound imaging.
  
  
  RESULTS
  The Achilles tendon length test-retest reliability (intraclass correlation coefficient = 0.97) was excellent. For the healthy subjects, there were no side-to-side differences in tendon length and heel-rise height. Patients with Achilles tendon ruptures had significant differences between the injured and uninjured side for both tendon length (mean [SD] difference, 2.6-3.1 [1.2-1.4] cm, P = .017-.028) and heel-rise height (mean [SD] difference, -4.1 to -6.1 [1.7-1.8] cm, P = .012-.028). There were significant negative correlations (r = -0.943, P = .002, and r = -0.738, P = .037) between the side-to-side difference in heel-rise height and Achilles tendon length at the 6- and 12-month evaluations, respectively.
  
  
  CONCLUSIONS
  The side-to-side difference found in maximal heel-rise height can be explained by a difference in Achilles tendon length in patients recovering from an Achilles tendon rupture. Minimizing tendon elongation appears to be an important treatment goal when aiming for full return of function.
authors.affiliation: University of Delaware, Newark, Delaware, USA. k.silbernagel@usciences.edu
authors.forename: Karin Grävare
authors.initials: KG
authors.lastname: Silbernagel
authors.forename: Robert
authors.initials: R
authors.lastname: Steele
authors.forename: Kurt
authors.initials: K
authors.lastname: Manal
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D000328:Adult; D000842:Ankle / Q000503:physiopathology; D005260:Female; D005684:Gait / Q000502:physiology*; D006365:Heel / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000503:physiopathology*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012421:Rupture / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult