Dargel Jens, Ninck Jutta, Koebke Jürgen, Appell Hans-Joachim, Pennig Dietmar, Hillekamp Jörn
St. Vinzenz Hospital Cologne, Clinic for Trauma Surgery, Orthopedics, Hand- and Reconstructive Surgery, Merheimer Str. 221-223, Cologne, 50733, Germany.
Foot Ankle Int. 2009 Jun;30(6):551-7. doi: 10.3113/FAI.2009.0551.
The influence of the knee angle on plantarflexion moments after Achilles tendon repair has yet to be analyzed. It was hypothesized that flexion of the knee joint will disproportionately influence isometric plantarflexion moments after Achilles tendon repair.
Isometric plantarflexion moments and functional heel rise performance were retrospectively assessed in 32 patients at a mean follow-up of 36.9 (+/- 17.83) months after open or percutaneous repair of acute Achilles tendon rupture. Plantarflexion moments were measured with the knee joint in 0, 30, and 60 degrees of flexion and the ankle joint positioned in neutral, 15 degrees plantar flexion and 15 degrees dorsiflexion. Data were compared between the involved and the noninvolved leg as well as between open and percutaneous repair.
Flexion of the knee had no significant effect on isometric plantarflexion moments in either the involved or the noninvolved leg, while at any knee angle, plantarflexion moments decreased from dorsiflexion to plantar flexion. In accordance, dynamic heel rise performance revealed no significant strength deficits between the involved and the noninvolved limb. No overall differences in plantarflexion strength were observed between open and percutaneous Achilles tendon repair.
The flexion angle of the knee had no influence on plantarflexion moments when comparing the involved with the noninvolved leg after open or percutaneous Achilles tendon repair. Weakness of plantarflexion after open or percutaneous Achilles tendon repair is determined by the position of the ankle joint rather than by the flexion angle of the knee.
跟腱修复术后膝关节角度对跖屈力矩的影响尚未得到分析。研究假设为，膝关节屈曲对跟腱修复术后等长跖屈力矩有不成比例的影响。
对32例急性跟腱断裂开放或经皮修复术后平均随访36.9（±17.83）个月的患者进行等长跖屈力矩和功能性足跟抬起表现的回顾性评估。在膝关节处于0度、30度和60度屈曲且踝关节处于中立位、15度跖屈和15度背屈时测量跖屈力矩。对患侧与健侧以及开放修复与经皮修复的数据进行比较。
膝关节屈曲对患侧或健侧的等长跖屈力矩均无显著影响，而在任何膝关节角度下，跖屈力矩从背屈到跖屈均降低。相应地，动态足跟抬起表现显示患侧与健侧肢体之间无明显力量缺陷。开放和经皮跟腱修复术后在跖屈力量方面未观察到总体差异。
在开放或经皮跟腱修复术后，比较患侧与健侧时，膝关节屈曲角度对跖屈力矩无影响。开放或经皮跟腱修复术后跖屈无力取决于踝关节的位置而非膝关节的屈曲角度。
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