Department of Orthopedic Surgery, Rehasport Clinic, 60-201 Poznań, Poland.
Sport Championship School on the Handball Federation in Poland, 09-402 Płock, Poland.
Medicina (Kaunas). 2022 Oct 9;58(10):1417. doi: 10.3390/medicina58101417.
The Achilles tendon, the largest tendon in the body, is vulnerable to injury because of its limited blood supply and the combination of forces to which it is subjected. Given the relevance of the Achilles tendon in the proper function of the foot and ankle, the primary goal of the present study was to use a holistic approach for a comprehensive evaluation of Achilles tendon reconstruction results on multiple levels. The study was designed in the following way: 30 patients with partial or total Achilles tendon tears were subjected to the minimally invasive Achilles tendon reconstruction. Patients were then subjected to the clinical, functional and isokinetic tests 12 and 24 months after the treatment. The clinical evaluation included calf circumference measurements and subjective patient-reported tests: ATRS, EQ-5D-5L and VAS scales. The functional evaluation was based on three tests: the weight-bearing lunge test, the heel rise test and single leg hop. Isometric and isokinetic evaluation was performed using a Biodex 3 dynamometer. The calf circumference of the operated limbs was significantly lower than the non-operated limb 12 months after the surgical procedure, however this improved at the second evaluation. All subjective outcomes improved significantly 24 months after the surgery. Significantly better results in the function of the operated limbs were also obtained 24 months after the surgery. However, most of the muscle strength parameters of the operated limbs were already comparable to non-operated ones 12 months after the surgery and were comparable between two evaluation times. : The overall results of this extensive evaluation are highly satisfactory and patients returned to their normal physical activity. From a medical point of view, it is assumed that the healing process is completed 12 months after the surgery, however, importantly, our results indicate that we should consider the healing process and the rehabilitation process separately.
跟腱是人体最大的肌腱，由于其血液供应有限以及所承受的力的组合，容易受伤。鉴于跟腱在足踝正常功能中的重要性，本研究的主要目的是采用整体方法在多个层面上全面评估跟腱重建的结果。
30 名部分或完全跟腱撕裂的患者接受微创跟腱重建。然后，在治疗后 12 个月和 24 个月对患者进行临床、功能和等速测试。临床评估包括小腿围测量和主观患者报告测试：ATR 评分、EQ-5D-5L 和 VAS 量表。功能评估基于三项测试：负重弓步测试、脚跟抬高测试和单腿跳跃。等长和等速评估使用 Biodex 3 测力计进行。
手术后 12 个月，手术肢体的小腿围明显小于非手术肢体，但在第二次评估时有所改善。所有主观结果在手术后 24 个月均显著改善。手术后 24 个月，手术肢体的功能也取得了明显更好的结果。然而，手术后 12 个月，手术肢体的大部分肌肉力量参数已经与非手术肢体相当，并且在两次评估之间相当。
综上所述，这种广泛评估的总体结果非常令人满意，患者恢复了正常的身体活动。从医学角度来看，假设手术后 12 个月愈合过程已经完成，但重要的是，我们的结果表明，我们应该分别考虑愈合过程和康复过程。
