Hoeffner Rikke, Svensson Rene B, Bjerregaard Nicolai, Kjær Michael, Magnusson Stig Peter
Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark.
Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Transl Sports Med. 2022 Jul 16;2022:7445398. doi: 10.1155/2022/7445398. eCollection 2022.
Persistent muscle weakness, tendon elongation, and incomplete return to preinjury level are frequent sequelae after acute Achilles tendon rupture, and evidence-based knowledge of how to best rehabilitate the injury is largely absent in the literature. The objective of this review is to illuminate and discuss to what extent an Achilles tendon rupture affects muscle, tendon, and function when assessed with the Achilles tendon total rupture score (ATRS), muscle strength, muscle cross-sectional area, tendon length, and the heel-rise test. The patient-reported outcome measures (PROM) data in the literature suggest that the recovery takes longer than 6 months (ATRS, 70 out of 100), that one-year postinjury, the ATRS only reaches 82, and that this does not appear to noticeably improve thereafter. Loss of muscle mass, strength, and function can in some cases be permanent. Over the first 6 months postinjury, the tendon undergoes elongation, which appears to be negatively correlated to heel-rise function. More recently, there has been some interest in how muscle length and excursion is related to the reduced function. The available literature indicates that further research is highly warranted and that efforts to restore normal tendon length may improve the likelihood of returning to preinjury level after an Achilles tendon rupture.
急性跟腱断裂后，持续的肌肉无力、肌腱延长以及无法完全恢复到受伤前水平是常见的后遗症，而文献中很大程度上缺乏关于如何最佳康复该损伤的循证知识。本综述的目的是阐明并讨论在使用跟腱完全断裂评分（ATRS）、肌肉力量、肌肉横截面积、肌腱长度和提踵试验进行评估时，跟腱断裂在多大程度上影响肌肉、肌腱和功能。文献中的患者报告结局指标（PROM）数据表明，恢复时间超过6个月（ATRS为满分100分中的70分），受伤一年后，ATRS仅达到82分，且此后似乎没有明显改善。在某些情况下，肌肉质量、力量和功能的丧失可能是永久性的。在受伤后的前6个月，肌腱会发生延长，这似乎与提踵功能呈负相关。最近，人们对肌肉长度和移动与功能降低之间的关系产生了一些兴趣。现有文献表明，非常有必要进行进一步研究，而且恢复正常肌腱长度的努力可能会提高跟腱断裂后恢复到受伤前水平的可能性。
