Impingement in Insertional Achilles Tendinopathy Occurs Across a Larger Range of Ankle Angles and Is Associated With Increased Tendon Thickness.
Impingement in Insertional Achilles Tendinopathy Occurs Across a Larger Range of Ankle Angles and Is Associated With Increased Tendon Thickness.
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DOI：
10.1177/10711007211069570
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发表时间：
2022-05
影响因子：
2.7
通讯作者：
Richards, Michael S.
中科院分区：
文献类型：
--
作者：
Aggouras, Anthony N.;Chimenti, Ruth L.;Flemister, A. Samuel;Ketz, John;Slane, Laura C.;Buckley, Mark R.;Richards, Michael S.
插入性跟腱病（IAT）的特征是肌腱退行性变和肌腱-骨附着点附近增厚。跟骨撞击被认为是IAT发病机制的一部分。然而，目前尚不清楚IAT患者肌腱厚度的增加如何影响撞击。本研究旨在比较有和没有IAT的个体的跟腱撞击。8名健康成人和12名临床诊断为症状性IAT的成人进行被动屈曲运动，在此期间采集踝关节屈曲角度、前后（A-P）厚度和跟腱止点的超声（US）图像序列。跟骨首次撞击跟腱的踝跖屈角度（定义为撞击起始角）通过以下方法确定：（1）盲法观察者（目视检查法）和（2）基于计算图像变形的方法（曲率法）。尽管两种方法提供了不同的撞击起始角，但测量结果具有很强的相关性（R2 = 0.751，P <0.05）。临床诊断为IAT的受试者的撞击起始角和跟腱止点厚度更大（P = .0048，P = .0047）。此外，撞击起始角被证明与前后厚度具有中等相关性（R2 = 0.454，P <0.05）。我们的研究结果表明，IAT患者肌腱厚度增加与较大的撞击起始角度相关，增加了肌腱暴露于撞击的踝关节角度范围。增加对撞击的敏感性可能会加剧或延续病理学，强调需要临床策略来减少IAT患者的撞击。
Insertional Achilles tendinopathy (IAT) is characterized by tendon degeneration and thickening near the tendon-bone insertion. Calcaneal impingement is believed to contribute in the pathogenesis of IAT. However, it is unclear how increased tendon thickness in individuals with IAT influences impingement. This study aimed to compare Achilles tendon impingement in individuals with and without IAT. Eight healthy adults and twelve adults with clinically diagnosed symptomatic IAT performed a passive flexion exercise during which ankle flexion angle, anterior-posterior (A-P) thickness, and an ultrasound (US) image sequence of the Achilles tendon insertion were acquired. The angle of ankle plantarflexion at which the calcaneus first impinges the Achilles tendon, defined as the impingement onset angle, was identified by; (1) a blinded observer (visual inspection method) and (2) a computational image deformation-based approach (curvature method). Although the two methods provided different impingement onset angles, the measurements were strongly correlated (R2 = 0.751, P < .05). The impingement onset angle and the thickness of the Achilles tendon insertion were greater in subjects with clinically diagnosed IAT (P = .0048, P = .0047). Furthermore, impingement onset angle proved to have a moderate correlation with anterior-posterior thickness (R2 = 0.454, P < .05). Our findings demonstrated that increased tendon thickness in IAT patients is associated with larger impingement onset angles, raising the range of ankle angles over which the tendon is exposed to impingement. Increased susceptibility to impingement may exacerbate or perpetuate the pathology, highlighting the need for clinical strategies to reduce impingement in IAT patients.
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DOI：
10.1002/jor.23338
发表时间：
2017-04
期刊：
Journal of orthopaedic research : official publication of the Orthopaedic Research Society
影响因子：
--
作者：
Chimenti RL;Bucklin M;Kelly M;Ketz J;Flemister AS;Richards MS;Buckley MR
通讯作者：
Buckley MR
影响因子：
5
作者：
Karjalainen, PT;Soila, K;Tirman, PFJ
通讯作者：
Tirman, PFJ
影响因子：
2.7
作者：
Maffulli, Nicola;Reaper, Jacqueline;Barrass, Victoria
通讯作者：
Barrass, Victoria
影响因子：
1.3
作者：
Shibuya, Naohiro;Thorud, Jakob C.;Jupiter, Daniel C.
通讯作者：
Jupiter, Daniel C.
影响因子：
5.3
作者：
Uquillas, Carlos A.;Guss, Michael S.;Strauss, Eric J.
通讯作者：
Strauss, Eric J.