The Distal Free Achilles Tendon Is Longer in People with Tendinopathy than in Controls: A Retrospective Case-Control Study.

IF 1.2 Q3 SPORT SCIENCES Translational sports medicine Pub Date : 2022-08-28 eCollection Date: 2022-01-01 DOI:10.1155/2022/6585980

Joanne H Callow, Mark Cresswell, Faraz Damji, Joshua Seto, Antony J Hodgson, Alex Scott

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Abstract

Objectives: The free Achilles tendon is defined as the region of tendon distal to the soleus which is "unbuttressed," i.e., unsupported by muscular tissue. We reasoned that a relative lack of distal buttressing could place the tendon at a greater risk for developing Achilles tendinopathy. Therefore, our primary goal was to compare the free Achilles tendon length between those with midportion or insertional Achilles tendinopathy and healthy controls.

Design: This is a retrospective case-control study. Setting. Hospital in Vancouver, Canada. Participants. 66 cases with Achilles tendinopathy (25 insertional, 41 midportion) consecutively drawn from a hospital database within a 5-year period and matched to 66 controls (without tendinopathy) based on sex, age, and weight. Main outcome measures. Odds ratio of the risk of developing Achilles tendinopathy given the length of free tendon, defined anatomically on MRI, after adjustment for confounders.

Results: MRI-defined free Achilles tendon length is a statistically significant predictor of having midportion Achilles tendinopathy (odds ratio = 0.53, 95% confidence interval 1.13 to 2.07). Midportion Achilles tendinopathy cases had significantly longer free tendons (Mdn = 51.2 mm, IQR = 26.9 mm) compared to controls (Mdn = 40.8 mm, IQR = 20.0 mm), p = 0.007. However, there was no significant difference between the free Achilles tendon lengths in insertional AT cases (Mdn = 47.9 mm, IQR = 15.1 mm) and controls (Mdn = 39.2 mm, IQR = 17.9 mm), p = 0.158. Free Achilles tendon length was also correlated with the tendon thickness among those with Achilles tendinopathy, r_τ = 0.25, and p = 0.003.

Conclusions: The MRI-defined length of the free Achilles tendon is positively associated with the risk of midportion Achilles tendinopathy. A relative lack of distal muscular buttressing of the Achilles tendon may therefore influence the development of tendinopathy.

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肌腱病变患者远端游离跟腱比对照组更长:一项回顾性病例对照研究

目标。游离跟腱被定义为比目鱼肌远端的肌腱区域，该区域“未被束缚”，即没有肌肉组织支撑。我们推断，相对缺乏远端支撑可能会使肌腱发生跟腱病的风险更大。因此，我们的主要目标是比较中段或插入性跟腱病患者和健康对照组的游离跟腱长度。设计这是一项回顾性病例对照研究。背景加拿大温哥华的医院。参与者。在5年内从医院数据库中连续抽取66例跟腱病患者（25例插入，41例中段），并根据性别、年龄和体重与66名对照组（无肌腱病）进行匹配。主要成果衡量标准。根据MRI解剖定义的游离肌腱长度，在调整混杂因素后，发展为跟腱病的风险的比值比。后果MRI定义的游离跟腱长度是患有中段跟腱病的统计学显著预测因素（比值比 = 0.53，95%置信区间1.13至2.07）。中段跟腱病患者的游离肌腱明显较长（Mdn = 51.2 mm，IQR = 26.9 mm）与对照组（Mdn = 40.8 mm，IQR = 20 mm），p＝0.007。然而，插入性AT患者的游离跟腱长度之间没有显著差异（Mdn = 47.9 mm，IQR = 15.1 mm）和对照组（Mdn = 39.2 mm，IQR = 17.9 mm），p＝0.158。跟腱疾病患者的游离跟腱长度也与肌腱厚度相关，rτ = 0.25，p＝0.003。结论。MRI定义的游离跟腱长度与跟腱中段病变的风险呈正相关。因此，跟腱远端肌肉支撑的相对缺乏可能会影响腱病的发展。

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Translational sports medicine

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3.00

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0.00%

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