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Proprioception level after endoscopically guided percutaneous Achilles tendon

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To evaluate ankle function following endoscopically guided percutaneous Achilles tendon repair. The hypothesis of this study was that patients with percutaneous repair of the Achilles tendon would still display impaired involved side ankle proprioception.

Methods

Nineteen male patients with percutaneous Achilles tendon surgery were tested for bilateral ankle active angle reproduction at 10° dorsiflexion and 15° plantar flexion, peak concentric isokinetic ankle dorsiflexor and plantar flexor torque, one-leg hop for distance, and single-leg vertical jump height. Dominant sides of age- and sex-matched 19 healthy controls were evaluated for ankle active angle reproduction at 10° dorsiflexion and 15° plantar flexion, peak concentric isokinetic ankle dorsiflexor and plantar flexor torque.

Results

Peak isokinetic torque, one-leg hop for distance, single-leg vertical jump for height and ankle joint position sense at 10° dorsiflexion did not differ between the affected and unaffected side. Ankle joint position sense for active angle replication at 15° plantar flexion revealed a significant side-to-side difference. Joint position sense at 10° dorsiflexion and at 15° plantar flexion at affected side was poor in patients compared with the controls, while joint position sense at 10° dorsiflexion and at 15° plantar flexion at unaffected side was same in patients compared with the controls.

Conclusions

It has revealed a significant difference in joint position sense at plantar flexion of the patients at least 1 year after percutaneous Achilles tendon surgery compared to their unaffected limb. Large prospective longitudinal studies are needed to evaluate therapeutic interventions designed to improve proprioception.

Level of evidence

III.

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References

  1. Bolgla LA, Keskula DR (1997) Reliability of lower extremity functional performance tests. J Orthop Sports Phys Ther 26:138–142

    PubMed  CAS  Google Scholar 

  2. Bressel E, Larsen BT, McNair PJ, Cronin J (2004) Ankle joint proprioception and passive mechanical properties of calf muscles after an Achilles tendon rupture: a comparison with matched controls. Clin Biomech 19:284–291

    Article  Google Scholar 

  3. Callaghan MJ, Selfe J, Bagley P, Oldham JA (2002) Effect of patellar taping on knee joint proprioception. J Athl Train 37:19–24

    PubMed  Google Scholar 

  4. Carmont MR, Maffulli N (2008) Modified percutaneous repair of ruptured Achilles tendon. Knee Surg Sports Traumatol Arthrosc 16:199–203

    Article  PubMed  Google Scholar 

  5. Cetti R, Henriksen LO, Jacobsen KS (1994) A new treatment of ruptured Achilles tendons: a prospective randomized study. Clin Orthop Relat Res 308:155–165

    PubMed  Google Scholar 

  6. Doral MN, Bozkurt M, Turhan E, Ayvaz M, Atay OA, Uzumcugil A, Leblebicioglu G, Kaya D, Aydog T (2009) Percutaneous suturing of the ruptured Achilles tendon with endoscopic control. Arch Orthop Trauma Surg 129:1093–1101

    Article  PubMed  Google Scholar 

  7. Feuerbach JW, Grabiner MD, Koh TJ, Weiker GG (1994) Effect of an ankle orthosis and ankle anesthesia on ankle joint proprioception. Am J Sports Med 22:223–229

    Article  PubMed  CAS  Google Scholar 

  8. Fortis AP, Dimas A, Lamprakis AA (2008) Repair of Achilles tendon rupture under endoscopic control. Arthroscopy 24:683–688

    Article  PubMed  Google Scholar 

  9. Gigante A, Moschini A, Verdenelli A, Del Torto M, Ulisse S, de Palma L (2008) Open versus percutaneous repair in the treatment of acute Achilles tendon rupture: a randomized prospective study. Knee Surg Sports Traumatol Arthrosc 16:204–209

    Article  PubMed  CAS  Google Scholar 

  10. Goren D, Ayalon M, Nyska M (2005) Isokinetic strength and endurance after percutaneous and open surgical repair of Achilles tendon ruptures. Foot Ankle Int 26:286–290

    PubMed  Google Scholar 

  11. Gross MT, Everts JR, Roberson SE, Roskin DS, Young KD (1994) Effect of Donjoy ankle ligament protector and Aircast sport-stirrup orthoses on functional performance. J Orthop Sports Phys Ther 19:150–156

    PubMed  CAS  Google Scholar 

  12. Henríquez H, Muñoz R, Carcuro G, Bastías C (2012) Is percutaneous repair better than open repair in acute Achilles tendon rupture? Clin Orthop Relat Res 470:998–1003

    Article  PubMed  Google Scholar 

  13. Irrgang JJ, Whitney SL, Cox ED (1994) Balance and proprioceptive training for rehabilitation of the lower extremity. J Sport Rehabil 3:68–83

    Google Scholar 

  14. Järvinen TA, Kannus P, Maffulli N, Khan KM (2005) Achilles tendon disorders: etiology and epidemiology. Foot Ankle Clin 10:255–266

    Article  PubMed  Google Scholar 

  15. Kangas J, Pajala A, Siira P, Hämäläinen M, Leppilahti J (2003) Early functional treatment versus early immobilization in tension of the musculotendinous unit after Achilles rupture repair: a prospective, randomized, clinical study. J Trauma 54:1171–1180

    Article  PubMed  Google Scholar 

  16. Khan RJ, Fick D, Keogh A, Crawford J, Brammar T, Parker M (2005) Treatment of acute Achilles tendon ruptures: a meta-analysis of randomized, controlled trials. J Bone Jt Surg Am 87:2202–2210

    Article  Google Scholar 

  17. LaRiviere J, Osternig LR (1994) The effect of ice immersion on joint sense position. J Sport Rehabil 3:58–67

    Google Scholar 

  18. Lui TH (2007) Endoscopic-assisted Achilles tendon repair with plantaris tendon augmentation. Arthroscopy 23:556.e1–556.e5

    Article  Google Scholar 

  19. Maffulli N, Tallon C, Wong J, Lim KP, Bleakney R (2003) Early weightbearing and ankle mobilization after open repair of acute midsubstance tears of the Achilles tendon. Am J Sports Med 31:692–700

    PubMed  Google Scholar 

  20. Maffulli N, Tallon C, Wong J, Peng LK, Bleakney R (2003) No adverse effect of early weight bearing following open repair of acute tears of the Achilles tendon. J Sports Med Phys Fit 43:367–379

    CAS  Google Scholar 

  21. Maffulli N (1999) Current concepts review: rupture of the Achilles tendon. J Bone Jt Surg Am 81:1019–1036

    CAS  Google Scholar 

  22. Mortensen HM, Skov O, Jensen PE (1999) Early motion of the ankle after operative treatment of a rupture of the Achilles tendon. A prospective, randomized clinical and radiographic study. J Bone Jt Surg Am 81:983–990

    CAS  Google Scholar 

  23. Rouvillain JL, Navarre T, Labrada-Blanco O, Garron E, Daoud W (2010) Percutaneous suture of acute Achilles tendon rupture. A study of 60 cases. Acta Orthop Belg 76:237–242

    PubMed  Google Scholar 

  24. Selfe J, Callaghan M, McHenry A, Richards J, Oldham J (2006) An investigation into the effect of number of trials during proprioceptive testing in patients with patellofemoral pain syndrome. J Orthop Res 24:1218–1224

    Article  PubMed  Google Scholar 

  25. Simoneau GG, Derr JA, Ulbrecht JS, Becker MB, Cavanagh PR (1996) Diabetic sensory neuropathy effect on ankle joint movement perception. Arch Phys Med Rehabil 77:453–460

    Article  PubMed  CAS  Google Scholar 

  26. Tang KL, Thermann H, Dai G, Chen GX, Guo L, Yang L (2007) Arthroscopically assisted percutaneous repair of fresh closed Achilles tendon rupture by Kessler’s suture. Am J Sports Med 35:589–596

    Article  PubMed  Google Scholar 

  27. Tenenbaum S, Dreiangel N, Segal A, Herman A, Israeli A, Chechik A (2010) The percutaneous surgical approach for repairing acute Achilles tendon rupture: a comprehensive outcome assessment. J Am Podiatr Med Assoc 100:270–275

    PubMed  Google Scholar 

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Acknowledgments

Authors declare that they have no sponsor in the study design, in the collection, analysis, and interpretation of data; in writing of the manuscript; and in the decision to submit the manuscript for publication.

Conflict of interest

All authors have no conflicts of interest with respect to the data collected and procedures used within this study.

Ethical statement

The authors confirm that this study meets the guidelines of the Declaration of Helsinki, and after local ethical approval, all subjects provided written informed consent. Ethical approval for the study was received from Hacettepe University in Turkey. Number is HEK 11/26-6.

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Authors and Affiliations

  1. Department of Sports Medicine, Faculty of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey

    Defne Kaya, Mahmut Nedim Doral & Gürhan Donmez

  2. Department of Orthopaedic and Traumatology, Faculty of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey

    Mahmut Nedim Doral & Ozgur Ahmet Atay

  3. University of Louisville, Louisville, KY, USA

    John Nyland

  4. Department of Radiology, Ministry of Health, Ankara Numune Training and Research Hospital, Ankara, Turkey

    Uğur Toprak

  5. Department of Orthopaedic and Traumatology, Faculty of Medicine, Karaelmas University, Zonguldak, Turkey

    Egemen Turhan

  6. Department of Physical Therapy and Rehabilitation, Faculty of Health Science, Gazi University, Ankara, Turkey

    Seyit Citaker

  7. Centre for Rehabilitation Science, Manchester University, Manchester, UK

    Michael J. Callaghan

Authors
  1. Defne Kaya
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  2. Mahmut Nedim Doral
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  3. John Nyland
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  4. Uğur Toprak
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  5. Egemen Turhan
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  6. Gürhan Donmez
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  7. Seyit Citaker
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  8. Ozgur Ahmet Atay
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  9. Michael J. Callaghan
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Corresponding authors

Correspondence to Defne Kaya or Mahmut Nedim Doral.

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Kaya, D., Doral, M.N., Nyland, J. et al. Proprioception level after endoscopically guided percutaneous Achilles tendon. Knee Surg Sports Traumatol Arthrosc 21, 1238–1244 (2013). https://doi.org/10.1007/s00167-012-2007-5

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  • DOI: https://doi.org/10.1007/s00167-012-2007-5

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