Biomechanical and biochemical changes in the muscle soleus of rats during imitation of hind limbs unuse were studied in the model of the Achilles tendon rupture (Achillotenotomy). Oral administration of water-soluble C60 fullerene at a dose of 1 mg/kg was used as a therapeutic agent throughout the experiment. Changes in the force of contraction and the integrated power of the muscle, the time to reach the maximum force response, the mechanics of fatigue processes development, in particular, the transition from dentate to smooth tetanus, as well as the levels of pro- and antioxidant balance in the blood of rats on days 15, 30 and 45 after injury were described. The obtained results indicate a promising prospect for C60 fullerene use as a powerful antioxidant for reducing and correcting pathological conditions of the muscular system arising from skeletal muscle atrophy.

/pdf/effect-of-c60-fullerene-on-recovery-of-muscle-soleus-in-rats-1u8iejmd.pdf

Effect of C60 Fullerene on Recovery of Muscle Soleus in Rats after Atrophy Induced by Achillotenotomy

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.

Persistent Deficits after an Achilles Tendon Rupture: A Narrative Review

Background:Deficits in sporting performance after Achilles tendon repair may be due to changes in musculotendinous unit structure, including tendon elongation and muscle fascicle shortening.Purpose...

Functional Ankle Range of Motion but Not Peak Achilles Tendon Force Diminished With Heel-Rise and Jumping Tasks After Achilles Tendon Repair.

Commonly reported isokinetic parameters do not reveal long-term strength deficits of the Triceps surae complex following operative treatment of Achilles tendon rupture.

There is no uniform consensus on the gold standard therapy for acute Achilles tendon rupture. The aim of this pilot study was to compare operative and conservative treatment regarding imaging findings and clinical outcome.Surgically or conservatively treated patients with acute Achilles tendon rupture were retrospectively evaluated. Differences in tendon length and diameter with and without load were analysed using kinematic MRI, tendon perfusion, structural alterations, movement and scar tissue by means of grey-scale and contrast-enhanced ultrasound (CEUS). Intra- and interobserver agreement were recorded.No significant difference was detected regarding clinical outcome, B mode ultrasonography, contrast-enhanced sonography or MRI findings, although alterations in MRI-based measurements of tendon elasticity were found for both groups. Considerable elongation and thickening of the injured tendon were detected in both groups.Both, conservative and surgical treatment showed comparable outcomes in our preliminary results and may suggest non-inferiority of a conservative approach. 

/pdf/operative-versus-conservative-treatment-of-acute-achilles-2r59afh4.pdf

Operative versus conservative treatment of acute Achilles tendon ruptures: preliminary results of clinical outcome, kinematic MRI and contrast-enhanced ultrasound

Objectives: Achilles tendon rupture leads to functional impairments and these may be underpinned by morphological changes in the muscle-tendon unit. Functional performance of the injured limb will be impaired regardless of time since surgery and these impairments occur alongside changes in muscle-tendon morphology. Methods: Following operative treatment of Achilles tendon rupture and short term immobilisation, 12 patients completed a battery of tests during a single visit to the laboratory (performed an average of 4.4 ± 2.6 years post-surgery). Patients completed the Achilles’ tendon rupture score (ATRS), tests of ankle and hip range of motion (ROM) and ultrasound measurements of muscle-tendon architecture. Data on isokinetic (30 o/s, 60 o/s) plantar flexion strength, jumping performance and walking-running were also collected on the same visit. Percentage deficits were expressed relative to the non-injured limb and determined for statistical significance (p < 0.05). Relationships between outcomes measures and time since surgery were tested using Pearson’s correlation coefficients (p < 0.05). Results: The repaired limb showed a shorter muscle fascicle length (12.1-19.6%), increased fascicle pennation (18.0±22.14%) and reduced muscle thickness (9.1-20.1%) in the gastrocnemius and/or soleus along with greater tendon cross-sectional area (46.7±34.47%). Functionally, the repaired limb displayed lower countermovement jump height (-12.6±15.68%) and longer drop jump contact times (5.5±5.7%). Also, the repaired limb showed reduced hip internal-external ROM (6.3±8.2%) but no differences existed between limbs for plantar flexion ROM and strength or gait characteristics. Good ATRS outcomes were reported (mean: 87.9±16.2, range: 43-100) which related to time since surgery (r=0.79) but individual ATRS items did not correlate with corresponding objective measures. Conclusion: Plantar flexor atrophy following surgically treated Achilles tendon rupture is partially compensated for by remodelling of the fascicles however, impairments may still persist many years into the postoperative period although these may be more pronounced in high-velocity activities.

/pdf/morphological-and-functional-outcomes-of-operatively-treated-3s52j293ce.pdf

Morphological and functional outcomes of operatively treated Achilles tendon ruptures.

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Morphological and functional outcomes of operatively treated Achilles tendon ruptures.