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. 2017 Sep 25;12(1):139.
doi: 10.1186/s13018-017-0638-4.

Calcaneal CT is a useful tool for identifying Achilles tendon disorders: a pilot study

Affiliations

Calcaneal CT is a useful tool for identifying Achilles tendon disorders: a pilot study

Krzysztof Ficek et al. J Orthop Surg Res. .

Abstract

Background: In various Achilles tendon disorders, little attention is paid to the bone environment at the tendon insertion sites. The aim of the present study was to assess the calcaneal bone structure in Achilles tendon disorders using computed tomography (CT).

Methods: This study included 31 male patients diagnosed with various Achilles disorders, including episodes of tendon rupture (TR), conservatively treated tendinopathy (TP), and critical-stage Achilles TP treated with endoscopic surgery (TS). CT scans of both feet were conducted to assess the calcaneal bone structure in the TP and TS groups, which comprised 23 patients. Bone measurements were calculated, including the bone volume-to-total volume ratio (BV/TV), cross-sectional area (CSA), product moment of area (Ipm), and polar section modulus (Zpol).

Results: The results demonstrated increased BV/TV, CSA, Ipm, and Zpol values in patients who underwent tendinoscopy and in patients with insertional TP.

Conclusions: CT images are useful for evaluating calcaneal trabecular structural alterations in patients with Achilles pathology and correlate with the TP type.

Keywords: Achilles tendon; Calcaneus; Computed tomography.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the local ethics committee of the Academy of Physical Education in Katowice, Poland, under agreement number KB/13/2007. The patients involved in the study were informed about the study’s aims, and consent was obtained.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Calcaneal region of interest (ROI) constructed on various cross sections
Fig. 2
Fig. 2
The figure shows 3D visualizations of calcanei with bone tissue distributions: a calcaneus from the CG and b calcaneus from the TS group. White color represents bone tissue of high density; red color represents bone tissue of low density
Fig. 3
Fig. 3
Boxplots showing the calcaneal bone structure measurement results from analysis A. Boxplot legend: the top and the bottom of the boxes represent the 1st and 3rd quartiles, respectively. The whiskers correspond to the maximal and minimal value within the 1.5 × inter-quartile range (IQR). Outliers are plotted as points
Fig. 4
Fig. 4
Boxplots showing the calcaneal bone structure measurement results from analysis B. Boxplot legend: the top and the bottom of the boxes represent the 1st and 3rd quartiles, respectively. The whiskers correspond to the maximal and minimal value within the 1.5 × inter-quartile range (IQR). Outliers are plotted as points

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References

    1. van Dijk CN, van Sterkenburg MN, Wiegerinck JI, Karlsson J, Maffulli N. Terminology for Achilles tendon related disorders. Knee Surg Sports Traumatol Arthrosc. 2011;19:835–841. doi: 10.1007/s00167-010-1374-z. - DOI - PMC - PubMed
    1. Niek Van Dijk C, Karlsson J, Maffulli N, Thermann H, editors. Achilles tendon rupture. Current concepts. Guildford, UK: DJO Publications; 2008.
    1. Cummins EJ, Anson BJ. The structure of the calcaneal tendon (of Achilles) in relation to orthopedic surgery, with additional observations on the plantaris muscle. Surg Gynecol Obs. 1946;83:107–116. - PubMed
    1. Szaro P, Witkowski G, Smigielski R, Krajewski P, Ciszek B. Fascicles of the adult human Achilles tendon—an anatomical study. Ann Anat. 2009;191:586–593. doi: 10.1016/j.aanat.2009.07.006. - DOI - PubMed
    1. Rossetti L, Kuntz LA, Kunold E, Schock J, Müller KW, Grabmayr H, et al. The microstructure and micromechanics of the tendon-bone insertion. Nat Mater. 2017;16:664–670. doi: 10.1038/nmat4863. - DOI - PubMed

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