The effect of foot type on the Achilles tendon moment arm and biomechanics. 2019

Manja Deforth, and Lukas Zwicky, and Tamara Horn, and Beat Hintermann
Clinic for Orthopaedic and Trauma Surgery, Kantonsspital Baselland, Switzerland.

BACKGROUND The aim was to calculate the Achilles tendon moment arm in different degrees of plantarflexion for pes planus, pes cavus and normal arched feet. METHODS 99 patients (99 radiographs; 40 males, 59 females; mean age 49 years, SD 15) with a healthy ankle joint and a preoperative weightbearing lateral radiograph of the foot were included. Three groups (pes planus, pes cavus and normal-arched feet) with equal sample sizes (n=33) were formed. On radiographs, the angle formed between a horizontal line and the line connecting the insertion of the Achilles tendon with the center of rotation of the ankle, was measured. The interrater reliabilities (ICC) of the angle alpha were compared on radiographs and on MRIs. Using the angle alpha, the Achilles tendon moment arm was calculated in different plantarflexion positions. RESULTS The ICC of alpha was higher on radiographs (0.84, [0.73-0.91]) than on MRIs (0.61, [0.27-0.81]). The average alpha was statistically significantly different (normal arched foot 31 degrees (°), pes planus 24°, pes cavus 36°, p=0.021), resulting in a significant shorter Achilles tendon moment arm for pes cavus than for pes planus (p<0.0001) and normal arched feet (p=0.006) in neutral position. CONCLUSIONS The data suggests that it is feasible to use radiographs to measure the Achilles tendon moment arm. The maximum Achilles tendon moment arm is reached at different angles of ankle flexion for pes cavus, pes planus and normal-arched feet. This has to be taken into consideration when planning surgeries.

UI MeSH Term Description Entries
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D005413 Flatfoot Anomaly in which one or more of the arches of the feet are flat. Pes Planus,Acquired Adult Flatfoot Deformity,Convex Foot,Convex Pes Valgus,Flat Feet,Flat Foot,Flatfeet,Flexible Flatfoot,Pes Valgus, Congenital Convex,Rigid Flatfoot,Rocker-Bottom Foot,Splayfoot,Talipes Calcaneovalgus,Talipes Valgus,Vertical Talus,Vertical Talus, Congenital,Calcaneovalgus, Talipes,Congenital Vertical Talus,Feet, Flat,Flatfoot, Flexible,Flatfoot, Rigid,Foot, Convex,Foot, Flat,Foot, Rocker-Bottom,Pes Valgus, Convex,Rocker Bottom Foot,Talus, Congenital Vertical,Talus, Vertical,Valgus, Talipes
D005528 Foot The distal extremity of the leg in vertebrates, consisting of the tarsus (ANKLE); METATARSUS; phalanges; and the soft tissues surrounding these bones. Feet
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000070589 Talipes Cavus A foot deformity in which the arch of the foot is high and often the heel adducted. Cavus Deformity,Pes Cavus,Cavovarus Foot Deformity,Cavus Foot,High-Arched Foot,Cavovarus Foot Deformities,Cavus Deformities,Foot Deformities, Cavovarus,Foot Deformity, Cavovarus,High Arched Foot
D000125 Achilles Tendon Tendon that connects the muscles in the back of the calf to the HEEL BONE. Calcaneal Tendon,Tendo Calcaneus,Calcaneal Tendons,Tendon, Achilles,Tendon, Calcaneal,Tendons, Calcaneal
D001696 Biomechanical Phenomena The properties, processes, and behavior of biological systems under the action of mechanical forces. Biomechanics,Kinematics,Biomechanic Phenomena,Mechanobiological Phenomena,Biomechanic,Biomechanic Phenomenas,Phenomena, Biomechanic,Phenomena, Biomechanical,Phenomena, Mechanobiological,Phenomenas, Biomechanic

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