Evidence map›Paper›PMID 28660438›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2018

Lower material stiffness in rupture-repaired Achilles tendon during walking: transmission-mode ultrasound for post-surgical tendon evaluation.

Mathias Wulf, Mihir Shanker, Michael Schuetz, Michael Lutz, Christian M Langton, Sue L Hooper, James E Smeathers, Torsten Brauner, Scott C Wearing

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In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.9field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 10 citations in OpenAlex.

  1. Muscle Contraction Is Essential for Tendon Healing and Muscle Function Recovery After Achilles Tendon Rupture and Surgical Repair.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Mathias WulfInstitute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4059, Australia. m.wulf@hdr.qut.edu.au.ORCID http://orcid.org/0000-0002-9997-8601
Mihir ShankerPrincess Alexandra Hospital, Brisbane, Australia.
Michael SchuetzCharite Universitätsmedizin Berlin, Humboldt University, Berlin, Germany.
Michael LutzSt Andrew's War Memorial Hospital, Wickham Tce, Spring Hill, QLD, 4000, Australia.
Christian M LangtonInstitute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4059, Australia.
Sue L HooperInstitute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4059, Australia.
James E SmeathersInstitute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4059, Australia.
Torsten BraunerFaculty of Sports and Health Sciences, Technische Universität München, Munich, Germany.
Scott C WearingInstitute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4059, Australia.
Queensland University of Technology · AUHumboldt-Universität zu Berlin · DEPrincess Alexandra Hospital · AUSt Andrew’s Hospital · AUTechnical University of Munich · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis cross-sectional study used transmission-mode ultrasound to evaluate dynamic tendon properties during walking in surgically repaired and contralateral Achilles tendon (AT), with a median (range) post-operative period of 22 (4-58) months. It was hypothesised that the axial transmission speed of ultrasound (TSOU) during walking would be slower, indicating lower material stiffness in repaired compared with contralateral AT.

methodsTen patients [median (range) age 47 (37-69) years; height 180 (170-189) cm; weight 93 (62-119) kg], who had undergone open surgical repair of the AT and were clinically recovered according to their treating clinicians, walked barefoot on a treadmill at self-selected speed (1.0 ± 0.2 m/s). Synchronous measures of TSOU, sagittal ankle motion, vertical ground reaction force (GRF), and spatiotemporal gait parameters were recorded during 20 s of steady-state walking. Paired t tests were used to evaluate potential between-limb differences in TSOU, GRF, ankle motion, and spatiotemporal gait parameters.

resultsTSOU was significantly lower (≈175 m/s) in the repaired than in the contralateral AT over the entire gait cycle (P < 0.05). Sagittal ankle motion was significantly greater (≈3°) in the repaired than in the contralateral limb (P = 0.036). There were no significant differences in GRF or spatiotemporal parameters between limbs.

conclusionsRepaired AT was characterised by a lower TSOU, reflecting a lower material stiffness in the repaired tendon than in the contralateral tendon. A lower material stiffness may underpin greater ankle joint motion of the repaired limb during walking and long-term deficits in the muscle-tendon unit reported with AT repair. Treatment and rehabilitation approaches that focus on increasing the material stiffness of the repaired AT may be clinically beneficial. Transmission-mode ultrasound would seem useful for quantifying tendon properties post AT rupture repair and may have the potential to individually guide rehabilitation programmes, thereby aiding safer return to physical activity. LEVEL OF EVIDENCE: II.

Indexed as

Achilles TendonAdultAgedAnkleAnkle JointBiomechanical PhenomenaCross-Sectional StudiesExercise TestFemaleGaitHumansMaleMiddle AgedRuptureTendon InjuriesUltrasonographyBiomechanicsGait analysisLocomotionSpeed of soundTendon healingTendon rupture

Identifiers

PMID28660438
OpenAlexW2732270427

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.