Mechanical changes in the Achilles tendon due to insertional Achilles tendinopathy

Ibrahima Bah; Ruth L Chimenti; Samuel T Kwak; Michael S Richards; John P Ketz; A Samuel Flemister; Mark R Buckley

doi:10.1016/j.jmbbm.2015.08.022

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Mechanical changes in the Achilles tendon due to insertional Achilles tendinopathy

Journal article

Peer reviewed

Mechanical changes in the Achilles tendon due to insertional Achilles tendinopathy

Ibrahima Bah, Ruth L Chimenti, Samuel T Kwak, Michael S Richards, John P Ketz, A Samuel Flemister and Mark R Buckley

Journal of the mechanical behavior of biomedical materials, Vol.53, pp.320-328

01/2016

DOI: 10.1016/j.jmbbm.2015.08.022

PMCID: PMC5003051

PMID: 26386166

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Abstract

Insertional Achilles tendinopathy (IAT) is a painful and debilitating condition that responds poorly to non-surgical interventions. It is thought that this disease may originate from compression of the Achilles tendon due to calcaneal impingement. Thus, compressive mechanical changes associated with IAT may elucidate its etiology and offer clues to guide effective treatment. However, the mechanical properties of IAT tissue have not been characterized. Therefore, the objective of this study was to measure the mechanical properties of excised IAT tissue and compare with healthy cadaveric control tissue. Tissue from the Achilles tendon insertion was acquired from healthy donors and from patients undergoing debridement surgery for IAT. Several tissue specimens from each donor were then mechanically tested under cyclic unconfined compression and the acquired data was analyzed to determine the distribution of mechanical properties for each donor. While the median mechanical properties of tissue excised from IAT tendons were not significantly different than healthy tissue, the distribution of mechanical properties within each donor was dramatically altered. In particular, healthy tendons contained more low modulus (compliant) and high transition strain specimens than IAT tendons, as evidenced by a significantly lower 25th percentile secant modulus and higher 75th percentile transition strain. Furthermore, these parameters were significantly correlated with symptom severity. Finally, it was found that preconditioning and slow loading both reduced the secant modulus of healthy and IAT specimens, suggesting that slow, controlled ankle dorsiflexion prior to activity may help IAT patients manage disease-associated pain.

Insertional Achilles tendinopathy

Achilles tendon

Compression

Tendon

Details

Title: Subtitle: Mechanical changes in the Achilles tendon due to insertional Achilles tendinopathy
Creators: Ibrahima Bah - University of Rochester, Department of Biomedical Engineering, United States
Ruth L Chimenti - University of Rochester, Department of Biomedical Engineering, United States
Samuel T Kwak - University of Rochester, Department of Biomedical Engineering, United States
Michael S Richards - University of Rochester, Department of Surgery, United States
John P Ketz - University of Rochester, Department of Orthopaedics, United States
A Samuel Flemister - University of Rochester, Department of Orthopaedics, United States
Mark R Buckley - University of Rochester, Department of Biomedical Engineering, United States
Resource Type: Journal article
Publication Details: Journal of the mechanical behavior of biomedical materials, Vol.53, pp.320-328
DOI: 10.1016/j.jmbbm.2015.08.022
PMID: 26386166
PMCID: PMC5003051
NLM abbreviation: J Mech Behav Biomed Mater
ISSN: 1751-6161
eISSN: 1878-0180
Publisher: Elsevier Ltd
Grant note: DOI: 10.13039/100000069, name: National Institute of Arthritis and Musculoskeletal and Skin Diseases, award: R03 AR067484, P30 AR061307; DOI: 10.13039/100000002, name: National Institutes of Health, award: R03 AR067484, P30 AR061307
Language: English
Date published: 01/2016
Academic Unit: Physical Therapy and Rehabilitation Science
Record Identifier: 9984083880802771

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