Quantifying the effects of achilles tendon lengthening surgery: An intraoperative approach

Brendecke, Elena; Tsitlakidis, Stefanos; Götze, Marco; Hagmann, Sébastien; Ateş, Filiz

doi:10.3389/fphys.2023.1143292

Cited by 3 publications

(1 citation statement)

References 55 publications

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“…For these very reasons, it is necessary to carefully examine the muscle force data obtained directly from the experimental studies using the intraoperative approach and to continue to carry out similar studies in different groups of people and different muscles. A recent study ( Brendecke et al, 2023 ), in which the triceps surae muscle group forces were measured using the intraoperative technique from the Achilles tendon in patients with non-neurological and neurological conditions, has been the first application of the intraoperative approach to the ankle joint. Interestingly, they reported lower passive forces in patients with idiopathic foot deformities than in patients with neurological conditions.…”

Section: Discussionmentioning

confidence: 99%

How mechanics of individual muscle-tendon units define knee and ankle joint function in health and cerebral palsy—a narrative review

Kaya Keles,

Ates

2023

Front. Bioeng. Biotechnol.

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This study reviews the relationship between muscle-tendon biomechanics and joint function, with a particular focus on how cerebral palsy (CP) affects this relationship. In healthy individuals, muscle size is a critical determinant of strength, with muscle volume, cross-sectional area, and moment arm correlating with knee and ankle joint torque for different isometric/isokinetic contractions. However, in CP, impaired muscle growth contributes to joint pathophysiology even though only a limited number of studies have investigated the impact of deficits in muscle size on pathological joint function. As muscles are the primary factors determining joint torque, in this review two main approaches used for muscle force quantification are discussed. The direct quantification of individual muscle forces from their relevant tendons through intraoperative approaches holds a high potential for characterizing healthy and diseased muscles but poses challenges due to the invasive nature of the technique. On the other hand, musculoskeletal models, using an inverse dynamic approach, can predict muscle forces, but rely on several assumptions and have inherent limitations. Neither technique has become established in routine clinical practice. Nevertheless, identifying the relative contribution of each muscle to the overall joint moment would be key for diagnosis and formulating efficient treatment strategies for patients with CP. This review emphasizes the necessity of implementing the intraoperative approach into general surgical practice, particularly for joint correction operations in diverse patient groups. Obtaining in vivo data directly would enhance musculoskeletal models, providing more accurate force estimations. This integrated approach can improve the clinicians’ decision-making process and advance treatment strategies by predicting changes at the muscle and joint levels before interventions, thus, holding the potential to significantly enhance clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

How mechanics of individual muscle-tendon units define knee and ankle joint function in health and cerebral palsy—a narrative review

Kaya Keles,

Ates

2023

Front. Bioeng. Biotechnol.

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Experiments meet simulations: Understanding skeletal muscle mechanics to address clinical problems

Ateş,

Röhrle

2024

GAMM-Mitteilungen

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This article aims to present some novel experimental approaches and computational methods providing detailed insights into the mechanical behavior of skeletal muscles relevant to clinical problems associated with managing and treating musculoskeletal diseases. The mechanical characterization of skeletal muscles in vivo is crucial for better understanding of, prevention of, or intervention in movement alterations due to exercise, aging, or pathologies related to neuromuscular diseases. To achieve this, we suggest an intraoperative experimental method including direct measurements of human muscle forces supported by computational methodologies. A set of intraoperative experiments indicated the major role of extracellular matrix (ECM) in spastic cerebral palsy. The force data linked to joint function are invaluable and irreplaceable for evaluating individual muscles however, they are not feasible in many situations. Three‐dimensional, continuum‐mechanical models provide a way to predict the exerted muscle forces. To obtain, however, realistic predictions, it is important to investigate the muscle not by itself, but embedded within the respective musculoskeletal system, for example, a 6‐muscle upper arm model, and the ability to obtain non‐invasively, or at least, minimally invasively material parameters for continuum‐mechanical skeletal muscle models, for example, by presently proposed homogenization methodologies. Botulinum toxin administration as a treatment option for spasticity is exemplified by combining experiments with modeling to find out the mechanical outcomes of altered ECM and the controversial effects of the toxin. The potentials and limitations of both experimental and modeling approaches and how they need each other are discussed.

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Detecting age-related changes in skeletal muscle mechanics using ultrasound shear wave elastography

Ateş,

Marquetand,

Zimmer

2023

Sci Rep

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Aging leads to a decline in muscle mass and force-generating capacity. Ultrasound shear wave elastography (SWE) is a non-invasive method to capture age-related muscular adaptation. This study assessed biceps brachii muscle (BB) mechanics, hypothesizing that shear elastic modulus reflects (i) passive muscle force increase imposed by length change, (ii) activation-dependent mechanical changes, and (iii) differences between older and younger individuals. Fourteen healthy volunteers aged 60–80 participated. Shear elastic modulus, surface electromyography, and elbow torque were measured at five elbow positions in passive and active states. Data collected from young adults aged 20–40 were compared. The BB passive shear elastic modulus increased from flexion to extension, with the older group exhibiting up to 52.58% higher values. Maximum elbow flexion torque decreased in extended positions, with the older group 23.67% weaker. Significant effects of elbow angle, activity level, and age on total and active shear elastic modulus were found during submaximal contractions. The older group had 20.25% lower active shear elastic modulus at 25% maximum voluntary contraction. SWE effectively quantified passive and activation-dependent BB mechanics, detecting age-related alterations at rest and during low-level activities. These findings suggest shear elastic modulus as a promising biomarker for identifying altered muscle mechanics in aging.

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Quantifying the effects of achilles tendon lengthening surgery: An intraoperative approach

Cited by 3 publications

References 55 publications

How mechanics of individual muscle-tendon units define knee and ankle joint function in health and cerebral palsy—a narrative review

How mechanics of individual muscle-tendon units define knee and ankle joint function in health and cerebral palsy—a narrative review

Experiments meet simulations: Understanding skeletal muscle mechanics to address clinical problems

Detecting age-related changes in skeletal muscle mechanics using ultrasound shear wave elastography

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