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Bouysset, M., T. Tavernier, E. Decullier, C. Confavreux, J. G. Tebib, and F. Coury. "Posterior Tibial Tendon and Spring Ligament Lesions in Rheumatoid Arthritis." Médecine et Chirurgie du Pied 35, no. 4 (2019): 65–69. http://dx.doi.org/10.3166/mcp-2020-0039.
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In rheumatoid arthritis, a significant number of patients have hindfoot pain while they are considered in low disease activity. Then the rheumatoid hindfoot may evolve in valgus flat foot with disability. The aim of our study was to observe the lesions of the main stabilizers of the hindfoot in rheumatoid arthritis to improve the followup and the treatment of the disease. Thirty-three feet (from 21 patients) with rheumatoid arthritis and pain of the hindfoot were consecutively observed. The patients have had no biologic treatment. Every foot had Magnetic Resonance Imaging (MRI) of the hindfoot with gadolinium injection. The tendon of the tibialis posterior muscle, the spring ligament and the inter-osseous talocalcaneal ligament were considered. All the feet presented tenosynovitis of the posterior tibial tendon. Structural lesions of the posterior tibial tendon (23/33 feet, 69.7%) were more frequent than lesions of the spring ligament (12/33 feet, 36.4%). There was no inferior spring ligament lesion without superior spring ligament lesion. No interosseous talocalcaneal ligament lesion was observed. In rheumatoid arthritis, the hindfoot, and particularly the posterior tibial tendon, should be evaluated during patient follow-up to detect a possible lesion. Posterior tibial tendon lesion arises at the same time as the spring ligament lesion, before interosseous talocalcaneal ligament lesion. Imaging, especially MRI, may complete clinical examination. If rheumatoid involvement of the posterior tibial tendon is observed, treatment intensification is required.
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Pasapula, Chandra, Nicolas Yanguma, Brayan David Solorzano, Tamas Kobezda, Christian Cifuentes-De la Portilla, and Md Abdul Aziz. "Biomechanical Evaluation of the Flexor Digitorum Longus and Flexor Hallucis Longus Transfer Used for the Treatment of Adult Acquired Flatfoot Deformity: A Finite Element Study." Biomechanics 5, no. 1 (2025): 9. https://doi.org/10.3390/biomechanics5010009.
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Introduction: Management strategies for stage II tibialis posterior tendon dysfunction are centered on tendon transfers and osteotomies. One of the most commonly used tendon transfers is flexor digitorum longus (FDL) tendon to navicular, but its superiority over transfers to other locations or transfers of other tendons, along with the role of spring ligament and tibialis posterior tendons, have not been objectively evaluated. Aims: We aimed to quantify both the location and magnitude of secondary stresses that develop as a consequence of the initial pathology. Methods: In this study, we used a computational model to study flat foot development and evaluate the effects of various tendon transfers and failures of passive structural elements, as well as their effect on the biomechanics of the foot. Results: We found that both FDL and FHL transfers have biomechanical advantages and disadvantages. Neither of these transfers decrease the stress on the tibialis posterior tendon if the underlying pathologies such as spring ligament failure are not addressed. Conclusions: Of the tendon transfers evaluated, FDL transfer to the navicular had the most profound effect on reducing the stresses on the spring ligament.
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MIYASHITA, Kazuhiro, Yoichi MASUDA, Megu GUNJI, Akira FUKUHARA, Kenjiro TADAKUMA, and Masato ISHIKAWA. "Development of Series Spring Tendon Module Imitating Tendon Properties of Horses." Proceedings of JSME annual Conference on Robotics and Mechatronics (Robomec) 2021 (2021): 2P1—I05. http://dx.doi.org/10.1299/jsmermd.2021.2p1-i05.
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Alexander, R. McN. "Tendon elasticity and positional control." Behavioral and Brain Sciences 18, no. 4 (1995): 745. http://dx.doi.org/10.1017/s0140525x00040711.
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AbstractThe spring-like behaviour of a joint following a sudden change of torque is partly a result of the elastic properties of tendons. A large fall in a muscle with a long tendon may be accompanied by tendon recoil causing joint movements as large as 20°.
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Sy Hung, Nguyen, Phan Doan Anh Tuan, Nguyen Ngoc Phuong, and Nguyen Truong Thinh. "Flower Robot – A Product of Biomimetic Technology." Key Engineering Materials 467-469 (February 2011): 2149–54. http://dx.doi.org/10.4028/www.scientific.net/kem.467-469.2149.
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In this paper, we propose a new prototype model of a robotic flower with active guide tendon wires which has two bending degrees of freedom. The design and fabrication methods of this flower robot are described. We also modeled this robotic flower for characteristic evaluation. Experimental results show that the model of the flower robot is reasonable for practical applications. The flower robot is a multi-degree-of-freedom (DOF) device which was developed using a tendon-driven system. Two DOF motion for the robotic stem was realized by the tendon mechanism combining flexible spring, and 1-DOF motion of flower was created by a servo motor. Each leaf uses a spring and a tendon-driven string. The proposal structure consists of flower, stem and leaves operating like a flower robot. The experimental results indicate that the proposed flower robot with active guide wire is applicable to reality. Furthermore, it is integrated with sensors to perform its functions like a flower.
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Ariyanto, Mochammad, Rifky Ismail, Joga D. Setiawan, and Elga P. Yuandi. "Anthropomorphic transradial myoelectric hand using tendon-spring mechanism." TELKOMNIKA (Telecommunication Computing Electronics and Control) 17, no. 1 (2019): 537. http://dx.doi.org/10.12928/telkomnika.v17i1.11600.
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Williams, Benjamin Roller, Scott Jacob Ellis, and Jonathan Thorndike Deland. "Spring ligament reconstruction in posterior tibial tendon insufficiency." Current Orthopaedic Practice 21, no. 3 (2010): 268–72. http://dx.doi.org/10.1097/bco.0b013e3181d8a181.
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Tang, Yuk-Ming, and Kin-Chuen Hui. "Simulating tendon motion with axial mass–spring system." Computers & Graphics 33, no. 2 (2009): 162–72. http://dx.doi.org/10.1016/j.cag.2009.01.002.
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Robinson, Samuel P., Christopher W. Hodgkins, Peter Sculco, and John G. Kennedy. "Spring Ligament Reconstruction for Posterior Tibial Tendon Insufficiency." Techniques in Foot & Ankle Surgery 5, no. 3 (2006): 198–203. http://dx.doi.org/10.1097/01.btf.0000219307.06253.2e.
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Mochammad, Ariyanto, Ismail Rifky, D. Setiawan Joga, and P. Yuandi Elga. "Anthropomorphic transradial myoelectric hand using tendon-spring mechanism." TELKOMNIKA Telecommunication, Computing, Electronics and Control 17, no. 1 (2019): 537–48. https://doi.org/10.12928/TELKOMNIKA.v17i1.11600.
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In the developing countries, the need for prosthetic hands is increasing. In general, transradial amputee patients use prosthetic hands that are passive like a body-powered prosthesis. This research proposes a low-cost myoelectric prosthetic hand based on 3D printing technology. Hand and finger size were designed based on the average size of human hands in Indonesia. The proposed myoelectric hand employs linear actuator combined with the tendon-spring mechanism. Myoelectric hand was developed with five modes of grip pattern to perform various objects grasping in activity of daily living. Control strategy had been developed for controlling the motion of flexion and extension on the hand and saving the energy consumed by the actuators. The control strategy was developed under MATLAB/Simulink environment and embedded to Arduino Nano V3 using Simulink Support Package for Arduino Hardware. Surface electromyography (EMG) sensor was used in this research for reading the muscle activity of the user/wearer. The proposed myoelectric hand had been tested in object grasping test and was implemented on a study participant with transradial amputee.
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Konow, Nicolai, Jorn A. Cheney, Thomas J. Roberts, J. Rhea S. Waldman, and Sharon M. Swartz. "Spring or string: does tendon elastic action influence wing muscle mechanics in bat flight?" Proceedings of the Royal Society B: Biological Sciences 282, no. 1816 (2015): 20151832. http://dx.doi.org/10.1098/rspb.2015.1832.
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Tendon springs influence locomotor movements in many terrestrial animals, but their roles in locomotion through fluids as well as in small-bodied mammals are less clear. We measured muscle, tendon and joint mechanics in an elbow extensor of a small fruit bat during ascending flight. At the end of downstroke, the tendon was stretched by elbow flexion as the wing was folded. At the end of upstroke, elastic energy was recovered via tendon recoil and extended the elbow, contributing to unfurling the wing for downstroke. Compared with a hypothetical ‘string-like’ system lacking series elastic compliance, the tendon spring conferred a 22.5% decrease in muscle fascicle strain magnitude. Our findings demonstrate tendon elastic action in a small flying mammal and expand our understanding of the occurrence and action of series elastic actuator mechanisms in fluid-based locomotion.
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Konow, Nicolai, Jorn A. Cheney, Thomas J. Roberts, J. Rhea S. Waldman, and Sharon M. Swartz. "Spring or string: does tendon elastic action influence wing muscle mechanics in bat flight?" Proceedings of the Royal Society B: Biological Sciences 282, no. 1816 (2015): 20151832. https://doi.org/10.5281/zenodo.13447505.
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(Uploaded by Plazi for the Bat Literature Project) Tendon springs influence locomotor movements in many terrestrial animals, but their roles in locomotion through fluids as well as in small-bodied mammals are less clear. We measured muscle, tendon and joint mechanics in an elbow extensor of a small fruit bat during ascending flight. At the end of downstroke, the tendon was stretched by elbow flexion as the wing was folded. At the end of upstroke, elastic energy was recovered via tendon recoil and extended the elbow, contributing to unfurling the wing for downstroke. Compared with a hypothetical 'string-like' system lacking series elastic compliance, the tendon spring conferred a 22.5% decrease in muscle fascicle strain magnitude. Our findings demonstrate tendon elastic action in a small flying mammal and expand our understanding of the occurrence and action of series elastic actuator mechanisms in fluid-based locomotion.
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Konow, Nicolai, Jorn A. Cheney, Thomas J. Roberts, J. Rhea S. Waldman, and Sharon M. Swartz. "Spring or string: does tendon elastic action influence wing muscle mechanics in bat flight?" Proceedings of the Royal Society B: Biological Sciences 282, no. 1816 (2015): 20151832. https://doi.org/10.5281/zenodo.13447505.
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(Uploaded by Plazi for the Bat Literature Project) Tendon springs influence locomotor movements in many terrestrial animals, but their roles in locomotion through fluids as well as in small-bodied mammals are less clear. We measured muscle, tendon and joint mechanics in an elbow extensor of a small fruit bat during ascending flight. At the end of downstroke, the tendon was stretched by elbow flexion as the wing was folded. At the end of upstroke, elastic energy was recovered via tendon recoil and extended the elbow, contributing to unfurling the wing for downstroke. Compared with a hypothetical 'string-like' system lacking series elastic compliance, the tendon spring conferred a 22.5% decrease in muscle fascicle strain magnitude. Our findings demonstrate tendon elastic action in a small flying mammal and expand our understanding of the occurrence and action of series elastic actuator mechanisms in fluid-based locomotion.
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Choi, Kyungjin, Samuel Lee, James C. Otis, and Jonathan T. Deland. "Anatomical Reconstruction of the Spring Ligament Using Peroneus Longus Tendon Graft." Foot & Ankle International 24, no. 5 (2003): 430–36. http://dx.doi.org/10.1177/107110070302400510.
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Posterior tibial tendon insufficiency is often associated with failure of the spring ligament and flatfoot deformity. Arch correction procedures involving bony realignment, such as lateral column lengthening or joint fusions, can predispose to arthritis. Soft tissue reconstruction may provide a more anatomical correction without these complications. The purpose of this investigation was to compare the ability of three different spring ligament reconstruction procedures to correct flatfoot deformity. A deformity model of 5°–15° talonavicular abduction was created in 10 cadaver foot-ankle specimens. Three reconstructions utilizing the peroneus longus tendon were evaluated for their ability to correct talonavicular abduction and subtalar eversion under 357 N vertical GRF load. A superomedial/plantar passage of the tendon through the calcaneus and navicular was shown to be more effective than either of the other two approaches, correcting the talonavicular joint from 9.1° ± 8.1° abducted to 1.0° ± 6.8° adducted, and the subtalar joint from 3.1° ± 3.3° everted to 0.4° ± 4.2° inverted. Thus, an anatomical reconstruction of a model of a failed spring ligament was demonstrated to be effective in the correction of a flatfoot deformity produced in cadaver foot–ankle specimens.
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Hollander, Kevin W., Robert Ilg, Thomas G. Sugar, and Donald Herring. "An Efficient Robotic Tendon for Gait Assistance." Journal of Biomechanical Engineering 128, no. 5 (2006): 788–91. http://dx.doi.org/10.1115/1.2264391.
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A robotic tendon is a spring based, linear actuator in which the stiffness of the spring is crucial for its successful use in a lightweight, energy efficient, powered ankle orthosis. Like its human analog, the robotic tendon uses its inherent elastic nature to reduce both peak power and energy requirements for its motor. In the ideal example, peak power required of the motor for ankle gait is reduced from 250 W to just 77 W. In addition, ideal energy requirements are reduced from nearly 36 J to just 21 J. Using this approach, an initial prototype has provided 100% of the power and energy necessary for ankle gait in a compact 0.95kg package, seven times less than an equivalent motor/gearbox system.
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Rosario, M. V., G. P. Sutton, S. N. Patek, and G. S. Sawicki. "Muscle–spring dynamics in time-limited, elastic movements." Proceedings of the Royal Society B: Biological Sciences 283, no. 1838 (2016): 20161561. http://dx.doi.org/10.1098/rspb.2016.1561.
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Muscle contractions that load in-series springs with slow speed over a long duration do maximal work and store the most elastic energy. However, time constraints, such as those experienced during escape and predation behaviours, may prevent animals from achieving maximal force capacity from their muscles during spring-loading. Here, we ask whether animals that have limited time for elastic energy storage operate with springs that are tuned to submaximal force production. To answer this question, we used a dynamic model of a muscle–spring system undergoing a fixed-end contraction, with parameters from a time-limited spring-loader (bullfrog: Lithobates catesbeiana ) and a non-time-limited spring-loader (grasshopper: Schistocerca gregaria ). We found that when muscles have less time to contract, stored elastic energy is maximized with lower spring stiffness (quantified as spring constant). The spring stiffness measured in bullfrog tendons permitted less elastic energy storage than was predicted by a modelled, maximal muscle contraction. However, when muscle contractions were modelled using biologically relevant loading times for bullfrog jumps (50 ms), tendon stiffness actually maximized elastic energy storage. In contrast, grasshoppers, which are not time limited, exhibited spring stiffness that maximized elastic energy storage when modelled with a maximal muscle contraction. These findings demonstrate the significance of evolutionary variation in tendon and apodeme properties to realistic jumping contexts as well as the importance of considering the effect of muscle dynamics and behavioural constraints on energy storage in muscle–spring systems.
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Aerts, Peter, Kristiaan D'Août, Susannah Thorpe, Gilles Berillon, and Evie Vereecke. "The gibbon's Achilles tendon revisited: consequences for the evolution of the great apes?" Proceedings of the Royal Society B: Biological Sciences 285, no. 1880 (2018): 20180859. http://dx.doi.org/10.1098/rspb.2018.0859.
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The well-developed Achilles tendon in humans is generally interpreted as an adaptation for mechanical energy storage and reuse during cyclic locomotion. All other extant great apes have a short tendon and long-fibred triceps surae, which is thought to be beneficial for locomotion in a complex arboreal habitat as this morphology enables a large range of motion. Surprisingly, highly arboreal gibbons show a more human-like triceps surae with a long Achilles tendon. Evidence for a spring-like function similar to humans is not conclusive. We revisit and integrate our anatomical and biomechanical data to calculate the energy that can be recovered from the recoiling Achilles tendon during ankle plantar flexion in bipedal gibbons. Only 7.5% of the required external positive work in a stride can come from tendon recoil, yet it is delivered at an instant when the whole-body energy level drops. Consequently, an additional similar amount of mechanical energy must simultaneously dissipate elsewhere in the system. Altogether, this challenges the concept of an energy-saving function in the gibbon's Achilles tendon. Cercopithecids, sister group of the apes, also have a human-like triceps surae. Therefore, a well-developed Achilles tendon, present in the last common ‘Cercopithecoidea–Hominoidea’ ancestor, seems plausible. If so, the gibbon's anatomy represents an evolutionary relict (no harm–no benefit), and the large Achilles tendon is not the premised key adaptation in humans (although the spring-like function may have further improved during evolution). Moreover, the triceps surae anatomy of extant non-human great apes must be a convergence, related to muscle control and range of motion. This perspective accords with the suggestions put forward in the literature that the last common hominoid ancestor was not necessarily great ape-like, but might have been more similar to the small-bodied catarrhines.
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Stuart, Hannah, Shiquan Wang, Oussama Khatib, and Mark R. Cutkosky. "The Ocean One hands: An adaptive design for robust marine manipulation." International Journal of Robotics Research 36, no. 2 (2017): 150–66. http://dx.doi.org/10.1177/0278364917694723.
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Underactuated, compliant, tendon-driven robotic hands are suited for deep-sea exploration. The robust Ocean One hand design utilizes elastic finger joints and a spring transmission to achieve a variety of pinch and wrap grasps. Compliance in the fingers and transmission determines the degree of load-sharing among contacts and the hands’ ability to secure irregularly shaped objects. However, it can also decrease external grasp stiffness and acquisition reliability. SimGrasp, a flexible dynamic hand simulator, enables parametric studies of the hand for acquisition and pull-out tests with varying transmission spring rates. In the present application, we take advantage of achieving different stiffnesses by reversing the direction of tendon windup using a torsional spring-loaded winch. With this provision, the hand can be relatively soft for handling delicate objects and stiff for tasks requiring strength. Two hands were field-tested as part of the Ocean One humanoid platform, which acquired a vase from the La Lune shipwreck site at a 91 m depth in the Mediterranean Sea.
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Nery, Caio, André Vitor Kerber C. Lemos, Fernando Raduan, Nacime Salomão B. Mansur, and Daniel Baumfeld. "Combined Spring and Deltoid Ligament Repair in Adult-Acquired Flatfoot." Foot & Ankle International 39, no. 8 (2018): 903–7. http://dx.doi.org/10.1177/1071100718770132.
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Background: Adult-acquired flatfoot deformity (AAFD) is usually due to a combination of mechanical failure of the osteoligamentous complex that maintains the medial longitudinal arch of the foot and attenuation or complete tear of the posterior tibial tendon. Magnetic resonance imaging studies in patients with flatfoot deformities have reported the posterior tibial tendon to be pathologic in up to 100% of patients, the spring ligament in up to 87%, and the deltoid ligament in 33%. Many studies in the literature describe reconstruction of the spring ligament or the deltoid ligament associated with AAFD, but there is no study in which both (spring and deltoid) ligaments are reconstructed at the same time. We describe a novel technique to reconstruct the deltoid ligament and the spring ligament at the same time. Methods: We described the technique and evaluated 10 consecutive patients with AAFD and insufficient ankle and midfoot ligaments. Results: We found no postoperative complications, stiffness, or loss of correction. Conclusion: We present a novel technique to reconstruct the failed deltoid and spring ligament during flatfoot correction. It is unique in that it uses internal brace augmentation with FiberTape® to help and protect the soft tissue healing. Level of Evidence: Level IV, retrospective case series.
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MacDonald, Ashlee, David Ciufo, Emma Knapp, et al. "Tibiocalcaneonavicular Ligament Reconstruction in Simulated Flatfoot Deformity with Medial Ligament Insufficiency." Foot & Ankle Orthopaedics 3, no. 3 (2018): 2473011418S0032. http://dx.doi.org/10.1177/2473011418s00327.
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Category: Hindfoot Introduction/Purpose: Spring ligament tear is often present in advanced stages of the AAFD. Anatomic studies have demonstrated that the superficial deltoid ligament blends with the superomedial spring ligament to provide medial tibiotalar and talonavicular stability. Reconstruction of combined deltoid-spring ligament, or the Tibiocalcaneonvaicular ligament (TCNL) was proposed to augment medial stability in advanced AAFD with large spring ligament tears. A tendon allograft is placed to cross three peritalar (tibiotalar, talonavicular and subtalar) joints to augment medial stability. We aimed to 1) investigate the kinematic effects of TCNL reconstruction in cadaveric flatfoot model with medial ligament insufficiency, and 2) compare TCNL reconstruction with anatomic spring and anatomic deltoid ligament reconstructions (Figure 1). We hypothesized that TCNL reconstruction is effective in restoring peritalar kinematics. Methods: Five fresh-frozen cadaveric foot specimens were employed. Advanced stage flatfoot model was created by sectioning the medial and inferior talonavicular interosseous ligament and extending the release 2 cm proximally along the superomedial spring ligament. Cyclic axial load of 1150 N under a hydraulic loading frame with constant 350 N Achilles tendon load were applied until >15° talo-first metatarsal abduction was achieved. Bone tunnels were drilled for three reconstruction types, and the peroneus longus tendon was configured to reconstruct the 1) anatomic spring ligament, 2) anatomic deltoid ligament, and 3) TCNL. Reflective markers were mounted on the tibia, talus, navicula, calcaneus and first metatarsus. Each reconstruction type was loaded with 800 N ground reaction force, and kinematics of the peritalar joints were captured by 4-camera motion capture system. Forefoot abduction angle, Meary’s angle, and hindfoot valgus were calculated and compared to the severe flatfoot prior to reconstruction and to each using two-way ANOVA. Results: In creating the flatfoot deformity, both the tibiotalar and subtalar joints demonstrated an increase in valgus deformity by 5.6+3.7° and 6.1+5.3°, respectively, compared to the initial measurements. When comparing to the flatfoot deformity, the TCNL reconstruction achieved a significant improvement in percent correction of total hindfoot valgus (59.7+21.1%, p=0.017) and forefoot abduction angle (83.4+17.7%, p<0.01). The spring ligament reconstruction also demonstrated a significant improvement in forefoot abduction correction compared to the flatfoot (52+10.6%, p<0.05). No other reconstruction technique achieved a statistically significant improvement in percent correction compared to the flatfoot model in forefoot or hindfoot alignments. Additionally, no statistical differences were noted in the percent correction when comparing the three reconstructive techniques to each other. Conclusion: In advanced stage cadaveric flatfoot with spring ligament tear, we found increased valgus alignment at both the tibiotalar and subtalar joints. This kinematic changes reflects increased strain across the medial peritalar ligaments. The deltoid-spring ligament complex (TCNL) reconstruction demonstrated significantly improved alignment of hindfoot valgus and forefoot abduction compared to the severe flatfoot condition. This finding suggests that in addition to osseous correction and tendon transfer, the TCNL reconstruction may serve as an important component in augmenting medial stability in advanced AAFD with medial ligament insufficiency.
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Caldwell, Jon-Michael, Harry Lightsey, Hasani Swindell, Justin Greisberg, and J. Turner Vosseller. "Seasonal Variation of Achilles Tendon Injury." Foot & Ankle Orthopaedics 3, no. 3 (2018): 2473011418S0017. http://dx.doi.org/10.1177/2473011418s00179.
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Category: Sports Introduction/Purpose: Achilles tendon ruptures are increasingly common injuries. There are several known risk factors for Achilles tendon rupture, although little is reported on the seasonal variation of the incidence of these injuries. Of the few studies in the literature touching on this question, the results have been varied. We sought to determine if there is any seasonal pattern of Achilles tendon ruptures. Knowledge of such a seasonal pattern could be advantageous for patient education, risk assessment, and ultimately prevention of these injuries. Methods: We queried billing records for CPT codes 27650, 27652, and 27654 as well as ICD diagnosis codes 727.67, 845.09, and S86.01x pertaining to Achilles tendon injury, repair, and reconstruction. Charts were screened and included if the patient suffered an acute Achilles tendon rupture on a known date. Charts were excluded if the patient had a chronic Achilles tear or underwent reconstruction or debridement for tendonitis, Haglunds deformity, tendon laceration, or any other indication aside from acute rupture. Data was analyzed using a chi-squared test for categorical variables, binomial tests for dichotomous variables and Mann-Whitney-U or Welch t-test for continuous variables. Significance was set at p < 0.05. Results: Our search yielded 499 cases with 245 meeting inclusion criteria. Sixty-six percent (66%) of injuries were identified as sports-related while 34% were non-sports related. When stratified by month, significant peaks occurred in April and July (p = .036, .011 respectively) with significantly fewer injuries occurring in October through December (p = 0.049). The highest rate of injury was seen in Spring (p = .015) and the lowest was seen in Fall (p < .001). There was no significant difference between seasons when only the non-sports related injuries were considered. Basketball was the most common sport involved (n=78) accounting for 51% of injuries (p < .001), followed by soccer and tennis. There was no significant variation between seasons in any particular sport. Conclusion: There was significant seasonal variation in the incidence of Achilles tendon ruptures. Both sports and non-sports-related injuries followed a similar pattern, with most injuries occurring during the Spring and Summer and fewer during Fall and Winter. This increase corresponds to the increase in activity in the recreational athlete population in the region which is often preceded by a time of relative inactivity. Our study confirms that the deconditioned athlete is at particularly elevated risk for Achilles tendon rupture during the Spring season when abrupt increases in sporting activity are common. Targeted education and prevention efforts could help mitigate this risk.
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Yanguma-Muñoz, Nicolás, Brayan David Solorzano Quevedo, Chandra Pasapula, et al. "The Effects of Midfoot/Hindfoot Fusions on the Behaviour of Peroneus Longus Tendon in Adult-Acquired Flatfoot Deformity: A Biomechanical and Finite Element Analysis." Biomechanics 4, no. 3 (2024): 494–506. http://dx.doi.org/10.3390/biomechanics4030035.
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Adult-acquired flatfoot has been considered to arise from tibialis posterior tendon deficiency. Recent evidence shows that arch stability is mainly maintained by structures such as plantar fascia and spring ligament. The dysfunction of these ’passive’ stabilizers results in loss of arch integrity that causes forefoot pronation and reactive tendon overload, especially in the tibialis posterior tendon and peroneus longus tendon. The peroneus longus tendon (PLT) spans several midfoot joints and overloads with arch lengthening. The biomechanical stress/changes that occurs in this tendon are not well recognized. This study evaluates the biomechanical consequences that fusions have on peroneus longus tendon stresses in soft-tissue deficiencies associated with flatfoot deformity. A complete computational human foot model was used to simulate different scenarios related to the flatfoot deformity and associated common midfoot/hindfoot fusions, to quantify the biomechanical changes in the peroneus longus tendon. The results showed that the stress of the peroneus longus tendon is especially affected by the fusion of hindfoot joints and depends on the soft tissue types that fail, causal in generating the flatfoot. These results could be useful to surgeons when evaluating the causes of flatfoot and the secondary effects of surgical treatments on tissues such as the peroneus longus tendon.
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Robertson, Benjamin D., and Gregory S. Sawicki. "Unconstrained muscle-tendon workloops indicate resonance tuning as a mechanism for elastic limb behavior during terrestrial locomotion." Proceedings of the National Academy of Sciences 112, no. 43 (2015): E5891—E5898. http://dx.doi.org/10.1073/pnas.1500702112.
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In terrestrial locomotion, there is a missing link between observed spring-like limb mechanics and the physiological systems driving their emergence. Previous modeling and experimental studies of bouncing gait (e.g., walking, running, hopping) identified muscle-tendon interactions that cycle large amounts of energy in series tendon as a source of elastic limb behavior. The neural, biomechanical, and environmental origins of these tuned mechanics, however, have remained elusive. To examine the dynamic interplay between these factors, we developed an experimental platform comprised of a feedback-controlled servo-motor coupled to a biological muscle-tendon. Our novel motor controller mimicked in vivo inertial/gravitational loading experienced by muscles during terrestrial locomotion, and rhythmic patterns of muscle activation were applied via stimulation of intact nerve. This approach was based on classical workloop studies, but avoided predetermined patterns of muscle strain and activation—constraints not imposed during real-world locomotion. Our unconstrained approach to position control allowed observation of emergent muscle-tendon mechanics resulting from dynamic interaction of neural control, active muscle, and system material/inertial properties. This study demonstrated that, despite the complex nonlinear nature of musculotendon systems, cyclic muscle contractions at the passive natural frequency of the underlying biomechanical system yielded maximal forces and fractions of mechanical work recovered from previously stored elastic energy in series-compliant tissues. By matching movement frequency to the natural frequency of the passive biomechanical system (i.e., resonance tuning), muscle-tendon interactions resulting in spring-like behavior emerged naturally, without closed-loop neural control. This conceptual framework may explain the basis for elastic limb behavior during terrestrial locomotion.
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Bernasconi, Alessio, Francesco Sadile, Matthew Welck, Nazim Mehdi, Julien Laborde, and François Lintz. "Role of Tendoscopy in Treating Stage II Posterior Tibial Tendon Dysfunction." Foot & Ankle International 39, no. 4 (2018): 433–42. http://dx.doi.org/10.1177/1071100717746192.
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Background: Stage II tibialis posterior tendon dysfunction (PTTD) resistant to conservative therapies is usually treated with invasive surgery. Posterior tibial tendoscopy is a novel technique being used in the assessment and treatment of posterior tibial pathology. The aims of this study were (1) to clarify the role of posterior tibial tendon tendoscopy in treating stage II PTTD, (2) to arthroscopically classify spring ligament lesions, and (3) to compare the arthroscopic assessment of spring ligament lesions with magnetic resonance imaging (MRI) and ultrasonographic (US) data. Methods: We reviewed prospectively collected data on 16 patients affected by stage II PTTD and treated by tendoscopy. We report the reoperation rate and functional outcomes evaluated by comparing pre- and postoperative visual analogic scale for pain (VAS-pain) and the Short-Form Health Survey (SF-36; with its physical [PCS] and mental [MCS] components). Postoperative satisfaction was assessed using a VAS-satisfaction scale. One patient was lost to follow-up. Spring ligament lesions were arthroscopically classified in 3 stages. Discrepancies between preoperative imaging and intraoperative findings were evaluated. Results: At a mean of 25.6 months’ follow-up, VAS-pain ( P < .001), SF-36 PCS ( P = .039), and SF-36 MCS ( P < .001) significantly improved. The mean VAS-satisfaction score was 75.3/100. Patients were relieved from symptoms in 80% of cases, while 3 patients required further surgery. MRI and US were in agreement with intraoperative data in 92% and 67%, respectively, for the tendon assessment and in 78% and 42%, respectively, for the spring ligament. Conclusions: Tendoscopy may be considered a valid therapeutic tool in the treatment of stage II PTTD resistant to conservative treatment. It provided objective and subjective encouraging results that could allow continued conservative therapy while avoiding more invasive surgery in most cases. MRI and US were proven more useful in detecting PT lesions than spring ligament tears. Further studies on PT could use this tendoscopic classification to standardize its description. Level of Evidence: Level IV, therapeutic study, case series.
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Lee, Woo-Chun, and Young Yi. "Spring Ligament Reconstruction Using the Autogenous Flexor Hallucis Longus Tendon." Orthopedics 37, no. 7 (2014): 467–71. http://dx.doi.org/10.3928/01477447-20140626-04.
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Chen, Shangzhi, Fangxin Jiang, Yue Sun, and Wutong Yan. "Modeling Schemes and Performance Comparisons of Unbonded and Partially Bonded Tendon in Post-Tensioned Concrete Beam." Buildings 14, no. 6 (2024): 1682. http://dx.doi.org/10.3390/buildings14061682.
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The modeling method of unbonded effects is a challenging and hot topic for the structural performance analysis of unbonded and partially bonded post-tensioned concrete beams. The main concerns accounting for the unbonded effects are the longitudinal free-slip behaviors and the vertical deformation compatibility relationship between the unbonded tendon and concrete beam. Three modeling schemes, namely, the beam–truss element model, the slipping cable element model, and the slack spring model, are presented in this paper. These modeling schemes are, for the first time, systematically compared regarding applicability, convenience, and accuracy. Then, these modeling schemes are applied to experimental beams with different tendon layouts and bonding conditions, including external tendons, internal unbonded tendons, and partially bonded tendons. The beam–truss element model and the slipping cable element model are only applicable to the fully bonded and unbonded members, respectively. The slack spring model is recommended as the generally applicable model for analyzing post-tensioned concrete beams with different bonding conditions. Crucial suggestions are put forward as to the zero-length slack spring element, which have the potential to improve the prediction accuracy for tendon stress. In addition, parametrical analysis is conducted to determine the influence of unbonded length on flexural performance. With the increase of unbonded length, the flexural capacity of the beam will decrease, but the self-centering performance can be improved. Interestingly, the effects of unbonded length on the structural deformability are not monotonic, and the reasons for this are clarified.
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Mason, Lyndon, Eric Swanton, Lauren Fisher, Andrew Fisher, and Andrew Molloy. "The Plantar Support of the Navicular-Cunieform Joint." Foot & Ankle Orthopaedics 3, no. 3 (2018): 2473011418S0033. http://dx.doi.org/10.1177/2473011418s00338.
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Category: Midfoot/Forefoot Introduction/Purpose: Weight-bearing radiographic analysis of pes planus deformities shows, with varying degree of severity, a break in Meary’s line, uncovering of the talar head and an increase in talar-first metatarsal angle. Work by Alsousou (BOFAS 2016) has shown the break in Meary’s line to occur not only at the talonavicular joint (2/3rds of cases) but also at the navicular-cuneiform joint (1/3 rd of cases), distal to the spring ligament and reported posterior tibial tendon insertion. There are currently no anatomical studies analysing the medial longitudinal arch distal to the spring ligament insertion. We aimed to examine this area and assess the anatomy supporting the distal medial longitudinal arch. Methods: We examined 11 cadaveric lower limbs that had been preserved for dissection at the Human Anatomy and Resource Centre at Liverpool University, in a solution of formaldehyde. The lower limbs were carefully dissected to identify the plantar aspect of the medial longitudinal arch Results: In all specimens, the posterior tibial tendon inserted into the plantar medial aspect of the navicular with separate slips to the intermediate and lateral cuneiform. Following insertion, on the navicular, a tendon-like structure extended from this navicular insertion point to the medial cuneiform. This tendon-like structure is statically inserted between the navicular and medial cuneiform allowing the pull of tibialis posterior to act on the navicular and medial cuneiform in tandem. The average width of this ligament (15.2 mm) is much greater than that of the tibialis posterior tendon (9.5 mm). A separate smaller plantar ligament is also present between the navicular and medial cuneiform. Conclusion: The posterior tibialis tendon inserts into the navicular, and what is likely an anthropological remnant, extends onto the medial cuneiform as the navicular cuneiform ligament. This provides a static restraint between two bony insertions and increases the lever arm of the posterior tibial tendon. The major support of the distal aspect of the medial longitudinal arch (i.e. the navicular-cuneiform joint) is provided by the substantial navicular cuneiform ligament.
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Deland, Jonathan T., Stephen P. Arnoczky, and Francesca M. Thompson. "Adult Acquired Flatfoot Deformity at the Talonavicular Joint: Reconstruction of the Spring Ligament in an in Vitro Model." Foot & Ankle 13, no. 6 (1992): 327–32. http://dx.doi.org/10.1177/107110079201300606.
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The mobile unilateral flatfoot deformity of chronic posterior tibial tendon insufficiency has been difficult to correct by soft tissue procedures. The procedures can decrease pain, but they do not always correct the longitudinal arch or relieve all the symptoms. Using 10 fresh frozen cadaveric specimens and a rig for stimulation of weightbearing, the deformity associated with chronic posterior tibial tendon insufficiency was produced by multiple ligamentous release and documented by AP and lateral radiographs. Reconstruction of the spring ligament using a ligament bone autograft from the superficial deltoid ligament was then performed and tested under load. The mean correction was within 2.5° of normal (over or undercorrection) on both the AP and lateral radiographs with the specimens under load. Clinical Relevance. In posterior tibial tendon insufficiency, it may be possible to address the ligament as well as tendon insufficiency to gain a corrected arch. The success of such a procedure will depend upon adequate tendon and ligament reconstruction in a fully mobile deformity. Questions remain as to the adequacy of this ligament graft, and a stronger free ligament graft, as well as correction of any bony malalignment, may be required.
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Deland, Jonathan T., Richard J. de Asla, Il-Hoon Sung, Lauren A. Ernberg, and Hollis G. Potter. "Posterior Tibial Tendon Insufficiency: Which Ligaments are Involved?" Foot & Ankle International 26, no. 6 (2005): 427–35. http://dx.doi.org/10.1177/107110070502600601.
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Background: The pathology manifested in posterior tibial tendon insufficiency (PTTI) is not limited to the posterior tibial tendon. The association of ligament failure with deformity has been discussed in numerous publications, but extensive documentation of the structures involved has not been performed. The purpose of this observational study was to identify the pattern of ligament involvement using standarized, high-resolution magnetic resonance imaging (MRI) in a series of 31 consecutive patients diagnosed with PTTI compared to an age matched control group without PTTI. Method: The structures evaluated by MRI were the posterior tibial tendon, superomedial and inferomedial components of the spring ligament complex, talocalcaneal interosseous ligament, long and short plantar ligaments, plantar fascia, deltoid ligament, plantar naviculocuneiform ligament, and tarsometatarsal ligaments. Structural derangement was graded on a five-part scale (0 to IV) with level 0 being normal and level IV indicating a tear of more than 50% of the cross-sectional area of the ligament. Standard flatfoot measurements taken from preoperative plain standing radiographs were correlated with the MRI grading system. Results: Statistically significant differences in frequency of pathology in the PTTI group and controls were found for the superomedial calcaneonavicular ligament ( p < 0.0001), inferomedial calcaneonavicular ligament ( p < 0.0001), interosseous ligament ( p = 0.0009), anterior component of the superficial deltoid ( p < 0.0001), plantar metatarsal ligaments ( p = 0.0002) and plantar naviculocuneiform ligament ( p = 0.0006). The ligaments with the most severe involvement were the spring ligament complex (superomedial and inferomedial calcaneonavicular ligaments) and the talocalcaneal interosseous ligament. Conclusion: Ligament involvement is extensive in PTTI, and the spring ligament complex is the most frequently affected. Because ligament pathology in PTTI is nearly as common as posterior tibial tendinopathy, treatment should seek to protect or prevent progressive failure of these ligaments.
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Cracchiolo, Andrea. "EVALUATION OF SPRING LIGAMENT PATHOLOGY IN PATIENTS WITH POSTERIOR TIBIAL TENDON RUPTURE, TENDON TRANSFER, AND LIGAMENT REPAIR." Foot and Ankle Clinics 2, no. 2 (1997): 297–307. http://dx.doi.org/10.1016/s1083-7515(23)00235-8.
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Lee, David V., M. Polly McGuigan, Edwin H. Yoo, and Andrew A. Biewener. "Compliance, actuation, and work characteristics of the goat foreleg and hindleg during level, uphill, and downhill running." Journal of Applied Physiology 104, no. 1 (2008): 130–41. http://dx.doi.org/10.1152/japplphysiol.01090.2006.
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We model the action of muscle-tendon system(s) about a given joint as a serial actuator and spring. By this technique, the experimental joint moment is imposed while the combined angular deflection of the actuator and spring are constrained to match the experimental joint angle throughout the stance duration. The same technique is applied to the radial leg (i.e., shoulder/hip-to-foot). The spring constant that minimizes total actuator work is considered optimal, and this minimum work is expressed as a fraction of total joint/radial leg work, yielding an actuation ratio (AR; 1 = pure actuation and 0 = pure compliance). To address work modulation, we determined the specific net work (SNW), the absolute value of net divided by total work. This ratio is unity when only positive or negative work is done and zero when equal energy is absorbed and returned. Our proximodistal predictions of joint function are supported during level and 15° grade running. The greatest AR and SNW are found in the proximal leg joints (elbow and knee). The ankle joint is the principal spring of the hindleg and shows no significant change in SNW with grade, reflecting the true compliance of the common calcaneal tendon. The principal foreleg spring is the metacarpophalangeal joint. The observed pattern of proximal actuation and distal compliance, as well as the substantial SNW at proximal joints, minimal SNW at intermediate joints, and variable energy absorption at distal joints, may emerge as general principles in quadruped limb mechanics and help to inform the leg designs of highly capable running robots.
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HYODO, Kazuhito, and Hiroaki KOBAYASHI. "A Study on Tendon Controlled Wrist Mechanism with Nonlinear Spring Tensioner." Journal of the Robotics Society of Japan 11, no. 8 (1993): 1244–51. http://dx.doi.org/10.7210/jrsj.11.1244.
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Monte, Andrea, Paolo Tecchio, Francesca Nardello, and Paola Zamparo. "Achilles Tendon Mechanical Behavior and Ankle Joint Function at the Walk-to-Run Transition." Biology 11, no. 6 (2022): 912. http://dx.doi.org/10.3390/biology11060912.
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Walking at speeds higher than transition speed is associated with a decrease in the plantar-flexor muscle fibres’ ability to produce force and, potentially, to an impaired behaviour of the muscle–tendon unit (MTU) elastic components. This study aimed to investigate the ankle joint functional indexes and the Achilles tendon mechanical behaviour (changes in AT force and power) to better elucidate the mechanical determinants of the walk-to-run transition. Kinematics, kinetic and ultrasound data of the gastrocnemius medialis (GM) were investigated during overground walking and running at speeds ranging from 5–9 km·h−1. AT and GM MTU force and power were calculated during the propulsive phase; the ankle joint function indexes (damper, strut, spring and motor) were obtained using a combination of kinetic and kinematic data. AT force was larger in running at speeds > 6.5 km/h. The contribution of AT to the total power provided by the GM MTU was significantly larger in running at speeds > 7.5 km/h. The spring and strut indexes of the ankle were significantly larger in running at speeds > 7.5 km/h. These data suggest that the walk-to-run transition could (at least partially) be explained by the need to preserve AT mechanical behaviour and the ankle spring function.
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Farris, Dominic James, Benjamin D. Robertson, and Gregory S. Sawicki. "Elastic ankle exoskeletons reduce soleus muscle force but not work in human hopping." Journal of Applied Physiology 115, no. 5 (2013): 579–85. http://dx.doi.org/10.1152/japplphysiol.00253.2013.
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Inspired by elastic energy storage and return in tendons of human leg muscle-tendon units (MTU), exoskeletons often place a spring in parallel with an MTU to assist the MTU. However, this might perturb the normally efficient MTU mechanics and actually increase active muscle mechanical work. This study tested the effects of elastic parallel assistance on MTU mechanics. Participants hopped with and without spring-loaded ankle exoskeletons that assisted plantar flexion. An inverse dynamics analysis, combined with in vivo ultrasound imaging of soleus fascicles and surface electromyography, was used to determine muscle-tendon mechanics and activations. Whole body net metabolic power was obtained from indirect calorimetry. When hopping with spring-loaded exoskeletons, soleus activation was reduced (30–70%) and so was the magnitude of soleus force (peak force reduced by 30%) and the average rate of soleus force generation (by 50%). Although forces were lower, average positive fascicle power remained unchanged, owing to increased fascicle excursion (+4–5 mm). Net metabolic power was reduced with exoskeleton assistance (19%). These findings highlighted that parallel assistance to a muscle with appreciable series elasticity may have some negative consequences, and that the metabolic cost associated with generating force may be more pronounced than the cost of doing work for these muscles.
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Saarensilta, I. A., G. Edman, and P. W. Ackermann. "Achilles tendon ruptures during summer show the lowest incidence, but exhibit an increased risk of re-rupture." Knee Surgery, Sports Traumatology, Arthroscopy 28, no. 12 (2020): 3978–86. http://dx.doi.org/10.1007/s00167-020-05982-x.
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Abstract Purpose Achilles tendon rupture (ATR) is a common injury. The knowledge of seasonal factors´ impact is incomplete, but may provide means for preventive approaches for Achilles tendon related morbidity. The aim of this study was to investigate seasonal variations in ATR incidence in relation to injury mechanism, adverse events including risk of re-rupture, and patient-reported outcome in adults in Stockholm, Sweden. Methods In total, 349 patients with unilateral acute Achilles tendon rupture, prospectively treated with standardized surgical techniques, were retrospectively assessed. Date of injury was assigned to one of the four internationally defined meteorological seasons in the northern hemisphere. Injury mechanism and the rate of adverse events; deep venous thrombosis, infection and re-rupture in relation to per-operative complications. Patient-reported outcome at 1 year was assessed with the validated Achilles tendon Total Rupture Score. Results ATR incidence was significantly highest during winter and spring, and lowest during summer (p < 0.05). The most common sporting activities associated with ATR were badminton, floorball and soccer (> 50%). The rate of soccer-related ATR was highest during summer (p < 0.05). Patients sustaining an ATR during summer, compared to other seasons, exhibited more per-operative complications (p < 0.05), a significantly higher risk of re-rupture (p < 0.05) and a lower rate of good outcome (n.s.). The risk of other adverse events after ATR did not differ between the seasons. Conclusion Winter and spring are the high risk seasons for sports-related ATR and the risk sports are badminton, soccer and floorball. The reason for the higher risk of re-rupture after ATR repair during summer should be further investigated. Level of evidence III.
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Suchak, Amar A., Geoff Bostick, David Reid, Sandra Blitz, and Nadr Jomha. "The Incidence of Achilles Tendon Ruptures in Edmonton, Canada." Foot & Ankle International 26, no. 11 (2005): 932–36. http://dx.doi.org/10.1177/107110070502601106.
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Background: The incidence of Achilles tendon ruptures specific to the North American population has not been previously reported and current epidemiological data are primarily reported from European communities. The purpose of this study was to determine the incidence of Achilles tendon ruptures in the city of Edmonton, Alberta, Canada, and to compare this data to those reported in European studies. Methods: A retrospective chart review from all five acute care hospitals in Edmonton from 1998 to 2002 (inclusive) were reviewed for Achilles tendon ruptures. Data such as gender, age, side, mechanism of injury, and season of injury were obtained. Results: The incidence of Achilles tendon ruptures ranged from an annual average of 5.5 ruptures to 9.9 ruptures per 100,000 inhabitants with an overall mean of 8.3 ruptures per 100,000 people. There was a statistically significant difference in Achilles tendon ruptures over the last two study years for both genders (women, p < 0.02; men, p < 0.03). The mean age for an Achilles tendon rupture was 40.6 years for men and 44.5 years for women. The Achilles tendon ruptures occurred most frequently in the 30 to 39 and 40 to 49 year old age groups in both men and women, respectively ( p < 0.02). Most ruptures occurred in the spring season, but there was no statistical difference in the incidence of Achilles tendon ruptures by season ( p > 0.05). Conclusions: The incidence of Achilles tendon ruptures in this community was comparable to those reported in European communities (range 6 to 37 ruptures per 100,000 people), although a bimodal age distribution of rupture previously reported was not observed in this study.
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Smith, Roger K. W. "Pathogenesis and prevention strategies for equine tendinopathy." Ciencias Veterinarias 37, no. 3 (2019): 18–19. http://dx.doi.org/10.15359/rcv.37-3.5.
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Equine tendinopathy arises through two main mechanisms – external trauma or overstrain injury. The pathogenesis of the former is straight forward and prevention relies on avoiding risk factors for palmar/plantar lacerations and protecting the tendons through the use of boots. For over-strain injuries, these mostly arise from overloading of the distal limb resulting in mid-substance tearing of the digital flexor tendons or borders tears of the deep digital flexor tendon within the confines of the digital sheath and navicular bursa. While some of these injuries may be spontaneous injuries associated solely with overload (such as the intra-thecal injuries of the deep digital flexor tendon), it is widely accepted that most overstrain injuries of the superficial digital flexor tendon (and suspensory ligament) occur as a result of accumulated microdamage which predisposes the tendon to over-strain injury. The mechanisms of this accumulated microdamage are poorly understood but probably relate to the effect of high impact loading of the tendon, sustained during normal exercise, which drives degradative changes in the tendon fascicles (Dudhia et al. 2007) and, in particular, the interfascicular matrix (endotenon) that allows the fascicles to slide past one another as a mechanism for the spring-like extension of the tendon under load (Thorpe et al. 2013). This is compounded by the lack of adaptive remodelling in adult tendon (Smith et al. 2002). This subclinical damage makes the tendon prone to sudden tearing of the tendon matrix during normal exercise, the risk of which is increased by factors such as the firmness of the ground, weight, speed, and fatigue. Strategies for prevention of injury rely on identifying at risk individuals through more sensitive monitoring of tendon health, maximising the quality of tendon during growth using carefully tailored ‘conditioning’ exercise regimes (Smith & Goodship 2008), reducing the degeneration induced by normal training and competition, and avoiding high risk factors for the initiation of the clinical injury.
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Aynardi, Michael C., Kaitlin Saloky, Evan P. Roush, Paul Juliano, and Gregory S. Lewis. "Biomechanical Evaluation of Spring Ligament Augmentation With the FiberTape Device in a Cadaveric Flatfoot Model." Foot & Ankle International 40, no. 5 (2019): 596–602. http://dx.doi.org/10.1177/1071100719828373.
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Background: The structural importance of the spring ligament complex in arch stability has been described. Furthermore, the pathology of this complex is often noted in patients with posterior tibial tendon dysfunction. The purpose of this biomechanical study was to evaluate spring ligament repair alone versus augmentation with the FiberTape device in a cadaveric flatfoot model. Methods: Eight paired, below-the-knee, cadaveric specimens underwent flatfoot creation and reconstruction. The experimental group received augmentation with FiberTape (InternalBrace). After potting, specimens were loaded statically to measure talonavicular contact pressures and flatfoot correction. Cyclic loading was performed in a stepwise fashion. Loading was performed at 1 Hz and 100 cycles, at 100-N intervals from 500 to 1800 N, with the Achilles tendon also loaded to simulate weightbearing in the postoperative period. Results: Control specimen analysis demonstrated failures of 8 of 8 (100%) spring ligament suture repairs, occurring through suture cut-through (5 specimens), suture fatigue and elongation (2), or knot failure (1). One of 8 (12.5%) FiberTape-augmented repairs failed after cyclic loading. The difference in number of repair failures was statistically significant between the 2 groups ( P = .0014). Analysis revealed that at forces of 1600 N ( P = .03) and 1700 N ( P = .02) there were statistically significant differences between the FiberTape-augmented group and the control group, with a greater collapse in the lateral Meary talo–first metatarsal angle in the controls. There was no significant difference or abnormal increase in contact pressures of the talonavicular joint in both groups. Conclusion: FiberTape augmentation of the spring ligament appears biomechanically safe and effective under cyclic loading. Clinical relevance: Spring ligament augmentation with this device may be another biomechanically safe and reasonable treatment modality for surgeons during flatfoot reconstruction. It is possible that early protected weightbearing after these procedures may be performed.
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Andres, L. K., R. Donners, D. Harder, and N. Krähenbühl. "ASSOCIATION BETWEEN WEIGHTBEARING CT AND MRI FINDINGS IN PROGRESSIVE COLLAPSING FOOT DEFORMITY." Orthopaedic Proceedings 106-B, SUPP_13 (2024): 18. http://dx.doi.org/10.1302/1358-992x.2024.13.018.
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BackgroundWeightbearing computed tomography scans allow for better understanding of foot alignment in patients with Progressive Collapsing Foot Deformity. However, soft tissue integrity cannot be assessed via WBCT. As performing both WBCT and magnetic resonance imaging is not cost effective, we aimed to assess whether there is an association between specific WBCT and MRI findings.MethodsA cohort of 24 patients of various stages of PCFD (mean age 51±18 years) underwent WBCT scans and MRI. In addition to signs of sinus tarsi impingement, four three-dimensional measurements (talo-calcaneal overlap, talo-navicular coverage, Meary's angle axial/lateral) were obtained using a post processing software (DISIOR 2.1, Finland) on the WBCT datasets. Sinus tarsi obliteration, spring ligament complex and tibiospring ligament integrity, as well as tibialis posterior tendon degeneration were evaluated with MRI. Statistical analysis was performed for significant (P<0.05) correlation between findings.ResultsNone of the assessed 3D measurements correlated with spring ligament complex or tibiospring ligament tears. Age, body mass index, and TCO were associated with tibialis posterior tendon tears. 75% of patients with sinus tarsi impingement on WBCT also showed signs of sinus tarsi obliteration on MRI. Of the assessed parameters, only age and BMI were associated with sinus tarsi obliteration diagnosed on MRI, while the assessed WBCT based 3D measurements were, with the exception of MA axial, associated with sinus tarsi impingement.ConclusionWhile WBCT reflects foot alignment and indicates signs of osseous impingement in PCFD patients, the association between WBCT based 3D measurements and ligament or tendon tears in MRI is limited. Partial or complete tears of the tibialis posterior tendon were only detectable in comparably older and overweight PCFD patients with an increased TCO. WBCT does not replace MRI in diagnostic value. Both imaging options add important information and may impact decision-making in the treatment of PCFD patients.
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Williams, Benjamin R., Scott J. Ellis, Timothy W. Deyer, Helene Pavlov, and Jonathan T. Deland. "Reconstruction of the Spring Ligament Using a Peroneus Longus Autograft Tendon Transfer." Foot & Ankle International 31, no. 7 (2010): 567–77. http://dx.doi.org/10.3113/fai.2010.0567.
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GHORBANI, REZA, and QIONG WU. "ON IMPROVING BIPEDAL WALKING ENERGETICS THROUGH ADJUSTING THE STIFFNESS OF ELASTIC ELEMENTS AT THE ANKLE JOINT." International Journal of Humanoid Robotics 06, no. 01 (2009): 23–48. http://dx.doi.org/10.1142/s0219843609001656.
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Impact at each leg transition is one of the main causes of energy dissipation in most of the current bipedal walking robots. Minimizing impact can reduce the energy loss. Instead of controlling the joint angle profiles to reduce the impact, which requires a significant amount of energy, installing elastic mechanisms (with adjustable stiffness) on the robots structure is proposed in this paper, enabling the robot to reduce the impact, and to store part of the energy in the elastic form and return it to the robot. The conceptual design of an adjustable stiffness artificial tendon is proposed which is added to the ankle joint of a bipedal walking robot model. Simulation results on the stance phase demonstrate significant improvements in the energetics of the bipedal walking robot by proper stiffness adjustment of the tendon as compared to using a single linear spring. A controller based on energy feedback is designed to automatically adjust the stiffness of the tendon. Computer simulations illustrate improvements in performance of the energetics of the bipedal walking robot in consecutive walking steps while the stiffness of the tendon is adjusted properly.
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Molnár, László, and Annamária Paróczi. "Analysis of Mechanical Behaviour of Tendon Implant by Using Numerical Method." Materials Science Forum 589 (June 2008): 329–34. http://dx.doi.org/10.4028/www.scientific.net/msf.589.329.
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The structural improvement of tendon implant is running in frame of a research project at our department for 3 years. The main goal is to improve a tendon implant construction which has a tensile stiffness similar to the sound tendon. The tendon implant developed on such way that implant should be able to take over the functions of a sound tendon. To reach this goal firstly the measurement results of tensile stiffness of cadaver tendons were evaluated. The tensile tests of cadaver tendons happened in earlier phase of this research. Beside the aim of enhance the tensile stiffness of the implant was a second request that we need to change the place of maximal mechanical stress from end of implant to inside of the implant. To enhance the mechanical behaviour (tensile stiffness) of implant the type of matrix material along longitudinal and radial directions as well as the length of the fibre in the silicone implant were modified. Improvement of construction was performed by numerical simulation using ANSYS. At first we prepared 2D and 3D geometry models on which the tensile analysis was evaluated. Improvement of the construction was supported by a concentrated spring model also which helped us to check the resultant stiffness of the construction. It was successful to increase the stiffness of the original implant with fibre reinforcing. We reached with the new construction (with one reinforcing fibre) almost half of an average cadaver tendon’s tensile stiffness.
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Athavale, Sunita A., Sheetal Kotgirwar, and Rekha Lalwani. "Revisiting the inferior supports of Chopart joint complex." Bone & Joint Open 5, no. 4 (2024): 335–42. http://dx.doi.org/10.1302/2633-1462.54.bjo-2023-0120.r1.
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AimsThe Chopart joint complex is a joint between the midfoot and hindfoot. The static and dynamic support system of the joint is critical for maintaining the medial longitudinal arch of the foot. Any dysfunction leads to progressive collapsing flatfoot deformity (PCFD). Often, the tibialis posterior is the primary cause; however, contrary views have also been expressed. The present investigation intends to explore the comprehensive anatomy of the support system of the Chopart joint complex to gain insight into the cause of PCFD.MethodsThe study was conducted on 40 adult embalmed cadaveric lower limbs. Chopart joint complexes were dissected, and the structures supporting the joint inferiorly were observed and noted.ResultsThe articulating bones exhibit features like a cuboid shelf and navicular beak, which appear to offer inferior support to the joint. The expanse of the spring ligament complex is more medial than inferior, while the superomedial part is more extensive than the intermediate and inferoplantar parts. The spring ligament is reinforced by the tendons in the superomedial part (the main tendon of tibialis posterior), the inferomedial part (the plantar slip of tibialis posterior), and the master knot of Henry positioned just inferior to the gap between the inferomedial and inferoplantar bundles.ConclusionThis study highlights that the medial aspect of the talonavicular articulation has more extensive reinforcement in the form of superomedial part of spring ligament and tibialis posterior tendon. The findings are expected to prompt further research in weightbearing settings on the pathogenesis of flatfoot.Cite this article: Bone Jt Open 2024;5(4):335–342.
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Haiya, Kazuo, Satoshi Komada, and Junji Hirai. "Tension Control for Tendon Mechanisms by Compensation of Nonlinear Spring Characteristic Equation Error." IEEJ Transactions on Industry Applications 130, no. 6 (2010): 816–23. http://dx.doi.org/10.1541/ieejias.130.816.
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Ribbans, William John, and Ajit Garde. "Tibialis Posterior Tendon and Deltoid and Spring Ligament Injuries in the Elite Athlete." Foot and Ankle Clinics 18, no. 2 (2013): 255–91. http://dx.doi.org/10.1016/j.fcl.2013.02.006.
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Ryssman, Daniel B., and Clifford L. Jeng. "Reconstruction of the Spring Ligament With a Posterior Tibial Tendon Autograft: Technique Tip." Foot & Ankle International 38, no. 4 (2016): 452–56. http://dx.doi.org/10.1177/1071100716682332.
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Kimura, Yusuke, Tsuneo Yamashiro, Yuki Saito, Kaoru Kitsukawa, Hisateru Niki, and Hidefumi Mimura. "MRI findings of spring ligament injury: association with surgical findings and flatfoot deformity." Acta Radiologica Open 9, no. 12 (2020): 205846012098014. http://dx.doi.org/10.1177/2058460120980145.
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Background Spring ligament injury is an important cause for flatfoot deformity; however, reliability of magnetic resonance imaging (MRI) findings of spring ligament injury is still ambiguous. Purpose To investigate the reliability of MRI findings for the diagnosis of spring ligament injury. Material and methods Forty-three cases with spring ligament injury proven by surgery and 29 control cases were enrolled. The spring ligament complex was demonstrated on proton density-weighted images reconstructed from 3D-isotropic MRI data. The presence of waviness, discontinuity, and abnormally high signal intensity of the spring ligament complex was evaluated by two radiologists in cooperation. Also, injury of the posterior tibial tendon (PTT) on MRI and the lateral talo-1st metatarsal angles on weight-bearing X-rays were evaluated. Results Discontinuity and abnormally high signal intensity of the superomedial calcaneonavicular ligament (SmCNL) on MRI were more frequently observed in patients with spring ligament injury than in controls ( p < 0.001). Discontinuity and abnormally high signal intensity of the SmCNL were found more often in the PTT injury group than in those without ( p < 0.001). The talo-1st metatarsal angle was greater in patients with discontinuity and abnormally high signal intensity of the SmCNL on MRI than in patients without these findings ( p < 0.001). Conclusion Discontinuity and abnormally high signal intensity are reliable MRI findings for spring ligament injury and related disorders, such as flatfoot deformity and PTT injury.
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Danos, Nicole, Natalie C. Holt, Gregory S. Sawicki, and Emanuel Azizi. "Modeling age-related changes in muscle-tendon dynamics during cyclical contractions in the rat gastrocnemius." Journal of Applied Physiology 121, no. 4 (2016): 1004–12. http://dx.doi.org/10.1152/japplphysiol.00396.2016.
Full textAbstract:
Efficient muscle-tendon performance during cyclical tasks is dependent on both active and passive mechanical tissue properties. Here we examine whether age-related changes in the properties of muscle-tendon units (MTUs) compromise their ability to do work and utilize elastic energy storage. We empirically quantified passive and active properties of the medial gastrocnemius muscle and material properties of the Achilles tendon in young (∼6 mo) and old (∼32 mo) rats. We then used these properties in computer simulations of a Hill-type muscle model operating in series with a Hookean spring. The modeled MTU was driven through sinusoidal length changes and activated at a phase that optimized muscle-tendon tuning to assess the relative contributions of active and passive elements to the force and work in each cycle. In physiologically realistic simulations where young and old MTUs started at similar passive forces and developed similar active forces, the capacity of old MTUs to store elastic energy and produce positive work was compromised. These results suggest that the observed increase in the metabolic cost of locomotion with aging may be in part due to the recruitment of additional muscles to compensate for the reduced work at the primary MTU. Furthermore, the age-related increases in passive stiffness coupled with a reduced active force capacity in the muscle can lead to shifts in the force-length and force-velocity operating range that may significantly impact mechanical and metabolic performance. Our study emphasizes the importance of the interplay between muscle and tendon mechanical properties in shaping MTU performance during cyclical contractions.
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Koç, Ali, and Özgür Karabiyik. "MRI evaluation of ligaments and tendons of foot arch in talar dome osteochondral lesions." Acta Radiologica 59, no. 7 (2017): 869–75. http://dx.doi.org/10.1177/0284185117730853.
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Background There are no publications in literature describing an association between disorders of the ligaments and tendons supporting the foot arch and osteochondral lesions of the talus (OCLT). We believe there may be a correlation between the damage of these structures. Purpose To investigate the pathologies of main ligaments and tendons that support the foot arch in sprained ankles, by reviewing magnetic resonance imaging (MRI) studies and comparing the results in two groups of patients, with and without OCLT. Material and Methods MR images from 316 patients examined in the orthopedic clinic for ankle sprain were evaluated for pathologic findings of the plantar fascia, short and long plantar ligaments, spring ligament, sinus tarsi, and ankle tendons supporting the foot arch. Findings were compared between two groups of patients: 158 patients with OCLT and 158 patients without OCLT. Results Plantar fascia, short plantar ligament, and spring ligament abnormalities were seen in 50 (31.6%), 28 (17.7%), and 60 (38%) patients with OCLT, and in nine (5.6%), three (1.9%), and 18 (11.4%) patients without OCLT, respectively ( P < 0.05). Sinus tarsi and tendon abnormalities were seen in 11 (6.7%) and nine (5.7%) patients with OCLT, and in eight (5%) and eight (5%) patients without OCLT, respectively ( P > 0.05). Two or more associated abnormalities were present in 50 (31.6%) patients with OCLT and in 11 (6.7%) without OCLT ( P < 0.05). Conclusion Plantar fascia, short plantar ligament, and spring ligament abnormalities were commonly seen in patients with OCLT on MRI, while sinus tarsi and tendon abnormalities were not. Concomitant pathologies have an increased incidence in patients with OCLT.
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Ohta, Shigeki, Kazuo Hongo, Yuto Nakanishi, Ikuo Mizuuchi, and Masayuki Inaba. "Improvement of Performance for Musculoskeletal Robots by Mountable Actuator Units." Journal of Robotics and Mechatronics 22, no. 3 (2010): 391–401. http://dx.doi.org/10.20965/jrm.2010.p0391.
Full textAbstract:
It is very difficult to decide and to optimize the layouts of muscle which may completely fulfill the demands for muscle tension and joint stiffness of tendon driven systems at the design stage. However, muscle that can be easily added to the system depending on the situation makes it possible to seek optimal layouts of muscle through experimentation. This paper describes the development of two types of actuator units which can be easily added to the tendon-driven system. One is the regulable stiffness actuator unit which a nonlinear spring element is built into, and the other is an actuator unit which is smaller than actuator unit with regulable stiffness. To verify the effects of the actuator units on performance, we experiment with a musculoskeletal humanoid, Kojiro, to which the two types of actuator units developed are added.