March 2016

Years after Achilles tear, injured limb demonstrates elevated knee loading

In the moment: OA

By Jordana Bieze Foster

A history of Achilles tendon rupture is associated with elevated knee loading during hopping and running, suggesting an increased risk of knee osteoarthritis and other overuse knee pathologies, according to research from East Carolina University in Greenville, NC.

Investigators analyzed 34 individuals who had experienced a unilateral Achilles tear a mean of six years previously, as they jogged at a self-selected speed and performed a single-leg hopping task. Peak concentric knee power, peak patello­femoral joint reaction force, and peak tibiofemoral contact force were significantly higher in the injured limb than the uninjured limb for both tasks.

The asymmetries were evident despite a high level of self-reported function for the group, a mean of 84 out of 100 on the Achilles Tendon Total Rupture Score.

“Rehabilitation may need to include the knee in addition to the foot and ankle,” said Hayley Powell, a graduate student in the university’s Department of Physical Therapy, who presented the findings in February at the annual Combined Sections Meeting of the American Physical Therapy Association in Anaheim.


Powell H, Silbernagel KG, Brorsson A, et al. Patellofemoral and tibiofemoral joint loading asymmetries are present during running and hopping in individuals 5 years post–Achilles tendon rupture. J Orthop Sports Phys Ther 2016;46(1):A50.

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