This study aimed to provide a comprehensive and current overview of the anatomy of the Achilles tendon (AT) twisted structure, as there is a discrepancy in the literature regarding its rotating morphology.
MethodsAn extensive literature search was conducted across multiple databases to identify all studies that reported relevant data on the AT torsion, with no date or language restrictions applied. Data was extracted and assessed for this meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the included articles was examined using the anatomical quality assessment (AQUA) tool.
ResultsSeven articles (n=690 limbs) were pooled into this meta-analysis. The prevalence of Achilles tendon torsion types was as follows: type II was the most common (46.7%, 95% CI: 31.6–60.9%), followed by type I (44.7%, 95% CI: 29.8–59.0%), and least commonly, type III (8.6%, 95% CI: 1.8–18.8%). Additionally, morphometric analysis, utilizing the method described by van Gils et al., revealed a mean Achilles tendon torsion of 46.5° (95% CI: 25.1–67.9°).
ConclusionsThis meta-analysis underscores the prominent and variable twist within the Achilles tendon among individuals, emphasizing the inherent diversity in AT morphology. Furthermore, the study highlights the importance of considering torsion angle as a potential factor influencing AT pathologies and biomechanical function.
AbbreviationsMGmedial head of the gastrocnemius muscle
LGlateral head of the gastrocnemius muscle
PRISMAPreferred Reporting Items for Systematic Reviews and Meta-Analyses
AQUAanatomical quality assessment
KeywordsAchilles tendon
calcaneal tendon
subtendons
torsion
clinical anatomy
meta-analysis
© 2024 The Authors. Published by Elsevier GmbH.
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