Effect of ankle and knee position on tension in the Achilles tendon.

The purpose of this study was to evaluate the relative contributions of ankle and knee position to tension in the Achilles tendon and to determine whether there exists a position of plantarflexion at which the passive tensioning effect of knee extension is eliminated. Seven matched pairs of fresh-frozen cadaver lower extremities were tested. A buckle transducer was used to measure forces in the tendon throughout the full range of knee motion, with the hindfoot fixed. Positioning the hindfoot in 20 degrees to 25 degrees of plantarflexion effectively eliminates tension in the Achilles tendon, regardless of knee position. This information is directly applicable both to the nonoperative treatment of ruptures of the Achilles tendon employing a short leg cast and to surgical repairs, in which tension must be controlled precisely.