{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T19:29:38Z","timestamp":1783020578751,"version":"3.54.6"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005350","name":"Centrum f\u00f6r idrottsforskning","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005350","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007435","name":"\u00c5ke Wiberg Stiftelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007435","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006285","name":"Magnus Bergvalls Stiftelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006285","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Incomplete recovery with persistent muscle weakness is frequently observed following Achilles tendon rupture. The mechanisms for this weakness remain unclear, but tendon elongation has been suggested as a contributing factor. The aim of this study was to compare tendon and muscle morphology in high\u2010 and low\u2010functioning patients more than 2 years after non\u2010surgical treatment of a total Achilles tendon rupture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty\u2010six patients underwent screening, including a standardized heel\u2010rise work test on both legs. Based on this test, a heel\u2010rise index (HRI) for total muscle work, categorized 29 patients into a low\u2010 (HRI\u2009&lt;\u200933%) or high\u2010functioning (HRI\u2009&gt;\u200967%) group. Both groups underwent bilateral magnetic resonance imaging to assess tendon and muscle morphology, and the main variable was tendon elongation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      High\u2010functioning patients were on average 13 years younger than the low\u2010functioning patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Free tendon length was longer on the injured side in both groups, 3.59 and 5.19\u2009cm in the high\u2010 and low\u2010functioning group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.053). Tendon cross\u2010sectional area was significantly larger in the high\u2010functioning group compared to the low\u2010functioning group (383% vs. 256% after normalization to the uninjured side,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). The soleus muscle had notable differences between the groups, as low\u2010functioning patients had a smaller mediolateral diameter (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), a more pronounced muscle length difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009) and a higher atrophy grading. Additionally, there were significant correlations between age, HRI and tendon size.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Free tendon length after rupture may play a role in muscle weakness. However, tendon elongation does not necessarily lead to low function, as it was also evident in the high\u2010functioning group. These findings may be important, as they suggest that tendon elongation is not the sole determinant of functional outcome and that other factors may contribute to muscle performance after rupture. Further research is needed on the role of age in muscle function following Achilles tendon ruptures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70445","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T11:12:29Z","timestamp":1779275549000},"page":"2623-2638","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tendon elongation in the free tendon is evident in patients with and without persistent muscle weakness following an Achilles tendon rupture"],"prefix":"10.1002","volume":"34","author":[{"given":"Pawel","family":"Szaro","sequence":"first","affiliation":[{"name":"Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"},{"name":"Department of Radiology Sahlgrenska University Hospital, Region V\u00e4stra G\u00f6taland Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Meunier","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Link\u00f6ping University Hospital Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Bokwa\u2010Dabrowska","sequence":"additional","affiliation":[{"name":"Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"},{"name":"Department of Radiology Sahlgrenska University Hospital, Region V\u00e4stra G\u00f6taland Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina Nilsson","family":"Helander","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"},{"name":"Department of Orthopaedics Sahlgrenska University Hospital, Region V\u00e4stra G\u00f6taland Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6718-034X","authenticated-orcid":false,"given":"Pernilla","family":"Eliasson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"},{"name":"Department of Orthopaedics Sahlgrenska University Hospital, Region V\u00e4stra G\u00f6taland Gothenburg Sweden"},{"name":"Center for Medical Image Science and Visualization (CMIV) Link\u00f6ping University Link\u00f6ping 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