• 1

    Pinzur MS: Benchmark analysis of diabetic patients with neuropathic (Charcot) foot deformity. .Foot Ankle Int 20::564. ,1999. .

  • 2

    Lavery LA, Armstrong DG, Walker SC: Healing rates of diabetic foot ulcers associated with midfoot fracture due to Charcot’s arthropathy. .Diabet Med 14::46. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Caputo GM, Ulbrecht J, Cavanaugh PR, et al: The Charcot foot in diabetes; six key points. .Am Fam Physician 57::2705. ,1998. .

  • 4

    Grant WP, Sullivan RS: Electron microscopic investigation of the effects of diabetes on the Achilles tendon. .J Foot Ankle Surg 36::272. ,1997. .

  • 5

    Reihsner R, Pfeiler W, Menzel EJ: Comparison of normal and in vitro aging by non-enzymatic glycation as verified by differential scanning calorimetry. .Gerontology 44::85. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Melling M, Pfeiler W, Karimian-Tehrani D, et al: Differential scanning calorimetry, biochemical, and biomechanical analysis of human skin from individuals with diabetes mellitus. .Anat Rec 259::327. ,2000. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Brownlee M, Vlassara H, Cerami A: Nonenzymatic glycosylation and the pathogenesis of diabetic complications. .Ann Intern Med 101::527. ,1984. .

  • 8

    Wang X, Bank R, Tekoppele J, et al: The role of collagen in determining bone mechanical properties. .J Orthop Res 19::1021. ,2001. .

  • 9

    Martin RB, Lau ST, Matthews PV, et al: Collagen fiber organization as related to mechanical properties and remodeling in equine bone: a comparison of two methods. .J Biomech 12::1515. ,1996. .

    • Search Google Scholar
    • Export Citation
  • 10

    Salsich GB, Mueller MJ, Sahrmann SA: Passive ankle stiffness in subjects with diabetes and peripheral neuropathy versus an age-matched comparison group. .Phys Ther 80::352. ,2000. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Wang X, Bank R, Tekoppele JM, et al: Effect of collagen denaturation on the toughness of bone. .Clin Orthop 371::228. ,2000. .

  • Armstrong DG, Lavery LA: Elevated peak plantar pressures in patients who have Charcot arthropathy. .J Bone Joint Surg Am 80::365. ,1998. .

    • PubMed
    • Search Google Scholar
  • Mueller MJ, Diamond JE, Dellito A, et al: Insensitivity, limited joint mobility and plantar ulcers in patients with diabetes mellitus. .Phys Ther 69::453. ,1989. .

    • PubMed
    • Search Google Scholar

Evaluation of Young’s Modulus in Achilles Tendons with Diabetic Neuroarthropathy

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  • 1 Diabetic Foot and Limb Salvage, Eastern Virginia Medical School, Norfolk.
  • | 2 Tidewater Foot and Ankle Center, Virginia Beach, Virginia.
  • | 3 Research and Development, Lifenet, Virginia Beach, Virginia.
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The Achilles tendon of the patient with Charcot’s foot neuroarthropathy has significantly altered physical properties compared with a normal tendon. Twenty-nine Achilles tendons from patients with Charcot’s foot (n = 20) and non-Charcot’s foot controls (n = 9) were loaded onto a biomechanical testing instrument. The biomechanical properties of the Charcot and control tendons were determined and the tendons were evaluated for differences in ultimate tensile strength and elasticity (Young’s modulus). Biomechanical test data show that there is a significant difference in ultimate tensile strength and elasticity between tendons of patients with Charcot’s foot and those of non-Charcot’s controls. The term diabetic tendo Achillis equinus is introduced as a new finding in diabetic neuroarthropathy. (J Am Podiatr Med Assoc 95(3): 242–246, 2005)

Corresponding author: William P. Grant, DPM, 762 Independence Blvd, Ste 771, Virginia Beach, VA 23455.