Proximal medial gastrocnemius release: Muscle strength evaluation

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Sports Medicine

Background:

• Gastrocnemius contracture is linked to various foot and ankle conditions.
• Limited improvement with physical therapy necessitates surgical intervention for medial gastrocnemius contracture.

Purpose of the Study:

• To assess the impact of proximal medial gastrocnemius release (PMGR) on triceps surae muscle strength.
• To evaluate changes in isometric and isokinetic strength following PMGR in patients with gastrocnemius contracture.

Main Methods:

• Prospective study involving 14 patients (12 female, mean age 52) undergoing PMGR.
• Inclusion criteria: medial gastrocnemius contracture unresponsive to physical therapy, affecting forefoot and/or hindfoot.
• Isometric and isokinetic force evaluations using an isokinetic dynamometer were conducted preoperatively and at 6 and 12 months postoperatively for both limbs.

Main Results:

• Preoperative isometric triceps strength was significantly lower in the affected ankle compared to the asymptomatic limb.
• A statistically significant improvement in isokinetic triceps strength at 60°/s was observed at 6 months post-surgery (p=0.008), sustained at 1 year (p=0.05).
• No significant strength differences were noted at a speed of 120°/sec.

Conclusions:

• Gastrocnemius contracture is associated with reduced preoperative isometric ankle plantarflexion force.
• PMGR leads to a significant improvement in isokinetic triceps surae strength, evident by 6 months post-operation.