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Quantifying the motion of Kager's fat pad

Ghazzawi, Ahmad Ali, Theobald, Peter ORCID:, Pugh, Neil D. ORCID:, Byrne, Carlton Barrie Baylis and Nokes, Leonard Derek Martin ORCID: 2009. Quantifying the motion of Kager's fat pad. Journal of Orthopaedic Research 27 (11) , pp. 1457-1460. 10.1002/jor.20900

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Kager's fat pad is located in Kager's triangle between the Achilles tendon, the superior cortex of the calcaneus, and flexor hallucis longus (FHL) muscle and tendon. Its biomechanical functions are not yet established, but recent studies suggest it performs important biomechanical roles as it is lined by a synovial membrane and its retrocalcaneal protruding wedge can be observed moving into the bursal space during ankle plantarflexion. Such features have prompted hypotheses that the protruding wedge assists in the lubrication of the Achilles tendon subtendinous area, distributes stress at the Achilles enthesis, and removes debris from within the retrocalcaneal bursa. This study examined the influence of FHL activity and Achilles tendon load on the protruding wedge sliding distance, using both dynamic ultrasound imaging and surface electromyogram. Intervolunteer results showed sliding distance was independent of FHL activity. This study has shown the protruding wedge to slide on average 60% further into the retrocalcaneal bursa when comparing the Achilles tendon loaded versus unloaded, consistently reaching the distal extremity. Sliding distance was dependant on a change in the Achilles tendon insertion angle. Our results support a number of hypothesized biomechanical functions of the protruding wedge including: lubrication of the subtendinous region; reduction of pressure change within the Achilles tendon enthesis organ; and removal of debris from within the retrocalcaneal bursa.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Engineering
Uncontrolled Keywords: retrocalcaneal bursa; Achilles tendon; enthesis organ; Kager's triangle
Publisher: John Wiley & Sons
ISSN: 0736-0266
Last Modified: 11 Feb 2023 02:06

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