Functional anatomy, histology and biomechanics of the human Achilles tendon - A comprehensive review

Ann Anat. 2020 May:229:151461. doi: 10.1016/j.aanat.2020.151461. Epub 2020 Jan 21.

Abstract

Objectives: The aim of this study was to provide a comprehensive overview of the anatomical, histological, and biomechanical aspects of the Achilles tendon.

Methods: A comprehensive search on the relevant aspects of the Achilles tendon was performed through the main electronic databases up to October 2019. Data from relevant articles was gathered, analyzed, and included in this review.

Results: This review outlines crucial topics on the anatomy, histology, and biomechanics of the Achilles tendon. The first part, focusing on clinically relevant anatomy, describes the tendon as well as its surrounding structures. Particular focus is made on anatomical divisions. The second part discusses histologic features, contrasting normal morphology with pathologic changes. The third part summarizes various biomechanical aspects of the Achilles tendon, especially those crucial to understanding the key functionality of the tendon. These components make up this review aimed to aggregate relevant information regarding the Achilles tendon to provide an up to date assessment of current knowledge, as well as visions for future directions of Achilles tendon research.

Conclusions: Comprehensive knowledge regarding the Achilles tendon is crucial whilst rates of injury continue to be relevant. A proper understanding of the anatomy, histology, and biomechanics is vital for clinical perception as well as establishing the direction of further research in new therapies.

Keywords: Achilles tendon; Anatomy; Biomechanics; Histology; Rupture.

Publication types

  • Review

MeSH terms

  • Achilles Tendon / anatomy & histology*
  • Achilles Tendon / blood supply
  • Achilles Tendon / injuries
  • Achilles Tendon / physiology*
  • Biomechanical Phenomena
  • Humans
  • Muscle, Skeletal / anatomy & histology
  • Muscle, Skeletal / injuries
  • Muscle, Skeletal / physiology
  • Rupture
  • Tendinopathy / pathology
  • Tendons / anatomy & histology
  • Tendons / physiology
  • Tibial Arteries / anatomy & histology