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Year : 2022  |  Volume : 71  |  Issue : 1  |  Page : 18-23

Ossification of calcaneal tendon: Plausible role of hypoxia-induced factor 1 alpha

1 Department of Anatomy, Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities, New Delhi, India
2 Department of Anatomy, NDMC Medical College and Hindu Rao Hospital, New Delhi, India
3 Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
4 Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
5 Department of Anatomy, Banaras Hindu University, Banaras, Uttar Pradesh, India

Correspondence Address:
Dr. Neerja Rani
Department of Anatomy, All India Institute of Medical Sciences, New Delhi - 110 029
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jasi.jasi_178_21

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Introduction: Tendons may rarely be ossified. The calcaneal tendon (CT) is the largest in the body. The incidence and mechanism of ossification of CT is not known. Material and Methods: We carried out a morphological, radiological, histological, and immunohistochemical study on the CT of 50 (30 – male and 20 – female) human cadavers. Results: The mean length (cm) of the CT was 27.60 ± 2.30 (right) and 27.51 ± 2.60 (left) in males and 25.43 ± 0.77 on both sides in females. The contribution to the formation of the CT from the two heads of gastrocnemius muscle was greater from medial head in 84%, lateral head in 12%, and equal in 4%. On screening the CT by C-arm radiography, slight opacification at the site of insertion of CT (bilaterally) was noted in an elderly male. Large, bilateral opacification was seen in another elderly male cadaver. Well-defined lamellar bone with osteocytes lying in lacunae and bone marrow amid the tendon collagenous tissue was noted in hematoxylin- and eosin-stained sections. The osteocytes expressed hypoxia-induced factor 1 alpha. Discussion and Conclusion: In this study, we confirmed that the radiological opacification in the CT was ossification that may have been triggered by hypoxia.

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