Postoperative MR Imaging and Ultrasonography of Surgically Repaired Achilles Tendon Ruptures

1996 ◽  
Vol 37 (3P2) ◽  
pp. 639-646 ◽  
Author(s):  
P. T. Karjalainen ◽  
J. Ahovuo ◽  
H. K. Pihlajamäki ◽  
K. Soila ◽  
H. J. Aronen
Keyword(s):  
Mr Imaging ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
High Signal ◽  
Proton Density ◽  
Time Interval ◽  
Unaffected Side ◽  
Cross Sectional ◽  
The Cross

Purpose: To evaluate and compare MR and US findings in an unselected group of patients with 1–3-year-old surgically repaired complete ruptures of the Achilles tendon. Material and Methods: Thirteen patients with complete Achilles tendon rupture underwent clinical, MR and US examinations. The average time interval from rupture to postoperative imaging was 18 months. Results: The cross-sectional area of a postoperative tendon was 4.2 times that of the unaffected side. The shape of the operated tendon was more rounded than the unaffected side and it had irregular margins both in MR imaging and in US examination. In 4 of 13 cases an intratendinous area of intermediate to high signal intensity on proton density- and T2- weighted images was seen on MR. The size of this area varied from 4 to 18% of the cross-sectional tendon area. Two patients with the largest intratendinous area had poor clinical outcome. On US the tendon had mixed echogenicity in all cases and the tendon bands were thinner and shorter than normal. Comparison of dimension between MR and US revealed that in a.p. dimension the correlation was good (r=0.87, p=0.001), but in transversal width there was no significant correlation (r=0.58, p=0.06). Conclusion: The increased size and round irregular area of the operated Achilles tendon rupture was well detected by both MR and US, but intratendinous lesions were seen only by MR.

scholarly journals Use of ankle resting angle as a surrogate for tendon elongation in individuals following Achilles tendon rupture

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Heather Gotha ◽  
Jennifer Zellers ◽  
Karin Silbernagel
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Plantar Flexors ◽  
Cross Sectional ◽  
Tendon Length ◽  
Tendon Elongation ◽  
The Relationship

Category: Ankle, Sports Introduction/Purpose: Tendon elongation is associated with poor functional outcome in individuals after Achilles tendon rupture. While imaging modalities are reliable to measure Achilles tendon length, alternative time- and cost-effective measures are of interest. The resting angle of the ankle in prone both with knee extended1 and knee flexed2 have been used in the literature as surrogates for measuring Achilles elongation, however, their relationship to tendon length is not well-established. The purpose of this study is to validate the ankle resting angle as a measure of tendon elongation and examine the relationship of ankle resting angle to tendon elongation and calf strength. Methods: Individuals following unilateral Achilles tendon rupture, treated surgically, were included in this cross-sectional study. Individuals were excluded if they had deep wound infection or lumbar radiculopathy affecting the ankle plantar flexors. Ankle resting angle with knee extended and knee flexed to 90 degrees was measured using a digital inclinometer positioned on the lateral, plantar surface of the foot. Relative resting angle was calculated by subtracting the uninjured from the injured side. Tendon length to gastrocnemius was measured using B mode, extended field of view ultrasound imaging3 (tendon elongation = ruptured- uninjured). Calf strength was measured using the heel-rise test4. Limb symmetry indexes (LSI) were calculated (ruptured/uninjured sidex100) for total work performed on the heel-rise test. Results: Twenty-five individuals, a mean(SD) age of 44.2(13.6) years and mean(SD) of 22.5(39.1) months post-rupture, were included in this study. Mean(SD) relative resting angle with knee flexed was -5.4(6.4)° and mean (SD) relative resting angle with knee extended was -6.7(8.8)°. Mean(SD) tendon elongation was 1.56(1.20)cm. Mean(SD) heel-rise test work LSI was 45.8(23.8)%. Ankle resting angle with knee flexed related to elongation (r = -0.452, p = 0.027) and heel-rise test work LSI (r = 0.591, p=0.006). Ankle resting angle with knee extended related to elongation (r=-0.528, p=0.008) (Figure 1) but not heel-rise test work LSI. Conclusion: The results of this study suggest that ankle resting angle with knee extended and flexed are related to tendon elongation, however, calf strength also has a relationship to resting angle with knee flexed. This suggests that the ability of the calf to put passive tension on the foot is also a component of resting angle. The relationship between tendon elongation and resting angle with knee flexed may have been limited by methodological concerns, as tendon length was measured with the participant positioned with knees extended.

Effect of Electroacupuncture Stimulation on Long-Term Recovery following Achilles Tendon Rupture in a Rat Model

2018 ◽  
Vol 36 (5) ◽  
pp. 327-332
Author(s):  
Miwa Imaeda ◽  
Tatsuya Hojo ◽  
Hiroshi Kitakoji ◽  
Kazuto Tanaka ◽  
Megumi Itoi ◽  
...  
Keyword(s):  
Mechanical Strength ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Breaking Strength ◽  
Achilles Tendon Rupture ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional

Aims In this study we examined the effect of electroacupuncture (EA) stimulation on the mechanical strength of the rat Achilles tendon after long-term recovery. Methods Using 20 rats, an Achilles tendon rupture model was created in an invasive manner. The rats were assigned to one of three groups, that received EA treatment (EA group), minimal acupuncture (MA group) or remained untreated (Control group). In the EA group, EA stimulation (5 ms, 50 Hz, 20 µA, 20 min) was applied to the rupture region over a period of 90 days (five times/week). In the MA group, needles were inserted into the same positions as in the EA group but no electrical current was applied. After 90 days the tendon was measured to calculate the cross-sectional area of the rupture region. Then, the mechanical strength of the tendon was measured by tensile testing. Results No significant differences were observed between the three groups in cross-sectional area of the injured tendon. For maximum breaking strength, the EA group showed a significantly higher threshold compared with the Control group (P<0.05) but not the MA group (P=0.24). No significant difference was seen between the MA group and the Control group (P=0.96). Conclusion Given the EA group showed a significant increase in maximum breaking strength, it is likely that EA stimulation increases the mechanical strength of a repaired tendon after long-term recovery, and EA stimulation could be useful for preventing re-rupture.

scholarly journals Comparing Absorbable and Nonabsorbable Suture Materials for Repair of Achilles Tendon Rupture: A Magnetic Resonance Imaging-Based Study

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1085
Author(s):  
Jaeho Cho ◽  
Hyun-Joo Kim ◽  
Jeong Seok Lee ◽  
Jahyung Kim ◽  
Sung Hun Won ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Sectional Area ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Cross Sectional ◽  
Significant Difference ◽  
Group A ◽  
Group B

We aimed to compare magnetic resonance imaging (MRI) findings and corresponding clinical outcomes of repaired Achilles tendons using absorbable and nonabsorbable sutures. Patients who underwent Achilles tendon repair were divided into 2 groups, with 11 in the absorbable group (group A) and 11 in the nonabsorbable group (group B). For all patients, MRI findings taken 6 months postoperatively were evaluated for morphological changes in the tendon. Concurrently, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot score and incidence of postoperative complications were evaluated. Regarding MRI findings, the extent to which the cross-sectional area of the repaired tendon was thicker than that of the preoperative tendon was significantly greater in group B than in group A (p = 0.0012). Notably, more stitches remained within the tendon in group B than in group A (p = 0.0063). No other MRI findings showed a significant difference between the two groups. No significant difference was observed in the AOFAS score, and there was one re-rupture each in both groups. Because nonabsorbable suture material in the treatment of Achilles tendon rupture yielded a thicker postoperative MRI cross-sectional area, enhanced rehabilitation is recommended in order to prevent scar formation.

scholarly journals Financial Conflicts of Interest Among Systematic Review Authors Investigating Interventions for Achilles Tendon Ruptures

2021 ◽  
Vol 6 (2) ◽  
pp. 247301142110197
Author(s):  
W. Tanner Cole ◽  
Cody Hillman ◽  
Adam Corcoran ◽  
J. Michael Anderson ◽  
Michael Weaver ◽  
...  
Keyword(s):  
Systematic Review ◽  
Achilles Tendon ◽  
Systematic Reviews ◽  
Tendon Rupture ◽  
Conflicts Of Interest ◽  
Achilles Tendon Rupture ◽  
Individual Characteristics ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Financial Conflicts Of Interest

Background: The primary aim of our study was to evaluate the effects of undisclosed financial conflicts of interest in Achilles tendon rupture repair–focused systematic reviews. Methods: Following a cross-sectional study design, we searched MEDLINE and Embase for Achilles tendon rupture repair systematic reviews. We performed screening and data extraction in a blind, triplicate fashion. Each systematic review was evaluated on the individual characteristics of the study, presence of undisclosed and disclosed conflicts of interest, favorability of results and conclusions, and the relationship between conflicts of interest and the favorability of results and conclusions. Results: Our search produced 172 total systematic reviews pertaining to Achilles tendon rupture repair; of those, only 12 were included in our study. Undisclosed conflicts of interest were found in half (6/12) of the included reviews. However, no significant association was found between conflict of interest and the favorability of results and conclusions. Conclusion: Undisclosed conflicts of interests were discovered in a large percentage of our sample. This lack of disclosure did not appear to increase the likelihood of the systematic review results or conclusions reporting favorability of the intervention being investigated. Level of Evidence: Level II.

scholarly journals Percutaneous repair versus open repair for acute Achilles tendon rupture

2019 ◽  
Author(s):  
xiaomeng wang ◽  
Huixin Liu ◽  
dengke li ◽  
zixuan luo ◽  
Yansen Li ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Open Repair ◽  
Achilles Tendon Rupture ◽  
Visual Analogue Scale Pain ◽  
Consecutive Series ◽  
Cross Sectional ◽  
Group A ◽  
Group B

Abstract Backgroup: To compare the operative outcome between modified Kessler suture method and Bundle-Bundle suture for the treatment of acute rupture of Achilles tendon. Methods: A consecutive series of 72 patients who underwent operation of Achilles tendon rupture were evaluated. Thirty patients were treated by the bundle-bundle suture method (group A) and 31 patients by modified Kessler suture (group B). Functional examination included measurement of calf muscle circumference, and a single-leg heel-rise test. The diameter of the Achilles tendon of the trouble side was recorded compared with the contralateral limb through the MRI (magnetic resonance imaging). The number of single-leg heel-rise was recorded within 15s (height>5cm) compared with the uninjured side. The ankle joint range of motion is recorded. The evaluation form ATRS(Achilles Tendon Total Rupture Score), AOFAS(American Orthopedic Foot And ankle Society) Ankle-Hindfoot scale scores and VAS( visual analogue scale) pain score were used to evaluate the clinical outcome after a minimum follow-up period of 12 months postoperatively. Results: 61 patients at 1 year following surgery. There was no difference in mean follow-up time between the two groups (group A: 23.73±2.81 months; group B: 22.61±3.96 months). There were significant differences between the groups in heel-rise test 1.74±0.96 in group A, 2.37±1.42 in group B. Compared with the group B, the calf circumference of the injured side was bigger in group A (p=0.043). The cross-sectional diameters of the Achilles tendon after open repair was significantly different from that after percutaneus repair. There were no significant differences in ATRS, AOFAS and VAS at the final follow-up between the two groups. One patients of group A experienced delayed wound healing, which resolved in about 40 days. Conclusions : Two suture methods can provide good clinical results. Bundle-Bundle suture is more effective in solving the shortcomings of traditional methods. It is a safe and effective method, and is worthy of promotion.

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