Real-time sonoelastography as novel follow-up method in Achilles tendon surgery

Area of Science:

• Orthopedics
• Radiology
• Biomedical Engineering

Background:

• Achilles tendon ruptures are common injuries.
• Percutaneous treatment is a common surgical approach.
• Assessing tendon healing and biomechanical recovery is crucial.

Purpose of the Study:

• To evaluate Achilles tendon healing after percutaneous treatment using real-time sonoelastography (RTSE).
• To quantify deformation and assess elasticity of healing tendons.
• To correlate sonoelastographic findings with clinical outcomes.

Main Methods:

• Patients with Achilles tendon ruptures treated percutaneously were assessed using RTSE.
• Sonoelastography measured the "strain index" (SI) at multiple tendon sites.
• Clinical outcomes were evaluated using the ATRS questionnaire and correlated with SI.

Main Results:

• Treated tendons showed progressive stiffening over time, with higher SI than contralateral and healthy tendons.
• Peak tendon thickness occurred at 6 months, with some reduction at 1 year.
• ATRS scores improved significantly, negatively correlating with SI.

Conclusions:

• RTSE demonstrates progressive stiffening in surgically treated Achilles tendons, suggesting incomplete biomechanical recovery.
• Achilles tendons do not achieve full "restitutio ad integrum" one year post-surgery.
• RTSE offers valuable quantitative and qualitative data for diagnosing and monitoring Achilles tendon healing.