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Updated: Feb 4, 2026

Ultrasound Tissue Characterization of Human Achilles Tendon by Stability Quantification of Echo Patterns
Published on: September 5, 2025
Achilles tendinosis does not always precede Achilles tendon rupture
Young Hwan Park1, Tae Jin Kim1, Gi Won Choi2
1Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, South Korea.
Achilles tendon rupture can occur without prior tendinosis, particularly in non-athletic injuries. This finding challenges previous assumptions about Achilles tendinosis being a prerequisite for rupture.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Histopathology
Background:
- Achilles tendinosis is commonly observed in ruptured Achilles tendons.
- The role of degenerative changes in Achilles tendon rupture etiology is debated.
Purpose of the Study:
- To investigate the histological findings of ruptured Achilles tendons.
- To analyze the relationship between Achilles tendinosis, demographics, and injury patterns.
Main Methods:
- Retrospective analysis of 152 acute Achilles tendon ruptures (2008-2015).
- Histological examination for Achilles tendinosis.
- Comparison of demographics, sports activity (Ankle Activity Score), and outcomes (Achilles Tendon Total Rupture Score - ATRS) between groups with and without tendinosis.
Main Results:
- 77% of ruptures showed histological evidence of Achilles tendinosis.
- 23% of ruptures occurred without prior tendinosis.
- Patients without tendinosis had lower sports activity levels and a higher incidence of non-sports-related injuries.
Conclusions:
- Achilles tendon rupture can occur in the absence of prior tendinosis.
- Non-sports-related injuries and low activity levels are associated with rupture without tendinosis.
- Findings enhance understanding of Achilles tendon rupture etiology.
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