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Correlation analysis of metabolic parameters influencing postoperative tendon healing after Achilles tendon rupture
Weixin Ye1,2,3,4, Zhenchen Hou1,2,3,4, Chang Liu1,2,3,4
1Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China.
Background:
Postoperative healing quality critically determines functional recovery following Achilles tendon rupture (ATR) repair. Poor healing often leads to postoperative re-rupture. While mechanical factors influencing healing are well-studied, the role of metabolic disease remains unclear. Emerging evidence suggests metabolic disorders may impair tendon repair, yet their impact on early postoperative outcomes is underexplored.
Purpose:
This study hypothesized that metabolic disease (such as hyperuricemia and dyslipidemia) negatively affect early tendon healing after ATR repair. We aimed to identify key metabolic predictors of delayed healing to guide optimal management of perioperative metabolic parameters.
Methods:
Sixty patients with acute ATR undergoing surgical repair were included. Preoperative serum levels of uric acid (UA), triglycerides (TG), total cholesterol (TC), high-/low-density lipoprotein (HDL-C, LDL-C), and total bilirubin (TBIL) were measured. Postoperative signal-to-noise quotient (SNQ) values were calculated from T2-weighted MRI at 3 months. In preliminary analyses, Spearman's rank correlation and multivariate linear regression were conducted to assess associations between six metabolic biomarkers and SNQ, identifying significant metabolic markers. Subgroup analyses subsequently stratified patients into cohorts based on these determinants, with Mann-Whitney U test comparing intergroup SNQ differences.
Results:
Serum UA showed a significant positive correlation with SNQ (ρ = 0.400, p = 0.002). Multivariate linear regression confirmed UA as an independent predictor of elevated SNQ (β = 0.394, p = 0.006). Lipid markers (TC, TG, HDL-C, LDL-C) and TBIL demonstrated no significant associations. Subgroup analyses compared SNQ levels between hyperuricemic patients and normouricemic controls. Hyperuricemia patients exhibited markedly higher median SNQ values than controls (14.57 vs. 7.27, p < 0.001), indicating delayed healing.
Conclusion:
Hyperuricemia is a significant metabolic factor impairing early ATR healing, highlighting the clinical utility of preoperative UA screening for personalized rehabilitation. Perioperative uric acid control is recommended for hyperuricemic patients to optimize Achilles tendon healing outcomes.
