Magnetic resonance imaging during healing of surgically repaired Achilles tendon ruptures

Twenty consecutive patients with 21 surgically repaired Achilles tendon ruptures were imaged with a 0.1-T magnet at 3 and 6 weeks, and at 3 and 6 months after surgery. Clinical follow-up examinations and functional tests were performed at the time of scanning. An intratendinous area of high-intensity signal was observed in 19 of the 21 surgically repaired Achilles tendons at 3 months after surgery on proton density- and T2-weighted images. The three patients with the largest lesions had clinically poor outcomes at 3 months, whereas those with smaller intratendinous lesions had normal recoveries. Furthermore, patients with an abnormal walk at 3 months (N = 5) had statistically larger intratendinous lesions than patients who could walk normally. In all patients the cross-sectional area of the rejoined Achilles tendon showed the largest increase after cast removal (between 6 weeks and 3 months after surgery). In all cases the largest tendon area was measured at 3 months after surgery. Magnetic resonance imaging provides a precise valuable tool to evaluate the postsurgical internal structure of the surgically repaired Achilles tendon.