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Evaluation of Elastic Stiffness in Healing Achilles Tendon After Surgical Repair of a Tendon Rupture Using In Vivo Ultrasound Shear Wave Elastography

Li-ning Zhang, Wen-bo Wan, Yue-xiang Wang, Zi-yu Jiao, Li-hai Zhang, Yu-kun Luo, Pei-fu Tang

(Department of Orthopedics, Chinese People’s Liberation Army General Hospital, Beijing, China (mainland))

Med Sci Monit 2016; 22:1186-1191

DOI: 10.12659/MSM.895674

Published: 2016-04-09

BACKGROUND: There has been no published report assessing the mechanical properties of a repaired Achilles tendon after surgery using shear wave elastography (SWE). The aim of this study was to investigate the changes in mechanical properties of the healing Achilles tendon after surgical repair of a tendon rupture using ultrasound SWE and how these changes correlate with tendon function.
MATERIAL AND METHODS: Twenty-six patients who underwent surgical repair for Achilles tendon rupture were examined with ultrasound SWE coupled with a linear array transducer (4–15 MHz). The elasticity values of the repaired Achilles tendon in a longitudinal view were measured at 12, 24, and 48 weeks postoperatively. Functional outcomes were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system at 12, 24, and 48 weeks postoperatively. General linear regression analysis and correlation coefficients were used to analyze the relationship between elasticity and the AOFAS score.
RESULTS: There were significant differences with respect to the mean elasticity values and functional scores of the repaired Achilles tendon at 12, 24, and 48 weeks postoperatively (all P<0.05). Tendon function was positively correlated with the elasticity of the repaired Achilles tendon (P=0.0003).
CONCLUSIONS: Our findings suggest that SWE can provide biomechanical information for evaluating the mechanical properties of healing Achilles tendon and predict Achilles tendon function.

Keywords: Adult, Achilles Tendon - surgery, Aged, elastic modulus, Elasticity Imaging Techniques - methods, Female, Humans, Male, Middle Aged, Orthopedic Procedures - methods, Reconstructive Surgical Procedures - methods, Rupture, Tendon Injuries - surgery, Treatment Outcome, Ultrasonics, Ultrasonography - methods, Wound Healing - physiology