The ultrasonographic appearance of the ruptured Achilles tendon during healing: a longitudinal evaluation of surgical and nonsurgical treatment, with comparisons to MRI appearance

Abstract

This prospective, randomized trial compared healing characteristics of the Achilles tendon after surgical and nonsurgical treatment for complete rupture of the Achilles tendon. Fifty-eight patients were examined by ultrasonography after 6, 12, and 24 months and by magnetic resonance imaging after 12 months. A standardized protocol was used, and the outcome was correlated with clinical findings. Common findings 1 year after the injury were tendon thickening and moderate heterogeneity of the tendon. Peritendinous reactions, edema, and defects were present only in a minority of patients. There were no significant differences between the treatment groups in any of the evaluated parameters apart from the gliding function of the tendon, which was significantly less in the surgically treated group than in the nonsurgically treated group. No correlations were found between the radiological findings and the clinical parameters, such as muscle strength, endurance, and range of motion. We conclude that the roles of ultrasonography and magnetic resonance imaging during the healing process after Achilles tendon rupture are limited, due to a weak correlation with clinical findings.