Gordana Ivanac1,2, Domagoj Lemac3, Vilma Kosovic4, Kristina Bojanic5, Tomislav Cengic6, Ivo Dumic-Cule7,8, Marko Pecina2, Boris Brkljacic1,2. 1. Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia. 2. School of Medicine, University of Zagreb, Salata 3, 10000, Zagreb, Croatia. 3. Department of Orthopaedic and Trauma Surgery, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia. 4. Department of Radiology,, General Hospital Dubrovnik, Dubrovnik, Croatia. 5. Department of Biophysics and Radiology, Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, 31000, Osijek, Croatia. 6. Department of Orthopaedic and Trauma Surgery, University Hospital Center "Sisters of Mercy", Draskoviceva 19, 10000, Zagreb, Croatia. 7. Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia. ivodc1@gmail.com. 8. School of Medicine, University of Zagreb, Salata 3, 10000, Zagreb, Croatia. ivodc1@gmail.com.
Abstract
PURPOSE: It was demonstrated that about 6% of patients with a ruptured Achilles tendon experience the rupture of contralateral tendon in the future; the aim of this study was to estimate the risk for rupture of contralateral tendon in patients who underwent surgical reconstruction of ruptured Achilles tendon by using subjective questionnaires and shear-wave elastography. METHODS: Twenty-four patients who underwent surgical repair of the ruptured Achilles tendon and twelve age-matched healthy controls were examined with ultrasound SWE. Functional outcomes were assessed with American Orthopedic Foot and Ankle Society (AOFAS) scoring system and subjective rating system which we introduced and validated. RESULTS: The elasticity of injured tendon was markedly decreased (by 42%) compared to the contralateral tendon of the patient, as expected. Both AOFAS score and our novel subjective assessment scale positively correlate with ultrasound SWE values in ruptured Achilles tendons. The elasticity of contralateral Achilles tendons in patients was 23% lower than among healthy individuals. CONCLUSION: Irrespective of the lack of difference in the subjective feeling assessed by AOFAS, the contralateral tendon in the patients with reconstructed Achilles tendon has significantly lower stiffness than healthy individuals. Therefore, contralateral tendons in patients who suffered from rupture are more prone to future ruptures.
PURPOSE: It was demonstrated that about 6% of patients with a ruptured Achilles tendon experience the rupture of contralateral tendon in the future; the aim of this study was to estimate the risk for rupture of contralateral tendon in patients who underwent surgical reconstruction of ruptured Achilles tendon by using subjective questionnaires and shear-wave elastography. METHODS: Twenty-four patients who underwent surgical repair of the ruptured Achilles tendon and twelve age-matched healthy controls were examined with ultrasound SWE. Functional outcomes were assessed with American Orthopedic Foot and Ankle Society (AOFAS) scoring system and subjective rating system which we introduced and validated. RESULTS: The elasticity of injured tendon was markedly decreased (by 42%) compared to the contralateral tendon of the patient, as expected. Both AOFAS score and our novel subjective assessment scale positively correlate with ultrasound SWE values in ruptured Achilles tendons. The elasticity of contralateral Achilles tendons in patients was 23% lower than among healthy individuals. CONCLUSION: Irrespective of the lack of difference in the subjective feeling assessed by AOFAS, the contralateral tendon in the patients with reconstructed Achilles tendon has significantly lower stiffness than healthy individuals. Therefore, contralateral tendons in patients who suffered from rupture are more prone to future ruptures.