gms | German Medical Science

German Congress of Orthopedic and Trauma Surgery (DKOU 2017)

24.10. - 27.10.2017, Berlin

Prospective evaluation of changes in elastic properties of ruptured achilles tendons by shear wave elastography

Meeting Abstract

  • presenting/speaker Leopold Henssler - Universitätsklinikum Regensburg, Klinik und Poliklinik für Unfallchirurgie, Regensburg, Germany
  • Johannes Weber - Universitätsklinikum Regensburg, Klinik und Poliklinik für Unfallchirurgie, Regensburg, Germany
  • Natascha Platz Batista da Silva - Universitätsklinikum Regensburg, Institut für Röntgendiagnostik, Regensburg, Germany
  • Ernst-Michael Jung - Universitätsklinikum Regensburg, Institut für Röntgendiagnostik, Regensburg, Germany
  • Denitsa Docheva - Universitätsklinikum Regensburg, Klinik und Poliklinik für Unfallchirurgie, Regensburg, Germany
  • Michael Nerlich - Universitätsklinikum Regensburg, Klinik und Poliklinik für Unfallchirurgie, Regensburg, Germany
  • Christian Pfeifer - Universitätsklinikum Regensburg, Klinik und Poliklinik für Unfallchirurgie, Regensburg, Germany
  • Borys Frankewycz - Universitätsklinikum Regensburg, Klinik und Poliklinik für Unfallchirurgie, Regensburg, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017). Berlin, 24.-27.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocPO21-635

doi: 10.3205/17dkou758, urn:nbn:de:0183-17dkou7587

Published: October 23, 2017

© 2017 Henssler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives: A few studies have investigated the biomechanical properties of injured Achilles tendons (AT) compared to healthy tendons, but none of them in a prospective survey. Our main objective was to show the development of changes in elastic properties of the AT within the healing period after rupture. Further objectives were to compare non-operatively vs. operatively treated tendon ruptures and to examine a correlation between the patients' subjective outcome and changes in the elastic properties.

Methods: Shear wave elastography (SWE) was performed on AT of patients who had ruptured their AT and received operative (O) or non-operative (N) treatment at stated intervals (1, 3, 6, 9 and 12, 24 and 36 weeks after injury). We included patients who presented at our emergency department with partial or total rupture of the AT. Exclusion criteria were bi-lateral injury in their history, arthrodesis of one of the upper ankle joints, neuropathic or malignant diseases, age < 18 years. Both AT (injured and healthy) of each patient were scanned in the distal, middle and proximal portion as well as in the rupture area (of the injured tendon respectively) using Virtual TouchTM IQ sonography (Siemens Acuson S3000, 4 - 9 MHz linear probe). For evaluation of the patients' outcome we used both the FAOS (Foot an Ankle Outcome Score) and VISA-A-Questionnaire (Victorian Institute of Sport Assessment - Achilles). Statistical analysis was performed by using linear regression analysis.

Results and Conclusion: 8 patients were included in the study by the time of abstract submission [6 (N), 2 (O)]. Results indicate a positive linear correlation between shear wave velocity at the rupture site and time after injury (see Figure 1 [Fig. 1]). Conclusion: Evaluating our patients, we found that quantitative SWE is capable of displaying changes in elastic properties during tendon healing. Furthermore, we found that after an absence of 'elastographic stiffness' in the first weeks after injury there is a noticeable increase of stiffness. No significant differences were found between non-operatively and operatively treated tendons. Further analyses need to be done in order to correlate ultrasound findings with clinical scores and biomechanical parameters. To assess the utility of SWE for monitoring purposes more studies are necessary.