Achilles tendon elastic properties remain decreased in long term after rupture
Achilles tendon elastic properties remain decreased in long term after rupture
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DOI：
10.1007/s00167-017-4791-4
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发表时间：
2018-07-01
影响因子：
3.8
通讯作者：
Pfeifer, C. G.
中科院分区：
文献类型：
--
作者：
Frankewycz, B.;Penz, A.;Pfeifer, C. G.
跟腱断裂导致下方瘢痕组织形成。弹性成像允许对跟腱的生物力学特性进行可行的体内研究。本研究的目的是研究长期愈合的跟腱的生物力学特性。我们招募跟腱断裂的患者进行弹性成像评估。单侧跟腱断裂包括在内，并在断裂后至少2年使用横波弹性成像在中间物质和跟骨止点扫描。结果与患者对侧未受伤的跟腱以及健康人群进行了比较。进行描述性统计、信度分析及与临床评分的相关性分析。41例患者纳入研究，平均随访时间为74 +/- 30；[26-138]破裂后数月。与对照组（对侧和健康人群分别为2.5 +/- 1.5 m/s （p < 0.01）和2.8 +/- 1.6 m/s (p < 0.0001)）相比，愈合肌腱中间物质的横波弹性成像（横波速度为1.2 +/- 1.5 m/s）存在显著差异。测量结果与临床结果之间没有相关性。本研究表明，愈合后的跟腱断裂后，即使经过长期愈合阶段，其弹性性能也较差。断裂后弹性性能的差异主要源于跟腱的中间部分，大多数断裂发生在这里。弹性图的结果与主观感觉不一致。临床上，生物力学性能的超声弹性测量可以为肌腱恢复提供客观的见解。
Rupture of the Achilles tendon results in inferior scar tissue formation. Elastography allows a feasible in vivo investigation of biomechanical properties of the Achilles tendon. The purpose of this study is to investigate the biomechanical properties of healed Achilles tendons in the long term.Patients who suffered from Achilles tendon rupture were recruited for an elastographic evaluation. Unilateral Achilles tendon ruptures were included and scanned in the mid-substance and calcaneal insertion at least 2 years after rupture using shear wave elastography. Results were compared to patients' contralateral non-injured Achilles tendons and additionally to a healthy population. Descriptive statistics, reliability analysis, and correlation analysis with clinical scores were performed.Forty-one patients were included in the study with a mean follow-up-time of 74 +/- 30; [26-138] months after rupture. Significant differences were identified in shear wave elastography in the mid-substance of healed tendons (shear wave velocity 1.2 +/- 1.5 m/s) compared to both control groups [2.5 +/- 1.5 m/s (p < 0.01) and 2.8 +/- 1.6 m/s (p < 0.0001) contralateral and healthy population, respectively]. There was no correlation between the measurements and the clinical outcome.This study shows that the healed Achilles tendon after rupture has inferior elastic properties even after a long-term healing phase. Differences in elastic properties after rupture mainly originate from the mid-substance of the Achilles tendon, in which most of the ruptures occur. Elastographic results do not correspond with subjective perception. Clinically, sonoelastographical measurements of biomechanical properties can be useful to provide objective insights in tendon recovery.