MAGNETIC-RESONANCE-IMAGING DURING HEALING OF SURGICALLY REPAIRED ACHILLES-TENDON RUPTURES

Twenty consecutive patients with 21 surgically repaired Achilles tendo n ruptures were imaged with a 0.1-T magnet at 3 and 6 weeks, and at 3 and 6 months after surgery. Clinical follow-up examinations and functi onal tests were performed at the time of scanning. An intratendinous a rea of high-intensity signal was observed in 19 of the 21 surgically r epaired Achilles tendons at 3 months after surgery on proton density- and T2-weighted images. The three patients with the largest lesions ha d clinically poor outcomes at 3 months, whereas those with smaller int ratendinous lesions had normal recoveries. Furthermore, patients with an abnormal walk at 3 months (N = 5) had statistically larger intraten dinous lesions than patients who could walk normally. In all patients the cross-sectional area of the rejoined Achilles tendon showed the la rgest increase after cast removal (between 6 weeks and 3 months after surgery). In all cases the largest tendon area was measured at 3 month s after surgery. Magnetic resonance imaging provides a precise valuabl e tool to evaluate the postsurgical internal structure of the surgical ly repaired Achilles tendon.