Abstract
Purpose To evaluate differences of Achilles tendon (AT) hardness and morphology between asymptomatic tendons in patients with acute AT ruptures on the contralateral side and asymptomatic tendons in healthy people by using computer-assisted quantification on axial-strain sonoelastography (ASE). Methods The study consisted of 33 asymptomatic tendons in 33 patients (study group) and 34 tendons in 19 healthy volunteers (control group). All the tendons were examined by both ASE and conventional ultrasound. Computer-assisted quantification on ASE was applied to extract hardness variables, including the mean (Hmean), 20th percentile (H20), median (H50) and skewness (Hsk) of the hardness within tendon, and the ratio of the mean hardness within tendon to that outside tendon (Hratio) and three morphological variables: the thickness (THK), cross-sectional area, and eccentricity (ECC) of tendons. Results The Hmean, Hsk, H20, H50, and Hratio in the proximal third of the tendon body in study group were significantly smaller than those in control group (Hmean: 0.43±0.09 vs 0.50±0.07, p=0.001; Hsk: -0.53±0.51 vs -1.09±0.51, p<0.001; H20: 0.31±0.10 vs 0.40±0.10, p=0.001; H50: 0.45±0.10 vs 0.53±0.08, p<0.001; Hratio: 1.01±0.25 vs 1.20±0.23, p=0.003). The THK and cross-sectional area of tendons in the study group were larger than those in the control group (p<0.05). Conclusions As a quantitative objective method, the computer-assisted ASE reveals that the asymptomatic ATs contralateral to acute rupture are softer than those of healthy control group at the proximal third and the asymptomatic tendons in people with rupture history are thicker, larger, and rounder than those of normal volunteers especially at the middle and distal thirds of AT body.
Highlights
The Achilles tendon (AT) is the thickest and strongest tendon in the human body
Given the critical function of AT, the rupture of AT can be a devastating event for general population and a career threatening injury for athletes as one-thirds of the national sports players who suffered an Achilles tendon rupture could never play at the same sports level again [2]
There was no significant difference between the two groups in terms of gender, age, body mass index (BMI) and included tendons (Table 1)
Summary
The Achilles tendon (AT) is the thickest and strongest tendon in the human body. Given the critical function of AT, the rupture of AT can be a devastating event for general population and a career threatening injury for athletes as one-thirds of the national sports players who suffered an Achilles tendon rupture could never play at the same sports level again [2]. The Achilles tendon is one of the most frequently injured tendons in the human body [4], and the incidence of AT ruptures is increasing over the past decades [5, 6]. We suppose that the quality of an asymptomatic Achilles tendon in people suffering contralateral rupture previously is different from that of healthy control group
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
