Achilles Tendon After Percutaneous Surgical Repair: Serial MRI Observation of Uncomplicated Healing

Fujikawa, Akira; Kyoto, Yukishige; Kawaguchi, Masahisa; Naoi, Yutaka; Ukegawa, Yo

doi:10.2214/ajr.07.2260

Cited by 39 publications

(67 citation statements)

References 11 publications

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“…In significant partial tears of the Achilles tendon the excision of the degenerated tissue can lead to complete pain relief and full restoration of function [29]. Several studies compared the different treatment options of Achilles tendon disorders using MRI to document the size and the morphology of the tendon and the muscles [6,7,30]. Hahn et al [31] evaluated the clinical outcome and MRI findings in 13 patients with chronic Achilles tendinopathy and tears treated with flexor hallucis tendon transfer.…”

Section: Discussionmentioning

confidence: 99%

Oedema and fatty degeneration of the soleus and gastrocnemius muscles on MR images in patients with achilles tendon abnormalities

et al. 2011

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Objective The purpose of this study was to evaluate the frequency of oedema and fatty degeneration of the soleus and gastrocnemius muscles in patients with Achilles tendon abnormalities. Methods Forty-five consecutive patients (mean 51 years; range 14-84 years) with achillodynia were examined with magnetic resonance (MR) images of the calf. The frequency of oedema and fatty degeneration in the soleus and gastrocnemius muscles was determined in patients with normal tendons, tendinopathy and in patients with a partial tear or a complete tear of the Achilles tendon. Results Oedema was encountered in 35% (7/20) of the patients with tendinopathy (n=20; range 13-81 years), and in 47% (9/19) of the patients with partial tears or complete tears (n=19; 28-78 years). Fatty degeneration was encountered in 10% (2/20) of the patients with tendinopathy, and in 32% (6/19) of the patients with tears. The prevalence of fatty degeneration was significantly more common in patients with a partial or complete tear compared with the patients with a normal Achilles tendon (p=0.032 and p= 0.021, respectively). Conclusion Oedema and fatty degeneration of the soleus and gastrocnemius muscles are common in patients with Achilles tendon abnormalities.

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Section: Discussionmentioning

confidence: 99%

Oedema and fatty degeneration of the soleus and gastrocnemius muscles on MR images in patients with achilles tendon abnormalities

et al. 2011

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“…Some investigators have indicated that increased SI on T2-weighted images may cause a misdiagnosis as a retear due to postoperative hyperemic granulation tissue, edematous changes, or ongoing inflammation at the repair site (6, 9, 22). This suggestion has been supported by follow-up studies reporting interval changes in MRI SI of repaired tendons (4, 25, 26). Jost et al (26) reported that eight of 20 patients diagnosed with a retear on the first postoperative MRI had no evidence of a retear on a long-term follow-up MRI 7.6 years later.…”

Section: Discussionmentioning

confidence: 72%

“…Serial MRIs after uncomplicated Achilles tendon repair show an inevitable tendon gap during the early follow-up period, although the incidence decreased over time and was absent 12 weeks after surgery (25). The authors suggested that this may have been related to the normal healing process.…”

Section: Discussionmentioning

confidence: 99%

Repaired Supraspinatus Tendons in Clinically Improving Patients: Early Postoperative Findings and Interval Changes on MRI

et al. 2015

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ObjectiveTo demonstrate and further determine the incidences of repaired supraspinatus tendons on early postoperative magnetic resonance imaging (MRI) findings in clinically improving patients and to evaluate interval changes on follow-up MRIs.Materials and MethodsFifty patients, who showed symptomatic and functional improvements after supraspinatus tendon repair surgery and who underwent postoperative MRI twice with a time interval, were included. The first and the second postoperative MRIs were obtained a mean of 4.4 and 11.5 months after surgery, respectively. The signal intensity (SI) patterns of the repaired tendon on T2-weighted images from the first MRI were classified into three types of heterogeneous high SI with fluid-like bright high foci (type I), heterogeneous high SI without fluid-like bright high foci (type II), and heterogeneous or homogeneous low SI (type III). Interval changes in the SI pattern, tendon thickness, and rotator cuff interval thickness between the two postoperative MRIs were evaluated.ResultsThe SI patterns on the first MRI were type I or II in 45 tendons (90%) and type III in five (10%). SI decreased significantly on the second MRI (p < 0.050). The mean thickness of repaired tendons and rotator cuff intervals also decreased significantly (p < 0.050).ConclusionRepaired supraspinatus tendons exhibited high SI in 90% of clinically improving patients on MRI performed during the early postsurgical period. The increased SI and thickness of the repaired tendon decreased on the later MRI, suggesting a gradual healing process rather than a retear.

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“…Recent insights have revealed that percutaneous approaches to tendon repair tend to minimize infection and improve patient satisfaction despite the inability of the surgeon to visualize the defect [24]. While the cosmetic difference between the open and percutaneous method is noteworthy, there is still contention as to whether the percutaneous approach has an effect on the rates of tendon re rupture, the residual gap between blunted ends, or the level of nerve injury [25–27]. …”

Section: Current Therapeutic Strategiesmentioning

confidence: 99%

Engaging Stem Cells for Customized Tendon Regeneration

Thaker

Sharma

2012

Stem Cells International

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The need for a consistent therapeutic approach to tendon injury repair is long overdue. Patients with tendon microtears or full ruptures are eligible for a wide range of invasive and non invasive interventions, often subjectively decided by the physician. Surgery produces the best outcomes, and while studies have been conducted to optimize graft constructs and to track outcomes, the data from these studies have been inconclusive on the whole. What has been established is a clear understanding of healthy tendon architecture and the inherent process of healing. With this knowledge, tissue regeneration efforts have achieved immense progress in scaffold design, cell line selection, and, more recently, the appropriate use of cytokines and growth factors. This paper evaluates the plasticity of bone-marrow-derived stem cells and the elasticity of recently developed biomaterials towards tendon regeneration efforts. Mesenchymal stem cells (MSCs), hematopoietic progenitor cells, and poly(1,8-octanediol co-citrate) scaffolds (POC) are discussed in the context of established grafting strategies. With POC scaffolds to cradle the growth of MSCs and hematopoietic progenitor cells, developing a fibroelastic network guided by cytokines and growth factors may contribute towards consistent graft constructs, enhanced functionality, and better patient outcomes.

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Achilles Tendon After Percutaneous Surgical Repair: Serial MRI Observation of Uncomplicated Healing

Abstract: The time course of the MR findings in the ruptured Achilles tendon after percutaneous surgical repair appears to reflect regular healing.

Cited by 39 publications

References 11 publications

Oedema and fatty degeneration of the soleus and gastrocnemius muscles on MR images in patients with achilles tendon abnormalities

Oedema and fatty degeneration of the soleus and gastrocnemius muscles on MR images in patients with achilles tendon abnormalities

Repaired Supraspinatus Tendons in Clinically Improving Patients: Early Postoperative Findings and Interval Changes on MRI

Engaging Stem Cells for Customized Tendon Regeneration

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