PURPOSE Optimizing tendon structural recovery during the first 12 weeks after Achilles tendon rupture is a prime target to improve patient outcomes, but a comprehensive understanding of biomarkers is needed to track early healing. The purpose of this study was to observe healing of tendon structure over time using ultrasound-based, tendon-specific measures and to identify relationships between tendon structural characteristics and clinical measures of gait and strength. METHODS Twenty-seven participants (21 males, mean (SD) age 39 (11) years) were assessed at 4, 8, 12, and 24 weeks after injury or surgery using ultrasound imaging techniques. Gait analysis and strength testing were added at the later time points. RESULTS Ruptured tendons had significantly lower dynamic shear modulus (p < 0.001), greater tendon cross-sectional area (p < 0.001), and greater length (p < 0.001) than the uninjured side. Dynamic shear modulus, cross-sectional area, and length were found to increase over time (p < 0.01). Tendon structure at 4 weeks post-injury [cross-sectional area symmetry (r = 0.737, p = 0.002) and dynamic shear modulus (r = 0.518, p = 0.040)] related to stance phase walking symmetry at 24 weeks. CONCLUSIONS Tendon structure assessed by ultrasound imaging changes over the first 24 weeks of healing after Achilles tendon rupture, suggesting it could be used as a biomarker to track tendon healing early in recovery. Additionally, tendon structure within the first 12 weeks relates to later walking gait and heel-rise symmetry, which may indicate that tendon structure could have prognostic value in the care of these patients. This study's clinical relevance is in its support for using ultrasound imaging to assess early patient healing and prognosticate later patient outcomes after Achilles tendon rupture. LEVEL OF EVIDENCE Level 2, prospective cohort prognostic study.

中文翻译：

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通过超声评估的肌腱形态和力学性能显示，恢复期较早变化，并且对6个月的结果具有潜在的预后能力。

目的优化跟腱断裂后的最初12周内的肌腱结构恢复是改善患者预后的主要目标，但需要全面了解生物标志物以追踪早期愈合。这项研究的目的是使用基于超声的特定于肌腱的措施观察肌腱结构随时间的愈合情况，并确定肌腱结构特征与步态和力量临床测量之间的关系。方法采用超声成像技术在受伤或手术后第4、8、12和24周对27名参与者（21名男性，平均（SD）年龄39（11）岁）进行了评估。步态分析和强度测试在稍后的时间点添加。结果破裂的肌腱具有明显较低的动态剪切模量（p <0.001），较大的肌腱横截面积（p <0。001），并且长度（p <0.001）大于未受伤的一侧。动态剪切模量，横截面积和长度随时间增加（p <0.01）。损伤后4周的肌腱结构[横截面积对称性（r = 0.737，p = 0.002）和动态剪切模量（r = 0.518，p = 0.040）]与24周时的姿态相走对称性有关。结论在跟腱断裂后的最初24周内，通过超声成像评估的肌腱结构发生了变化，这表明它可以用作追踪肌腱恢复早期的生物标记。此外，前12周内的肌腱结构与后来的步态和脚跟抬起对称有关，这可能表明肌腱结构在这些患者的护理中可能具有预后价值。这项研究' 它的临床意义在于支持使用超声成像评估阿喀琉斯腱断裂后的早期患者愈合情况并预测晚期患者的预后。证据级别2级，前瞻性队列预后研究。