Value of magnetic resonance imaging in monitoring Achilles tendon healing after percutaneous suture using the Dresden technique

Abstract Purpose Tendon healing is a complex process taking place in several stages. There is a paucity of data on tendon morphology after percutaneous repair for acute Achilles tendon rupture. Materials and methods We used high field MRI (1.5 Tesla to 3 Tesla) with T1 and T2-weighted sequences including fat suppression to assess the healing process after percutaneous Achilles tendon repair using the Dresden technique. MRI was performed at 3, 6, 8 and 12 months postoperatively. Results During tendon repair a gradual transition from an irregular and hyperintense signal toward a more homogeneous and hypointense signal was observed inside the Achilles tendon after percutaneous repair. These changes took place centripetally. During the early and late remodeling phase at 6 and 12 months, respectively, the tendons look thickened and homogeneous in both sequences. Conclusions MRI represents an excellent means of monitoring the healing process after percutaneous Achilles tendon repair. The results of the present study confirm that the percutaneous, peritendineum preserving technique with the Dresden instrument results in a near physiologic centripetal tendon healing.