May 2016

Metabolic activity suggests Achilles tendons are still healing at 6 months

In the moment: Rehabilitation

By Jordana Bieze Foster

Metabolic activity evident six months after an Achilles tendon rupture—when rehabilitation protocols typically allow running and other high-load activities—suggests the tendon is still healing at that time, according to research from Denmark.

Investigators from Bispebjerg Hospital in Copenhagen used positron emission tomography (PET) and power Doppler ultrasonography to assess Achilles tendon metabolism and vascularization in 23 patients three, six, and 12 months after surgeons repaired their ruptured tendons.

Relative glucose uptake on PET scans, an indicator of metabolic activity, was significantly higher in repaired tendons than intact tendons at all three time points, and was negatively related to patient-reported outcomes at six months. Glucose uptake was also higher in the tendon core than the periphery at three and six months. Vascular flow activity was significantly higher in repaired tendons than intact tendons at three and six months but had normalized by 12 months.

The findings were epublished in April by the European Journal of Nuclear Medicine and Molecular Imaging.


Eliasson P, Couppe C, Lonsdale M, et al. Ruptured human Achilles tendon has elevated metabolic activity up to 1 year after repair. Eur J Nucl Med Mol Imaging 2016 Apr 13. [Epub ahead of print]

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