MRI recovery of the Achilles tendon after percutaneous tenotomy in older children.
BACKGROUND
An observational study was conducted to evaluate the recovery of older children with relapsed congenital clubfoot who underwent an Achilles tenotomy for the second time as part of the Ponseti treatment.


METHODS
Thirteen patients (19 feet) with congenital clubfoot underwent Achilles tenotomy where magnetic resonance images of the severed tendons were taken after 1, 3, and 6 weeks post-procedure. The participants were categorized into older children who underwent tenotomy for the first time (group A: mean, 4.9±1.8, and range, 2.8-7 years old) and older children who underwent tenotomy for a second time (group B: mean, 4.9±1.5, and range, 3-6.8 years old). The area of high signal intensity between the severed tendons on MRI scans was computed using Python programming language and compared with clinical assessment.


RESULTS
Three weeks after Achilles tenotomy, groups A and B had clinically intact tendons in 9 out of 11 and 2 out of 8 feet, respectively, according to both clinical and MRI assessment. From week 1 to week 3 post-tenotomy, computational analysis showed that the mean high signal intensity area of group A decreased by 88.5±15.2%, which was significantly different (P .048 < .05) than the percent reduction of high signal intensity area of group B (69.0±24.9%).


CONCLUSION
Children who underwent Achilles tenotomy for the second time showed slower tendon recovery on the third week post-procedure. A possible reason for slower healing times may be due to the location of tenotomy in being further away from the musculotendinous junction where extrinsic healing mechanisms take place.
['Yao|Manye|M|http://orcid.org/0000-0002-6805-7527', 'Zhang|Chunxu|C|', 'Cheng|Weyland|W|', 'Guo|Junhong|J|', 'Dong|Shijie|S|']
D000125:Achilles Tendon D000367:Age Factors D002648:Child D002675:Child, Preschool D003025:Clubfoot D005260:Female D006801:Humans D008279:Magnetic Resonance Imaging D008297:Male D020127:Recovery of Function D012008:Recurrence D012086:Reoperation D058971:Tenotomy D016896:Treatment Outcome
MRI Clubfoot Achilles tenotomy Ponseti Congenital talipes equinovarus