• Am J Sports Med · Aug 2019

    Quantitative Magnetic Resonance Imaging Analysis of the Common Site of Acute Achilles Tendon Rupture: 5 to 8 cm Above the Distal End of the Calcaneal Insertion.

    • Young Hwan Park, Jung Wook Lim, Gi Won Choi, and Hak Jun Kim.
    • Department of Orthopaedic Surgery, Korea University Guro Hospital, Guro-gu, Seoul, Republic of Korea.
    • Am J Sports Med. 2019 Aug 1; 47 (10): 2374-2379.

    BackgroundPrevious studies have not quantitatively analyzed the site of acute Achilles tendon rupture.PurposeTo investigate the site of acute Achilles tendon rupture via magnetic resonance imaging (MRI).Study DesignCross-sectional study; Level of evidence, 4.MethodsThe medical records and MRIs of 195 patients with acute Achilles tendon rupture were retrospectively reviewed. The rupture site was measured as the distance from the most distal fibers of the Achilles tendon at the calcaneal insertion to the proximal end of the distal stump. The relationship between the site of rupture and patient characteristics was analyzed, and the intra- and interobserver reliability of the measurements was assessed using intraclass correlation coefficients.ResultsThe rupture site had a mean distance of 6.4 cm (SD, 1.5) and the 10th to 90th percentile range was 5.0 to 8.4 cm. There was no significant difference in location of the rupture according to patient characteristics and the time of imaging. The intra- and interobserver reliability of measurements was excellent.ConclusionMost acute Achilles tendon ruptures visible on MRI occurred 5 to 8 cm above the distal end of the calcaneal insertion, which is more proximal than the previously reported 2 to 6 cm location.

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