27 Structure and function of the Achilles tendon and plantarflexors after non-surgical management of Achilles tendon rupture: a 12-month cohort study

Introduction Achilles tendon rupture’s (ATR) are increasing globally and are commonly managed non-surgically. We aimed to understand recovery using ultrasound imaging, strength testing and patient reported outcomes.Materials and Methods Longitudinal cohort study consisting of 60 participants post-ATR managed non-surgically. Assessments were performed at week 0, 8, 10, 16, 26, and 52. Outcomes included Ultrasound Tissue Characterisation (UTC): Cross-Sectional Area (CSA) of Aligned Fibrillar Structure (AFS) and Disorganised Fibrillar Structure (DFS). Plantarflexor strength was measured using maximal voluntary isometric contraction (MVIC) and the calf raise test. Patient-reported outcomes included the Achilles Tendon Rupture Score (ATRS), EQ-5D-5L and Tampa Scale for Kinesiophobia (TSK). Achilles tendon resting angle (ATRA) indirectly measured tendon elongation.Results Thirty-six participants completed 52 week follow up (mean age 49 years, 85% male, body mass index 30). Primary ATR mechanism was sport (75%)At all assessments, the ruptured tendon CSA and DFS was significantly greater than the non-ruptured side (p