Acute Achilles Tendon Ruptures

Cooper, Minton Truitt

doi:10.1016/j.csm.2015.06.001

Cited by 15 publications

(7 citation statements)

References 57 publications

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“…Wound complications after ATR surgical repair have been documented as a concern that warrants consideration of nonoperative treatment for these injuries. 8 A retrospective study of 60 operatively managed ATR patients by Marican et al found that 16.7% of patients suffered infectious complications. 18 In contrast to this study, we did not find an association between obesity and risk of superficial wound infections.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for complications after primary repair of Achilles tendon ruptures

Pean

Christiano

Rubenstein

et al. 2018

Journal of Orthopaedics

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Section: Discussionmentioning

confidence: 99%

Risk factors for complications after primary repair of Achilles tendon ruptures

Pean

Christiano

Rubenstein

et al. 2018

Journal of Orthopaedics

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“…Wound complications after ATR surgical repair have been documented as a concern that warrants consideration of non operative treatment for these injuries [18]. A retrospective study of 60 operatively managed ATR patients by Marican et al found that 16.7% of patients suffered infectious complications [19].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Complications after Primary Repair of Achilles Tendon Ruptures

Pean

Christiano

Rubenstein

et al. 2017

Clin Res Foot Ankle

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Background: Operative treatment of Achilles tendon ruptures is associated with lower rates of rereupture compared to nonoperative treatment. However, concerns regarding adverse events (AE) in the postoperative period such as wound complications and surgical site infection (SSI) persist. The purpose of this study was to identify patient characteristics associated with the occurrence of adverse events in Achilles tendon rupture (ATR) surgical repair cases.

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“…Despite the benefits of operative management, there are considerable costs associated with surgery and hospitalization and an increased risk for complications such as wound infection and nerve injury [13, 37, 39]. Also, the introduction and increased utilization of accelerated functional rehabilitation strategies have made non-operative management a more attractive treatment option [4, 41]. Consequently, the choice of operative versus non-operative management remains highly controversial.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of Operative Versus Non-operative Management of Acute Achilles Tendon Ruptures

Koltsov

Gribbin

Ellis

et al. 2020

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: The management of acute Achilles tendon ruptures is controversial, and most injuries are treated with surgery in the USA. The cost utility of operative versus non-operative treatment of acute Achilles tendon injury is unclear. Questions/Purposes: The purpose of this study was to compare the cost-effectiveness of operative versus functional non-operative treatment of acute Achilles tendon ruptures. Methods: A Markov cost-utility analysis was conducted from the societal perspective using a 2-year time horizon. Hospital costs were derived from New York State billing data, and physician and rehabilitation costs were derived from the Medicare physician fee schedule. Indirect costs of missed work were calculated using estimates from the US Bureau of Labor Statistics. Rates of rerupture, major and minor complications, and the associated costs were obtained from the literature. Effectiveness was expressed in quality-adjusted life years (QALYs). For the base-case analysis, operative and non-operative patients were assumed to have the same utilities (quality of life) following surgery. Deterministic and probabilistic sensitivity analyses were conducted to evaluate the robustness of model assumptions. Results: In the base-case model, non-operative management of acute Achilles tendon ruptures dominated operative management, resulting in both lower costs and greater QALY gains. The differences in costs and effectiveness were relatively small. The benefit of non-operative treatment was 1.69 QALYs, and the benefit of operative treatment was 1.67 QALYs. Similarly, the total cost of operative and non-operative management was $13,936 versus $13,413, respectively. In sensitivity analyses, surgical costs and days of missed work were important drivers of cost-effectiveness. If hospitalization costs dropped below $2621 (compared with $3145) or the hourly wage rose above $29 (compared with $24), then operative treatment became a cost-effective strategy at the willingnessto-pay threshold of $50,000/QALY. The model results were also highly sensitive to the relative utilities for operative versus nonoperative treatment. If non-operative utilities decreased relative to operative utilities by just 2%, then operative management became the dominant treatment strategy. Conclusion: For acute Achilles tendon ruptures, non-operative treatment provided greater benefits and lower costs than operative management in the base case; however, surgical costs and the economic impact associated with return to work are important determinants of the preferred cost-effective strategy.

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Acute Achilles Tendon Ruptures

Cited by 15 publications

References 57 publications

Risk factors for complications after primary repair of Achilles tendon ruptures

Risk factors for complications after primary repair of Achilles tendon ruptures

Risk Factors for Complications after Primary Repair of Achilles Tendon Ruptures

Cost-effectiveness of Operative Versus Non-operative Management of Acute Achilles Tendon Ruptures

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