Influence of Achilles tendon rupture site on surgical repair outcomes

Abstract

Purpose: This study aims to measure the distance between the common site of Achilles tendon rupture and calcaneal insertion through ultrasound and to compare the outcomes between proximal and distal rupture groups. Methods: We investigated the electronic medical records of 117 patients and preoperative ultrasound describing the rupture site. Among 88 patients, we compared the patient-reported outcome and re-rupture rate of proximal and distal rupture groups. Results: The mean rupture site of the 117 included subjects was 4.5 ± 1.3 cm. The rupture site had a weak negative correlation with body mass index ( ρ = −0.230, P = 0.013). Furthermore, 77% of the patients with distal rupture reported good outcome (Achilles Tendon Rupture Score > 80) compared to 56% of the patients with proximal rupture ( P = 0.041). Conclusion: Patients with proximal rupture had less satisfactory postoperative outcomes than those with distal rupture.

Nonoperative or Surgical Treatment of Acute Achilles’ Tendon Rupture

“…Proximal tears at the musculotendinous junction are usually treated non-operatively due to surgical challenges related to repairing the tear using suture material in muscle tissue 262 . The present thesis focuses on patients with tendon ruptures in the mid-substance part of the Achilles´ tendon.…”

The Delayed Presentation of Achilles Tendon Ruptures Is Associated With Marked Alterations in the Gene Expression of COL1A1, MMPs, TIMPs, and IL-6

“…21 It is therefore not possible to draw conclusions from the present study on whether this higher mRNA level is related to more macrophage infiltration or the proliferation of resident tendon cells. However, it is known that the rupture site affects tendon healing, 2 and this is the first study to indicate that there was a biological difference in human Achilles tendon healing depending on where the rupture was located. The other macrophage marker, MRC1 , did somewhat surprisingly remain at the same level between the 3 temporal groups.…”

Is a Preoperative MRI Scan Necessary for Acute Achilles Tendon Rupture?

“…Accordingly, the authors recommended graded and differentiated treatments for these types of acute ATR. Cao et al 28 investigated the relationship between the ATR site (the distance from the calcaneal insertion to the proximal broken end) and the postoperative outcome (Achilles tendon rupture score) through ultrasound, demonstrating that a proximal rupture had a negative influence on the postoperative outcome. To sum up, the rupture site and shape must be comprehensively considered before surgery to obtain a satisfactory postoperative outcome.…”