Surgical Treatment of Reruptures of the Tendoachilles Following Nonsurgical Treatment

Scott, W. Norman; Inglis, Allan E.; Tp, Sculco

doi:10.1097/00003086-197905000-00033

Cited by 14 publications

(9 citation statements)

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“…Other authors have drawn similar conclusions demonstrating superior and more consistent results with early repair. 5,6,7,14,15,17,18 However, surgical intervention is not discouraged in chronic injury cases.…”

Section: Discussionmentioning

confidence: 99%

Surgical repair of Achilles tendon ruptures

et al. 1987

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We evaluated the surgical results of 42 consecutive patients with spontaneous rupture of the Achilles tendon treated from 1973 to 1984 to determine the causes of rupture and to evaluate our treatment methods. Patients were divided into early and late repair groups and their charts reviewed to determine common clinical features. A new method of repair with early functional range of motion exercises before casting was used and compared to other techniques in common use. Thirty-one patients were contacted for long-term followup (average, 4.7 years). Twenty-three of these patients returned for intensive reevaluation and Cybex testing. We found a high incidence of gout (14.3%) and previous steroid injections (7.1%) in our patients. Good results were obtained from the four surgical methods used. There were no reruptures and only 7% of the patients experienced minor wound problems. Patients treated with early functional range of motion exercises averaged 12.5 degrees more dorsiflexion at the time of cast removal and did not require adjunctive protective devices. Long-term results, however, revealed equilibration of range of motion and near normal function in all repair techniques with 88% of all patients returning to preinjury activity levels.

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Section: Discussionmentioning

confidence: 99%

Surgical repair of Achilles tendon ruptures

et al. 1987

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“…Conventional nonoperative treatment for rupture of tendo Achillis has an unacceptably high rate of rerupture varying from 13% to 30% [7,14], while both open and percutaneous methods of repair carry a rerupture rate of 2-8% [4,5]. We did not encounter any instances of infection, while open repair carries a risk of infection as high as 5% [5].…”

Section: Resultsmentioning

confidence: 64%

“…Die konservative Behandlung der Achillessehnenruptur ist mit einem inakzeptabel hohen Rerupturrisiko zwischen 13% und 30% behaftet [7,14], während sowohl offene als auch perkutane Methoden ein Rerupturrisiko von 2-8% aufweisen [4,5]. Bei unserer Methode kam es zu keiner Wundinfektion, während offene Verfahren ein Infektionsrisiko von bis zu 5% haben [5].…”

Section: Resultsunclassified

Die Bassi-Methode: eine modifizierte Lappentechnik als Alternative zur offenen Achillessehnennaht

Bassi

Mahindra

2006

Orthop Traumatol

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“…There are few previous studies that have evaluated the long-term outcome of an Achilles tendon re-rupture and all these studies have included fewer than 20 patients [ 11 , 21 , 22 , 25 ]. A total of 44 patients, from a heterogeneous study population, have been evaluated in all four studies, using non-validated outcome measurements, making it difficult to draw any strong conclusions from these data.…”

Section: Introductionmentioning

confidence: 99%

Patients with an Achilles tendon re-rupture have long-term functional deficits in function and worse patient-reported outcome than primary ruptures

Westin

Helander

Silbernagel

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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PurposeThe aim of this study was to perform a long-term follow-up of patients treated for an Achilles tendon re-rupture, using established outcome measurements for tendon structure, lower extremity function and symptoms, and to compare the results with those for the uninjured side. A secondary aim was to compare the outcome with that of patients treated for primary ruptures. The hypotheses were that patients with a re-rupture recover well, and have similar long-term outcome as primary ruptures.MethodsTwenty patients (4 females) with a mean (SD) age of 44 (10.9) years, ranging from 24 to 64, were included. The patients were identified by reviewing the medical records of all Achilles tendon ruptures at Sahlgrenska University Hospital and Kungsbacka Hospital, Sweden, between 2006 and 2016. All patients received standardised surgical treatment and rehabilitation. The mean (SD) follow-up was 51 (38.1) months. A test battery of validated clinical and functional tests, patient-reported outcome measurements and measurements of tendon elongation were performed at the final follow-up. This cohort was then compared with the 2-year follow-up results from a previous randomised controlled trial of patients treated for primary Achilles tendon rupture.ResultsThere were deficits on the injured side compared with the healthy side in terms of heel-rise height (11.9 versus 12.5 cm, p = 0.008), repetitions (28.5 versus 31.7, p = 0.004) and drop-jump height (13.2 versus 15.1 cm, p = 0.04). There was a significant difference in calf circumference (37.1 versus 38.4 cm, p =< 0.001) and ankle dorsiflexion on the injured side compared with the healthy side (35.3° versus 40.8°, p = 0.003). However, no significant differences were found in terms of tendon length 22.5 (2.5) cm on the injured side and 21.8 (2.8) cm on the healthy side. Compared with primary ruptures, the re-rupture cohort obtained significantly worse results for the Achilles tendon total rupture score, with a mean of 78 (21.2) versus 89.5 (14.6) points, (p = 0.007). The re-ruptures showed a higher mean LSI heel-rise height, 94.7% (9.3%) versus 83.5% (11.7%) (p = < 0.0001), and superior mean LSI eccentric-concentic power, 110.4% (49.8%) versus 79.3% (21%) (p = 0.001), than the primary ruptures.ConclusionThe results of this study indicate that patients with an Achilles tendon re-rupture had continued symptoms and functional deficits on the injured side, after a long-term follow-up. Patients with an Achilles tendon re-rupture had worse patient-reported outcomes but similar or superior functional results compared with patients with primary ruptures.Level of evidenceCase series, Level IV.

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Surgical Treatment of Reruptures of the Tendoachilles Following Nonsurgical Treatment

Cited by 14 publications

References 0 publications

Surgical repair of Achilles tendon ruptures

Surgical repair of Achilles tendon ruptures

Die Bassi-Methode: eine modifizierte Lappentechnik als Alternative zur offenen Achillessehnennaht

Patients with an Achilles tendon re-rupture have long-term functional deficits in function and worse patient-reported outcome than primary ruptures

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