The Risk of Achilles Tendon Rupture in the Patients with Achilles Tendinopathy: Healthcare Database Analysis in the United States

Abstract

Introduction. Disorders of the Achilles tendon can be broadly classified into acute and chronic entities. Few studies have established chronic Achilles tendinopathy as a precursor to acute Achilles ruptures. In this study, we assessed the relationship between Achilles tendinopathy and rupture, clarifying the incidence of rupture in the setting of underlying tendinopathy. Methods. The United Healthcare Orthopedic Dataset from the PearlDiver Patient Record Database was used to identify patients with ICD-9 codes for Achilles rupture and/or Achilles tendinopathy. The number of patients with acute rupture, chronic tendinopathy, and rupture following a prior diagnosis of tendinopathy was assessed. Results. Four percent of patients with an underlying diagnosis of Achilles tendinopathy went on to sustain a rupture (7,232 patients). Older patients with tendinopathy were most vulnerable to subsequent rupture. Conclusions. The current study demonstrates that 4.0% of patients who were previously diagnosed with Achilles tendinopathy sustained an Achilles tendon rupture. Additionally, older patients with Achilles tendinopathy were most vulnerable. These findings are important as they can help clinicians more objectively council patients with Achilles tendinopathy.

Incidence, Risk Factors, and Treatment of Achilles Tendon Rupture in Patients With End-Stage Renal Disease

“…We speculate that ATR in the ESRD population is less attributable to sports and more attributable to other factors such as metabolic abnormality, 21,27 use of fluoroquinolones and steroids, 5,30 lower levels of regular physical activity, 2 or preinjury tendinosis. 14,35…”

Mechanotransduction of stem cells for tendon repair

“…Histologically, disorganization of collagen, increased noncollagenous ECM, hypercellularity, and neovascularization can be seen[ 11 , 12 ]. The exact relationship between tendinopathy and tendon rupture remains unknown, but it has been reported that tendinopathy increases the risk of tendon rupture[ 13 ]. Acute partial or complete tendon rupture interrupts tendon continuity, leading to bleeding, clotting, and the release of PDGF, TGF-β, ATP, and ADP from platelets and of epinephrine and norepinephrine from blood vessels at the wound site[ 9 ], resulting in a decrease or even loss of function and, potentially, in the loss of mobility.…”

Estrogen and mechanical loading-related regulation of estrogen receptor-β and apoptosis in tendinopathy

“…Secondly, a rat Achilles tendinopathy used to model hand diseases here might not be suitable since known knowledge demonstrated that Achilles tendon rupture rates were widely and thoroughly acknowledged to be strongly male dominant. USA health care data indicates males sustained ruptures more frequently than females (male versus female; 141 per 100,000 versus 67 per 100,000) [ 31 ]. In a 10-year-period in Sweden of 27,702 patients with acute Achilles tendon ruptures 79% were men (21,979 men) [ 32 ].…”