Treatment of acute achilles tendon ruptures

Kuhn, H.; Thomas, Manfred

doi:10.1016/s1619-9987(08)60280-9

Cited by 4 publications

(9 citation statements)

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“…Given the high prevalence of Achilles tendon ruptures and the extended recovery time that often follows surgical repairs, 6,7,13 improved suturing techniques that can strengthen repairs and allow for earlier active mobilization are highly desirable. 10,14,15,18,24 Despite much research on which core suturing techniques maximize the strength of repaired Achilles tendons, 4,17,26 few published studies have investigated the biomechanical properties of supplemental epitenon sutures added to Achilles tendon repairs.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Comparison of the Simple Running and Cross-Stitch Epitenon Sutures in Achilles Tendon Repairs

2008

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Section: Introductionmentioning

confidence: 99%

Biomechanical Comparison of the Simple Running and Cross-Stitch Epitenon Sutures in Achilles Tendon Repairs

2008

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“…Khan et al determined in a meta-analysis that open operative treatment of acute Achilles tendon ruptures decreased the rerupture rate when compared to nonoperative treatment. 6 However, operative treatment was associated with a significantly higher rate of major complications including wound breakdown, adhesions, infection, and neurovascular damage. This meta-analysis concluded that these major complications can be reduced by performing the surgery percutaneously.…”

Section: Discussionmentioning

confidence: 99%

“…This meta-analysis concluded that these major complications can be reduced by performing the surgery percutaneously. 6…”

Section: Discussionmentioning

confidence: 99%

“…Despite the extensive literature concerning Achilles tendon ruptures, there is no consensus on a surgical procedure for the primary repair of acute Achilles tendon ruptures. 2,3,6,8,11 Ultimately, the goal is to restore function to preinjury levels and avoid complications. Open surgical techniques have been associated with wound healing problems, and both open and percutaneous surgical methods have the potential for nerve damage.…”

Section: Introductionmentioning

confidence: 99%

“…Recent literature has shown improved results with early mobilization after Achilles repair. 5,6,12 A standard rehabilitation program usually restricts weightbearing during the first 6 weeks, allows biking and jogging at 12 weeks, and a full return to sports at 6 months. A more accelerated rehabilitation program would have many advantages.…”

Section: Introductionmentioning

confidence: 99%

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Primary Achilles Tendon Repair with Mini-Dorsolateral Incision Technique and Accelerated Rehabilitation

Hrnack¹,

Crates

Barber

2012

Foot Ankle Int.

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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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Treatment of acute achilles tendon ruptures

Cited by 4 publications

References 0 publications

Biomechanical Comparison of the Simple Running and Cross-Stitch Epitenon Sutures in Achilles Tendon Repairs

Biomechanical Comparison of the Simple Running and Cross-Stitch Epitenon Sutures in Achilles Tendon Repairs

Primary Achilles Tendon Repair with Mini-Dorsolateral Incision Technique and Accelerated Rehabilitation

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

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