Partial achilles tendon rupture presenting with giant hematoma; MRI findings of 4 year follow up

Background: The purpose of this retrospective study was to clarify the operative outcomes of the side-locking loop suture (SLLS) technique accompanied by autologous semitendinosus tendon grafting for chronic Achilles tendon rupture. Methods: A chart review was conducted of consecutive patients treated with the SLLS technique at our department from 2012 to 2017. Postoperatively, a below-knee splint was applied for 2 weeks in 20 degrees of plantar flexion and then active range of motion exercise was started. Partial weightbearing exercise was allowed at 4 weeks according to patient tolerance, and full weightbearing without crutches was allowed at 8 weeks. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale score and the Achilles tendon rupture score (ATRS) were used to evaluate clinical outcomes preoperatively and at the final follow-up. Results: Ten patients (6 men, 4 women) were included in the analysis. Mean AOFAS ankle-hindfoot scale score increased significantly from 64.2 ± 5.6 points preoperatively to 95.0 ± 5.3 points at the final follow-up ( P < .001). The mean ATRS also increased significantly from 29.8 ± 4.4 points to 86.2 ± 7.7 points, respectively ( P < .001). Mean time between surgery and ability to perform 20 continuous double-leg heel raises of the operated foot was 13.5 ± 3.4 (range 10-18) weeks. One patient complained of postoperative hypoesthesia in the foot, which had spontaneously resolved by 3 months after surgery. Conclusion: The SLLS technique accompanied by autologous semitendinosus tendon grafting provided successful operative outcomes for patients with chronic Achilles tendon rupture regardless of the size of the defect, and thus long-term orthotic use was not needed after surgery. Level of Evidence: Level IV, retrospective case series.

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V-Y Tendon Plasty for Reconstruction of Chronic Achilles Tendon Rupture: A Medium-term and Long-term Follow-up

Orthopaedic Surgery ◽

10.1111/os.12429 ◽

2019 ◽

Vol 11 (1) ◽

pp. 109-116 ◽

Cited By ~ 2

Author(s):

Yang-jing Lin ◽

Xiao-jun Duan ◽

Liu Yang

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Medium Term ◽

Long Term Follow Up

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Risk of Deep Vein Thrombosis After Acute Achilles Tendon Rupture: A Secondary Analysis of a Randomized Controlled Trial Comparing Early Controlled Motion of the Ankle Versus Immobilization

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120915909 ◽

2020 ◽

Vol 8 (4) ◽

pp. 232596712091590 ◽

Cited By ~ 3

Author(s):

Kristoffer Weisskirchner Barfod ◽

Emil Graakjær Nielsen ◽

Beth Hærsted Olsen ◽

Pablo Gustavo Vinicoff ◽

Anders Troelsen ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Achilles Tendon ◽

Tendon Rupture ◽

Controlled Trial ◽

Achilles Tendon Rupture ◽

Vein Thrombosis ◽

Randomized Controlled ◽

Deep Vein ◽

D Dimer

Background: Immobilization of the ankle joint has been suggested as a key element in the pathogenesis leading to deep vein thrombosis (DVT). Purpose: To investigate whether early controlled ankle motion (ECM) could reduce the incidence of DVT compared with immobilization (IM) in the treatment of acute Achilles tendon rupture. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: Patients aged 18 to 70 years were eligible for inclusion, and treatment was nonoperative. The ECM group performed movements of the ankle 5 times a day from weeks 3 to 8 after rupture. The control group was immobilized for 8 weeks. The outcome measure was DVT diagnosed with color Doppler ultrasound for above- and below-knee DVT at 2 and 8 weeks. The Achilles tendon Total Rupture Score, the heel-rise work test, and the Copenhagen Achilles ultrasonographic Length Measurement were performed at 4-, 6-, and 12-month follow-up. Results: A total of 189 patients were assessed for eligibility from February 2014 to December 2016. Of these, 130 were randomized: 68 patients were allocated to the ECM group and 62 to the IM group. All patients participated in follow-up at 8 weeks assessing for DVT. In total, 62 (47.7%) patients were diagnosed with DVT: 33 of 68 (48.5%) in the ECM group and 28 of 61 (46.8%) in the IM group ( P = .84). DVT did not affect treatment outcomes at 4, 6, and 12 months. D-dimer had low sensitivity (71%) for detecting DVT. Conclusion: We found that 1 in 2 patients presented with DVT in nonoperative treatment of acute Achilles tendon rupture. The ECM protocol revealed no benefit versus IM in reducing the incidence of DVT. DVT did not influence functional and patient-reported outcomes the first year after rupture. D-dimer seems an inappropriate test for detection of DVT in patients with acute Achilles tendon rupture. Registration: NCT02015364 ( ClinicalTrials.gov identifier).

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Comparison of Gastrocnemius Turn Flap and Hamstring Graft for the Treatment of Kuwada Type 3 Chronic Ruptures of the Achilles Tendon: A Retrospective Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119887673 ◽

2019 ◽

Vol 7 (12) ◽

pp. 232596711988767

Author(s):

Lu Bai ◽

Siyao Guan ◽

Tian You ◽

Wentao Zhang ◽

Peng Chen

Keyword(s):

Retrospective Study ◽

Achilles Tendon ◽

Clinical Outcomes ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Hamstring Graft ◽

Early Recovery ◽

Level Of Evidence ◽

Type 3

Background: Chronic Achilles tendon rupture is challenging to repair, and many procedures have been suggested to fill the gap that separates the distal and proximal ends of the ruptured tendon. Purpose: To compare clinical outcomes between the free hamstring graft (HG) and gastrocnemius turn flap (GTF) procedures in the treatment of chronic Achilles tendon rupture. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study included 26 patients (25 males, 1 female; mean age, 36.7 years; range, 22-53 years) with Kuwada type 3 chronic rupture of the Achilles tendon. A total of 11 patients underwent GTF surgery, whereas 15 patients underwent HG surgery. Follow-up assessments were conducted at 3, 6, and 12 months postoperatively. Results: The complication rate was significantly higher in the GTF group compared with the HG group (27.2% vs 6.6%, respectively; χ2 = 12.462; P = .001). At the 3-month follow-up, the degree of ankle dorsiflexion was significantly higher in the HG group than in the GTF group ( t = 3.144; P = .004). At 6-month and 1-year follow-up, no significant differences in ankle function were seen between the 2 groups. Conclusion: Hamstring tendon graft is associated with better early recovery of dorsiflexion compared with GTF. The long-term clinical outcomes of these 2 procedures are similar.

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Results of tenorrhaphy with early rehabilitation for acute tear of Achilles tendon

Journal of Orthopaedic Surgery ◽

10.1177/2309499018802483 ◽

2018 ◽

Vol 26 (3) ◽

pp. 230949901880248 ◽

Cited By ~ 2

Author(s):

Chang Hyun Ryu ◽

Ho Seong Lee ◽

Sang Gyo Seo ◽

Ho Yeon Kim

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Surgical Repair ◽

Plantar Flexion ◽

Achilles Tendon Rupture ◽

Early Rehabilitation ◽

Calf Circumference ◽

Major Complications ◽

The Mean

Background: For the treatment of acute Achilles tendon rupture, early rehabilitation after surgical repair is believed to be a useful method. The purpose of this study was to evaluate the outcome of open tenorrhaphy followed by early rehabilitation. Methods: A total of 112 patients who underwent open repair and early rehabilitation for acute Achilles tendon rupture from January 2003 to March 2015 were retrospectively reviewed. These 112 patients (80 men, 32 women) had an average age of 43.1 years (22–62 years), and the mean follow-up period was 91.8 months (12–171 months). A short leg cast was applied postoperatively for an average of 16.5 days (12–20 days). The mean duration of bracing was 6.9 weeks (6–8 weeks). Each patient was assessed based on range of motion, single heel raising test, calf circumference compared to the contralateral limb, ability to return to previous activity, the Arner–Lindholm scale, and the American orthopaedic foot and ankle society (AOFAS) hind foot scale. Isokinetic plantar flexion power was also checked. Results: All patients were fully satisfied (AOFAS ≥ 90) with the treatment results, and 96 patients were able to return to their previous athletic activities. As assessed by the Arner–Lindholm scale, 103 cases were rated as excellent and the other 9 cases were rated as good. At the 1-year follow-up period, single heel raise and hopping was possible in every patient. Compared to the contralateral side, 10 subjects (8.9%) had minor limitation of dorsiflexion motion, and an average of 1.6 cm calf circumference difference without functional disabilities. There were no major complications such as re-rupture, nerve injury, or infection. Conclusion: For acute Achilles tendon ruptures, open surgical repair with optimal length restoration, followed by earlier rehabilitation results in good functional outcomes and a successful return to pre-injury levels of physical activity without major complications. Level of evidence: Level IV.

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Achilles tendon rupture owing to rheumatoid disease. Case report with a nine-year follow-up

JAMA ◽

10.1001/jama.239.5.435 ◽

1978 ◽

Vol 239 (5) ◽

pp. 435-436 ◽

Cited By ~ 2

Author(s):

M. R. Rask

Keyword(s):

Case Report ◽

Achilles Tendon ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Rheumatoid Disease ◽

Disease Case

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Effect of Achilles Tendon Rupture on Player Performance and Longevity in National Basketball Association Players

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120966041 ◽

2020 ◽

Vol 8 (11) ◽

pp. 232596712096604

Author(s):

Lafi S. Khalil ◽

Toufic R. Jildeh ◽

Joseph S. Tramer ◽

Muhammad J. Abbas ◽

Luke Hessburg ◽

...

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Demographic Characteristics ◽

National Basketball Association ◽

Control Group ◽

Tendon Ruptures ◽

And Performance ◽

Player Performance

Background: National Basketball Association (NBA) players who return to sport (RTS) after Achilles tendon rupture have been reported to have poor outcomes. Purpose: To evaluate the effect of Achilles tendon ruptures on player performance and career longevity in NBA athletes. Study Design: Cohort study; Level of evidence, 3. Methods: NBA players who sustained Achilles tendon ruptures between 1970 and 2019 were identified using publicly available resources and were matched 1:1 to a healthy control group by age, position, height, and body mass index. Demographic characteristics, player utilization (games and minutes), and performance efficiency rating (PER) were documented for all athletes. The season of Achilles tendon rupture was set as the index year, and statistical analysis compared postindex versus preindex data both acutely and in the long term. Percentages relative to preoperative values were calculated to compare the injured and control groups in a standardized fashion. Results: Of 47 players, 34 (72.3%) with Achilles tendon ruptures returned to play at the NBA level after surgical intervention. A total of 7 players were excluded from the study. No differences were found in demographic characteristics or PER (2 years before injury) between the remaining 27 players and matched controls. The injured players had significantly shorter careers compared with control players (3.1 ± 2.3 vs 5.8 ± 3.5 seasons, respectively; P < .05). Injured players demonstrated significant declines in games per season (GPS), minutes per game (MPG), and PER at 1 year and 3 years after RTS compared with preindex baseline ( P < .05). Injured players, compared with control players, had reduced relative percentages of games started (GS) (50% vs 125%, respectively), MPG (83% vs 103%), and PER (80% vs 96%) at 1 year after return ( P < .05), but reductions at extended 3-year follow-up were seen only in GPS (71% vs 91%) and GS (39% vs 99%) ( P < .05). Conclusion: Our study found that 72.3% of NBA players returned to play after Achilles tendon repair, but they had shorter careers compared with uninjured controls. Players returning from Achilles tendon repairs had decreased game utilization and performance at all time points relative to their individual preindex baseline. However, for the injured players when compared with controls, game utilization but not performance was found to be decreased at 3-year follow-up.

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