scholarly journals Long-Term Follow-Up after Acute Achilles Tendon Rupture - Does Treatment Strategy Influence Functional Outcomes?

The Foot ◽  
2021 ◽  
pp. 101769
Author(s):  
Laurine Nilsson ◽  
Jonas Bloch Thorlund ◽  
Inge Lunding Kjær ◽  
Andrius Kazlauskas ◽  
Marianne Christensen
Keyword(s):  
Achilles Tendon ◽  
Treatment Strategy ◽  
Functional Outcomes ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Long Term Follow Up ◽  
Influence Functional

scholarly journals Long Term Clinical–Functional and Ultrasound Outcomes in Recreational Athletes after Achilles Tendon Rupture: Ma and Griffith Versus Tenolig

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1073
Author(s):  
Carlo Biz ◽  
Mariachiara Cerchiaro ◽  
Elisa Belluzzi ◽  
Nicola Luigi Bragazzi ◽  
Giacomo De Guttry ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Return To Sport ◽  
Functional Results ◽  
Return To Sports ◽  
Recreational Athletes ◽  
Sport Activities ◽  
Long Term Follow Up

Background and Objectives: The purpose of this retrospective study was to compare the long-term clinical–functional and ultrasound outcomes of recreational athletes treated with two percutaneous techniques: Ma and Griffith (M&G) and the Tenolig technique (TT). Materials and Methods: recreational athletes, between 18 and 50 years of age, affected by acute Achilles tendon rupture (AATR), treated by M&G or Tenolig techniques were recruited. Clinical–functional outcomes were evaluated using Achilles Tendon Rupture Score (ATRS), AOFAS Ankle–Hindfoot score, VAS (for pain and satisfaction) questionnaires, and ultrasound analysis (focal thickening, hypoechoic areas, presence of calcifications, tendinitis and alteration of normal fibrillar architecture). Results: 90 patients were included: 50 treated by M&G, 40 by TT. In all, 90% of patients resumed sports activities, with pre-injury levels in 56% of cases after M&G and in 60% after TT. In the M&G group, the averages of the questionnaires were ATRS 90.70 points, AOFAS 91.03, VAS satisfaction 7.08, and VAS pain 1.58. In the TT group: ATRS 90.38 points, AOFAS 90.28, VAS satisfaction 7.76, and VAS pain 1.34. The TT group showed a significantly higher satisfaction and return to sport activities within a shorter time. In the M&G group, ultrasound check showed a significantly greater incidence of thickening and an alteration of fibrillar architecture in the treated tendon. Three infections were reported, including one deep after M&G, two superficial in the TT group, and two re-ruptures in the Tenolig group following a further trauma. Conclusions: At long-term follow-up, M&G and TT are both valid techniques for the treatment of AATRs in recreational athletes, achieving comparable clinical–functional results. However, TT seems to have a higher patient satisfaction rate, a faster return to sports and physical activities, and fewer ultrasound signs of tendinitis. Finally, the cost of the device makes this technique more expensive.

Operative repair of acute Achilles tendon rupture does not give superior patient-reported outcomes to nonoperative management

2020 ◽  
Vol 102-B (7) ◽  
pp. 933-940 ◽  
Author(s):  
Julian F. Maempel ◽  
Nicholas D. Clement ◽  
Neil R. Wickramasinghe ◽  
Andrew D. Duckworth ◽  
John F. Keating
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Patient Reported Outcome Measures ◽  
Nonoperative Treatment ◽  
Patient Reported Outcome ◽  
Significant Difference ◽  
Patient Reported ◽  
Long Term Follow Up

Aims The aim was to compare long-term patient-reported outcome measures (PROMs) after operative and nonoperative treatment of acute Achilles tendon rupture in the context of a randomized controlled trial. Methods PROMs including the Short Musculoskeletal Function Assessment (SMFA), Achilles Tendon Total Rupture Score (ATRS), EuroQol five-dimension (EQ-5D), satisfaction, net promoter score and data regarding re-rupture, and venous thromboembolic rates were collected for patients randomized to receive either operative or nonoperative treatment for acute Achilles tendon rupture in a previous study. Of the 80 patients originally randomized, 64 (33 treated surgically, 31 nonoperatively) patients were followed up at a mean of 15.7 years (13.4 to 17.7). Results There was no statistically significant difference between operatively and nonoperatively treated patients, in SMFA Dysfunction Index (median 1.56 (interquartile range (IQR) 0 to 5.51) vs 1.47 (IQR 0 to 5.15); p = 0.289), SMFA Bother Index (2.08 (IQR 0 to 12.50) vs 0.00 (IQR 0 to 6.25); p = 0.074), ATRS (94 (IQR 86 to 100) vs 95 (IQR 81 to 100); p = 0.313), EQ-5D-5L (1 (IQR 0.75 to 1) vs 1 (IQR 0.84 to 1); p = 0.137) or EQ-5D health today visual analogue score (85 (IQR 72.5 to 95) vs 85 (IQR 8 to 95); p = 0.367). There was no statistically significant difference between operative and nonoperative groups in terms of satisfaction (84% vs 100%; p = 0.119) or willingness to recommend treatment to friends or family (79% vs 87%; p = 0.255). Four nonoperative patients and two in the operative group sustained a re-rupture (p = 0.306). Conclusion Both patient groups reported good results at long-term follow-up. The findings give no evidence of superior long-term patient reported outcomes (as measured by the SMFA) for surgical treatment over nonoperative treatment. There was no demonstrable difference in other patient reported outcome measures, satisfaction, or re-rupture rates at long-term follow-up. Cite this article: Bone Joint J 2020;102-B(7):933–940.

scholarly journals PO 18150 - Comparison between the open and minimally invasive repair techniques in acute Achilles tendon injuries

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. S32
Author(s):  
João Paulo Primo de Araujo ◽  
Marcus Vinicius Mota Garcia Moreno ◽  
Janice De Souza Guimarães ◽  
Marilton Jorge Torres Gomes ◽  
Túlio Eduardo Marçal Vieira ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Functional Outcomes ◽  
Tendon Rupture ◽  
Open Repair ◽  
Achilles Tendon Rupture ◽  
Invasive Technique ◽  
Repair Technique ◽  
Repair Techniques

Objective: Our study compares the functional outcomes of patients who underwent open repair of the Achilles tendon with those of patients treated with the minimally invasive technique using the percutaneous Achilles repair system (PARS) over a 1-year minimum follow-up period and presents the complication rates for the 2 techniques. Methods: Between 2011 and 2016, 31 patients were reviewed; of these, 20 were included in the study (10 PARS X 10 open repair technique). Patients with chronic Achilles tendon rupture, insertional or bilateral, and patients with a history of surgery or previous ankle pathology that could mask functional outcomes were excluded from the study. The open repair technique was performed via a posteromedial incision to the ankle to repair the tendon and was combined with myotendinous transfer of the flexor hallucis longus tendon, which was fixed with a Biotenodesis screw. The minimally invasive technique was performed using the PARS of the company Arthrex through a small transverse incision at the site of the Achilles tendon rupture. Functional outcomes and complications were collected after at least 1 year of follow-up. Results: Both groups had similar American Orthopedic Foot and Ankle Society (AOFAS) scores (PARS: 95.3±5.1, open: 96.5±5.1; p=0.604), demonstrating similar functional outcomes. The PARS group had a higher number of complications than the open repair group (PARS: 20% x open: 10%), but the difference was not significant (p=0.383). Conclusion: For the treatment of acute Achilles tendon injuries, the PARS and open repair techniques had similar functional outcomes after 1 year of follow-up.

scholarly journals Minimally invasive treatment of acute Achilles tendon rupture with endoscopic flexor hallucis longus transfer

2019 ◽  
Vol 13 (2) ◽  
pp. 129-134
Author(s):  
Thiago Coelho Paim Lima ◽  
Rodrigo Gonçalves Pagnano ◽  
Gustavo Eiji Nodu Sato ◽  
Carolina Lins ◽  
Mauro Cesar Mattos e Dinato
Keyword(s):  
Achilles Tendon ◽  
Functional Outcomes ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Contralateral Side ◽  
Flexor Hallucis Longus ◽  
Flexor Hallucis Longus Transfer ◽  
The Mean ◽  
Flexion Strength

Objective: To evaluate the clinical and functional outcomes of acute Achilles tendon rupture or rerupture repaired with minimally invasive surgery and reinforcement with flexor hallucis longus transfer via posterior ankle arthroscopy in patients with poor compliance with follow-up. Methods: A retrospective study was conducted that evaluated five patients with more than 24 months of postoperative follow-up using the American Orthopaedic Foot and Ankle Society (AOFAS) scale, Victorian Institute of Sport Assessment-Achilles (VISA-A) scale, Achilles tendon total rupture score (ATRS), and visual analog scale (VAS) for pain, as well as the range of motion and flexion strength. Results: The mean scores on the VAS, AOFAS scale, and VISA-A scale and the ATRS were 0.6, 98, 98.2, and 100, respectively. The mean dorsiflexion range of motion was 4.8° on the operated side and 7.6° on the contralateral side. The mean plantar flexion strength was 24.02 kgf on the operated side and 24.64 kgf on the contralateral side. The flexion strength of the interphalangeal joint of the hallux was 13.94 kgf on the operated side and 17.6 kgf on the contralateral side. The patients had no functional complaints. Conclusion: The proposed surgical treatment had good clinical and functional outcomes in the evaluated patients. The surgical technique described may be a good alternative for treating patients with poor compliance diagnosed with acute tendon rupture or cases of rerupture. Level of Evidence IV; Therapeutic Studies; Case Series.

scholarly journals Operative Outcome of Side-Locking Loop Suture Technique Accompanied by Autologous Semitendinosus Tendon Grafting for Chronic Rupture of Achilles Tendon

2021 ◽  
Vol 6 (2) ◽  
pp. 247301142110035
Author(s):  
Keisuke Tsukada ◽  
Youichi Yasui ◽  
Maya Kubo ◽  
Shinya Miki ◽  
Kentaro Matsui ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Scale Score ◽  
Tendon Rupture ◽  
Plantar Flexion ◽  
Achilles Tendon Rupture ◽  
Case Series ◽  
Semitendinosus Tendon ◽  
Level Of Evidence ◽  
Operative Outcomes

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.

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

The Foot ◽  
2011 ◽  
Vol 21 (4) ◽  
pp. 204-206
Author(s):  
Aysegul Sarsilmaz ◽  
Makbule Varer ◽  
Gulten Coskun ◽  
Melda Apaydın ◽  
Orhan Oyar
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Mri Findings

scholarly journals Management of Missed Traumatic Achilles Tendon Rupture in a Pediatric Patient: A Case Report

2021 ◽  
Vol 9 (4) ◽  
pp. 465-470
Author(s):  
Saad Andaloussi
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Skin Wound ◽  
Plantaris Tendon ◽  
First Case ◽  
Tendon Ruptures ◽  
Post Traumatic

BACKGROUND: Missed traumatic Achilles tendon ruptures in children are rarely reported in the literature. Various techniques have been described to reconstruct delayed Achilles tendon ruptures for adults, but the long-term consequences in the growing child are unknown. CLINICAL CASE: The article presents a clinical observation of a 8-year-old girl with missed rupture of the Achilles tendon operated 7 weeks after the trauma by end-to-end Kessler-type sutures augmented with the plantaris tendon. At 2-year follow-up, the patient was completely asymptomatic. DISCUSSION: A review of the literature shows that this is the third neglected pediatric case of post-traumatic Achilles tendon rupture. The first case concerns a 10-year-old boy treated successfully six weeks after the traumat by open surgical repair using the Bunnell sutures technique. The second patient was a 7-year-old girl, she was operated 8 weeks after the trauma with a termino-terminal tenorrhaphy using the Bunnell technique augmented with the plantaris tendon. CONCLUSIONS: Using the plantaris tendon to reinforce the Achilles tendon repair offers satisfactory results with minimal morbidity. Prognosis depends on the extent of tendon defect which determines the long-term functional outcome. Any skin wound that sits on the back of the leg requires a systematic and careful physical examination to check the integrity of the Achilles tendon.

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