Incidence of Symptomatic Deep Venous Thrombosis after Achilles Tendon Rupture

2013 ◽  
Vol 52 (5) ◽  
pp. 584-587 ◽  
Author(s):  
Asim M. Makhdom ◽  
Adam Cota ◽  
Neil Saran ◽  
Ruth Chaytor
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture

scholarly journals Deep venous thrombosis after Achilles tendon rupture is associated with poor patient-reported outcome

2020 ◽  
Vol 28 (10) ◽  
pp. 3309-3317
Author(s):  
Simon Svedman ◽  
Gunnar Edman ◽  
Paul W. Ackermann
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Surgical Techniques ◽  
Patient Reported Outcome ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Patient Reported

Abstract Purpose The aim of this study was to investigate whether patient subjective and functional outcomes after Achilles tendon rupture (ATR) are related to deep venous thrombosis (DVT) during leg immobilization. Methods A cohort study with prospectively collected randomized data was conducted between 2010 and 2017. Two-hundred and fifty-one Patients with an Achilles tendon rupture (mean age = 41 ± 8), treated with uniform surgical techniques, were retrospectively analyzed. DVT incidence at 2 and 6 weeks was assessed using compression duplex ultrasound. At 12 months patient-reported outcomes were assessed using the Achilles tendon Total Rupture Score (ATRS), Foot- and Ankle Outcome Score (FAOS), Physical Activity Scale (PAS) and functional outcome with the calf-muscle endurance test. ANOVA analyses were used and adjusted for assumed confounding factors (patient age, sex, BMI and rehabilitation). Results The total DVT incidence was 122 out of 251 (49%). Patients suffering a DVT exhibited significantly lower ATRS at 1 year compared to patients without DVT (mean 76 vs 83, 95% CI 71–79 vs 80–87; p < 0.01). Sixty-seven percent (95% CI 57–77%) of the patients devoid of DVT reported a good outcome (ATRS > 80) compared to 51% (95% CI 41–61%) of the patients sustaining a DVT (p < 0.05). Quality of life displayed significantly better outcome in the non-DVT versus DVT patients (mean = 75 (95% CI 71–79) vs. mean = 68 (95% CI 64–72); p < 0.05). A significant difference in total concentric work was observed between non-DVT and DVT patients (median = 1.9 kJ (IQR = 0.9 kJ) vs. median = 1.6 kJ (IQR = 1.0 kJ); p < 0.01). Conclusion Sustaining a DVT during leg immobilization significantly impairs patient-reported outcome at 1 year after surgical repair of ATR. Level of evidence III.

scholarly journals Early mobilization does not reduce the risk of deep venous thrombosis after Achilles tendon rupture: a randomized controlled trial

2019 ◽  
Vol 28 (1) ◽  
pp. 312-319 ◽  
Author(s):  
Susanna Aufwerber ◽  
Annette Heijne ◽  
Gunnar Edman ◽  
Karin Grävare Silbernagel ◽  
Paul W. Ackermann
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Controlled Trial ◽  
Achilles Tendon Rupture ◽  
Control Group ◽  
Level Of Evidence ◽  
Treatment As Usual ◽  
Patient Reported

Abstract Purpose The hypothesis was that early functional mobilization would reduce the incidence of deep venous thrombosis (DVT) during leg immobilization after Achilles tendon rupture surgery. A secondary aim was to evaluate if the amount of weightbearing and daily steps influenced the risk of sustaining a DVT. Methods One-hundred and fifty patients with Achilles tendon rupture repair were randomized to treatment with early functional mobilization, encouraging full weightbearing and ankle motion in orthosis, or treatment-as-usual, i.e., 2 weeks of unloading in plaster cast followed by 4 weeks weightbearing in orthosis. At 2 and 6 weeks postoperatively, all patients were screened for DVT using compression duplex ultrasound. During the first 2 weeks postoperatively, patient-reported loading, pain and step counts were assessed. Results At 2 weeks, 28/96 (29%) of the patients in early functional mobilization group and 15/49 (31%) in the control group (n.s) had sustained a DVT. At 6 weeks, the DVT rate was 35/94 (37%) in the early functional mobilization and 14/49 (29%) in the control group (n.s). During the first postoperative week, the early functional mobilization group reported low loading and higher experience of pain vs. the control group (p = 0.001). Low patient-reported loading ≤ 50% (OR = 4.3; 95% CI 1.28–14.3) was found to be an independent risk factor for DVT, in addition to high BMI and higher age. Conclusions Early functional mobilization does not prevent the high incidence of DVT during leg immobilization in patients with Achilles tendon rupture as compared to treatment-as-usual. The low efficacy of early functional mobilization is mainly explained by postoperative pain and subsequent low weightbearing. To minimize the risk of DVT, patients should be encouraged to load at least 50% of body weight on the injured leg 1 week after surgery. Level of evidence Therapeutic, level 1

scholarly journals Analysis of Risk Factors for Deep Venous Thrombosis in Patients With Achilles Tendon Rupture: A Retrospective Study of 247 Patients

2021 ◽  
Author(s):  
Feiyu Cai ◽  
Kai Liu ◽  
Yanshi Liu ◽  
Jiasharete Jielile ◽  
Aihemaitijiang Yusufu
Keyword(s):  
Risk Factors ◽  
Blood Loss ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Operative Time ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Perioperative Period

Abstract Background and purpose The high incidence of deep venous thrombosis (DVT) was presented in patients with Achilles tendon rupture (ATR), and affects the prognosis of patients significantly. The purpose of this study was to identify and quantify the risk factors for perioperative DVT and the role of DVT in clinical outcomes, which may provide a guideline for DVT prevention and Achilles tendon repair. Methods The study was conducted on 247 patients who underwent surgical treatment for ATR at our institution from 2009 to 2019. Ultrasound results from injury to 4 weeks after operation were collected to diagnose DVT. Odds ratios (OR) were calculated using logistic regression to describe factors associated with DVT diagnosis including sex, age, body mass index (BMI), nicotine usage, mechanism of injury, rupture side, types of rupture, medical morbidity (hypertension, diabetes, coronary heart disease, stroke), time to operation, operative time and blood loss. The outcomes were assessed using the Achilles tendon Total Rupture Score (ATRS) and American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hind-Foot Scale Score at postoperative 3, 6, and 12 months. Results There were 216 males and 31 females with a mean age of 37.4 years (range from 20 to 75 years). Out of 247 patients, 113 patients were diagnosed with DVT during the perioperative period, accounting for 46 % of total patients. The independent risk factors were identified with age > 40 years (OR 0.41; 95% CI 0.21–0.82; p = 0.013), BMI > 26 (OR 0.39; 95% CI 0.19–0.79; p = 0.009), traumatic ATR (OR 2.44; 95% CI 1.22–4.91; p = 0.012), operative time (OR 0.95; 95% CI 0.91–1.01; p = 0.028), and blood loss (OR 1.09; 95% CI 1.03–1.14; p = 0.001). Worse patient-subjective and functional outcomes were presented in patients with a perioperative DVT according to ATRS and AOFAS. Conclusions Routine thromboprophylaxis should be encouraged in patients with ATR requiring surgery, which was caused by trauma. Age > 40 years and BMI > 26 were important risk factors for perioperative DVT. This study also showed that the presence of DVT of patients with ATR in the perioperative period has clear impairment of outcome within one year after surgery, which may postpone the return of athletes to the field severely.

scholarly journals Incidence of Venous Thromboembolism After Achilles Tendon Surgery in Patients Receiving Thromboprophlaxis

2020 ◽  
Vol 110 (1) ◽  
Author(s):  
İlker Çolak ◽  
Deniz Gülabi ◽  
Engin Eceviz ◽  
Bilgehan H. Çevik ◽  
Güven Bulut ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Pulmonary Embolism ◽  
Surgical Treatment ◽  
Venous Thrombosis ◽  
Achilles Tendon ◽  
Body Mass ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Thromboembolism Prophylaxis ◽  
Record System

Background: Surgical or nonsurgical treatment of an Achilles tendon rupture includes a period of immobilization that is a well-documented risk factor for deep venous thrombosis (DVT). The DVT is a source of morbidity in orthopedic surgery because it can progress to pulmonary embolism. The aim of this study was to investigate the incidence of DVT and pulmonary embolism after surgical treatment of an Achilles tendon rupture. Methods: A retrospective analysis was made of patients who underwent surgical treatment of Achilles tendon rupture between January 1, 2006, and November 30, 2014. Patient data were collected from the hospital medical record system. Results: Of 238 patients with a mean age of 39 years (range, 18–66 years), 18 (7.6%) were diagnosed as having symptomatic DVT. The average body mass index of the patients with DVT was 31.8 (range, 24–33). Of the patients with DVT, 11 were older than 40 years and two-thirds had a body mass index of 30 or greater. Pulmonary embolism was diagnosed in four patients (1.7%), none of whom had DVT symptoms. Conclusions: Venous thrombosis continues to be a major cause of morbidity and mortality in postoperative patients. Limited data are available for the use of thromboprophylaxis in foot and ankle surgery. In light of the literature review and results of this study, we suggest that routine thromboembolism prophylaxis should be considered for patients with Achilles tendon rupture.

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