scholarly journals Financial Conflicts of Interest Among Systematic Review Authors Investigating Interventions for Achilles Tendon Ruptures

2021 ◽  
Vol 6 (2) ◽  
pp. 247301142110197
Author(s):  
W. Tanner Cole ◽  
Cody Hillman ◽  
Adam Corcoran ◽  
J. Michael Anderson ◽  
Michael Weaver ◽  
...  
Keyword(s):  
Systematic Review ◽  
Achilles Tendon ◽  
Systematic Reviews ◽  
Tendon Rupture ◽  
Conflicts Of Interest ◽  
Achilles Tendon Rupture ◽  
Individual Characteristics ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Financial Conflicts Of Interest

Background: The primary aim of our study was to evaluate the effects of undisclosed financial conflicts of interest in Achilles tendon rupture repair–focused systematic reviews. Methods: Following a cross-sectional study design, we searched MEDLINE and Embase for Achilles tendon rupture repair systematic reviews. We performed screening and data extraction in a blind, triplicate fashion. Each systematic review was evaluated on the individual characteristics of the study, presence of undisclosed and disclosed conflicts of interest, favorability of results and conclusions, and the relationship between conflicts of interest and the favorability of results and conclusions. Results: Our search produced 172 total systematic reviews pertaining to Achilles tendon rupture repair; of those, only 12 were included in our study. Undisclosed conflicts of interest were found in half (6/12) of the included reviews. However, no significant association was found between conflict of interest and the favorability of results and conclusions. Conclusion: Undisclosed conflicts of interests were discovered in a large percentage of our sample. This lack of disclosure did not appear to increase the likelihood of the systematic review results or conclusions reporting favorability of the intervention being investigated. Level of Evidence: Level II.

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.

scholarly journals Interest of platelet rich plasma in Achilles tendon rupture management: a systematic review

2021 ◽  
Author(s):  
Pauline Daley ◽  
Pierre Menu ◽  
Bastien Louguet ◽  
Vincent Crenn ◽  
Marc Dauty ◽  
...  
Keyword(s):  
Systematic Review ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Platelet Rich Plasma ◽  
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 Use of ankle resting angle as a surrogate for tendon elongation in individuals following Achilles tendon rupture

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Heather Gotha ◽  
Jennifer Zellers ◽  
Karin Silbernagel
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Plantar Flexors ◽  
Cross Sectional ◽  
Tendon Length ◽  
Tendon Elongation ◽  
The Relationship

Category: Ankle, Sports Introduction/Purpose: Tendon elongation is associated with poor functional outcome in individuals after Achilles tendon rupture. While imaging modalities are reliable to measure Achilles tendon length, alternative time- and cost-effective measures are of interest. The resting angle of the ankle in prone both with knee extended1 and knee flexed2 have been used in the literature as surrogates for measuring Achilles elongation, however, their relationship to tendon length is not well-established. The purpose of this study is to validate the ankle resting angle as a measure of tendon elongation and examine the relationship of ankle resting angle to tendon elongation and calf strength. Methods: Individuals following unilateral Achilles tendon rupture, treated surgically, were included in this cross-sectional study. Individuals were excluded if they had deep wound infection or lumbar radiculopathy affecting the ankle plantar flexors. Ankle resting angle with knee extended and knee flexed to 90 degrees was measured using a digital inclinometer positioned on the lateral, plantar surface of the foot. Relative resting angle was calculated by subtracting the uninjured from the injured side. Tendon length to gastrocnemius was measured using B mode, extended field of view ultrasound imaging3 (tendon elongation = ruptured- uninjured). Calf strength was measured using the heel-rise test4. Limb symmetry indexes (LSI) were calculated (ruptured/uninjured sidex100) for total work performed on the heel-rise test. Results: Twenty-five individuals, a mean(SD) age of 44.2(13.6) years and mean(SD) of 22.5(39.1) months post-rupture, were included in this study. Mean(SD) relative resting angle with knee flexed was -5.4(6.4)° and mean (SD) relative resting angle with knee extended was -6.7(8.8)°. Mean(SD) tendon elongation was 1.56(1.20)cm. Mean(SD) heel-rise test work LSI was 45.8(23.8)%. Ankle resting angle with knee flexed related to elongation (r = -0.452, p = 0.027) and heel-rise test work LSI (r = 0.591, p=0.006). Ankle resting angle with knee extended related to elongation (r=-0.528, p=0.008) (Figure 1) but not heel-rise test work LSI. Conclusion: The results of this study suggest that ankle resting angle with knee extended and flexed are related to tendon elongation, however, calf strength also has a relationship to resting angle with knee flexed. This suggests that the ability of the calf to put passive tension on the foot is also a component of resting angle. The relationship between tendon elongation and resting angle with knee flexed may have been limited by methodological concerns, as tendon length was measured with the participant positioned with knees extended.

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

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.

scholarly journals Achilles tendon detachment after local infiltration of corticosteroids

2021 ◽  
Vol 15 (1) ◽  
pp. 73-76
Author(s):  
Jorge Del Vecchio ◽  
Eric Dealbera ◽  
Jorge Batista ◽  
Mauricio Ghioldi ◽  
Lucas Chemes
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Imaging Studies ◽  
Level Of Evidence ◽  
Local Infiltration ◽  
Achilles Tendinosis ◽  
Retrocalcaneal Bursitis ◽  
Retrocalcaneal Bursa ◽  
Haglund Deformity

Complete disinsertion of the Achilles tendon is relatively rare but is an injury of considerable clinical significance. A 50-year-old non-smoking man presented with complete disinsertion of the Achilles tendon due to an indirect low-energy trauma shortly after administration of local corticosteroid injections (LCI) for treatment of deep retrocalcaneal bursitis. Imaging studies showed complete disinsertion of the Achilles tendon as well as severe Haglund syndrome and retrocalcaneal bursitis. The tendon was repaired, and the Haglund deformity and retrocalcaneal bursa were then resected. Although Achilles tendon rupture is a frequent complication after LCI, to date, no cases of disinsertion have been published. Surgeons must be aware of this issue, especially in patients with previous insertional calcific Achilles tendinosis and Haglund syndrome. Level of Evidence V; Therapeutic Studies; Expert Opinion.

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