Functional Outcome of Conservatively Managed Complete Achilles Tendon Ruptures Treated in a Functional Weight Bearing Orthosis

Bilateral simultaneous ruptures are rare comprising less than 1% of all Achilles tendon ruptures. Risk factors for bilateral ruptures include chronic diseases and medications such as corticosteroids and fluoroquinolones. There is little in the literature on the long-term functional outcome of bilateral Achilles tendon ruptures. This article present a series of 3 cases of simultaneous and spontaneous bilateral Achilles tendon ruptures with a minimum of 5-year follow up suggesting a good functional outcome. Level of Evidence: Therapeutic Level IV

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Immediate weight bearing and function following surgery for neglected Achilles tendon ruptures

Foot and Ankle Surgery ◽

10.1016/j.fas.2016.05.211 ◽

2016 ◽

Vol 22 (2) ◽

pp. 83-84

Author(s):

M. Monteagudo ◽

E. Maceira ◽

A. Avila ◽

P. Martinez-Albornoz

Keyword(s):

Achilles Tendon ◽

Weight Bearing ◽

Tendon Ruptures ◽

And Function

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Management of acute Achilles tendon ruptures

Bone and Joint Research ◽

10.1302/2046-3758.710.bjr-2018-0004.r2 ◽

2018 ◽

Vol 7 (10) ◽

pp. 561-569 ◽

Cited By ~ 19

Author(s):

X. Yang ◽

H. Meng ◽

Q. Quan ◽

J. Peng ◽

S. Lu ◽

...

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Open Repair ◽

Weight Bearing ◽

Achilles Tendon Rupture ◽

Complication Rates ◽

Functional Rehabilitation ◽

Percutaneous Repair ◽

Tendon Ruptures ◽

Mini Open

ObjectivesThe incidence of acute Achilles tendon rupture appears to be increasing. The aim of this study was to summarize various therapies for acute Achilles tendon rupture and discuss their relative merits.MethodsA PubMed search about the management of acute Achilles tendon rupture was performed. The search was open for original manuscripts and review papers limited to publication from January 2006 to July 2017. A total of 489 papers were identified initially and finally 323 articles were suitable for this review.ResultsThe treatments of acute Achilles tendon rupture include operative and nonoperative treatments. Operative treatments mainly consist of open repair, percutaneous repair, mini-open repair, and augmentative repair. Traditional open repair has lower re-rupture rates with higher risks of complications. Percutaneous repair and mini-open repair show similar re-rupture rates but lower overall complication rates when compared with open repair. Percutaneous repair requires vigilance against nerve damage. Functional rehabilitation combining protected weight-bearing and early controlled motion can effectively reduce re-rupture rates with satisfactory outcomes. Biological adjuncts help accelerating tendon healing by adhering rupture ends or releasing highly complex pools of signalling factors.ConclusionThe optimum treatment for complete rupture remains controversial. Both mini-open repair and functional protocols are attractive alternatives, while biotherapy is a potential future development. Cite this article: X. Yang, H. Meng, Q. Quan, J. Peng, S. Lu, A. Wang. Management of acute Achilles tendon ruptures: A review. Bone Joint Res 2018;7:561–569. DOI: 10.1302/2046-3758.710.BJR-2018-0004.R2.

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Weight-Bearing in the Nonoperative Treatment of Acute Achilles Tendon Ruptures

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.m.00248 ◽

2014 ◽

Vol 96 (13) ◽

pp. 1073-1079 ◽

Cited By ~ 39

Author(s):

Simon W Young ◽

Alpesh Patel ◽

Mark Zhu ◽

Stephanie van Dijck ◽

Peter McNair ◽

...

Keyword(s):

Achilles Tendon ◽

Weight Bearing ◽

Nonoperative Treatment ◽

Tendon Ruptures

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Comparative study of functional outcome between plantar fascia stretching and achilles tendon stretching exercises in choronic plantar fasciitis

Nepal Journal of Medical Sciences ◽

10.3126/njms.v3i2.13449 ◽

2015 ◽

Vol 3 (2) ◽

pp. 84-88

Author(s):

S Shrestha ◽

S Rai ◽

H Limbu ◽

S Bajracharya

Keyword(s):

Achilles Tendon ◽

Functional Outcome ◽

Plantar Fasciitis ◽

Weight Bearing ◽

Plantar Fascia ◽

Foot Function Index ◽

Function Index ◽

Pain Subscale ◽

Foot Function ◽

Stretching Exercises

Background: Plantar fasciitis is a self limiting disease, with only 10% of patient developing chronic condition even after ten months. We hypothesized that patient with chronic plantar fasciitis who are treated with standard plantar fascia stretching program can have a better functional outcome than those treated with Achilles tendon-stretching exercise.Method: Forty patients who had chronic plantar fasciitis for duration of at least ten months were randomized into one of two groups. Group A received plantar stretching exercise and Group B had Achilles tendon stretching program. All patients completed the pain subscale of Foot Function Index and a subject relevant outcome survey that incorporated generic and condition-specific outcome measures related to pain, function and satisfaction with treatment outcome.Result: The pain subscale scores of the Foot Function Index showed significantly better results at eight weeks for the patients managed with plantar fascia stretching program respect to item 1 (worst pain; p = 0.004) and item 2 (first steps in the morning; p =0.001). Similarly at ten months follow up, pain subscale score comparison was statistically significant for item 1 (p = 0.018) and item 2 (p =0.003).Conclusions: A treatment method of non-weight-bearing stretching exercises specific to plantar fascia is superior to the conventional method of weight-bearing Achilles tendon-stretching exercises for treating patients with chronic plantar fasciitis.Nepal Journal of Medical Sciences Vol.3(2) 2014: 84-88

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Management of acute Achilles tendon ruptures: a survey of Army orthopaedic surgeons

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04121-y ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Nischal Nadig ◽

Thomas Dowd ◽

Jeannie Huh

Keyword(s):

Achilles Tendon ◽

Demographic Data ◽

Weight Bearing ◽

Achilles Tendon Rupture ◽

Operative Management ◽

Survey Study ◽

Treatment Preference ◽

Treatment Preferences ◽

Orthopaedic Surgeons ◽

Tendon Ruptures

Abstract Background Despite the literature on acute Achilles tendon ruptures, there remains a lack of consensus regarding the optimal treatment. The purpose of this survey study was to investigate treatment preferences among Army orthopaedic surgeons when presented with a standardized case of an acute Achilles rupture and determine if surgeon factors correlated with treatment preference. Methods A hypothetical case of a 37-year-old male with history, physical exam, and imaging consistent with an Achilles rupture was sent to board-certified Army orthopaedic surgeons to determine their preferred management. Demographic data was collected to include: practice setting, years from residency graduation, and completion of fellowship. Correlations analyzed between demographics and treatment preferences. Results Sixty-two surgeons responded. 62% of respondents selected surgical intervention. Of these, 59% chose a traditional open technique. 50% of respondents were general orthopaedic. There was a correlation between fellowship training and operative management (P = 0.042). Within the operative management group there was no statistical difference (P > 0.05) in need for further imaging, technique used, post-operative immobilization, length of immobilization, weight-bearing protocol, and time to release to running. The majority of non-operative responders would splint/cast in plantarflexion or CAM boot with heel lift for < 3 weeks (50%) and keep non-weight bearing for < 4 weeks (63%). Only 38% of respondents would use DVT chemoprophylaxis. Conclusion When provided with a hypothetic case of an acute Achilles tendon rupture, queried Army orthopaedic surgeons would more often treat with a surgical procedure. This difference in treatment is secondary to training, fellowship or other. This propensity of surgical management, likely stems from the highly active population and the desire to return to duty.

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