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.

scholarly journals Incidence, Risk Factors, and Treatment of Achilles Tendon Rupture in Patients with End-Stage Renal Disease

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0025
Author(s):  
Casey Humbyrd ◽  
Sunjae Bae ◽  
Dorry Segev
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Surgical Treatment ◽  
Body Mass ◽  
End Stage Renal Disease ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Incidence Risk ◽  
Stage Renal Disease ◽  
End Stage

Category: Trauma Introduction/Purpose: Patients who are dialysis-dependent and those who have received kidney transplants may be at increased risk for Achilles tendon rupture (ATR) as a result of compromised kidney function. Our goal was to examine the incidence, risk factors, and type of ATR treatment in patients with end-stage renal disease (ESRD). Methods: We studied all Medicare patients with ESRD from 1999 through 2013, as captured by the Centers for Medicare & Medicaid Services and the United States Renal Data System. Patients were categorized as not waitlisted for a transplant, waitlisted but not yet transplanted, or received a transplant. Patients were migrated to the corresponding groups at the time when they were waitlisted or received a transplant. We performed multivariate negative binomial regression using age, race, sex, body mass index, cause of ESRD, comorbidities, and year of study entry as covariables to estimate the adjusted incidence rate ratios (aIRR) for all groups and to identify risk factors for ATR. We performed a subgroup analysis using the above methods for participants with Medicare Part D to characterize the association of fluoroquinolones and steroids with ATR. Results: We identified 1091 ATRs (incidence, 3.80 per 10,000 person-years; 95% confidence interval [CI], 3.58–4.03). Patients who sustained an ATR were significantly younger, had higher mean body mass index, and had fewer comorbidities than patients without ATR. Compared with the incidence of ATR among transplant recipients, the incidence of ATR was lower in the non-waitlisted group (aIRR, 0.44; 95% CI, 0.37–0.53) and similar in the waitlisted group (aIRR, 0.94; 95% CI, 0.78–1.12). Patients who used fluoroquinolones and steroids had a higher incidence of ATR (aIRR 1.65; 95% CI, 1.32 -1.84 and aIRR 1.72, 95% CI, 1.44-2.05 respectively). A small proportion of patients (n = 184; 17%) received surgical treatment within 14 days of diagnosis of ATR, and the 30-day cumulative incidence of surgical site infections was 6.5%. Conclusion: The incidence of ATR was higher in the transplanted and waitlisted groups compared with the non-waitlisted group. Younger age, higher body mass index, better health, fluoroquinolone use and steroid use were significant risk factors for ATR. Patients were more likely to receive nonoperative than surgical treatment for ATR. Those who underwent surgical treatment for ATR had a low incidence of surgical site infection.

scholarly journals Different Sutures in the Surgical Treatment of Acute Closed Achilles Tendon Rupture

2014 ◽  
Vol 77 (S3) ◽  
pp. 936-940 ◽  
Author(s):  
Yunhan Ji ◽  
Xin Ma ◽  
Xu Wang ◽  
Jiazhang Huang ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture

Surgical versus non-surgical treatment for acute Achilles’ tendon rupture. A systematic review of literature and meta-analysis

2020 ◽  
Vol 26 (3) ◽  
pp. 280-288 ◽  
Author(s):  
Yasser Reda ◽  
Amr Farouk ◽  
Ibrahim Abdelmonem ◽  
Ossama A. El Shazly
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Meta Analysis ◽  
Achilles Tendon Rupture ◽  
Review Of Literature ◽  
Non Surgical Treatment

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.

Missed Achilles tendon rupture due to oral levofloxacin: surgical treatment and result

2005 ◽  
Vol 125 (2) ◽  
pp. 124-126 ◽  
Author(s):  
Peter L�thje ◽  
Ilona Nurmi ◽  
Timo Nyyss�nen
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture

scholarly journals Delayed Pulmonary Embolism Following Achilles Tendon Repair

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0022
Author(s):  
İlker Çolak ◽  
Engin Eceviz ◽  
Özgür Baysal ◽  
Halil İbrahim Bekler
Keyword(s):  
Emergency Department ◽  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Factor V Leiden ◽  
Heterozygous Mutation ◽  
Factor V ◽  
Dvt Prophylaxis

Objectives: It is well known that venous thromboembolism is a common complication after lower limb injuries which requires long term immobilization, however venous thromboembolism prophylaxis after achilles tendon rupture is stil controversial. In this report our aim is to present a case of pulmonary embolism which developed 47 days after surgical repair of achilles tendon rupture and diagnosed factor V leiden heterozygous mutation. Methods: Case presentation: A 28 – years- old man was admitted to emergency department with left heel pain and he could not bear weight on it. Achilles tendon rupture was confirmed with physical examination and MRI and patient operated under the spinal anesthesia. Tendon was repaired with the modified Kesler technique. Patient was cast-immobilized and ambulating with crutches and rested for 47 days at home, when he was admitted to emergency department again with acute severe dyspnea, pain on right side, hemoptysis. There was no chronic disease history in in the patient´s anamnesis except migraine diagnosis. There were slight inspiratory rales in right lower lobe in auscultation of respiratuary system examination. Cardiovascular system and abdomen examination were normal. Plasma concentration of D-dimer was 1227 μg/mL in the laboratory evaluations. Patient was diagnosed pulmonary embolus (PE) by ventilation/perfusion lung scan. Result of detailed evaluation, genetic analysis showed that patient has factor V leiden heterozygous mutation. Patient hospitalized in Department of Chest Diseases and low-molecular-weight heparin was used to treat and 5 mg orally Warfarin was used for six months. Results: Conclusion: The incidence of deep venus thrombosis (DVT) and PE after Achilles tendon rupture were highly variable in the literature. This could depend on different designs used in studies. The most recent antihrombotic guidelines suggested no DVT prophylaxis for this type injuries. Existing orthopaedic guidelines does not provide optimal DVT/PE prophylaxis for injuries under the knee requires immobilization. Further research is needed to investigate the benefits of DVT prophylaxis on patients following Achilles tendon rupture.

scholarly journals Results of surgical versus non-surgical treatment of Achilles tendon rupture

2004 ◽  
Vol 28 (6) ◽  
pp. 370-373 ◽  
Author(s):  
Henrica M. J. van der Linden-van der Zwaag ◽  
Rob G. H. H. Nelissen ◽  
Jan B. Sintenie
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Non Surgical Treatment

scholarly journals Bearing Weight at the Same Day in Conservatively Treated Acute Achilles Tendon Rupture Patients

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0020
Author(s):  
Murat Korkmaz ◽  
Sadiye Yolcu ◽  
Özlem Balbaloğlu ◽  
Zekeriya Öztemur ◽  
Fatih Karaarslan
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Treatment Protocol ◽  
Early Mobilization ◽  
Treated Group ◽  
Plaster Cast ◽  
Wound Complications ◽  
American Orthopaedic

Objectives: Achilles tendon rupture (ATR) often occurs in 40- to 50-year-old men.. At treating there has been considerable research interest in attempting to identify the optimal treatment strategy, surgical or non-surgical, combined with functional early mobilisation or plaster cast immobilisation. Our aimed to compare the outcomes of bearing weight at the same day in conservatively treated and surgically treated groups of ATR patients. Methods: Thirty-two conservatively treated ATR patients and twenty nine surgically treated ATR patients were included to our study. Patients were over 18 years old who had been followed for 12 months by our clinic. All patients underwent knee supporting cast at four week and both group was asked for walking with bearing weight (%30-40) at same day. Results: In all groups 2nd and 12th months’ AOFAS (American Orthopaedic Foot and Ankle Society) scorings of the patients had significant differences (p<0.001). Return to work time results were significantly different and shorter in conservatively treated group (p= 0.035). This study founded a relatively high complication percentage of (6 patients) 20.6% in the surgically treated group. On the contrary the wound complications non-surgical group has not been be observed. Conclusion: In conclusion, this study adds to evidence that a well conducted non-surgical treatment protocol (early mobilization treatment regimen) gives a good clinical outcome and complication rate is not higher than after surgical treatment.

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