Achilles tendon elongation was somewhat less in the early motion group and correlated with the clinical outcome scores. We recommend early functional postoperative treatment after Achilles rupture repair.

No abstract

The isokinetic calf muscle strength results were somewhat better in the early motion group, whereas the other outcome results obtained in the two groups of patients were very similar. We recommend early functional postoperative treatment after Achilles rupture repair for athletes and well-motivated patients and for less-motivated patients and nonathletes.

Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

We compared the type 1 and I11 collagen amounts and cross-linked telopeptides at the rupture site and two other sites of the same tendon. Tendon saniples of ten individuals with total Achilles tendon rupture and six healthy cadavers were collected. The newly synthesized type I and 111 procollagens were assessed by extracting the soluble propeptides PINP, PICP and PIIINP. The insoluble matrix was solubilized by heat denaturation and trypsin digestion. Hydroxyproline, the cross-linked telopeptide structures of type I (ICTP and SP 4) and I11 collagens (IIINTP) and the degradation product of type I11 collagen (tryptic PIIINP) were measured from the digests.The type 111 collagen content was significantly increased at the rupture site when compared to control sites (5-and 12-fold increased) or cadavers (5-fold increased). No changes in the amounts of newly synthesized type I and I11 procollagens were observed. The ICTP content decreased and the SP 4/ICTP ratio increased along with ageing, suggesting a structural change in the type of cross-link in the carboxyterminal telopeptide of type I collagen.Type 111 collagen has accumulated at the rupture site probably due to microtrauinas and the subsequent healing process. The increased content of type I11 collagen can cause thinner collagen fibers, decrease the tensile strength and may finally result in total rupture of the tendon. The age-related change in the nature of the cross-link in the carboxyterminal telopeptide may contribute to this weakening.