A Combined Repair Technique for Early Neglected Achilles Tendon Ruptures

Fotiadis, Elias; Chatzisimeon, Apostolos; Samoladas, Efthimios; Antonarakos, Petros; Akritopoulos, P.; Akritopoulou, Kiriaki

doi:10.1007/s00068-007-7038-0

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…Those groups that investigated the gait cycle with kinetic and kinematic measurements expressed their values in range of motion, time (milliseconds), and/or moment (Newton meter per kg; n = 5). 27,95…”

Section: Resultsmentioning

confidence: 99%

Strength Measurement After Achilles Tendon Repair

Bäcker

Yenchak

Trofa

2018

Foot & Ankle Specialist

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The goal of treatment after Achilles tendon rupture (ATR) is to restore appropriate tension to the tendon, so that normal baseline strength and functional soft-tissue length can be achieved. The assessment of plantarflexion strength has shown widespread variability. The purpose of this study is to document variations in strength assessment after the treatment of ATR in the literature. A comprehensive literature review was performed. In total, 2758 articles were found on Achilles tendon rupture and Achilles tendon strength measurement. The full text of articles including strength as a functional outcome measurement in the abstract were assessed. All objective strength measurements performed were reviewed and recorded for comparison. One-hundred articles were included in our study. In 78 articles, a dynamometer was used to measure strength, whereas in 22 articles, an endurance test (n=14) or formal gait assessment (n=8) was applied. When a dynamometer was used, there was wide variability in the various methods used including the incorporation of both isokinetic (n = 65) and isometric (n = 29) exercises utilizing varying degrees of knee flexion and patient testing position. Furthermore, the number of measurements at certain angular velocities varied. This study illustrates that no general consensus exists regarding an optimal method for measuring strength after ATR. The variability creates difficulty and challenges medical professionals’ ability to formulate consistent conclusions when determining functional performance outcomes. A more uniform way of measuring strength after ATR may allow for better comparisons between studies in the literature, potentially leading to a better understanding of strength. Levels of Evidence: Therapeutic, Level II

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Section: Resultsmentioning

confidence: 99%

Strength Measurement After Achilles Tendon Repair

Bäcker

Yenchak

Trofa

2018

Foot & Ankle Specialist

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“…During the meeting, 21 specialist surgeons, all experienced in the treatment of CATR, engaged in discussions and modifications until a 70% agreement was achieved. These specialist surgeons were academic and non-academic orthopedics with at least 10 years of postfellowship independent practice, of consultant status, who practiced in hospital where at least 5 chronic Achilles tendon ruptures per year were managed (range [5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Basic Overview Of the Proceduresmentioning

confidence: 99%

“…The Achilles tendon is important to maintain the standing posture, and during walking, running, and jumping [2,3]. Tears of the Achilles tendon are classified as chronic after a fouror six-week period following the initial injury [4][5][6][7][8][9][10]. Patients with chronic Achilles tendon rupture (CATR) report weakness, instability, increased dorsiflexion of the ankle, swelling, tenderness, and thickening of the tendon, and, at times, persistent pain [11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Surgical management of chronic Achilles tendon rupture: evidence-based guidelines

Feng,

Maffulli,

Oliva

et al. 2024

J Orthop Surg Res

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Background Chronic Achilles tendon ruptures (CATR) often require surgical intervention to restore function. Despite numerous treatment modalities available, the optimal management strategy remains controversial given the limited high-quality evidence available. This article aims to provide evidence-based guidelines for the surgical management of CATR through a comprehensive systematic review of the available data. The consensus reached by synthesizing the findings will assist clinicians in making informed decisions and improving patient outcomes. Methods A group of 9 foot surgeons in three continents was consulted to gather their expertise on guidelines regarding the surgical management of CATR. Following the proposal of 9 clinical topics, a thorough and comprehensive search of relevant literature published since 1980 was conducted for each topic using electronic databases, including PubMed, MEDLINE, and Cochrane Library, to identify relevant studies published until 1 October 2023. All authors collaborated in drafting, discussing, and finalizing the recommendations and statements. The recommendations were then categorized into two grades: grade a (strong) and grade b (weak), following the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) concept. Additionally, feedback from 21 external specialists, who were independent from the authors, was taken into account to further refine and finalize the clinical guidelines. Results Nine statements and guidelines were completed regarding surgical indications, surgical strategies, and postoperative rehabilitation protocol. Conclusion Based on the findings of the systematic review, this guideline provides recommendations for the surgical management of CATR. We are confident that this guideline will serve as a valuable resource for physicians when making decisions regarding the surgical treatment of patients with CATR.

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Management of chronic Achilles ruptures: a scoping review

Arshad

Lau

Leow

et al. 2021

International Orthopaedics (SICOT)

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Purpose This scoping review aims to systematically map and summarise the available evidence on the management of chronic Achilles ruptures, whilst identifying prognostic factors and areas of future research. Methods A scoping review was performed according to the frameworks of Arksey and O’Malley, Levac and Peters. A computer-based search was performed in PubMed, Embase, EmCare, CINAHL, ISI Web of Science and Scopus, for articles reporting treatment of chronic Achilles ruptures. Two reviewers independently performed title/abstract and full text screening according to pre-defined selection criteria. Results A total of 747 unique articles were identified, of which 73 (9.8%) met all inclusion criteria. A variety of methods are described, with flexor hallucis longus tendon transfer being the most common. The most commonly reported outcome is the American Orthopaedic Foot and Ankle Society (AOFAS) score, although 16 other measures were reported in the literatures. All studies comparing pre- and post-operative outcomes reported significant post-treatment improvement. Complications were reported in 50 studies, with an overall pooled complication rate of 168/1065 (15.8%). Conclusion Although beneficial results were reported following a variety of techniques, comparison between these is challenging due to the low-level study designs used and confounding factors such as treatment delay and tendon gap size. Further research comparing the efficacy of different techniques is required in order to facilitate the development of an evidence-based treatment protocol. Such work would allow clinicians to better understand the suitability of the large variety of reported techniques and select the optimal strategy for each individual patient.

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A Combined Repair Technique for Early Neglected Achilles Tendon Ruptures

Abstract: This combined method appears to be safe and effective, with a low risk for complications, allowing us to obtain excellent results for the majority of our patients.

Cited by 3 publications

References 25 publications

Strength Measurement After Achilles Tendon Repair

Strength Measurement After Achilles Tendon Repair

Surgical management of chronic Achilles tendon rupture: evidence-based guidelines

Management of chronic Achilles ruptures: a scoping review

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