Disappointment and frustration, but long-term satisfaction: patient experiences undergoing treatment for a chronic Achilles tendon rupture—a qualitative study

Abstract

Background Delayed treatment of Achilles tendon ruptures is generally due to either misdiagnosis or patient delay. When the treatment is delayed more than 4 weeks, the rupture is defined as “chronic”, and almost always requires more invasive surgery and longer rehabilitation time compared with acute Achilles tendon ruptures. There is insufficient knowledge of patient experiences of sustaining and recovering from a chronic Achilles tendon rupture. Methods To evaluate patients’ experiences of suffering a chronic Achilles tendon rupture, semi-structured group interviews were conducted 4–6 years after surgical treatment using a semi-structured interview guide. The data were analyzed using qualitative content analysis described by Graneheim and Lundman. Results The experiences of ten patients (65 ± 14 years, 7 males and 3 females) were summarized into four main categories: (1) “The injury”, where the patients described immediate functional impairments, following either traumatic or non-traumatic injury mechanisms that were misinterpreted by themselves or the health-care system; (2) “The diagnosis”, where the patients expressed relief in receiving the diagnosis, but also disappointment and/or frustration related to the prior misdiagnosis and delay; (3) “The treatment”, where the patients expressed high expectations, consistent satisfaction with the surgical treatment, and addressed the importance of the physical therapist having the right expertise; and (4) “The outcomes”, where the patients expressed an overall satisfaction with the long-term outcome and no obvious limitations in physical activity, although some fear of re-injury emerged. Conclusions An Achilles tendon rupture can occur during both major and minor trauma and be misinterpreted by both the assessing health-care professional as well as the patient themselves. Surgical treatment and postoperative rehabilitation for chronic Achilles tendon rupture results in overall patient satisfaction in terms of the long-term outcomes. We emphasize the need for increased awareness of the occurrence of Achilles tendon rupture in patients with an atypical patient history.

Evaluating the effectiveness of Baker's procedure in restoring functionality in neglected Achilles tendon injuries

“…Previous research has indicated that delayed treatment of Achilles tendon injuries can affect outcomes, with early intervention often leading to better prognosis. 20,21 The fact that a significant portion of our participants underwent surgery between 6 to 10 weeks post-injury suggests a potential delay in seeking or receiving treatment, which could be a factor in the final outcomes observed. The cause of injury in our study, predominantly due to sharp-metal objects (57.14%) and toilet-pan incidents (35.71%), is somewhat atypical compared to the commonly reported sports-related causes in other literatures.…”

Endoscopic-assisted locking block modified Krackow technique combined with a V-Y flap for chronic Achilles tendon rupture

“…The most common cause is the misdiagnosis of acute Achilles tendon rupture. A missed diagnosis rate of approximately 20% has been reported in several studies [26, 29, 40]. Chronic rupture of the Achilles tendon often leads to severe calf muscle dysfunction and gait abnormalities and surgical intervention is generally required [6, 16, 27, 30, 39].…”