Function after Achilles tendon rupture in the elderly: 25 patients older than 65 years followed for 3 years

Abstract

We retrospectively analyzed the function after Achilles tendon rupture in 25 patients older than 65 years, 3 (1-5) years after the initial treatment. The patients' median age at the time of injury was 71 (65-86) years. The initial management was surgical in 14 patients and non-surgical (8-week immobilization) in 10, 1 patient was not treated.The ratio of the number of heel-raises on the injured to the uninjured side was median 0.64 (0-1.14), showing a reduction in performance. However, in both surgically-and non-surgically-treated patients, the subjective impairment was mild, and the patients were able to perform most walking activities. Only 9 patients reached their previous activity level. Co-morbidity was frequent: 17 patients had other diseases that affected their performance. 14 complications occurred in 11 patients. 5 patients sustained a rerupture (4 following initial closed treatment with plaster), 1 a deep venous thrombosis and 4 had superficial infections requiring antibiotic treatment. 1 patient sustained a fibular nerve injury following compression by the plaster cast and another a sural nerve injury during the operation. 2 patients had symptoms due to adhesions between the tendon and the skin.We conclude that Achilles tendon rupture in patients older than 65 years reduces lower limb function and that complications are common following surgical and non-surgical treatment.n

Favorable Outcome of Percutaneous Repair of Achilles Tendon Ruptures in the Elderly

“…In our study, we had two of 27 patients (7%) with a new episode of rupture. Our results were comparable in terms of complications to the study of Nestorson et al [46]. One patient of that study had a deep venous thrombosis, and four had superficial infections requiring antibiotics.…”

“…The authors concluded that AT rupture in patients older than 65 years reduces lower limb function, and that complications are common following surgical management. No ATRS data were presented in that study [46].…”

“…Second, we did not include a younger-age control group. Although percutaneous repair is well-established for the treatment of AT tears, comparisons are limited to one study reporting the treatment of AT tears in patients over 65 years old [46]. Third, in comparing outcomes of surgical repair of an acute AT rupture we used the ATRS as our main outcome measure.…”

“…Nestorson et al [46] retrospectively analyzed the clinical outcome of 25 patients older than 65 years with acute Achilles tendon rupture. In that study, the initial treatment was nonsurgical in 10 patients, surgical in 14 patients, and one patient received no treatment.…”

“…Studies on older populations do not seem to have the same degree of success for AT repairs, with reduction of lower limb function (as evaluated with the heel-raise test), and high rate of complications (including rerupture, deep venous thrombosis, infections, sural nerve damage) following both surgical and nonsurgical management [46].…”