Reduced Time to Surgery Improves Patient-Reported Outcome After Achilles Tendon Rupture

Abstract

Patients with acute ATR undergoing operation within 48 hours after injury had better outcomes and a lower number of adverse events compared with patients undergoing operation after 72 hours. These results align with evidence-based recommendations from other surgical disciplines and should be used as guidelines for optimizing ATR treatment protocols. Registration: NTC01317160 (ClinicalTrials.gov identifier).

Age and Tightness of Repair Are Predictors of Heel-Rise Height After Achilles Tendon Rupture

“…In humans, clinical studies 42,50 have shown conflicting outcomes for those undergoing repair within 48 hours of injury. Svedman et al 50 reported that repairs performed within 48 hours of injury lead to an improved outcome; however, other studies 7,42 have found no differences in outcome if surgery is performed within a week of injury. It may be that outcomes in the first weeks postinjury are affected by time to repair, but these improvements are mitigated over time and are not reflected in longer term, functional outcomes.…”

“…The elapsed time to repair is also controversial, with improved outcome reported if repair is performed within 48 hours of injury. 50 Other studies, 7,42 however, show no differences in terms of outcome if surgery is performed within a week of injury.…”

Total rupture of achilles tendon induces inflammatory response and glial activation on the mice spinal cord 

“…The treatment of ruptured Achilles tendon is generally made by surgical intervention being time of recovery variable among individuals 5,6 . As widely described in the literature, the time elapsed from tendon rupture to surgical repair is predictive of Achilles tendon recovery 7 . Different studies show that localized pain and changes in gait pattern are symptoms commonly described in injured subjects 8,9 .…”

Time-sensitive ambulatory orthopaedic soft-tissue surgery paradigms during the COVID-19 pandemic

“…Patients with acute Achilles tendon rupture who underwent surgery within 48 hours after the injury had better outcomes (Achilles Tendon Total Rupture Score) and a reduced number of adverse events (re-rupture, deep vein thrombosis) when compared with patients undergoing surgery after 72 hours and can be used as a guideline for optimizing Achilles tendon rupture treatment protocols [26].…”

“…Early manipulation under anaesthesia (< 12 weeks) is associated with greater flexion gains, final range of motion, and higher knee society scores compared with those performed after 12 weeks [48]. While there may still be a benefit from manipulation up to 26 weeks, open arthrolysis may be needed in the event of any further surgical delays [49].…”