Return to Sport and Patient Satisfaction at 5-Year Follow-up After Nonoperative Treatment for Acute Achilles Tendon Rupture

Lerch, Till; Schwinghammer, Andreas; Schmaranzer, Florian; Anwander, Helen; Ecker, Timo M.; Schmid, Timo; Weber, Martin; Krause, Fabian

doi:10.1177/1071100720919029

Cited by 26 publications

(22 citation statements)

References 38 publications

(69 reference statements)

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“…Despite numerous high-evidence studies, the optimal management of the ATR, conservative or operative, continues to be a subject of debate within the orthopedic community [ 7 ]; the superiority of one type of procedure over the other has not yet been demonstrated by comparing the results of the different procedures described in the literature: open, minimally invasive, or percutaneous [ 38 ]. Currently, operative treatment is particularly recommended in active patients who require a rapid return to daily activities, including sports.…”

Section: Discussionmentioning

confidence: 99%

“…ATR incidence has constantly increased due to aging of the population, growing prevalence of obesity, and increasing practice of sports [ 4 , 5 ]. Acute ruptures of the AT occur most frequently in middle-aged men, an incidence of 69 per 100,000, especially in those participating in sports with energetic repetitive jumping that use eccentric loading and sprinting movements that require pushing-off force [ 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Despite several randomized controlled trials and meta-analyses investigating surgical versus non-surgical treatment of acute Achilles tendon rupture (AATR), its treatment is still under debate [ 15 , 16 ]: controversy remains about whether nonoperative or operative treatment for AATR is superior, especially for athletic patients [ 7 , 17 ]. The treatment options include conservative treatment, traditional open surgery, mini open techniques, and percutaneous repair [ 5 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Long Term Clinical–Functional and Ultrasound Outcomes in Recreational Athletes after Achilles Tendon Rupture: Ma and Griffith versus Tenolig

et al. 2021

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Background and Objectives: The purpose of this retrospective study was to compare the long-term clinical–functional and ultrasound outcomes of recreational athletes treated with two percutaneous techniques: Ma and Griffith (M&G) and the Tenolig technique (TT). Materials and Methods: recreational athletes, between 18 and 50 years of age, affected by acute Achilles tendon rupture (AATR), treated by M&G or Tenolig techniques were recruited. Clinical–functional outcomes were evaluated using Achilles Tendon Rupture Score (ATRS), AOFAS Ankle–Hindfoot score, VAS (for pain and satisfaction) questionnaires, and ultrasound analysis (focal thickening, hypoechoic areas, presence of calcifications, tendinitis and alteration of normal fibrillar architecture). Results: 90 patients were included: 50 treated by M&G, 40 by TT. In all, 90% of patients resumed sports activities, with pre-injury levels in 56% of cases after M&G and in 60% after TT. In the M&G group, the averages of the questionnaires were ATRS 90.70 points, AOFAS 91.03, VAS satisfaction 7.08, and VAS pain 1.58. In the TT group: ATRS 90.38 points, AOFAS 90.28, VAS satisfaction 7.76, and VAS pain 1.34. The TT group showed a significantly higher satisfaction and return to sport activities within a shorter time. In the M&G group, ultrasound check showed a significantly greater incidence of thickening and an alteration of fibrillar architecture in the treated tendon. Three infections were reported, including one deep after M&G, two superficial in the TT group, and two re-ruptures in the Tenolig group following a further trauma. Conclusions: At long-term follow-up, M&G and TT are both valid techniques for the treatment of AATRs in recreational athletes, achieving comparable clinical–functional results. However, TT seems to have a higher patient satisfaction rate, a faster return to sports and physical activities, and fewer ultrasound signs of tendinitis. Finally, the cost of the device makes this technique more expensive.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long Term Clinical–Functional and Ultrasound Outcomes in Recreational Athletes after Achilles Tendon Rupture: Ma and Griffith versus Tenolig

et al. 2021

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“…The return to sport times ranged from 12 to 28 weeks when analyzing the different levels of return to sport. It could be stated that these return to sport times and rates are adequate in comparison to other foot and ankle sports-related injuries, such as when considering osteochondral lesions of the talus, Lisfranc injuries, and syndesmotic injuries, for example [ 8 , 14 , 21 , 24 ]. Steman et al [ 21 ] found a mean rate of 88% for RTS at any level in patients treated for osteochondral lesions of the talus treated with arthroscopic bone marrow stimulation, while a RTS at pre-injury level and type of sport of 79% was found for the same surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Six out of ten patients with sinus tarsi syndrome returned to pre-injury type of sport after subtalar arthroscopy

Lauf

Dahmen

Altink

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this study was to determine multiple return to sport rates, long-term clinical outcomes and safety for subtalar arthroscopy for sinus tarsi syndrome. Methods Subtalar arthroscopies performed for sinus tarsi syndrome between 2013 and 2018 were analyzed. Twenty-two patients were assessed (median age: 28 (IQR 20–40), median follow-up 60 months (IQR 42–76). All patients were active in sports prior to the injury. The primary outcome was the return to pre-injury type of sport rate. Secondary outcomes were time and rate of return to any type of sports, return to performance and to improved performance. Clinical outcomes consisted of Numerous Rating Scale of pain, Foot and Ankle Outcome Score, 36-item Short Form Survey and complications and re-operations. Results Fifty-five percent of the patients returned to their preoperative type of sport at a median time of 23 weeks post-operatively (IQR 9.0–49), 95% of the patients returned to any type and level sport at a median time of 12 weeks post-operatively (IQR 4.0–39), 18% returned to their preoperative performance level at a median time of 25 weeks post-operatively (IQR 8.0–46) and 5% returned to improved performance postoperatively at 28 weeks postoperatively (one patient). Median NRS in rest was 1.0 (IQR 0.0–4.0), 2.0 during walking (IQR 0.0–5.3) during walking, 3.0 during running (IQR 1.0–8.0) and 2.0 during stair-climbing (IQR 0.0–4.5). The summarized FAOS score was 62 (IQR 50–90). The median SF-36 PCSS and the MCSS were 46 (IQR 41–54) and 55 (IQR 49–58), respectively. No complications and one re-do subtalar arthroscopy were reported. Conclusion Six out of ten patients with sinus tarsi syndrome returned to their pre-injury type of sport after being treated with a subtalar arthroscopy. Subtalar arthroscopy yields effective outcomes at long-term follow-up concerning patient-reported outcome measures in athletic population, with favorable return to sport level, return to sport time, clinical outcomes and safety outcome measures. Level of evidence IV.

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“…Several treatment options have been recommended, including immediate immobilization, open repair, percutaneous repair, and functional rehabilitation (2)(3)(4). Conventionally, the open repair was favored secondary to its lower re-rupture rates, however in more recent years, and there has been a progressive shift away from surgical intervention to reduce wound complications (5,6). On the other hand, conservative options have been shown to carry an increased rate of re-rupture and tendon lengthening and other long-term complications (7,8).…”

Section: Introductionmentioning

confidence: 99%

Comparison of open repair and modified percutaneous repair techniques for the treatment of acute achilles tendon ruptures

Kehribar

Sürücü

2022

Journal of Health Sciences and Medicine

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Background: This study compared acute Achilles tendon repairs' functional and clinical outcomes with two different surgical techniques; modified percutaneous and open repair. Material and Method: This retrospective study analyzed 57 patients with an acute Achilles tendon rupture (AATR) who underwent modified percutaneous and open repair. 46 patients who met the eligibility criteria were enrolled and divided into two groups based on the surgical technique. 23 patients from Group 1 were treated using modified percutaneous repair under local anesthesia, and 23 patients from Group 2 were treated with an open repair under regional anesthesia. Postoperatively, patients were evaluated using American Orthopedic Foot and Ankle Society (AOFAS) Hindfoot Questionnaire score at final follow-up. The other outcomes included return to work, return to sports activities, capacity to complete single heel rise, leg circumference, estimated limb symmetry indices, Achilles tendon resting angle (ATRA), complications, and timing of index surgery. Results: At the time of surgery, the mean age of the patients was 35.9 7.5 years (range, 25-47 years). The average follow-up was 34.8±6.5 months (24-52 months). The mean age, gender, body mass index (BMI), rupture level, duration from injury to surgery, and mean follow-up time were similar in both groups. At a minimum 2-year follow-up, good pain relief was achieved for all patients. The AOFAS scores were 93.4±4.1 (88-100) in Group 1 and 92.2±5.2 (82-100) in Group 2. There was no statistically significant difference between groups concerning the Achilles tendon resting angle (ATRA), calf circumference, single-leg heel rise, return to work, and return to sports activities. However, the percutaneous repair procedure had a shorter surgical time than the open repair technique (p<0.05). Conclusion:Modified percutaneous and open repair techniques provide similar clinical and functional outcomes, but the percutaneous repair technique showed faster surgical time than open procedures. Furthermore, the percutaneous technique may be more practical than the open technique, which may be performed under local anesthesia.

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Return to Sport and Patient Satisfaction at 5-Year Follow-up After Nonoperative Treatment for Acute Achilles Tendon Rupture

Cited by 26 publications

References 38 publications

Long Term Clinical–Functional and Ultrasound Outcomes in Recreational Athletes after Achilles Tendon Rupture: Ma and Griffith versus Tenolig

Long Term Clinical–Functional and Ultrasound Outcomes in Recreational Athletes after Achilles Tendon Rupture: Ma and Griffith versus Tenolig

Six out of ten patients with sinus tarsi syndrome returned to pre-injury type of sport after subtalar arthroscopy

Comparison of open repair and modified percutaneous repair techniques for the treatment of acute achilles tendon ruptures

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