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Functional Outcome of Percutaneous Achilles Repair: Improvements in Achilles Tendon Total Rupture Score During the First Year.

Carmont MR, Silbernagel KG, Edge A, Mei-Dan O, Karlsson J, Maffulli N - Orthop J Sports Med (2013)

Bottom Line: There were no significant differences in outcome at each time point for those patients undergoing early (≤48 hours) compared with late surgery or between those <65 and those >65 years of age.The presence of a complication other than rerupture did not affect the end-stage outcome but did affect that at 3 months following surgery.This study demonstrates improving scores with time over the first year following surgery, against which other treatment methods can be compared.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Princess Royal Hospital, Telford, Shropshire, UK.

ABSTRACT

Background: Randomized studies have so far failed to show a difference in outcome between operative and nonoperative management of Achilles tendon rupture, provided that no rerupture occurs. Percutaneous Achilles repair has been suggested to result in superior patient satisfaction compared with open repair in patients with an acute Achilles tendon rupture, but there are no outcome data available with validated methods describing the progression of recovery during the first year.

Purpose: To evaluate the outcome of patients with a ruptured Achilles tendon, managed by percutaneous repair, during the first year following repair with a valid, reliable, and responsive outcome measure. Furthermore, the effects of time between injury and surgery, age, and complications on outcome were also evaluated.

Study design: Case series.

Methods: A total of 73 patients (60 males and 13 females) with a mean age of 45.5 years were included. Patient age, length of time between injury and surgery, and complications were documented. Patients were evaluated using the Achilles tendon Total Rupture Score (ATRS) at 3, 6, 9, and 12 months following repair.

Results: The median ATRS results at 3, 6, 9, and 12 months were 42.5, 73, 83, and 89, respectively. The number of patients who reported excellent or good scores (ATRS >84) at 3, 6, 9, and 12 months were 3%, 36%, 57%, and 69%, respectively. There were no significant differences in outcome at each time point for those patients undergoing early (≤48 hours) compared with late surgery or between those <65 and those >65 years of age. The complication rate was 13.5%. Patients who had a complication had a lower ATRS result at 3 months following surgery, but there were no differences after that time point.

Conclusion: The patients in the present study reported marked improvement in function between 3 and 6 months following surgery, with continuing but less steep improvement up to 1 year following surgery. The presence of a complication other than rerupture did not affect the end-stage outcome but did affect that at 3 months following surgery.

Clinical relevance: This study demonstrates improving scores with time over the first year following surgery, against which other treatment methods can be compared.

No MeSH data available.


Related in: MedlinePlus

Bimodal age distribution.
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fig1-2325967113494584: Bimodal age distribution.

Mentions: The continued evaluation included 73 patients. Their demographic details are typical for a cohort of patients who have sustained a rupture of the Achilles tendon (Table 1). There was a bimodal age distribution (Figure 1). The most frequent activity during which the tendon ruptured was playing football (n = 16); other sports included badminton (n = 11), running (n = 6), rugby (n = 5), and squash (n = 4). All but 2 patients underwent surgery within 14 days of injury (mean, 6 days; range, 0-20 days).


Functional Outcome of Percutaneous Achilles Repair: Improvements in Achilles Tendon Total Rupture Score During the First Year.

Carmont MR, Silbernagel KG, Edge A, Mei-Dan O, Karlsson J, Maffulli N - Orthop J Sports Med (2013)

Bimodal age distribution.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4555500&req=5

fig1-2325967113494584: Bimodal age distribution.
Mentions: The continued evaluation included 73 patients. Their demographic details are typical for a cohort of patients who have sustained a rupture of the Achilles tendon (Table 1). There was a bimodal age distribution (Figure 1). The most frequent activity during which the tendon ruptured was playing football (n = 16); other sports included badminton (n = 11), running (n = 6), rugby (n = 5), and squash (n = 4). All but 2 patients underwent surgery within 14 days of injury (mean, 6 days; range, 0-20 days).

Bottom Line: There were no significant differences in outcome at each time point for those patients undergoing early (≤48 hours) compared with late surgery or between those <65 and those >65 years of age.The presence of a complication other than rerupture did not affect the end-stage outcome but did affect that at 3 months following surgery.This study demonstrates improving scores with time over the first year following surgery, against which other treatment methods can be compared.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Princess Royal Hospital, Telford, Shropshire, UK.

ABSTRACT

Background: Randomized studies have so far failed to show a difference in outcome between operative and nonoperative management of Achilles tendon rupture, provided that no rerupture occurs. Percutaneous Achilles repair has been suggested to result in superior patient satisfaction compared with open repair in patients with an acute Achilles tendon rupture, but there are no outcome data available with validated methods describing the progression of recovery during the first year.

Purpose: To evaluate the outcome of patients with a ruptured Achilles tendon, managed by percutaneous repair, during the first year following repair with a valid, reliable, and responsive outcome measure. Furthermore, the effects of time between injury and surgery, age, and complications on outcome were also evaluated.

Study design: Case series.

Methods: A total of 73 patients (60 males and 13 females) with a mean age of 45.5 years were included. Patient age, length of time between injury and surgery, and complications were documented. Patients were evaluated using the Achilles tendon Total Rupture Score (ATRS) at 3, 6, 9, and 12 months following repair.

Results: The median ATRS results at 3, 6, 9, and 12 months were 42.5, 73, 83, and 89, respectively. The number of patients who reported excellent or good scores (ATRS >84) at 3, 6, 9, and 12 months were 3%, 36%, 57%, and 69%, respectively. There were no significant differences in outcome at each time point for those patients undergoing early (≤48 hours) compared with late surgery or between those <65 and those >65 years of age. The complication rate was 13.5%. Patients who had a complication had a lower ATRS result at 3 months following surgery, but there were no differences after that time point.

Conclusion: The patients in the present study reported marked improvement in function between 3 and 6 months following surgery, with continuing but less steep improvement up to 1 year following surgery. The presence of a complication other than rerupture did not affect the end-stage outcome but did affect that at 3 months following surgery.

Clinical relevance: This study demonstrates improving scores with time over the first year following surgery, against which other treatment methods can be compared.

No MeSH data available.


Related in: MedlinePlus