AJSM signin
HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Sign In to gain access to subscriptions and/or personal tools.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wong, J.
Right arrow Articles by Maffulli, N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wong, J.
Right arrow Articles by Maffulli, N.
Related Collections
Right arrow Achilles tendon
The American Journal of Sports Medicine 30:565-575 (2002)
© 2002 American Orthopaedic Society for Sports Medicine

Quantitative Review of Operative and Nonoperative Management of Achilles Tendon Ruptures

Jason Wong, MBChB*, Victoria Barrass, BMedSci* and Nicola Maffulli, MD, MS, PhD, FRCS (Orth){dagger},*,{ddagger}

* Department of Orthopaedic Surgery, University of Aberdeen Medical School, Aberdeen, Scotland
{dagger} Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, Stoke on Trent, England

{ddagger} Address correspondence and reprint requests to Nicola Maffulli, MD, Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, North Staffordshire Hospital, Thornburrow Drive, Hartshill, Stoke on Trent, Staffordshire, ST4 7QB, England

Background: There is no consensus on the best method for management of acute Achilles tendon ruptures. Individual preferences, drawn from experience and study, determine whether treatment is operative or nonoperative.

Purpose: Our goal was to review the literature to try to determine what management method was the most popular and effective. We wanted to ascertain the best results in terms of complication rates and patient outcomes.

Study Design: Retrospective review of retrospectively and prospectively collected data.

Methods: We analyzed 125 articles in peer-reviewed journals for year of publication, patient numbers, sex, management method, follow-up complications, and patient satisfaction. Each article was graded using a validated methods score. Methods, patient satisfaction, and complication rates were correlated with the year each article was published.

Results: Skin-healing complications were lowest in conservatively managed patients (3 of 578, 0.5%) and highest in open repair and immobilized patients (543 of 3718, 14.6%). General complication rates were lowest in open repair and early-mobilization groups (16 of 238, 6.7%) and highest in percutaneous and early-mobilization groups (19 of 122, 15.6%). Rerupture rates were highest in immobilized conservative management groups (62 of 578, 10.7%) and lowest in groups with external fixation (0%).

Conclusions: In general, the number of publications reporting Achilles tendon ruptures is increasing, the quality of articles is increasing, and the trend for the number of reported complications is decreasing. The published articles had a low methods score (mean, 50.9; range, 25 to 77) and showed a trend toward earlier mobilization. Open repair and early mobilization give the best functional recovery and an acceptable complication rate.




This article has been cited by other articles:


Home page
 Am J Sports MedHome page
B. C. Twaddle and P. Poon
Early Motion for Achilles Tendon Ruptures: Is Surgery Important?: A Randomized, Prospective Study
Am. J. Sports Med., December 1, 2007; 35(12): 2033 - 2038.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
E. Uchiyama, A. Nomura, Y. Takeda, K. Hiranuma, and H. Iwaso
A Modified Operation for Achilles Tendon Ruptures
Am. J. Sports Med., October 1, 2007; 35(10): 1739 - 1743.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
K. Nilsson-Helander, R. Thomee, K. Gravare-Silbernagel, P. Thomee, E. Faxen, B. I. Eriksson, and J. Karlsson
The Achilles Tendon Total Rupture Score (ATRS): Development and Validation
Am. J. Sports Med., March 1, 2007; 35(3): 421 - 426.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
R. Kotnis, S. David, R. Handley, K. Willett, and S. Ostlere
Dynamic Ultrasound as a Selection Tool for Reducing Achilles Tendon Reruptures
Am. J. Sports Med., September 1, 2006; 34(9): 1395 - 1400.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
M. Majewski, M. Rohrbach, S. Czaja, and P. Ochsner
Avoiding Sural Nerve Injuries During Percutaneous Achilles Tendon Repair
Am. J. Sports Med., May 1, 2006; 34(5): 793 - 798.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
R. J.K. Khan, D. Fick, A. Keogh, J. Crawford, T. Brammar, and M. Parker
Treatment of Acute Achilles Tendon Ruptures. A Meta-Analysis of Randomized, Controlled Trials
J. Bone Joint Surg. Am., October 1, 2005; 87(10): 2202 - 2210.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
A. C. Rettig, F. J. Liotta, T. E. Klootwyk, D. A. Porter, and P. Mieling
Potential Risk of Rerupture in Primary Achilles Tendon Repair in Athletes Younger Than 30 Years of Age
Am. J. Sports Med., January 1, 2005; 33(1): 119 - 123.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
N. Maffulli, C. Tallon, J. Wong, K. P. Lim, and R. Bleakney
Early Weightbearing and Ankle Mobilization after Open Repair of Acute Midsubstance Tears of the Achilles Tendon
Am. J. Sports Med., September 1, 2003; 31(5): 692 - 700.
[Abstract] [Full Text] [PDF]


HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2002 by the American Orthopaedic Society for Sports Medicine.