nach oben

MUSCULOSKELETAL SURGERY

Erschienen in:

01.04.2013 | Review

The ruptured Achilles tendon: a current overview from biology of rupture to treatment

verfasst von: G. Thevendran, K. M. Sarraf, N. K. Patel, A. Sadri, P. Rosenfeld

Erschienen in: MUSCULOSKELETAL SURGERY | Ausgabe 1/2013

Einloggen, um Zugang zu erhalten

Abstract

The Achilles tendon (AT) is the most frequently ruptured tendon in the human body yet the aetiology remains poorly understood. Despite the extensively published literature, controversy still surrounds the optimum treatment of complete rupture. Both non-operative management and percutaneous repair are attractive alternatives to open surgery, which carries the highest complication and cost profile. However, the lack of a universally accepted scoring system has limited any evaluation of treatment options. A typical UK district general hospital treats approximately 3 cases of AT rupture a month. It is therefore important for orthopaedic surgeons to correctly diagnose and treat these injuries with respect to the best current evidence-based practice. In this review article, we discuss the relevant pathophysiology and diagnosis of the ruptured AT and summarize the current evidence for treatment.

O’Brien M (1992) Functional anatomy and physiology of tendons. Clin Sports Med 11(3):505–520PubMed

Chalmers J (2000) Review article: treatment of Achilles tendon ruptures. J OrthopSurg (Hong Kong) 8(1):97–99

Landvater SJ, Renström PA (1992) Complete Achilles tendon ruptures. Clin Sports Med 11(4):741–758PubMed

Abrahamsen K (1923) Ruptura tendinis Achillis. UgesskrLaeger 85:279–285

Lea RB, Smith L (1972) Non-surgical treatment of tendo Achilles rupture. J Bone Joint Surg Am 54(7):1398–1407PubMed

Moller A, Anstrom M, Westlin NE (1996) Increasing incidence of Achilles tendon rupture. Acta Orthop Scand 67:277–279CrossRef

Carden DG, Noble J, Chalmers J et al (1987) Rupture of the calcaneal tendon: the early and late management. J Bone Joint Surg Br 69(3):416–420PubMed

Boyden EM, Kitaoka HB, Cahalan TD et al (1995) Late versus early repair of Achilles tendon rupture: clinical and biomechanical evaluation. Clin Orthop Relat Res 317:150–158PubMed

Jozsa L, Kvist M, Balint JB et al (1989) The role of recreational sports activity in Achilles tendon rupture: a clinical, pathoanatomical and sociological study of 292 cases. Am J Sports Med 17:338–343PubMedCrossRef

10.

Rufai A, Ralphs JR, Benjamin M (1995) Structure and histopathology of the insertional region of the human Achilles tendon. J Orthop Res 13(4):585–593PubMedCrossRef

11.

Mayer L (1916) The physiological method of tendon transplantation. Surg Gynecol Obstet 22:182–197

12.

Carr AJ, Norris SH (1989) The blood supply of the calcaneal tendon. J Bone Joint Surg Br 71(1):100–101PubMed

13.

Astrom M, Westlin N (1994) Blood flow in the human Achilles tendon assessed by Doppler flowmetry. J Orthop Res 12(2):246–252PubMedCrossRef

14.

Stilwell DL Jr (1957) The innervation of tendons and aponeuroses. Am J Anat 100(3):289–317PubMedCrossRef

15.

Coombs RRH, Klenerman L, Narcisi P et al (1980) Collagen typing in Achilles tendon rupture. In: Proceedings of the British orthopaedic research society. J Bone Joint Surg Am 62B(2):258

16.

Maffulli N, Ewen SW, Waterston SW et al (2000) Tenocytes from ruptured and tendinopathic Achilles tendons produce greater quantities of type III collagen than tenocytes from normal Achilles tendons. An in vitro model of human tendon healing. Am J Sports Med 28(4):499–505PubMed

17.

Kannus P, Josza L, Jarvinnen M (2000) Basic science of tendons. In: Garrett WJ, Speer K, Kirkendall DT (eds) Principles and practice of orthopaedic sports medicine. Lipincott Williams & Wilkins, Philadelphia

18.

Fukashiro S, Itoh M, Ichinose Y et al (1995) Ultrasonography gives directly but not noninvasively elastic characteristic of human tendon in vivo. Eur J Appl Physiol Occup Physiol 71(6):555–557PubMedCrossRef

19.

Arndt AN, Komi PV, Bruggeman GP et al (1998) Individual muscle contribution to the in vivo Achilles tendon force. ClinBiomech 13:532–541

20.

O’Brien T (1984) The needle test for complete rupture of the Achilles tendon. J Bone Joint Surg Am 66(7):1099–1101PubMed

21.

Maffulli N (1999) Rupture of the Achilles tendon. J Bone Joint Surg Am 81(7):1019–1036PubMed

22.

Langergren C, Lindholm A (1958) Vascular distribution in the Achilles tendon; an angiographic and microangiographic study. Acta Chir Scand 116(5–6):491–495

23.

Arner O, Lindholm A, Orell SR (1959) Histological changes in subcutaneous rupture of the Achilles tendon; a study of 74 cases. Acta Chir Scand 116(5–6):484–490PubMed

24.

Jozsa L, Kannus P (1997) Histopathological findings in spontaneous tendon ruptures. Scand J Med Sci Sports 7(2):113–118PubMedCrossRef

25.

Fox JM, Blazina ME, Jobe FW et al (1975) Degeneration and rupture of the Achilles tendon. Clin Orthop Relat Res 107:221–224PubMedCrossRef

26.

Tuite DJ, Renstrom PA, O’Brien M (1997) The aging tendon. Scand J Med Sci Sports 7(2):72–77PubMedCrossRef

27.

Blevins FT, Hecker AT, Bigler GT et al (1994) The effects of donor age and strain rate on the biomechanical properties of bone-patellar tendon-bone allografts. Am J Sports Med 22(3):328–333PubMedCrossRef

28.

Collins M, Raleigh SM (2009) Genetic risk factors for musculoskeletal soft tissue injuries. Med Sport Sci 54:136–149PubMedCrossRef

29.

Barfred T (1973) Achilles tendon rupture: aetiology and pathogenesis of subcutaneous rupture assessed on the basis of literature and rupture experiments on rats. Acta Orthop Scand 152(S):3–126

30.

Inglis AE, Sculco TP (1981) Surgical repair of ruptures of the tendo Achilles. Clin Orthop Relat Res 156:160–169PubMed

31.

Barfred T (1971) Experimental rupture of the Achilles tendon. Comparison of various types of experimental rupture in rats. Acta Orthop Scand 42(6):528–543PubMedCrossRef

32.

Clement DB, Taunton JE, Smart GW (1984) Achilles tendinitis and peritendinitis: etiology and treatment. Am J Sports Med 12(3):179–184PubMedCrossRef

33.

DiStefano VJ, Nixon JE (1973) Ruptures of the Achilles tendon. J Sports Med 1(2):34–37PubMedCrossRef

34.

Kennedy JC, Willis RB (1976) The effects of local steroid injections on tendons: a biomechanical and microscopic correlative study. Am J Sports Med 4(1):11–21PubMedCrossRef

35.

Shrier I, Matheson GO, Kohl HW III (1996) Achilles tendonitis: are corticosteroid injections useful or harmful? Clin J Sports Med 6(4):245–250CrossRef

36.

Royer RJ, Pierfitte C, Netter P (1994) Features of tendon disorders with fluroquinolones. Therapie 49(1):75–76PubMed

37.

Barge-Caballero E, Crespo-Leiro M, Paniagua-Martin M et al (2008) Quinolone-related Achilles tendonpathy in heart transplant patients: incidence and risk factors. J Heart Lung Transpl 27(1):46–51CrossRef

38.

Melhus A (2005) Fluoroquinolones and tendon disorders. Expert Opin Drug Saf 4(2):299–309PubMedCrossRef

39.

Petersen W, Pufe T, Zantop T et al (2004) Expression of VEGFR-1 and VEGFR-2 in degenerative Achilles tendons. Clin Orthop Relat Res 420:286–291PubMedCrossRef

40.

Webbon PM (1977) A post-mortem study of equine digital flexor tendons. Equine Vet J 9(2):61–67PubMedCrossRef

41.

Wilson A, Goodship AE (1994) Exercise-induced hyperthermia as a possible mechanism for tendon degeneration. J Biomech 27(7):899–905PubMedCrossRef

42.

Hattrup SJ, Johnson KA (1985) A review of ruptures of the Achilles tendon. Foot Ankle 6(1):34–38PubMedCrossRef

43.

Arner O, Lindholm A (1959) Subcutaneous rupture of the Achilles tendon: a study of 92 cases. Acta Chir Scand Suppl 116(S239):1–51PubMed

44.

Krueger-Franke M, Siebert CH, Scherzer S (1995) Surgical treatment of ruptures of the Achilles tendon: a review of long term results. Br J Sports Med 29(2):121–125PubMedCrossRef

45.

Inglis AE, Scott WN, Sculco TP et al (1976) Ruptures of the tendo Achilles: an objective assessment of surgical and non-surgical treatment. J Bone Joint Surg Am 58(7):990–993PubMed

46.

Maffulli N (1998) The clinical diagnosis of subcutaneous tear of the Achilles tendon. Am J Sports Med 26(2):266–270PubMed

47.

Kager H (1939) Zur Klinik und Diagnostik des Achillesshnenrisses. Chirurgie 11:691–695

48.

Toygar O (1947) Subkutane rupture der Achillesschne (Diagnostik und Behandlungsergebnisse). Helvet Chir Acta 14:209–231PubMed

49.

Bleakney RR, Tallon C, Wong JK et al (2002) Long term ultrasonographic features of the Achilles tendon after rupture. Clin J Sports Med 12(5):273–278CrossRef

50.

Barbolini G, Monetti G, Montorsi A et al (1988) Results with high definition sonography in the evaluation of Achilles tendon conditions. Int J Sports Traumatol 10:225–234

51.

Kalebo P, Allenmark C, Peterson L et al (1992) Diagnostic value of ultrasonography in partial ruptures of the Achilles tendon. Am J Sports Med 20(4):378–381PubMedCrossRef

52.

Mortensen HM, Skov O, Jensen PE (1999) Early motion of the ankle after operative treatment of a rupture of the Achilles tendon. A prospective, randomized clinical and radiographic study. J Bone Joint Surg Am 81(7):983–990PubMed

53.

Nistor L (1981) Surgical and non-surgical treatment of Achilles tendon rupture: a prospective randomised study. J Bone Joint Surg Am 63(3):394–399PubMed

54.

Saleh M, Marshall PD, Senior R et al (1992) The Sheffield splint for controlled early mobilization after rupture of the calcaneal tendon: a prospective randomized comparison with plaster treatment. J Bone Joint Surg Br 74(2):206–209PubMed

55.

Wallace RG, Traynor IE, Kernohan WG et al (2004) Combined conservative and orthotic management of acute ruptures of the Achilles tendon. J Bone Joint Surg Am 86-A(6):1198–1202PubMed

56.

Ingvar J, Tagil M, Eneroth M (2005) Non-operative treatment of Achilles tendon rupture: 196 consecutive patients with a 7 % re-rupture rate. Acta Orthop 76(4):597–601PubMedCrossRef

57.

Twaddle BC, Poon P (2007) Early motion for Achilles tendon ruptures: is surgery important? A randomized prospective study. Am J Sports Med 35(12):2033–2038PubMedCrossRef

58.

Lemaire R, Popovic N (1999) Diagnosis and treatment of acute ruptures of the Achilles tendon: current concepts review. Acta Orthop Belg 65(4):458–471PubMed

59.

Cetti R, Henriksen LO, Jacobsen KS (1994) A new treatment of ruptured Achilles tendons: a prospective randomised study. Clin Orthop Relat Res 308:155–165PubMed

60.

Zell RA, Santoro VM (2000) Augmented repair of acute Achilles tendon ruptures. Foot Ankle Int 21(6):469–474PubMed

61.

Giannini S, Girolami M, Ceccarelli F et al (1994) Surgical repair of Achilles tendon ruptures using polypropylene braid augmentation. Foot Ankle Int 15(7):372–375PubMedCrossRef

62.

Lynn TA (1966) Repair of the torn Achilles tendon using the plantaris tendon as a reinforcing membrane. J Bone J Surg Am 48(2):268–272

63.

Maffulli N, Tallon C, Wong J et al (2003) Early weight bearing and ankle mobilization after open repair of acute midsubstance tears of the Achilles tendon. Am J Sports Med 31(5):692–700PubMed

64.

Costa ML, MacMillan K, Halliday D et al (2006) Randomised controlled trials of immediate weight-bearing mobilisation for rupture of tendo Achilles. J Bone Joint Surg Br 88(1):69–77PubMedCrossRef

65.

Ma GW, Griffith TG (1977) Percutaneous repair of acute closed ruptured Achilles tendon: a new technique. Clin Orthop Relat Res 128:247–255PubMed

66.

Haji A, Sahai A, Symes A et al (2004) Percutaneous versus open tendo Achilles repair. Foot Ankle Int 25(4):215–218PubMed

67.

Bradley JP, Tibone JE (1990) Percutaneous and open surgical repairs of Achilles tendon ruptures: a comparative study. Am J Sports Med 18(2):188–195PubMedCrossRef

68.

Gorschewsky O, Pitzl M, Putz A et al (2004) Percutaneous repair of acute Achilles tendon rupture. Foot Ankle Int 25(4):219–224PubMed

69.

Krackow KA, Thomas SC, Jones LC (1986) A new stitch for ligament tendon fixation: brief note. J Bone Joint Surg Am 68(5):764–766PubMed

70.

Watson TW, Jurist KA, Yang KH et al (1995) The strength of Achilles tendon repair: an in vitro study of the biomechanical behaviour in human cadaver tendons. Foot Ankle Int 16(4):191–195PubMedCrossRef

71.

Hockenbury RT, Johns JC (1990) A biomechanical in vitro comparison of open versus percutaneous repair of tendon Achilles. Foot Ankle 11(2):67–72PubMedCrossRef

72.

Carmont MR, Maffulli N (2008) Modified percutaneous repair of ruptured Achilles tendon. Knee Surg Sports Traumatol Arthrosc 16(2):199–203PubMedCrossRef

73.

Bhandari M, Guyatt GH, Siddiqui F et al (2002) Treatment of acute Achilles tendon ruptures: a systematic overview and meta-analysis. Clin Orthop Relat Res 400:190–200PubMedCrossRef

74.

Cretnik A, Kosanovic M, Smrkolj V (2005) Percutaneous versus open repair of the ruptured Achilles tendon. A comparative study. Am J Sports Med 33(9):1369–1379PubMedCrossRef

75.

Goren D, Ayalon M, Nyska M (2005) Isokinetic strength and endurance after percutaneous and open surgical repair of Achilles tendon ruptures. Foot Ankle Int 26(4):286–290PubMed

76.

Calder JD, Saxby TS (2005) Early, active rehabilitation following mini-open repair of Achilles tendon rupture: a prospective study. Br J Sports Med 39(11):857–859PubMedCrossRef

77.

Valente M, Crucil M, Alecci V et al (2012) Minimally invasive repair of acute Achilles tendon ruptures with Achillon device. Musculoskelet Surg 96(1):35–39PubMedCrossRef

78.

Chiodo CP, Glazebrook M, Bluman EM et al (2010) Diagnosis and treatment of acute Achilles tendon rupture. J Am Acad Orthop Surg 18(8):503–510PubMed

79.

Wong J, Barrass V, Maffulli N (2002) Quantitative review of operative and nonoperative management of Achilles tendon ruptures. Am J Sports Med 30(4):565–575PubMed

80.

Khan RJ, Fick D, Keogh A et al (2005) Treatment of acute Achilles tendon ruptures. A meta-analysis of randomized, controlled trials. J Bone Joint Surg Am 87(10):2202–2210PubMedCrossRef

81.

Soroceanu A, Sidhwa F, Aarabi S et al (2012) Surgical versus nonsurgical treatment of acute Achilles tendon rupture: a meta-analysis of randomized trials. J Bone Joint Surg Am 94(23):2136–2143PubMedCrossRef

82.

Nilsson-Helander K, Thomee R, Gravare-Silbernagel K et al (2007) The Achilles tendon total rupture score (ATRS). Am J Sports Med 35(3):421–426PubMedCrossRef

83.

Nilsson-Helander K, Silbernagel KG, Thomeé R, Faxén E, Olsson N, Eriksson BI, Karlsson J (2010) Acute achilles tendon rupture: a randomized, controlled study comparing surgical and nonsurgical treatments using validated outcome measures. Am J Sports Med 38(11):2186–2193PubMedCrossRef

84.

Ebinesan AD, Sarai BS, Walley GD et al (2008) Conservative, open or percutaneous repair for acute rupture of the Achilles tendon. Disabil Rehabil 30(20–22):1721–1725PubMedCrossRef

Titel: The ruptured Achilles tendon: a current overview from biology of rupture to treatment
verfasst von: G. Thevendran
K. M. Sarraf
N. K. Patel
A. Sadri
P. Rosenfeld
Publikationsdatum: 01.04.2013
Verlag: Springer Milan
Erschienen in: MUSCULOSKELETAL SURGERY / Ausgabe 1/2013
Print ISSN: 2035-5106
Elektronische ISSN: 2035-5114
DOI: https://doi.org/10.1007/s12306-013-0251-6

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

23.04.2024 | Leitsymptom Rückenschmerzen | Nachrichten

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

The ruptured Achilles tendon: a current overview from biology of rupture to treatment

Abstract

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger

Update Orthopädie und Unfallchirurgie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2013

The Burch-Schneider antiprotrusio cage: medium follow-up results

Scenario of hand fractures in a tertiary hospital: a prospective study

Volar fixation of distal radial fracture using compression plate: clinical and radiographic evaluation of 20 patients

Transformation of solitary osteochondroma to dedifferentiated chondrosarcoma arising in the distal radius: a case report

Primary hydatid cyst of the thigh: on seven cases

Compartment syndrome of the thigh after blunt trauma: a complication not to be ignored

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger

Update Orthopädie und Unfallchirurgie