Skip to main content
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology 5/2020

09.03.2020 | Original Article

Surgical repair of acute Achilles tendon ruptures: a follow-up of 639 consecutive cases

verfasst von: Daniel Fell, Anders Enocson, Lasse J. Lapidus

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 5/2020

Einloggen, um Zugang zu erhalten

Abstract

Background

Most studies on acute Achilles tendon rupture (AATR) and its treatment contain only a small number of patients, and due to selection criteria, older patients and those with comorbidities are typically excluded. Therefore, little is known about true complication rates in an unselected population reflecting the situation in an ordinary orthopedic department.

Method

Patient files of 639 consecutive Achilles tendon repairs in 631 patients with AATR between February 1998 and December 2005 were reviewed, and all complications from the day of surgery until December 2011 were identified using the hospital’s patient records and the Swedish national registry.

Results

Twenty-five (3.9%) re-operations were done, out of which 22 were due to a re-rupture. Fifty-one (8.6%) cases were of deep vein thrombosis (DVT), no difference between patients given versus patients not given thromboprophylaxis. Nineteen (3.0%) cases were of surgical site infection (SSI), all of which resolved upon oral antibiotics.

Conclusions

Surgical repair of acute Achilles tendon rupture was associated with a low risk for re-operations, but the risk for deep vein thrombosis was considerable, despite the use of prophylaxis.
Literatur
1.
Zurück zum Zitat Huttunen TT, Kannus P, Rolf C, Felländer-Tsai L, Mattila VM (2014) Acute Achilles tendon ruptures: incidence of injury and surgery in Sweden between 2001 and 2012. Am J Sports Med 42(10):2419–2423CrossRef Huttunen TT, Kannus P, Rolf C, Felländer-Tsai L, Mattila VM (2014) Acute Achilles tendon ruptures: incidence of injury and surgery in Sweden between 2001 and 2012. Am J Sports Med 42(10):2419–2423CrossRef
2.
Zurück zum Zitat Ganestam A, Kallemose T, Troelsen A, Barfod KW (2016) Increasing incidence of acute Achilles tendon rupture and a noticeable decline in surgical treatment from 1994 to 2013. A nationwide registry study of 33,160 patients. Knee Surg Sports Traumatol Arthrosc 24(12):3730–3737CrossRef Ganestam A, Kallemose T, Troelsen A, Barfod KW (2016) Increasing incidence of acute Achilles tendon rupture and a noticeable decline in surgical treatment from 1994 to 2013. A nationwide registry study of 33,160 patients. Knee Surg Sports Traumatol Arthrosc 24(12):3730–3737CrossRef
3.
Zurück zum Zitat Holm C, Kjaer M, Eliasson P (2015) Achilles tendon rupture–treatment and complications: a systematic review. Scand J Med Sci Sports 25(1):e1–e10CrossRef Holm C, Kjaer M, Eliasson P (2015) Achilles tendon rupture–treatment and complications: a systematic review. Scand J Med Sci Sports 25(1):e1–e10CrossRef
4.
Zurück zum Zitat Khan RJK, Carey Smith RL (2010) Surgical interventions for treating acute Achilles tendon ruptures. Cochrane database of systematic reviews 2010, Issue 9. Art. No.: CD003674 Khan RJK, Carey Smith RL (2010) Surgical interventions for treating acute Achilles tendon ruptures. Cochrane database of systematic reviews 2010, Issue 9. Art. No.: CD003674
5.
Zurück zum Zitat Deng Senlin et al (2017) Surgical treatment versus conservative management for acute Achilles tendon rupture: a systematic review and meta-analysis of randomized controlled trials. J Foot Ankle Surg 56(6):1236–1243CrossRef Deng Senlin et al (2017) Surgical treatment versus conservative management for acute Achilles tendon rupture: a systematic review and meta-analysis of randomized controlled trials. J Foot Ankle Surg 56(6):1236–1243CrossRef
6.
Zurück zum Zitat Thompson TC (1962) A test for rupture of the tendo achillis. Acta Orthop Scand 32:461–465CrossRef Thompson TC (1962) A test for rupture of the tendo achillis. Acta Orthop Scand 32:461–465CrossRef
7.
Zurück zum Zitat Olsson N, Silbernagel KG, Eriksson BI, Sansone M, Brorsson A, Nilsson-Helander K, Karlsson J (2013) Stable surgical repair with accelerated rehabilitation versus nonsurgical treatment for acute Achilles tendon ruptures: a randomized controlled study. Am J Sports Med 41(12):2867–2876CrossRef Olsson N, Silbernagel KG, Eriksson BI, Sansone M, Brorsson A, Nilsson-Helander K, Karlsson J (2013) Stable surgical repair with accelerated rehabilitation versus nonsurgical treatment for acute Achilles tendon ruptures: a randomized controlled study. Am J Sports Med 41(12):2867–2876CrossRef
8.
Zurück zum Zitat Nilsson-Helander K, Silbernagel KG, Thomee R, Faxen 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 38:2186–2193CrossRef Nilsson-Helander K, Silbernagel KG, Thomee R, Faxen 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 38:2186–2193CrossRef
9.
Zurück zum Zitat Twaddle BC, Poon P (2007) Early motion for Achilles tendon ruptures: is surgery important? A randomized, prospective study. Am J Sports Med 35(12):2033–2038 (Epub 2007 Sep 20)CrossRef Twaddle BC, Poon P (2007) Early motion for Achilles tendon ruptures: is surgery important? A randomized, prospective study. Am J Sports Med 35(12):2033–2038 (Epub 2007 Sep 20)CrossRef
10.
Zurück zum Zitat Svedman S, Juthberg R, Edman G, Ackermann PW (2018) Reduced time to surgery improves patient-reported outcome after Achilles tendon rupture. Am J Sports Med 46(12):2929–2934CrossRef Svedman S, Juthberg R, Edman G, Ackermann PW (2018) Reduced time to surgery improves patient-reported outcome after Achilles tendon rupture. Am J Sports Med 46(12):2929–2934CrossRef
11.
Zurück zum Zitat Svedman S, Westin O, Aufwerber S, Edman G, Nilsson-Helander K, Carmont MR, Karlsson J, Ackermann PW (2018) Longer duration of operative time enhances healing metabolites and improves patient outcome after Achilles tendon rupture surgery. Knee Surg Sports Traumatol Arthrosc 26(7):2011–2020CrossRef Svedman S, Westin O, Aufwerber S, Edman G, Nilsson-Helander K, Carmont MR, Karlsson J, Ackermann PW (2018) Longer duration of operative time enhances healing metabolites and improves patient outcome after Achilles tendon rupture surgery. Knee Surg Sports Traumatol Arthrosc 26(7):2011–2020CrossRef
12.
Zurück zum Zitat Willits K, Amendola A, Bryant D, Mohtadi NG, Giffin JR, Fowler P, Kean CO, Kirkley A (2010) Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg Am 92:2767–2775CrossRef Willits K, Amendola A, Bryant D, Mohtadi NG, Giffin JR, Fowler P, Kean CO, Kirkley A (2010) Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg Am 92:2767–2775CrossRef
13.
Zurück zum Zitat Lapidus LJ, Rosfors S, Ponzer S, Levander C, Elvin A, Lärfars G, de Bri E (2007) Prolonged thromboprophylaxis with dalteparin after surgical treatment of Achilles tendon rupture: a randomized, placebo-controlled study. J Orthop Trauma 21(1):52–57CrossRef Lapidus LJ, Rosfors S, Ponzer S, Levander C, Elvin A, Lärfars G, de Bri E (2007) Prolonged thromboprophylaxis with dalteparin after surgical treatment of Achilles tendon rupture: a randomized, placebo-controlled study. J Orthop Trauma 21(1):52–57CrossRef
14.
Zurück zum Zitat Fuji T, Akagi M, Abe Y, Oda E, Matsubayashi D, Ota K, Kobayashi M, Matsushita Y, Kaburagi J, Ibusuki K, Takita A, Iwashita M, Yamaguchi T (2017) Incidence of venous thromboembolism and bleeding events in patients with lower extremity orthopedic surgery: a retrospective analysis of a Japanese healthcare database. J Orthop Surg Res. 12(1):55CrossRef Fuji T, Akagi M, Abe Y, Oda E, Matsubayashi D, Ota K, Kobayashi M, Matsushita Y, Kaburagi J, Ibusuki K, Takita A, Iwashita M, Yamaguchi T (2017) Incidence of venous thromboembolism and bleeding events in patients with lower extremity orthopedic surgery: a retrospective analysis of a Japanese healthcare database. J Orthop Surg Res. 12(1):55CrossRef
15.
Zurück zum Zitat Majewski M, Rohrbach M, Czaja S, Ochsner P (2006) Avoiding sural nerve injuries during percutaneous Achilles tendon repair. Am J Sports Med 34:793–798CrossRef Majewski M, Rohrbach M, Czaja S, Ochsner P (2006) Avoiding sural nerve injuries during percutaneous Achilles tendon repair. Am J Sports Med 34:793–798CrossRef
16.
Zurück zum Zitat Henríquez H, Muñoz R, Carcuro G, Bastías C (2012) Is percutaneous repair better than open repair in acute Achilles tendon rupture? Clin Orthop Relat Res 470(4):998–1003CrossRef Henríquez H, Muñoz R, Carcuro G, Bastías C (2012) Is percutaneous repair better than open repair in acute Achilles tendon rupture? Clin Orthop Relat Res 470(4):998–1003CrossRef
Metadaten
Titel
Surgical repair of acute Achilles tendon ruptures: a follow-up of 639 consecutive cases
verfasst von
Daniel Fell
Anders Enocson
Lasse J. Lapidus
Publikationsdatum
09.03.2020
Verlag
Springer Paris
Erschienen in
European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 5/2020
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-020-02650-1

Weitere Artikel der Ausgabe 5/2020

European Journal of Orthopaedic Surgery & Traumatology 5/2020 Zur Ausgabe

Arthropedia

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

Update Orthopädie und Unfallchirurgie

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