Achilles tendon rupture

NewsBot · Apr 25, 2025

Validation of a Composite Outcome Score for Assessing Return to Sports After Achilles Tendon Repair
Ronny Lopes et al
Source

Background:
The Ankle-GO is a composite outcome score based on 4 functional tests and 2 patient-reported outcome measures. It was initially described and validated for its ability to predict return to sports (RTS) at the same level of play after lateral ankle sprains.
Purpose/Hypothesis:
The main aim of this study was to assess the psychometric properties of the Ankle-GO in patients after Achilles tendon repair. The second objective was to evaluate its ability to predict RTS at the same level of play. It was hypothesized that this composite outcome score is a valid and reliable tool that is able to discriminate and predict the level of RTS at 9 months after Achilles tendon repair.
Study Design:
Case-control study; Level of evidence, 3.
Methods:
This was a prospective multicenter study. Patients who were active in sports and underwent primary acute Achilles tendon repair between April 2021 and December 2022 were included. A control group comprising 30 participants with no history of lower limb injuries was also evaluated. After standard rehabilitation for the first 2 months, the Ankle-GO was administered at 6 and 9 months after repair by the same experienced physical therapist. During testing, the patients were asked whether they were able to practice their main sport again and, if so, whether at the same or a lower level of play. A comparison between control participants and patients at 9 months after surgery was performed.
Results:
A total of 50 patients (24 women and 26 men), with a mean age of 38.3 ± 10.1 years, were included. No patients were lost to follow-up at 9 months. The Ankle-GO score at 6 months was 10.7 ± 4.8. At 9 months, the score had risen by 4.8 points. All participants scored above the minimum threshold. The minimum score achieved was 3 points (n = 5 [10%]). Only 1 patient (2%) obtained the maximum score (25 points). There was a significant difference in the Ankle-GO score between patients at 6 and 9 months and between control participants and patients at 9 months after Achilles tendon repair. Of the 50 patients included in the study, 14 (28%) returned to their preinjury level of sport at 9 months. The ability of the Ankle-GO score at 6 months to predict RTS at the preinjury level at 9 months was good (area under the curve = 0.71 [95% CI, 0.56-0.85]; P < .01). A Youden index of 0.42 was observed for a cut-off score of 8 points, which corresponds to a sensitivity of 81.8% and a specificity of 41.2%.
Conclusion:
The Ankle-GO is a valid tool to evaluate and discriminate patients during the RTS continuum after Achilles tendon repair and to predict RTS at the same level at 9 months after surgery. This composite outcome score assesses ankle function and the patient’s psychological readiness to avoid premature RTS and worsening of the injury. Further studies are needed to assess its value in identifying and predicting patients at risk of a recurrence.
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NewsBot · Apr 26, 2025

The top 50 most cited articles on minimally invasive Achilles tendon repair: a bibliometric analysis
Darcy Ottomanelli et al
Eur J Orthop Surg Traumatol. 2025 Apr 25;35(1):168.

Purpose: Achilles tendon rupture is an increasingly common injury seen in athletic and active populations which can be corrected through strategic operative techniques. The purpose of this study is to identify and review the top 50 most cited articles discussing minimally invasive Achilles tendon repair with regards to the operative technique, outcomes, and complications.

Methods: Scopus database was used to search for publications focusing on minimally invasive Achilles tendon repair. The top 50 most cited articles were screened for inclusion criteria and reviewed for year published, journal of publication, country of origin, study type, level of evidence, and citation density.

Results: The total number of citations from the top 50 most cited articles was 1,415 with a range of five to 168 citations per article. The year of publication ranged from 2004 to 2020, with the majority (n = 33) being published from 2010 to 2020. The most common level of evidence rating was III (25 articles), most of which were cohort studies. The next most common level of evidence rating was IV (11 articles), which were mostly case series. The articles were written across 18 countries, most commonly the United Kingdom (18%), and were published in 28 journals with Foot and Ankle International being the most prolific journal (n = 8).

Conclusion: The results of this study highlighted the prevalence of cohort studies, case series, and technical notes for minimally invasive Achilles tendon repair research. This demonstrates the need for more research with higher level, controlled studies to examine minimally invasive Achilles tendon repair techniques, outcomes, and complications in the future.
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NewsBot · Apr 26, 2025

Systematic Review and Meta-Analysis Comparing Open FHL Tendon Transfer, Hamstring Transfer, and Turndown Flaps to Treat Chronic Achilles Tendon Ruptures
Bedri Karaismailoglu et al
Source

Background:
Chronic Achilles tendon ruptures (CATRs) present significant challenges because of delayed diagnosis and more complicated salvage treatments that can result in unfavorable outcomes and increased rates of adverse events. Various reconstructive surgical options have been described, each with its own unique advantages and disadvantages. Comprehensive comparison of these techniques, however, is lacking. This meta-analysis aimed to compare clinical outcomes following 3 of the most commonly used salvage techniques including flexor hallucis longus (FHL) transfer, hamstring transfer, and gastric-soleal turndown flap.
Methods:
This systematic review adhered to PRISMA guidelines and included studies registered on PROSPERO. Searches were conducted across multiple databases, and eligibility criteria encompassed studies reporting on clinical scores and complications following surgical treatment of CATRs with FHL transfer, hamstring tendon transfer, or turndown flaps. Data extraction, quality assessment, and statistical analyses were performed following standardized protocols.
Results:
Among 1910 identified studies, 25 met inclusion criteria with 11 focusing on FHL transfer, 9 on hamstring tendon transfer, and 6 on turndown flap management. A meta-analysis revealed variations in patient demographics, surgical techniques, and rehabilitation protocols across the 3 intervention groups. Although the mean improvement in American Orthopaedic Foot & Ankle Society scores was comparable (38.9 for turndown flap, 31.8 for FHL transfer, and 26.0 for hamstring transfer), complication rates differed significantly. The turndown flap group exhibited the highest overall complication rate, particularly because of wound-related complications, with a wound complication rate of 12.5%, compared with 5.7% for FHL transfer and 3.5% for hamstring transfer.
Conclusion:
This study underscores the challenge of evidence-based decision making in the surgical management of CATRs. Despite apparently similar functional outcomes, the choice of open surgical technique affects complication rates. Turndown flaps, although effective in restoring musculotendinous continuity, carry higher risks of wound complications compared with the other techniques evaluated.
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NewsBot · Apr 28, 2025

Postoperative Complications After Acute Achilles Tendon Rupture Repair: A Survival Analysis of Minimally Invasive vs Open Techniques
Joris R H Hendriks et al
Foot Ankle Int. 2025 Apr 28:10711007251333777.

Background: The complication rates after surgical repair of acute Achilles tendon ruptures (ATRs) using open repair or minimally invasive surgical techniques (MIS) have been debated extensively. Despite significant research, a literature hiatus exists on the timing of these complications between techniques. In this study, we aimed to address this gap by conducting a Kaplan-Meier survival analysis to compare the incidence and timing of complications after open vs MIS repair of acute ATRs and examine associated risk factors.

Methods: This retrospective study included patients ≥18 years who underwent surgical treatment of an acute ATR within 28 days of injury and had a minimum of 90-day follow-up. Demographics, surgical technique (open vs MIS repair), and the occurrence and timing of postoperative complications were collected. Postoperative complications were classified as venous thromboembolism, rerupture, surgical site infection, wound dehiscence, and sural nerve injury. A Kaplan-Meier curve was employed to compare the complication rates between groups. The log-rank test was used to test the equality of survivor functions. The Cox proportional hazards model was used to determine predictors of complications.

Results: In total, out of 417 patients, 52 complications were reported in 50 patients. We found no significant difference in the complication rates between the MIS and open repair groups. Cox proportional hazards modeling revealed that BMI was a significant predictor of rerupture (HR 1.2, 95% CI 1.05-1.4) and that surgical delay increased the risk of wound dehiscence (HR 1.2, 95% CI 1.01-1.3) and sural nerve injury (HR 1.2, 95% CI 1.1-1.3).

Conclusion: MIS and open repair techniques for acute ATRs demonstrate comparable complication rates. However, patients with elevated BMI exhibit a modest increased risk of rerupture, regardless of the technique used. Those with surgical delay beyond 2 weeks are also modestly more likely to experience wound dehiscence with open surgical approach and sural nerve injury among MIS-treated patients.
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NewsBot · Apr 28, 2025

Shear Wave Tensiometry in the Evaluation of Achilles Tendon Loading: A Cross-Sectional Study on Conservatively Treated Tendons After Rupture
Alessandro Schneebeli et al
J Foot Ankle Res. 2025 Jun;18(2):e70047.

Purpose: The aim of this study was to quantify differences in the shear wave speed (SWS) between a conservatively treated Achilles tendon (AT) after rupture and the unaffected contralateral tendon.

Methods: Twenty-nine participants who received conservative treatment following Achilles tendon rupture (ATR) were enrolled. Measurements were taken during a single follow-up visit, which occurred between 1 and 7 years after the rupture. Tendon load was assessed using a shear wave tensiometer comprising a set of four accelerometers attached to the tendon. Stiffness, thickness, and cross-sectional area (CSA) were also assessed using MyotonPRO and ultrasound imaging.

Results: No significant differences in SWS were found between the affected AT and the unaffected side when analyzing the entire group (p > 0.05). However, significant differences between sides were observed at 3.5 Nm and 7 Nm (p = 0.001 and p = 0.020) for participants that experienced a lesion of the mid tendon. Higher plantar flexor strength was found for the unaffected side (320 ± 99.5 Nm) compared to the affected side (261 ± 80 Nm; p = 0.001). Thickness and CSA in the proximal and distal part of the tendon were significantly higher in the affected tendon compared to the unaffected side (p < 0.001).

Conclusion: There is no difference in SWS values between the affected and the unaffected AT in the longer term after the rupture. However, differences in SWS were detected at specific contraction levels in participants with a mid-tendon lesion. Moreover, tendon thickness and the cross-sectional area, as well as plantar flexor strength, remain different between the affected and the unaffected AT.
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Achilles tendon rupture

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Achilles tendon rupture

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Depression folowing surgery for an achilles tendon rupture

Are bacteria involved in achilles tendon ruptures?

Past ruptured achilles tendon

Achilles Tendon rupture and Plantar Fasciitis

The most frequent heel lift height to treat Achilles tendonitis

Testosterone replacement therapy is associated with increased odds of Achilles tendon injury

Achilles Tendon and Femoral Cartilage Thickness in Flatfoot

Share This Page

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