2015 ISAKOS Biennial Congress Paper #80

Severely Reduced Functional Outcome at Mean 9 Year Follow-Up After Complications Associated with Acute Achilles Tendon Rupture

Kristoffer W. Barfod, MD, PhD, Virum DENMARK
Thor Magnus Sveen, MD, Copenhagen DENMARK
Ann Ganestam, MD, Copenhagen DENMARK
Lars Bo Ebskov, MD, Copenhagen DENMARK
Anders Troelsen, MD, PhD, DMSc, Prof., Copenhagen DENMARK
Hvidovre Hospital, Clinical Orthopaedic Research Hvidovre, Copenhagen, Capital Region, DENMARK

FDA Status Not Applicable

Summary: 119 patients investigated at mean 9 years follow up had a remarkable reduction of the ATRS and PCS. Patients suffering from re-rupture had a significant elongation of the tendon and reduction of strength in the affected limb.

Abstract:

Background

Treatment of acute Achilles tendon rupture is highly debated. In the pursuit of the best treatment severity of complications is important.

Purpose

To investigate the long term effect of deep infection, sural nerve injury and re-rupture in the treatment of acute Achilles tendon rupture.

Materials And Methods

324 patients made a claim to the Danish Patient Insurance in the period 1992 to 2010 due to a complication after acute Achilles tendon rupture. Of those 233 agreed to receive written information concerning the investigation and 119 patients (m/f = 77/42) returned the Achilles tendon Total Rupture Score (ATRS) and the Short Form-36 (SF-36) questionnaires. Patients suffering from deep infection (n=10), Sural nerve injury (n=10) and re-rupture (n=16) were invited to participate in a follow up investigation.

Results

The mean follow up period was 8.9 years (3;21). Looking at the whole population a mean ATRS of 49 (SD 27) was found; in comparison healthy subjects have a median of 100 (94;100). The summary scores of SF-36 were PCS = 43 (SD 11) and MCS = 52 (SD 11); in comparison healthy subjects have a mean of 50 for both scores. No significant differences were found comparing the subpopulations who suffered from a deep infection, injury to the Sural nerve or re-rupture. The physical evaluation investigating tendon length and heel-rise work revealed a statistically significant difference between the affected and the unaffected limb after re-rupture (p<0.01) but not after injury to the Sural nerve (n.s.) and deep infection (n.s.).

Conclusion

The investigated patients who suffered from a complication after acute Achilles tendon rupture had a remarkable reduction of the ATRS and PCS at mean 9 year follow up. Patients suffering from re-rupture had a significant elongation of the tendon and reduction of strength in the affected limb.