PURPOSE: The purpose of this prospective randomized controlled study was to evaluate the long-term results after an acute Achilles tendon rupture in patients treated surgically or non-surgically. The focus was to evaluate whether any improvements occurred between the one and 2-year evaluation. METHOD:Eighty-one patients (67 men, 14 women) with a mean (SD) age of 42 (9.1) were included in this study. Forty-two patients were treated surgically, and 39 treated non-surgically otherwise the treatment was identical for the two groups. All patients were evaluated using the Achilles tendon Total Rupture Score (ATRS), the Physical Activity Scale (PAS) and validated functional tests one and 2 years after injury. RESULTS: There were significant functional deficits on the injured side compared with the contralateral side 2 years after Achilles tendon rupture, regardless of treatment. Only minor improvements, even though statistically significant, occurred between the 1- and 2-year evaluations. The physical activity level remained significantly reduced as compared with prior to injury, but the ATRS mean was relatively high in both groups (89 and 90). CONCLUSION: This long-term follow-up indicates that the majority of patients with an Achilles tendon rupture have not fully recovered (in regards to symptoms, physical activity level and function) 2 years after injury regardless of surgical or non-surgical treatment. Furthermore, only minor improvements occur between the 1- and 2-year evaluations. This indicates that to enhance the final outcome the focus should be on improvements in treatment within the first year. The patients appear to have adjusted to their impairments since the patient-reported outcome is relatively high in spite of functional deficits and lower activity level compared with pre-injury. LEVEL OF EVIDENCE: Prospective randomized study, Level I.
RCT Entities:
PURPOSE: The purpose of this prospective randomized controlled study was to evaluate the long-term results after an acute Achilles tendon rupture in patients treated surgically or non-surgically. The focus was to evaluate whether any improvements occurred between the one and 2-year evaluation. METHOD: Eighty-one patients (67 men, 14 women) with a mean (SD) age of 42 (9.1) were included in this study. Forty-two patients were treated surgically, and 39 treated non-surgically otherwise the treatment was identical for the two groups. All patients were evaluated using the Achilles tendon Total Rupture Score (ATRS), the Physical Activity Scale (PAS) and validated functional tests one and 2 years after injury. RESULTS: There were significant functional deficits on the injured side compared with the contralateral side 2 years after Achilles tendon rupture, regardless of treatment. Only minor improvements, even though statistically significant, occurred between the 1- and 2-year evaluations. The physical activity level remained significantly reduced as compared with prior to injury, but the ATRS mean was relatively high in both groups (89 and 90). CONCLUSION: This long-term follow-up indicates that the majority of patients with an Achilles tendon rupture have not fully recovered (in regards to symptoms, physical activity level and function) 2 years after injury regardless of surgical or non-surgical treatment. Furthermore, only minor improvements occur between the 1- and 2-year evaluations. This indicates that to enhance the final outcome the focus should be on improvements in treatment within the first year. The patients appear to have adjusted to their impairments since the patient-reported outcome is relatively high in spite of functional deficits and lower activity level compared with pre-injury. LEVEL OF EVIDENCE: Prospective randomized study, Level I.
Authors: Mohit Bhandari; Gordon H Guyatt; Farhan Siddiqui; Farrah Morrow; Jason Busse; Ross K Leighton; Sheila Sprague; Emil H Schemitsch Journal: Clin Orthop Relat Res Date: 2002-07 Impact factor: 4.176
Authors: Katarina Nilsson-Helander; Karin Grävare Silbernagel; Roland Thomeé; Eva Faxén; Nicklas Olsson; Bengt I Eriksson; Jon Karlsson Journal: Am J Sports Med Date: 2010-08-27 Impact factor: 6.202
Authors: Amar A Suchak; Geoff P Bostick; Lauren A Beaupré; D'Arcy C Durand; Nadr M Jomha Journal: J Bone Joint Surg Am Date: 2008-09 Impact factor: 5.284
Authors: Roderick Metz; Egbert-Jan M M Verleisdonk; Geert J-M-G van der Heijden; Geert-Jan Clevers; Erik R Hammacher; Michiel H J Verhofstad; Christiaan van der Werken Journal: Am J Sports Med Date: 2008-07-21 Impact factor: 6.202
Authors: Johannes Schneppendahl; Simon Thelen; Alberto Schek; Ioana Bala; Mohssen Hakimi; Jan-Peter Grassmann; Christian Eichler; Joachim Windolf; Michael Wild Journal: Int Orthop Date: 2011-09-21 Impact factor: 3.075
Authors: Mareen Braunstein; Sebastian F Baumbach; Wolfgang Boecker; Mike R Carmont; Hans Polzer Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-09-26 Impact factor: 4.342
Authors: Mathias Wulf; Mihir Shanker; Michael Schuetz; Michael Lutz; Christian M Langton; Sue L Hooper; James E Smeathers; Torsten Brauner; Scott C Wearing Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-06-28 Impact factor: 4.342