Ville M Mattila1, Tuomas T Huttunen2, Heidi Haapasalo3, Petri Sillanpää3, Antti Malmivaara4, Harri Pihlajamäki5. 1. Department of Orthopedics and Trauma Surgery, University Hospital of Tampere, Tampere, Finland Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden Department of Orthopedics, Karolinska University Hospital Huddinge, Stockholm, Sweden. 2. Department of Orthopedics and Trauma Surgery, University Hospital of Tampere, Tampere, Finland Department of Anesthesia and Perioperative Care, Valkeakoski Regional Hospital, Valkeakoski, Finland. 3. Department of Orthopedics and Trauma Surgery, University Hospital of Tampere, Tampere, Finland. 4. Centre for Health and Social Economics, National Institute for Health and Welfare, Helsinki, Finland. 5. Department of Orthopaedics and Trauma Surgery, Seinäjoki Central Hospital, Seinäjoki, Finland University of Tampere, Seinäjoki, Finland.
Abstract
OBJECTIVES: Acute Achilles tendon ruptures are common among highly active people. Recently published studies have provided increasing evidence to support non-surgical treatment. This study aimed to assess the incidence trends of surgically treated, acute Achilles tendon ruptures. Our hypothesis, based on the recent literature showing no difference in functional results between surgical and non-surgical treatment, was that the incidence of surgery would be declining. METHODS: We conducted a nationwide hospital register-based study. All patients 18 years of age or older with a diagnosis of acute Achilles tendon injury, and treated with Achilles tendon repair from 1987 to 2011 in Finland were included in the study. RESULTS: During the 25-year study period in Finland, a total of 15,252 patients received surgical treatment for an acute Achilles tendon rupture. The incidence of surgical treatment of acute Achilles tendon rupture in men was 11.1/100,000 person-years in 1987 and 20.5/100,000 person-years in 2011. The corresponding figures in women were 2.5/100,000 person-years in 1987 and 4.2/100,000 person-years in 2011. The highest rates occurred in 2008 in men and 2007 in women, and since then the decrease has been 42% in men and 55% in women. CONCLUSIONS: During the past few years, the rate of surgically treated acute Achilles tendon ruptures has declined remarkably. The findings of the present study indicate that orthopaedic surgeons have chosen more often non-surgical treatment option for acute Achilles ruptures. This can be considered as an example, how high-quality scientific evidence can lead to a rapid change in clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVES:Acute Achilles tendon ruptures are common among highly active people. Recently published studies have provided increasing evidence to support non-surgical treatment. This study aimed to assess the incidence trends of surgically treated, acute Achilles tendon ruptures. Our hypothesis, based on the recent literature showing no difference in functional results between surgical and non-surgical treatment, was that the incidence of surgery would be declining. METHODS: We conducted a nationwide hospital register-based study. All patients 18 years of age or older with a diagnosis of acute Achilles tendon injury, and treated with Achilles tendon repair from 1987 to 2011 in Finland were included in the study. RESULTS: During the 25-year study period in Finland, a total of 15,252 patients received surgical treatment for an acute Achilles tendon rupture. The incidence of surgical treatment of acute Achilles tendon rupture in men was 11.1/100,000 person-years in 1987 and 20.5/100,000 person-years in 2011. The corresponding figures in women were 2.5/100,000 person-years in 1987 and 4.2/100,000 person-years in 2011. The highest rates occurred in 2008 in men and 2007 in women, and since then the decrease has been 42% in men and 55% in women. CONCLUSIONS: During the past few years, the rate of surgically treated acute Achilles tendon ruptures has declined remarkably. The findings of the present study indicate that orthopaedic surgeons have chosen more often non-surgical treatment option for acute Achilles ruptures. This can be considered as an example, how high-quality scientific evidence can lead to a rapid change in clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Entities:
Keywords:
Achilles Tendon; Epidemiology; Evidence Based Reviews; Sporting Injuries
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