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Effect of Complications After Minimally Invasive Surgical Repair of Acute Achilles Tendon Ruptures.
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- Author(s): Metz, Roderik; van der Heijden, Geert J. M. G.; Verleisdonk, Egbert-Jan M. M.; Kolfschoten, Nicky; Verhofstad, Michiel H. J.; van der Werken, Christiaan
- Source:
American Journal of Sports Medicine. 04/01/2011, Vol. 39 Issue 4, p820-824. 5p. - Source:
- Additional Information
- Subject Terms: ACHILLES tendon rupture; THERAPEUTICS; ACHILLES tendon injuries; ACHILLES tendon; NERVE tissue; ACADEMIC medical centers; ANALYSIS of variance; COMPUTER software; CONFIDENCE intervals; EMPLOYMENT reentry; MINIMALLY invasive procedures; LIFE skills; LONGITUDINAL method; MEDICAL needs assessment; MEDICAL cooperation; HEALTH outcome assessment; REGRESSION analysis; RESEARCH; RESEARCH evaluation; SURGICAL complications; SURGICAL site infections; WOUNDS & injuries; DATA analysis; ACTIVITIES of daily living; SPORTS participation; RELATIVE medical risk; TREATMENT effectiveness; RETROSPECTIVE studies; SURGERY
- Subject Terms:
- Abstract: Background: Complications of acute Achilles tendon rupture treatment are considered to negatively influence outcome, but the relevance of these effects is largely unknown.Purpose: The Achilles Tendon Total Rupture Score (ATRS) was used to determine level of disability in patients with minimally invasive surgical Achilles tendon rupture repair with a complicated postoperative course.Study Design: Case series; Level of evidence, 4.Methods: The charts of 340 consecutive patients treated for an acute Achilles tendon rupture by minimally invasive surgical repair were reviewed. Complications were categorized as rerupture, severe wound infection, sural nerve injury, and other. Level of disability was evaluated by the 10-item ATRS with a sum score of minimum 0 to maximum 100 points.Results: A total of 211 patients returned a completed questionnaire: mean follow-up was 6.2 years (range, 3-10 years). Mean ATRS for all 211 patients was 84 (95% confidence interval: 82, 87). The mean ATRS for the 135 (64%) uncomplicated cases was 89 of 100 points, 71 points for the 17 (8%) patients with a rerupture (95% confidence interval: 63, 79; P < .0001), 79 points for the 41 patients (19%) with a sural nerve injury (95% confidence interval: 74, 85; P = .0008), and 75 points for the 17 patients (8%) with another complication (95% confidence interval: 67, 83; P = .001). Of these other complications, 13 patients (6%) suffered a wound-healing complication considered minor. Their average ATRS score was 80 points (95% confidence interval: 71, 88.7; P = .0445). One patient suffered a severe wound infection as well, scoring 28 of 100 points. Rerupture significantly increased the risk of quitting or changing sport participation on the long term.Conclusion: Long-term outcome after minimally invasive Achilles tendon rupture repair is excellent. Rerupture and severe wound infection are the most important complications with lasting negative effect on outcome. It justifies the use of rerupture as a relevant outcome measure in treatment evaluation. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of American Journal of Sports Medicine is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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