DOS Kongressen 2014 ·
97
Severely reduced functional outcome at mean 9 year
follow-up after complications associated with acute
Achilles tendon rupture
Kristoffer Weisskirchner Barfod, Thor Magnus Sveen, Ann Ganestam,
Lars Bo Ebskov, Marko Nabergoj, Anders Troelsen
Orthopaedic surgery, Clinical Orthopaedic Research Hvidovre, Copenhagen
University Hospital, Hvidovre, Denmark; Orthopaedic surgery, Copenhagen
University Hospital, Køge
Background:
Treatment of acute Achilles tendon rupture is highly debated. In
the pursuit of the best treatment severity of complications is important.
Purpose / Aim of Study:
To investigate the long term effect of deep infec-
tion, 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 150 agreed to receive written information concerning
the investigation and 98 patients (m/f = 63/35) returned the Achilles tendon
Total Rupture Score (ATRS) and the Short Form-36 (SF- 36) questionnaires.
Patients suffering from deep infection (n=8), Sural nerve injury (n=5) and re-
rupture (n=16) were invited to participate in a follow up investigation.
Findings / Results:
The mean follow up period was 8.9 years (3;21). Looking
at the whole population a mean ATRS of 50 (SD 30) was found; in comparison
healthy subjects have a median of 100 (94;100). The summary scores of SF-
36 were PCS = 42 (SD 12) and MCS = 52 (SD 11); in comparison healthy sub-
jects have a mean of 50 for both scores. No 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.).
Conclusions:
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.
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