DOS 2018

DOS Kongressen 2018 · 209 Individual treatment selection for acute Achilles tendon rupture based on the Copenhagen Achilles Length Measure (CALM) Kristoffer W. Barfod, Maria S Hansen, Håkon Sandholdt, Anders Boesen, Per Holmich, Anders Troelsen, Morten T Kristensen Sports Orthopedic Research Center - Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre; Physical Medicine and Rehabilitation Research – Copenhagen (PMR-C),Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Amager-Hvidovre; Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre; Clinical Orthopedic Research Hvidovre (CORH), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre Background: An evidence based selection tool is needed to guide choice of treatment after acute Achilles tendon rupture (ATR). Purpose / Aim of Study: To investigate if the 1-year outcome of patients with ATR can be predicted by Amlang’s ultrasound classification (AmC) or the Copenhagen Achilles Length Measure (CALM). Materials and Methods: The study was conducted as a prospective cohort study on patients included in an RCT (identifier: NCT02015364). Patients were 18 to 70 years, treated non-operatively and allocated to either early controlled motion of the ankle or immobilization. AmC and CALM were assessed within 4 days of rupture and correlated to outcomes at 1 year. The primary outcome was the Achilles tendon Total Rupture Score (ATRS). Secondary outcomes were: heel-rise-work test (HRW), re-rupture rate (RR) and CALM at 1 year. To define a cut-off for AmC and CALM at baseline ROC analysis was performed for mea- sures that correlated statistically significantly to outcomes. Acceptable elonga- tion at 1 year was defined as 10%. Findings / Results: From February 2014 to December 2016 CALM was as- sessed at baseline in 130 patients and AmC in 109. AmC showed no statistically significant correlation to any of the outcomes. CALM at baseline showed no sig- nificant correlation with ATRS, HRW or RR, but with CALM (r=0.214, p<0.01), at 1 year. The ROC model had AUC = 0.67. An elongation of 7% at baseline had a sensitivity of 0.77 and specificity of 0.50. Conclusions: Elongation of the Achilles tendon at baseline measured with CALM showed a weak positive correlation to CALM at 1 year suggesting that CALM at base line has some but limited ability in predicting elongation at one year. A cut-off of 7% elongation at baseline correctly identified 77% of patients with an elongation above 10% at 1 year, but also identified 50% of patients without elongation at 1 year. 150.