Risk factors for Achilles tendon rupture and postoperative problems

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Descriptions

Achilles tendon rupture is a common athletic injury especially among male in their third and fourth decade participating in indoor ball sports. Not much is known about risk factors and this make prevention measures difficult. Our study shows that the contra lateral side is subjected to an increased risk. Although it is recommended operatively treatment of this injury, the literature shows a high variation in the numbers of postoperative problems after an Achilles tendon rupture. Especially there seems to be fewer problems in the American studies on this issue. Local anesthesia is far more common in Scandinavia than USA and this might one explanation. It could be hypothesized that local anesthesia make it more difficult to get a close approximation of rupture tendon because the calf muscles are still in tension during the operative procedure. It could be also be due to a difference in postoperative rehabilitation. A rehabilitation program, which uses eccentric muscle work, might reduce the number with postoperative problems and reduce the observed risk of the contra lateral side.

 

The following studies are under preparation:

1. Randomized study on local versus spinal anesthesia with Achilles tendon rupture.

2. Randomized study on eccentric only on injured side or bilaterally after Achilles tendon rupture treated operatively.

Results

All patients (n=168) treated operatively from August 1990 to April 1997 at Akershus University hospital were contacted August 1998. Ten patients (6 %) had experienced a rupture on the contralateral side during the follow-up period (OR: 186 [96-362] vs. the general population risk of this injury, p<0.05. Thus, this study suggests that patients with an Achilles tendon rupture are at significantly increased risk of a contralateral tendon rupture. Also, as many as half of the patients suffer from post-injury problems at long-term follow-up.

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