Abstract
Achilles tendon ruptures are increasingly common, especially in males. The rupture commonly occurs in sports-active persons with a peak age around 40 years. Achilles tendon rupture should be diagnosed clinically, using the well-known Thompson’s and Matles tests. Ultrasonography and Magnetic Resonance Imaging are seldom needed to establish the diagnosis. The treatment is either non-surgical or surgical. Surgical treatment is related to lower risk of rerupture and is generally recommended in active athletes. A strong core suture, with local augmentation is a safe method with very low risk of rerupture. Early range of motion is recommended after surgical treatment. The rerupture rate is higher after non-surgical treatment, over 10 %. Interestingly, only 50–65 % of all patients who have sustained an Achilles tendon rupture return to the pre-injury activity level.
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References
Komi PV, Fukashiro S, Järvinen M (1992) Biomechanical loading of Achilles tendon during normal locomotion. Clin Sports Med 11(3):521–531
Keating JF, Will EM (2011) Operative versus non-operative treatment of acute rupture of tendo Achillis: a prospective randomised evaluation of functional outcome. J Bone Joint Surg Br 93(8):1071–1078. doi:10.1302/0301-620X.93B8.25998
Moller M, Lind K, Movin T, Karlsson J (2002) Calf muscle function after Achilles tendon rupture. A prospective, randomised study comparing surgical and non-surgical treatment. Scand J Med Sci Sports 12(1):9–16
Olsson N, Nilsson-Helander K, Karlsson J, Eriksson BI, Thomee R, Faxen E, Silbernagel KG (2011) Major functional deficits persist 2 years after acute Achilles tendon rupture. Knee Surg Sports Traumatol Arthrosc 19(8):1385–1393. doi:10.1007/s00167-011-1511-3
Willits K, Amendola A, Bryant D, Mohtadi NG, Giffin JR, Fowler P, Kean CO, Kirkley A (2010) Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg Am 92(17):2767–2775
Metz R, Verleisdonk EJ, van der Heijden GJ, Clevers GJ, Hammacher ER, Verhofstad MH, van der Werken C (2008) Acute Achilles tendon rupture: minimally invasive surgery versus nonoperative treatment with immediate full weightbearing–a randomized controlled trial. Am J Sports Med 36(9):1688–1694
Moller M, Movin T, Granhed H, Lind K, Faxen E, Karlsson J (2001) Acute rupture of tendon Achillis. A prospective randomised study of comparison between surgical and non-surgical treatment. J Bone Joint Surg Br 83(6):843–848
Parekh SG, Wray WH 3rd, Brimmo O, Sennett BJ, Wapner KL (2009) Epidemiology and outcomes of Achilles tendon ruptures in the National Football League. Foot Ankle Spec 2(6):283–286. doi:10.1177/1938640009351138
Houshian S, Tscherning T, Riegels-Nielsen P (1998) The epidemiology of Achilles tendon rupture in a Danish county. Injury 29(9):651–654
Leppilahti J, Puranen J, Orava S (1996) Incidence of Achilles tendon rupture. Acta Orthop Scand 67(3):277–279
Nyyssonen T, Luthje P, Kroger H (2008) The increasing incidence and difference in sex distribution of Achilles tendon rupture in Finland in 1987–1999. Scand J Surg 97(3):272–275
Maffulli N, Waterston SW, Squair J, Reaper J, Douglas AS (1999) Changing incidence of Achilles tendon rupture in Scotland: a 15-year study. Clin J Sport Med 9(3):157–160
Cretnik A, Frank A (2004) Incidence and outcome of rupture of the Achilles tendon. Wien Klin Wochenschr 116(Suppl 2):33–38
Gajhede-Knudsen M, Ekstrand J, Magnusson H, Maffulli N (2013) Recurrence of Achilles tendon injuries in elite male football players is more common after early return to play: an 11-year follow-up of the UEFA Champions League injury study. Br J Sports Med 47(12):763–768. doi:10.1136/bjsports-2013-092271
Maffulli N, Longo UG, Maffulli GD, Rabitti C, Khanna A, Denaro V (2010) Marked pathological changes proximal and distal to the site of rupture in acute Achilles tendon ruptures. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-010-1193-2
Arner O, Lindholm A, Orell SR (1959) Histologic changes in subcutaneous rupture of the Achilles tendon; a study of 74 cases. Acta Chir Scand 116(5–6):484–490
Jozsa L, Kannus P (1997) Histopathological findings in spontaneous tendon ruptures. Scand J Med Sci Sports 7(2):113–118
Sargon MF, Ozlu K, Oken F (2005) Age-related changes in human tendo calcaneus collagen fibrils. Saudi Med J 26(3):425–428
Jozsa LG, Kannus P (1997) Human tendons: anatomy, physiology, and pathology. Human Kinetics, Champaign/Leeds
Maffulli N, Almekinders L (2007) The Achilles tendon. Springer, New York/London
Chen TM, Rozen WM, Pan WR, Ashton MW, Richardson MD, Taylor GI (2009) The arterial anatomy of the Achilles tendon: anatomical study and clinical implications. Clin Anat 22(3):377–385. doi:10.1002/ca.20758
Theobald P, Benjamin M, Nokes L, Pugh N (2005) Review of the vascularisation of the human Achilles tendon. Injury 36(11):1267–1272. doi:10.1016/j.injury.2005.02.012
Mahler F, Fritschy D (1992) Partial and complete ruptures of the Achilles tendon and local corticosteroid injections. Br J Sports Med 26(1):7–14
Newnham DM, Douglas JG, Legge JS, Friend JA (1991) Achilles tendon rupture: an underrated complication of corticosteroid treatment. Thorax 46(11):853–854
Seeger JD, West WA, Fife D, Noel GJ, Johnson LN, Walker AM (2006) Achilles tendon rupture and its association with fluoroquinolone antibiotics and other potential risk factors in a managed care population. Pharmacoepidemiol Drug Saf 15(11):784–792. doi:10.1002/pds.1214
Melhus A (2005) Fluoroquinolones and tendon disorders. Expert Opin Drug Saf 4(2):299–309
Maganaris CN, Narici MV, Maffulli N (2008) Biomechanics of the Achilles tendon. Disabil Rehabil 30(20–22):1542–1547. doi:10.1080/09638280701785494
Wren TA, Yerby SA, Beaupre GS, Carter DR (2001) Mechanical properties of the human Achilles tendon. Clin Biomech (Bristol, Avon) 16(3):245–251
Wang JH (2006) Mechanobiology of tendon. J Biomech 39(9):1563–1582. doi:10.1016/j.jbiomech.2005.05.011
Arner O, Lindholm A (1959) Subcutaneous rupture of the Achilles tendon; a study of 92 cases. Acta Chir Scand Suppl 116(Supp 239):1–51
Maffulli N (1998) The clinical diagnosis of subcutaneous tear of the Achilles tendon. A prospective study in 174 patients. Am J Sports Med 26(2):266–270
Thompson TC, Doherty JH (1962) Spontaneous rupture of tendon of Achilles: a new clinical diagnostic test. J Trauma 2:126–129
Chiodo CP, Glazebrook M, Bluman EM, Cohen BE, Femino JE, Giza E, Watters WC 3rd, Goldberg MJ, Keith M, Haralson RH 3rd, Turkelson CM, Wies JL, Raymond L, Anderson S, Boyer K, Sluka P (2010) Diagnosis and treatment of acute Achilles tendon rupture. J Am Acad Orthop Surg 18(8):503–510
Nilsson-Helander KN-K (2008) A new surgical method to treat chronic ruptures and reruptures of the Achilles tendon. Knee Surg Sports Traumatol Arthrosc 16(6):614
Enwemeka CS (1989) Inflammation, cellularity, and fibrillogenesis in regenerating tendon: implications for tendon rehabilitation. Phys Ther 69(10):816–825
Jiang N, Wang B, Chen A, Dong F, Yu B (2012) Operative versus nonoperative treatment for acute Achilles tendon rupture: a meta-analysis based on current evidence. Int Orthop 36(4):765–773. doi:10.1007/s00264-011-1431-3
Khan RJ, Carey Smith RL (2010) Surgical interventions for treating acute Achilles tendon ruptures. Cochrane Database Syst Rev(Online) 9, CD003674. doi:10.1002/14651858.CD003674.pub4
Nilsson-Helander K, Silbernagel KG, Thomee R, Faxen E, Olsson N, Eriksson BI, Karlsson J (2010) Acute Achilles tendon rupture: a randomized, controlled study comparing surgical and nonsurgical treatments using validated outcome measures. Am J Sports Med 38(11):2186–2193. doi:10.1177/0363546510376052, 0363546510376052 [pii]
Olsson N, Silbernagel KG, Eriksson BI, Sansone M, Brorsson A, Nilsson-Helander K, Karlsson J (2013) Stable surgical repair with accelerated rehabilitation versus nonsurgical treatment for acute Achilles tendon ruptures: a randomized controlled study. Am J Sports Med 41(12):2867–2876. doi:10.1177/0363546513503282
Soroceanu A, Sidhwa F, Aarabi S, Kaufman A, Glazebrook M (2012) Surgical versus nonsurgical treatment of acute Achilles tendon rupture: a meta-analysis of randomized trials. J Bone Joint Surg Am 94(23):2136–2143. doi:10.2106/JBJS.K.00917
Maffulli N, Longo UG, Maffulli GD, Khanna A, Denaro V (2011) Achilles tendon ruptures in elite athletes. Foot Ankle Int 32(1):9–15. doi:10.3113/FAI.2011.0009, 50047363 [pii]
Gerdes MH, Brown TD, Bell AL, Baker JA, Levson M, Layer S (1992) A flap augmentation technique for Achilles tendon repair. Postoperative strength and functional outcome. Clin Orthop Relat Res 280:241–246
Carmont MR, Silbernagel KG, Mathy A, Mulji Y, Karlsson J, Maffulli N (2013) Reliability of Achilles tendon resting angle and calf circumference measurement techniques. Foot Ankle Surg 19(4):245–249. doi:10.1016/j.fas.2013.06.007
Kerkhoffs GM, Struijs PA, Raaymakers EL, Marti RK (2002) Functional treatment after surgical repair of acute Achilles tendon rupture: wrap vs walking cast. Arch Orthop Trauma Surg 122(2):102–105. doi:10.1007/s004020100312
Costa ML, MacMillan K, Halliday D, Chester R, Shepstone L, Robinson AH, Donell ST (2006) Randomised controlled trials of immediate weight-bearing mobilisation for rupture of the tendo Achillis. J Bone Joint Surg Br 88(1):69–77. doi:10.1302/0301-620X.88B1.16549, 88-B/1/69 [pii]
Suchak AA, Bostick GP, Beaupre LA, Durand DC, Jomha NM (2008) The influence of early weight-bearing compared with non-weight-bearing after surgical repair of the Achilles tendon. J Bone Joint Surg Am 90(9):1876–1883
Maayke N. van Sterkenburg BGD, van Dijk CN (2008) Guidelines for sport resumption. In: van Dijk CN, Nicola Maffuli JK, Thermann H (ed) Achilles tendon rupture, current concepts. DJO Publications, pp 108–117
Olsson N, Karlsson J, Eriksson BI, Brorsson A, Lundberg M, Silbernagel KG (2012) Ability to perform a single heel-rise is significantly related to patient-reported outcome after Achilles tendon rupture. Scand J Med Sci Sports. doi:10.1111/j.1600-0838.2012.01497.x
Sankey RA, Brooks JH, Kemp SP, Haddad FS (2008) The epidemiology of ankle injuries in professional rugby union players. Am J Sports Med 36(12):2415–2424. doi:10.1177/0363546508322889
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Karlsson, J., Olsson, N., Helander, K.N. (2015). Achilles Tendon Lesions in Soccer Players. In: Volpi, P. (eds) Football Traumatology. Springer, Cham. https://doi.org/10.1007/978-3-319-18245-2_31
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DOI: https://doi.org/10.1007/978-3-319-18245-2_31
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