Persistent disability despite sufficient calf muscle strength after rerupture of surgically treated acute achilles tendon ruptures.
Rerupture after treatment of acute Achilles tendon rupture is considered a serious complication. Yet data on long-term outcome after rerupture are limited. This study evaluated outcome after rerupture and compares it to a reference of uncomplicated cases. Thirteen patients with a rerupture following minimally invasive surgical Achilles tendon rupture repair were evaluated using Leppilahti score and resumption of work and sport. Mean follow-up was 8.7 years. Results were compared with a reference group of 23 uncomplicated cases with a follow-up of at least 1 year. The study was designed as a follow-up study. The relative risk for a fair/poor outcome by Leppilahti score after a rerupture when compared with uncomplicated cases is 2.83 (95% confidence interval=1.17-6.87; P=.0185). Although rerupture did not affect ultimate resumption of professional life, the relative risk for quitting sport or resuming sport at a lower level after a rerupture is 3.33 (95% confidence interval=1.71-6.51; P=.0001). In contrast, the plantar flexion strength deficit is 5% to 10% in the rerupture group and up to 20% in the reference group. Despite sufficient recovery of calf muscle strength, rerupture after acute Achilles tendon rupture treatment results in significant long-term functional disabilities.
Department of Surgery, Erasmus Medical Centre, H8-zuid (k802), Postbus 2040, 3000 CA Rotterdam, Netherlands. metz_r@hotmail.com
Roderik
R
Metz
Geert J M G
GJ
van der Heijden
Egbert-Jan M M
EJ
Verleisdonk
Milan
M
Andrlik
Christiaan
C
van der Werken
D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery; D000208:Acute Disease; D000328:Adult; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000150:complications / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology*; D009135:Muscular Diseases / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D019637:Orthopedic Procedures / Q000534:rehabilitation*; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult