title: Analysis of hereditary and medical risk factors in Achilles tendinopathy and Achilles tendon ruptures: a matched pair analysis.
abstract: OBJECTIVE
  In Achilles tendon injuries, it is suggested that a pathological continuum might be evident from the healthy Achilles tendon to Achilles tendinopathy to Achilles tendon rupture. As such, risk factors for both tendinopathy and rupture should be the same.
  
  
  OBJECTIVE
  Hereditary and medical risk factors for Achilles tendinopathy and Achilles tendon rupture are the same to a similar extent in a matched pair analysis.
  
  
  METHODS
  Matched pair study; level of evidence: 3.
  
  
  METHODS
  Recreational sportsmen as well as athletes on national level.
  
  
  METHODS
  566 questionnaires were analysed. 310 subjects were allocated to 3 groups (A, B, C) after matching the pairs for age, weight, height and gender: (A) healthy Achilles tendons (n = 89, age 39 ± 11 years, BMI 25.1 ± 3.9, females 36%), (B) chronic Achilles tendinopathy (n = 161, age 41 ± 11 years, BMI 24.4 ± 3.7, females 34%), (C) acute Achilles tendon rupture (n = 60, age 40 ± 9 years, BMI 25.2 ± 3.2, females 27%).
  
  
  RESULTS
  We found a positive family history of Achilles tendinopathy as a risk factor for Achilles tendinopathy (OR: 4.8, 95% CI: 1.1-21.4; p = 0.023), but not for Achilles tendon rupture (OR: 4.0, 95% CI 0.7-21.1, p = 0.118). Smoking and cardiac diseases had a lower incidence in Achilles tendinopathy than in healthy subjects (both p = 0.001), while cardiovascular medication did not change the risk profile.
  
  
  CONCLUSIONS
  Identifying risk factors associated with Achilles tendon disorders has a high clinical relevance regarding the development and implementation of prevention strategies and programs. This cross-sectional study identified a positive family history as a significant solitary risk factor for Achilles tendinopathy, increasing the risk fivefold. However, in this matched pair analysis excluding age, weight, height and gender as risk factors no further factor necessarily increases the risk for either Achilles tendinopathy or Achilles tendon rupture.
authors.affiliation: Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. Kraemer.Robert@mh-hannover.de
authors.forename: Robert
authors.initials: R
authors.lastname: Kraemer
authors.forename: Waldemar
authors.initials: W
authors.lastname: Wuerfel
authors.forename: Johan
authors.initials: J
authors.lastname: Lorenzen
authors.forename: Marc
authors.initials: M
authors.lastname: Busche
authors.forename: Peter M
authors.initials: PM
authors.lastname: Vogt
authors.forename: Karsten
authors.initials: K
authors.lastname: Knobloch
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001265:Athletic Injuries / Q000473:pathology*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D010147:Pain Measurement; D012307:Risk Factors; D012421:Rupture / Q000473:pathology; D011795:Surveys and Questionnaires; D052256:Tendinopathy / Q000235:genetics* / Q000473:pathology*