title: Surgical management of chronic ruptures of the Achilles tendon remains unclear: a systematic review of the management options.
abstract: BACKGROUND
  Chronic ruptures of the Achilles tendon cause marked functional impairment. Given the different repair techniques used, there is a need for a systematic review of the literature to investigate whether these procedure are comparable with one another when performed by experienced surgeons.
  
  
  METHODS
  A systematic literature search using the Medline (Pubmed), EMBASE and CINHAL databases.
  
  
  RESULTS
  Provided there are no contraindications, surgery is regarded the best management option.
  
  
  RESULTS
  Most reports are case series with small sample sizes using non-validated measures.
  
  
  CONCLUSIONS
  Long-term results of surgical repair procedures are now available.
  
  
  CONCLUSIONS
  The current literature does not allow clinicians to definitively determine the optimal management modality for chronic rupture of the Achilles tendon. There is a need for randomized controlled trials which use validated functional outcome measures.
authors.affiliation: University Hospital Coventry and Warwick, Coventry, UK.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Hadi
authors.forename: Jonathan
authors.initials: J
authors.lastname: Young
authors.forename: Lisa
authors.initials: L
authors.lastname: Cooper
authors.forename: Matthew
authors.initials: M
authors.lastname: Costa
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
mesh_terms: D000125:Achilles Tendon / Q000293:injuries / Q000601:surgery; D006801:Humans; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D012421:Rupture / Q000601:surgery; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome
keywords: Achilles tendon; chronic rupture; management; systematic review