title: Increasing incidence of acute Achilles tendon rupture and a noticeable decline in surgical treatment from 1994 to 2013. A nationwide registry study of 33,160 patients.
abstract: OBJECTIVE
  The purpose of this study is to investigate the incidence of acute Achilles tendon rupture in Denmark from 1994 to 2013 with focus on sex, age, geographical areas, seasonal variation and choice of treatment.
  
  
  METHODS
  The National Patient Registry was retrospectively searched to find the number of acute Achilles tendon rupture in Denmark during the time period of 1994-2013. Regional population data were retrieved from the services of Statistics Denmark.
  
  
  RESULTS
  During the 20-year period, 33,160 ruptures occurred revealing a statistically significant increase in the incidence (p < 0.001, range = 26.95-31.17/100,000/year). Male-to-female ratio was 3:1 and average age 45 years for men and 44 years for women. There was a statistically significant increasing incidence for people over 50 years. A higher incidence in rural compared with urban geographical areas was found, but this was not statistically significant. There was a statistically significant decreasing incidence of patients treated with surgery from 16.9/105in 1994 to 6.3/105in 2013.
  
  
  CONCLUSIONS
  The incidence of acute Achilles tendon rupture increased from 1994 to 2013 based on increasing incidence in the older population. There was no difference in incidence of acute Achilles tendon rupture in the rural compared with urban geographical areas. A steady decline in surgical treatment was found over the whole period, with a noticeable decline from 2009 to 2013, possibly reflecting a rapid change in clinical practice following a range of high-quality randomized clinical trials (RCT).
  
  
  METHODS
  IV.
authors.affiliation: Department of Orthopedics, Clinical Orthopedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark. ganestam@hotmail.com.
authors.forename: Ann
authors.initials: A
authors.lastname: Ganestam
authors.affiliation: Department of Orthopedics, Clinical Orthopedic Research Hvidovre, Clinical Research Center, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kallemose
authors.affiliation: Department of Orthopedics, Clinical Orthopedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Troelsen
authors.affiliation: Department of Orthopedics, Clinical Orthopedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark.
authors.forename: Kristoffer Weisskirchner
authors.initials: KW
authors.lastname: Barfod
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000639:trends; D012042:Registries; D012189:Retrospective Studies; D012421:Rupture / Q000453:epidemiology* / Q000601:surgery; D012424:Rural Population / Q000706:statistics & numerical data; D017678:Sex Distribution; D013708:Tendon Injuries / Q000453:epidemiology* / Q000601:surgery; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Achilles tendon rupture; Age; Epidemiology; Incidence; Operative treatment; Season