title: Twelve-month outcomes following surgical repair of the Achilles tendon.
abstract: BACKGROUND
  Incidence of Achilles tendon rupture (ATR) has increased over recent years, and debate regarding optimal management has been widely documented. Most papers have focused on surgical success, complications and short term region-specific outcomes. Inconsistent use of standardised outcome measures following surgical ATR repair has made it difficult to evaluate the impact of ATR on a patient's health status post-surgery, and to compare this to other injury types. This study aimed to report the frequency of surgical repairs of the Achilles tendon over a five-year period within an orthopaedic trauma registry, and to investigate return to work (RTW) status, health status and functional outcomes at 12 months post-surgical repair of the Achilles tendon.
  
  
  METHODS
  Two hundred and four adults registered by the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) who underwent surgical repair of the Achilles tendon between July 2009 and June 2014 were included in this prospective cohort study. The Extended Glasgow Outcome Scale (GOS-E), 3-level European Quality of Life 5 Dimension measure (EQ-5D-3L), and RTW status 12 months following surgical ATR repair were collected through structured telephone interviews conducted by trained interviewers.
  
  
  RESULTS
  At 12 months, 92% of patients were successfully followed up. Of those working prior to injury, 95% had returned to work. 42% of patients reported a full recovery on the GOS-E scale. The prevalence of problems on the EQ-5D-3L at 12 months was 0.5% for self-care, 11% for anxiety, 13% for mobility, 16% for activity, and 22% for pain. 16% of patients reported problems with more than one domain. The number of surgical repairs of the Achilles tendon within the VOTOR registry decreased by 68% over the five-year study period.
  
  
  CONCLUSIONS
  Overall, patients recover well following surgical repair of the Achilles tendon. However, in this study, deficits in function persisted for over half of patients at 12 months post-injury. The decreased incidence of surgical Achilles tendon repair may reflect a change in practice at VOTOR hospitals whereby surgery may be becoming less favoured for initial ATR management.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Fox
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: B J
authors.initials: BJ
authors.lastname: Gabbe
authors.affiliation: Epworth Hospital, Richmond, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Richardson
authors.affiliation: Department of Orthopaedic Surgery, Royal Melbourne Hospital, Parkville, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Oppy
authors.affiliation: Department of Orthopaedics, University Hospital Geelong, Geelong, Australia; School of Medicine, Deakin University, Geelong, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Page
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Department of Orthopaedic Surgery, Alfred Hospital, Melbourne, Australia.
authors.forename: E R
authors.initials: ER
authors.lastname: Edwards
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Northern Hospital, Epping, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Hau
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: christina.ekegren@monash.edu.
authors.forename: C L
authors.initials: CL
authors.lastname: Ekegren
mesh_terms: D000125:Achilles Tendon / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology*; D011446:Prospective Studies; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D020127:Recovery of Function / Q000502:physiology*; D062707:Return to Work / Q000706:statistics & numerical data*; D012421:Rupture / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D014193:Trauma Centers; D016896:Treatment Outcome; D055815:Young Adult
keywords: Achilles tendon; Extended Glasgow Outcome Scale; Injury; Outcomes; Quality of life; Return to work; Surgery