Achilles Tendon Rupture: Can the Tendon Gap on Ultrasound Scan Predict the Outcome of Functional Rehabilitation Program?

Islam Mubark,Charalampos Karagkevrekis,Donald Buchanan,Jennifer Parker,Amr Abouelela,Swati Arya,Mosab Elgalli,Neil Ashwood

doi:10.7759/cureus.10298

Islam Mubark, Charalampos Karagkevrekis + Show 6 more

Open Access

https://doi.org/10.7759/cureus.10298

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Abstract

Background and objectives There is a growing use of functional rehabilitation programs for the treatment of Achilles tendon rupture. Factors such as patient age and level of activity have been used to guide the decision. One of the debated indications is the gap size between the ruptured ends of the tendon. This study aims to define any correlation between the amount of the initial gap between tendon ends and patients outcome treated with the functional rehabilitation program.Method A prospective case series study of all patients with acute Achilles tendon rupture treated non-surgically with the functional rehabilitation program between 2016 and 2018. The tendon gap was measured with an ultrasound scan on the initial presentation. Patients were followed for a minimum of 12 months and assessed for Achilles Tendon Rupture Score (ATRS), plantarflexion strength, and re-rupture rate. Results A total of 56 patients completed one-year follow-up, and 2 patients had re-ruptures. The mean plantar flexion gap was 13.7 mm. The mean ATRS at 12 months was 85.12. There was no statistically significant correlation between the final ATRS and the mean rupture gap.Conclusion The outcome following non-operative functional rehabilitation treatment of rupture Achilles tendon did not correlate with the size of the tendon gap, and authors recommend that decision on functional rehabilitation should not be based on these criteria.

Highlights

Despite the increased incidence of Achilles tendon rupture over recent years, the optimal treatment for this injury remains controversial [1]
This is a prospective study of all patients with acute Achilles tendon ruptures treated using the functional rehabilitation program between January 2016 and February 2018 in Queens Hospital Burton and completing a minimum of 12-month follow-up
The patients included were all adults aged over 18 years, sustaining a closed Achilles tendon rupture and presenting within two weeks after the injury

Summary

Introduction

Despite the increased incidence of Achilles tendon rupture over recent years, the optimal treatment for this injury remains controversial [1]. Despite a lower re-rupture rate of open surgical repair, it has always been associated with a higher than usual wound-related complication [2]. The non-operative treatment of rupture tendon Achilles has historically been associated with higher rates of re-rupture, ankle stiffness, and tendon weakness. These complications were usually related to the use of plaster immobilization for prolonged periods. There is a growing use of functional rehabilitation programs for the treatment of Achilles tendon rupture. Factors such as patient age and level of activity have been used to guide the decision. This study aims to define any correlation between the amount of the initial gap between tendon ends and patients outcome treated with the functional rehabilitation program

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