Abstract
BackgroundAchilles tendon rupture (ATR) is a common sports injury, with a rising incidence and significant impairments. Due to the lack of treatment guidelines, there is no consensus about diagnostic methods, primary treatment (non-surgical or surgical) and rehabilitation. It is hypothesized that this lack of consensus and guidelines leads to sub-optimal recovery and higher societal costs.The primary aim of this study is to give a broad insight into the recovery after ATR. Secondarily this study aims to explore factors contributing to recovery and gain insight into the cost-effectiveness of ATR management.MethodsThis multicenter prospective cohort study will include all adult (≥ 18 years) patients with an ATR treated at the three main hospitals in the Northern Netherlands: University Medical Center Groningen, Martini Hospital Groningen and Medical Center Leeuwarden. All subjects will be invited for three visits at 3, 6 and 12 months post-injury. The following data will be collected: patient-reported outcome measures (PROMs), physical tests, imaging and economic questionnaires. At 3 months post-injury personal, injury, and treatment data will be collected through a baseline questionnaire and assessment of the medical file. The PROMs concern the Dutch version of the Achilles Tendon Total Rupture Score, EQ-5D-5 L, Oslo Sport Trauma Research Center Overuse Injury Questionnaire, Injury Psychological Readiness Return to Sport Scale, Tampa Scale of Kinesiophobia, Expectations, Motivation and Satisfaction questionnaire and a ranking of reasons for not returning to sport. The administered physical tests are the heel-rise test, standing dorsiflexion range of motion, resting tendon length and single leg hop for distance. Ultrasound Tissue Characterization will be used for imaging. Finally, economic data will be collected using the Productivity Cost Questionnaire and Medical Consumption Questionnaire.DiscussionThis prospective cohort study will contribute to optimal decision making in the primary treatment and rehabilitation of ATRs by providing insight into (1) ATR recovery (2) novel imaging for monitoring recovery (3) (barriers to) return to sport and (4) cost-effectiveness of management. The analysis of these data strives to give a broad insight into the recovery after ATR as well as provide data on novel imaging and costs, contributing to individualized ATR management.Trial registrationTrialregister.nl. NTR6484. 20/06/2017. 20/07/2017.
Highlights
MethodsThis multicenter prospective cohort study will include all adult (≥ 18 years) patients with an Achilles tendon rupture (ATR) treated at the three main hospitals in the Northern Netherlands: University Medical Center Groningen, Martini Hospital Groningen and Medical Center Leeuwarden
Achilles tendon rupture (ATR) is a common sports injury, with a rising incidence and significant impairments
The incidence of ATR is steadily increasing globally [9,10,11,12,13]; this increase is most prominent in the elderly, who are participating in recreational physical activity more often than in the past [14,15,16]
Summary
Design A multicenter prospective cohort study will be conducted. This study has been approved by the Medical Ethical Committee (METc) of the University Medical Center Groningen (UMCG) (METc 2017/126). PROMs The Achilles Tendon Total Rupture Score (ATRS) is a questionnaire used to measure outcome related to symptoms and physical activity after treatment in patients with an ATR [41]. It consists of ten questions each concerning ten points. This instrument is a valid and reliable method of measuring outcome in ATR patients [41]. The modified Dutch version, adapted for tendon injuries will be used [49] This questionnaire has been validated in Dutch for measurement of fear of movement/reininjury, not in an ATR population [49]. The cost-effectiveness of ATR management options will be determined at 3, 6, and 12 months post injury
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