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General Orthopaedics

PREDICTORS OF FUNCTIONAL OUTCOMES IN NON-OPERATIVELY MANAGED ACHILLES TENDON RUPTURES

British Indian Orthopaedic Society (previously IOSUK) Annual Conference, July 2016



Abstract

Acute Achilles tendon (AT) rupture management remains debatable but non-operative functional regimes are beginning to dominate current treatment algorithms. The aim of this study was to identify predictors of functional outcome in patients with AT ruptures treated non-operatively with an immediate weight bearing functional regime in an orthosis.

Analysis of prospectively gathered data from a local database of all patients treated non-operativelyat our institution with anAT rupture was performed. Inclusion criteria required a completed Achilles Tendon Rupture Score (ATRS) at a minimum of 8 months post rupture. The ATRS score was correlated against age, gender, time following rupture, duration of treatment in a functional orthoses (8- and 11-week regimes) and complications. 236 patients of average age 49.5 years were included.

The mean ATRS on completion of rehabilitation was 74 points. The mean ATRS was significantly lower in the 37 females as compared to the 199 males, 65.8 vs 75.6 (p = 0.013). Age inversely affected ATRS with a Pearsons correlation of −0.2. There was no significant difference in the ATRS score when comparing the two different treatment regime durations. There were 12 episodes of VTE and 4 episodes of re-rupture. The ATRS does not change significantly after 8 months of rupture.

Patients with AT ruptures treated non-operatively with a functional rehabilitation regime demonstrate good function with low re-rupture rates. Increasing age and female gender demonstrate inferior functional outcomes.