Patients with chronic Achilles tendon rupture have persistent limitations in patient-reported function and calf muscle function one year after surgical treatment - a case series

Anna Nordenholm; Niklas Nilsson; Eric Hamrin Senorski; Katarina Nilsson Helander; Olof Westin; Nicklas Olsson

doi:10.1186/s40634-022-00451-5

Patients with chronic Achilles tendon rupture have persistent limitations in patient-reported function and calf muscle function one year after surgical treatment - a case series

J Exp Orthop. 2022 Feb 9;9(1):15. doi: 10.1186/s40634-022-00451-5.

Authors

Anna Nordenholm^{1

2}, Niklas Nilsson³, Eric Hamrin Senorski^{4

5}, Katarina Nilsson Helander³, Olof Westin³, Nicklas Olsson³

Affiliations

¹ Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. anna.holm.2@gu.se.
² Sportrehab Sports Medicine Clinic, Gothenburg, Sweden. anna.holm.2@gu.se.
³ Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborgsvägen 31, 431 80, Mölndal Gothenburg, Sweden.
⁴ Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁵ Sportrehab Sports Medicine Clinic, Gothenburg, Sweden.

Abstract

Purpose: Evaluate the one-year postoperative outcomes in patients with Chronic Achilles tendon rupture.

Methods: Patients surgically treated for Chronic Achilles tendon rupture (n = 22, 14 males and 8 females, mean age 61 ± 15) were evaluated by Achilles tendon Total Rupture Score, The Physical Activity Scale, The Foot and Ankle Outcome Score, Calf muscle endurance test, counter movement jump, Hopping, ultrasound measurement of tendon length, Achilles Tendon Resting Angle, dorsi flexion range of motion and calf muscle circumference. Muscle function and tendon length outcomes on the injured side were compared with the healthy side.

Results: The patients scored a mean of 62 ± 26 on the Achilles tendon Total Rupture Score. Median scores on the injured compared with the healthy side were lower in heel-rise repetitions (20 vs 24 cm, p = 0.004), hel-rise height (8 vs 10 cm, p < 0.001), heel-rise total work (872 vs 1590 joule, p < 0.001) and hopping ratio (0.37 vs 0.48, p = 0.005). Median calf circumference was smaller (37 vs 38 cm, p = 0.001) and the mean tendon elongation greater on the injured side; Achilles tendon resting angle (55 vs 50°, p < 0.001) and ultrasound (22.4 vs 20.5 cm, p = 0.006).

Conclusions: At one year postoperatively, patients with chronic Achilles tendon rupture reported persistent limitations in subjective foot and ankle function. Heel-rise height and total work as well as hopping ratio were not recovered, and there was an elongation of the injured Achilles tendon compared with the healthy tendon.

Level of evidence: IV.

Keywords: Achilles tendon rupture score; Calf muscle endurance; Chronic Achilles tendon rupture; Outcome; Surgical treatment; Tendon length.