Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Sweden.
Knee Surg Sports Traumatol Arthrosc. 2011 Aug;19(8):1385-93. doi: 10.1007/s00167-011-1511-3. Epub 2011 Apr 30.
The purpose of this prospective randomized controlled study was to evaluate the long-term results after an acute Achilles tendon rupture in patients treated surgically or non-surgically. The focus was to evaluate whether any improvements occurred between the one and 2-year evaluation.
Eighty-one patients (67 men, 14 women) with a mean (SD) age of 42 (9.1) were included in this study. Forty-two patients were treated surgically, and 39 treated non-surgically otherwise the treatment was identical for the two groups. All patients were evaluated using the Achilles tendon Total Rupture Score (ATRS), the Physical Activity Scale (PAS) and validated functional tests one and 2 years after injury.
There were significant functional deficits on the injured side compared with the contralateral side 2 years after Achilles tendon rupture, regardless of treatment. Only minor improvements, even though statistically significant, occurred between the 1- and 2-year evaluations. The physical activity level remained significantly reduced as compared with prior to injury, but the ATRS mean was relatively high in both groups (89 and 90).
This long-term follow-up indicates that the majority of patients with an Achilles tendon rupture have not fully recovered (in regards to symptoms, physical activity level and function) 2 years after injury regardless of surgical or non-surgical treatment. Furthermore, only minor improvements occur between the 1- and 2-year evaluations. This indicates that to enhance the final outcome the focus should be on improvements in treatment within the first year. The patients appear to have adjusted to their impairments since the patient-reported outcome is relatively high in spite of functional deficits and lower activity level compared with pre-injury.
Prospective randomized study, Level I.
本前瞻性随机对照研究旨在评估手术或非手术治疗急性跟腱断裂患者的长期结果。重点评估在 1 年和 2 年评估之间是否有任何改善。
本研究纳入 81 例（67 名男性，14 名女性）患者，平均（SD）年龄为 42（9.1）岁。42 例患者接受手术治疗，39 例患者接受非手术治疗，两组的治疗方法相同。所有患者均在受伤后 1 年和 2 年接受跟腱总断裂评分（ATRS）、体力活动量表（PAS）和功能验证性测试评估。
跟腱断裂 2 年后，无论治疗方式如何，患侧均存在明显的功能缺陷，与健侧相比。即使有统计学意义的改善，1 年和 2 年评估之间的改善也较小。与受伤前相比，活动水平仍显著降低，但两组的 ATRS 均值均相对较高（89 和 90）。
本长期随访研究表明，大多数跟腱断裂患者在受伤后 2 年时（无论手术或非手术治疗）并未完全恢复（在症状、活动水平和功能方面）。此外，1 年和 2 年评估之间仅出现较小的改善。这表明，为了提高最终结果，应关注治疗方法在最初一年内的改进。尽管与受伤前相比，患者的功能缺陷和活动水平较低，但患者报告的结果相对较高，表明患者已经适应了他们的损伤。
前瞻性随机研究，I 级。
