Department of Orthopaedic Surgery, Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Sports Med. 2014 Sep;44(9):1241-59. doi: 10.1007/s40279-014-0200-z.
The Achilles tendon is the strongest tendon in the human body. The incidence of Achilles tendon ruptures appears to be increasing.
The aim of this review was to systematically summarize predictors influencing Achilles tendon rupture (ATR) risk.
A systematic literature search was performed of reported determinants influencing the ATR risk. Studies were eligible if there was: (i) description of determinants predicting ATR; (ii) an outcome defined as ATR; (iii) any study design with at least ten adults included with ATR; (iv) use of statistical tests regarding differences between patients with an ATR and healthy controls; (v) a full text article available; (vi) an article written in English, German or Dutch. Quality assessment was done using a standardized criteria set. Best-evidence synthesis was performed.
We included 31 studies, of which two (6.5%) were considered high-quality studies. Moderate evidence was found for increased ATR risk and decreased fibril size of Achilles tendon.
Based on the results of this systematic review there is moderate evidence that decreased tendon fibril size increases the ATR risk. There is limited evidence for many other factors, some of which are modifiable, such as increased body weight, oral corticosteroid use and quinolone use and living in an urban area, and therefore may be of interest in future studies. Furthermore, these results showed that more high-quality studies are needed for evaluating the determinants influencing the ATR risk.
跟腱是人体最强壮的肌腱。跟腱断裂的发病率似乎在上升。
本综述旨在系统总结影响跟腱断裂（ATR）风险的预测因素。
对报道的影响 ATR 风险的决定因素进行了系统的文献检索。如果符合以下标准，则研究合格：（i）描述预测 ATR 的决定因素；（ii）将 ATR 定义为结果；（iii）任何研究设计均至少包括 10 名成年人和 ATR；（iv）使用统计检验来比较 ATR 患者和健康对照组之间的差异；（v）可获得全文文章；（vi）文章为英文、德文或荷兰文。使用标准化标准集进行质量评估。进行最佳证据综合。
我们纳入了 31 项研究，其中 2 项（6.5%）被认为是高质量研究。有中度证据表明跟腱纤维尺寸减小会增加 ATR 风险。
根据这项系统综述的结果，有中度证据表明跟腱纤维尺寸减小会增加 ATR 风险。许多其他因素的证据有限，其中一些是可以改变的，例如体重增加、口服皮质类固醇和喹诺酮类药物的使用以及居住在城市地区，因此可能是未来研究的关注点。此外，这些结果表明，需要更多高质量的研究来评估影响 ATR 风险的决定因素。
