Sports Orthopedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark.
Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark.
Knee Surg Sports Traumatol Arthrosc. 2021 May;29(5):1617-1626. doi: 10.1007/s00167-020-06391-w. Epub 2021 Jan 2.
Studies have shown that elongation of the injured Achilles tendon after acute Achilles tendon rupture (ATR) is negatively associated with clinical outcomes. The difference between operative and non-operative treatment on the length of the Achilles tendon is only sparsely investigated. The aim of the study was to investigate if the operative and non-operative treatment of ATR had different effects on tendon elongation.
The study was performed as a registry study in the Danish Achilles tendon database (DADB). The primary outcome of the study was an indirect measure of Achilles tendon length: the Achilles tendon resting angle (ATRA) at 1-year follow-up. The variable of interest was treatment (operative or non-operative).
From August 2015 to January 2019, 438 patients (154 operatively treated and 284 non-operatively treated) were registered with full baseline data and had their ATRA correctly registered at 1-year follow-up in DADB. The analysis did not show a clinically relevant nor statistically significant difference in ATRA between operative and non-operatively treated patients at 1-year follow-up (mean difference - 1.2°; 95% CI - 2.5; 0.1; n.s) after adjustment for potential confounders.
There were neither clinically relevant nor statistically significant differences in terms of the ATRA at 1-year follow-up between the operative and non-operatively treated patients. This finding suggests that operative treatment does not lead to a clinically relevant reduction in tendon elongation compared to non-operative treatment and it should therefore not be used as an argument in the choice of treatment.
Level III.
研究表明，急性跟腱断裂（ATR）后跟腱的延长与临床结果呈负相关。手术与非手术治疗对跟腱长度的影响差异仅得到了稀疏的研究。本研究旨在探讨 ATR 的手术与非手术治疗是否对跟腱延长有不同的影响。
本研究在丹麦跟腱数据库（DADB）中进行了一项注册研究。本研究的主要结果是跟腱长度的间接测量：1 年随访时的跟腱休息角（ATRA）。感兴趣的变量是治疗（手术或非手术）。
2015 年 8 月至 2019 年 1 月，438 名患者（154 例手术治疗和 284 例非手术治疗）在 DADB 中注册了完整的基线数据，并在 1 年随访时正确记录了他们的 ATRA。分析显示，在调整了潜在混杂因素后，手术与非手术治疗患者在 1 年随访时的 ATRA 之间没有临床相关且无统计学意义的差异（平均差异-1.2°；95%CI-2.5；0.1；n.s）。
在 1 年随访时，手术与非手术治疗患者的 ATRA 之间既没有临床相关的差异，也没有统计学意义的差异。这一发现表明，与非手术治疗相比，手术治疗并不能显著减少跟腱延长，因此不应将其作为治疗选择的理由。
III 级。
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