Oliva Francesco, Marsilio Emanuela, Asparago Giovanni, Giai Via Alessio, Biz Carlo, Padulo Johnny, Spoliti Marco, Foti Calogero, Oliva Gabriella, Mannarini Stefania, Rossi Alessandro Alberto, Ruggieri Pietro, Maffulli Nicola
Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, Italy.
Department of Orthopaedic Surgery and Traumatology, San Camillo-Forlanini Hospital, 00152 Rome, Italy.
J Clin Med. 2022 Jun 27;11(13):3698. doi: 10.3390/jcm11133698.
Achilles tendon ruptures are common. Metabolic disorders, such as diabetes mellitus, hypercholesterolemia, thyroid disorders, and obesity, impair tendons health, leading to Achilles tendinopathy and likely predisposing patients to Achilles tendon ruptures. Patients who visited the Orthopedic Outpatient Clinics and the Accident and Emergency Departments of five different hospitals in Italy were recruited. Through telephone interviews, we administered a questionnaire to all the patients who had undergone surgical ATR repair, evaluating their past medical history, sport- and work-related activities, drug use, and post-operative rehabilitation outcomes. "Return to work activities/sport" was negatively predicted by the presence of a metabolic disorder (β = -0.451; OR = 0.637) and 'open' surgery technique (β = -0.389; OR = 0.678). "Medical complications" were significantly predicted by metabolic disorders (β = 0.600 (0.198); OR = 1.822) and was negatively related to 'mini-invasive' surgery (i.e., not 'open' nor 'percutaneous') (β = -0.621; OR = 0.537). "Immediate weightbearing" and "immediate walking without assistance" were negatively predicted by 'open' technique (β = -0.691; OR = 0.501 and β = -0.359 (0.174; OR = 0.698)). Metabolic conditions can strongly affect post-operative outcomes following surgical repair of acute Achilles tendon tears.
跟腱断裂很常见。代谢紊乱，如糖尿病、高胆固醇血症、甲状腺疾病和肥胖，会损害肌腱健康，导致跟腱病，并可能使患者易患跟腱断裂。我们招募了在意大利五家不同医院的骨科门诊和急诊就诊的患者。通过电话访谈，我们向所有接受过手术修复急性跟腱断裂的患者发放了问卷，评估他们的既往病史、与运动和工作相关的活动、药物使用情况以及术后康复结果。代谢紊乱（β = -0.451；OR = 0.637）和“开放”手术技术（β = -0.389；OR = 0.678）对“恢复工作活动/运动”有负面预测作用。代谢紊乱（β = 0.600（0.198）；OR = 1.822）对“医疗并发症”有显著预测作用，且与“微创”手术（即非“开放”也非“经皮”）呈负相关（β = -0.621；OR = 0.537）。“立即负重”和“立即独立行走”受到“开放”技术的负面预测（β = -0.691；OR = 0.501和β = -0.359（0.174；OR = 0.698））。代谢状况会强烈影响急性跟腱断裂手术修复后的术后结果。
