Factors affecting outcomes of functional rehabilitation treatment of Achilles ruptures.

INTRODUCTION

There has been a major shift towards nonoperative treatment of Achilles rupture in the past decade even though there are few studies analysing factors which could affect outcomes of this treatment. This retrospective observational study was undertaken to investigate if patient related factors of age and gender or injury related factors of tendon gap, location of the tendon rupture and laterality of rupture affected the long-term functional outcomes of nonoperatively treated Achilles Tendon rupture patients.

METHODS

Achilles Tendon Rupture Scores (ATRS) at a minimum follow up of one year for 22 patients treated by the functional treatment regime were analysed statistically using Wilcoxon Rank Sum Test and Welch -test to document if there were any significant differences in the scores for five factors: patients' age, gender, the size of tendon gap, location of the ruptures from tendon insertion and laterality of the rupture. Reruptures and failure to heal cases were also documented.

RESULTS AND CONCLUSION

The overall ATRS of the group was 85.8 (range 65-100). Age of the patients was the only factor affecting ATRS, patients less than 50 years had a better outcome (mean ATRS 92.6, range 65-100) than patients aged more than 50 years (mean ATRS 81.1, range 70-94, . None of the other factors analysed had any significant impact on the functional outcomes. Tendon Gap <20 mm (mean ATRS 81.1, range 65-100) or > 20 mm (mean ATRS 88.4, range 70-100) did not have a significant impact on outcomes . There were no reruptures or failure to heal cases. Results indicated that a relatively large tendon gap is not a contraindication for non-operative functional management especially in patients less than 50 years of age.