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No clinically relevant difference between operative and non-operative treatment in tendon elongation measured with the Achilles tendon resting angle (ATRA) 1 year after acute Achilles tendon rupture

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PURPOSE: 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.

METHODS: 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).

RESULTS: 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.

CONCLUSION: 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 OF EVIDENCE: Level III.

Original languageEnglish
JournalKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
Volume29
Issue number5
Pages (from-to)1617-1626
Number of pages10
ISSN0942-2056
DOIs
Publication statusPublished - May 2021

Bibliographical note

Publisher Copyright:
© 2021, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

    Research areas

  • ATRA, ATRS, Achilles tendon length, Achilles tendon resting angle, Achilles tendon rupture, Clinical outcome, Conservative, Elongation, Heel-rise height, Non-operative, Operative, Treatment

ID: 61651004