This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow [Supplementary Material]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pajala, A.
Right arrow Articles by Leppilahti, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pajala, A.
Right arrow Articles by Leppilahti, J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?
The Journal of Bone and Joint Surgery (American) 84:2016-2021 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.

Scientific Article

Rerupture and Deep Infection Following Treatment of Total Achilles Tendon Rupture

Ari Pajala, MD, Jarmo Kangas, MD, Pasi Ohtonen, MSc and Juhana Leppilahti, MD, PhD

Investigation performed at the Department of Orthopaedic Surgery, Oulu University Hospital, Oulu, Finland

Ari Pajala, MD
Jarmo Kangas, MD
Pasi Ohtonen, MSc
Juhana Leppilahti, MD, PhD
Department of Orthopaedic Surgery, Oulu University Hospital, Box 22, 90220 Oulu, Finland
The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: The incidence of total Achilles tendon rupture has increased, but we are not aware of any reports on the incidence of reruptures or deep infections following treatment. The outcome after successful treatment is good, but that after complications has not been well documented.

Methods: A group of 409 patients with a complete Achilles tendon rupture was treated at a university hospital orthopaedic unit between 1979 and 2000. Twenty-three reruptures (prevalence, 5.6%) and nine deep infections (prevalence, 2.2%) occurred in twenty-nine patients. We retrospectively reviewed the records of these patients to determine the overall incidence of ruptures, reruptures, and deep infections and to record the known risk factors for these major complications. We analyzed the final clinical outcome for twelve patients with a rerupture and seven patients with a deep infection at a mean of 4.1 years after the initial treatment.

Results: The annual incidence of reruptures (per 100,000 inhabitants) increased from 0.25 in 1979-1990 to 1.0 in 1991-2000, and that of deep infections increased from 0 in the 1980s to 0.63 in the 1990s. The ratio of complications to primary ruptures did not change. The patients with deep infections were significantly older, received corticosteroid medication more often, had sustained the tendon injury during everyday activities more often, and had a longer delay before treatment than the patients with simple reruptures. At 4.1 years after the primary treatment, eight of twelve patients in the rerupture group had a satisfactory clinical outcome and the overall average isokinetic plantar flexion strength deficit in that group was only 10%. In contrast, two of the patients in the infection group had a fair clinical outcome and five had a poor outcome, and the average isokinetic plantar flexion strength deficit in that group was 35%.

Conclusions: The incidence of Achilles tendon reruptures and deep infections has increased. The outcome is satisfactory after a simple rerupture without infection, but the results after a deep infection are often devastating.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 Am J Sports MedHome page
K. Nilsson-Helander, R. Thomee, K. Gravare-Silbernagel, P. Thomee, E. Faxen, B. I. Eriksson, and J. Karlsson
The Achilles Tendon Total Rupture Score (ATRS): Development and Validation
Am. J. Sports Med., March 1, 2007; 35(3): 421 - 426.
[Abstract] [Full Text] [PDF]

Home page
 Am J Sports MedHome page
M. Sanchez, E. Anitua, J. Azofra, I. Andia, S. Padilla, and I. Mujika
Comparison of Surgically Repaired Achilles Tendon Tears Using Platelet-Rich Fibrin Matrices
Am. J. Sports Med., February 1, 2007; 35(2): 245 - 251.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
S. S. Gill, M. K. Gelbke, S. L. Mattson, M. W. Anderson, and S. R. Hurwitz
Fluoroscopically Guided Low-Volume Peritendinous Corticosteroid Injection for Achilles Tendinopathy. A Safety Study
J. Bone Joint Surg. Am., April 1, 2004; 86(4): 802 - 806.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
M. D. Miller
What's New in Sports Medicine
J. Bone Joint Surg. Am., March 1, 2004; 86(3): 653 - 661.
[Full Text] [PDF]