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Delayed Achilles tendon ruptures. Does non-operative management work?

R D Macnair, A M Hutchison, R M Evans, N J Owen, C Topliss, P R Williams, Nicholas Owen Orcid Logo

Proceedings of the 13th meeting of the combined orthopaedic associations, Cape Town, 2016, Volume: 13, Pages: 325 - 325

Swansea University Author: Nicholas Owen Orcid Logo

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Delayed Achilles tendon ruptures. Does non-operative management work?Authors: R.D. Macnair, AM Hutchison, R.M. Evans, N.J. Owen, C. Topliss, P.R.Williams Delayed Achilles tendon ruptures are difficult to manage, with surgical treatmentgenerally advised. The purpose of this study was to report the ou...

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Published in: Proceedings of the 13th meeting of the combined orthopaedic associations, Cape Town, 2016
Published: Cape Town 2016
Online Access: http://www.comoc2016.org/wp-content/uploads/2016/03/COMOC-2016-Abstract-Book_download.pdf
URI: https://cronfa.swan.ac.uk/Record/cronfa31184
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2016-12-05T12:22:40.8555211</datestamp><bib-version>v2</bib-version><id>31184</id><entry>2016-11-22</entry><title>Delayed Achilles tendon ruptures. Does non-operative management work?</title><swanseaauthors><author><sid>360b7822fd760c7d73a1b0ca5bce1c07</sid><ORCID>0000-0002-7067-8082</ORCID><firstname>Nicholas</firstname><surname>Owen</surname><name>Nicholas Owen</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2016-11-22</date><deptcode>STSC</deptcode><abstract>Delayed Achilles tendon ruptures. Does non-operative management work?Authors: R.D. Macnair, AM Hutchison, R.M. Evans, N.J. Owen, C. Topliss, P.R.Williams Delayed Achilles tendon ruptures are difficult to manage, with surgical treatmentgenerally advised. The purpose of this study was to report the outcomes of patientswith a delayed presentation of an Achilles tendon rupture (2 weeks plus) treatedconservatively with a dedicated management programme.Methods. We identified all patients with a delayed presentation who had been treatedconservatively at our centre from 2008 &#x2013; 2014. The conservative management wasthe same as for our acute Achilles ruptures: the Swansea Morriston Achilles RuptureTreatment (SMART protocol). This includes 1) an ultrasound examination followed byimmobilisation in a position which allowed the smallest gap between the tendon ends2) referral to a dedicated Achilles tendon clinic and 3) strict rehabilitation guidelines.Outcome measures included complication rates (re-rupture / venous thromboembolism);Achilles Tendon Total Rupture Score (ATRS) and Achilles Repair Score (ARS); andmuscle function dynamometry assessing plantarflexion torque of the ankle. MRI ofruptured and non-ruptured legs allowed measurement of Achilles tendon length.Comparisons between the two sides were made (2-tailed t-test).Results. 19 patients were assessed; 16 males, 3 females. The mean age was 60years (range 39-80). The mean delay from injury to starting treatment was 61 days(range 14-249) and the mean follow-up was 40 months (range 13-87). There wereno re-ruptures. One patient had a pulmonary embolus. One patient went on to surgery.The mean ATRS was 65/100 (17-100), and ARS 71/100 (30-100). The meanplantarflexion torque for the injured side was 19.5 newton metres (N.m) (6.3-34.2,SD 8.2) and for the uninjured side 25.7 N.m (12.2-43.3, SD 9.1). The differencebetween the two sides was significant (t = 3.816 p = 0.001). The mean length ofthe injured Achilles tendon was 104.9mm (51.4-155.2) and uninjured 97.306mm(42.9-138.7). No significant difference (t = 1.684, p= 0.111).Conclusion. This comprehensive review of a conservative management regime forpatients with a delayed presentation Achilles rupture using the dedicated SMARTrehabilitation programme supports a satisfactory outcome in the majority of cases.Proceedings of the 13th meeting of the combined orthopaedic associations, Cape Town, 2016</abstract><type>Conference Paper/Proceeding/Abstract</type><journal>Proceedings of the 13th meeting of the combined orthopaedic associations, Cape Town, 2016</journal><volume>13</volume><paginationStart>325</paginationStart><paginationEnd>325</paginationEnd><publisher/><placeOfPublication>Cape Town</placeOfPublication><keywords>Achilles tendon, isokinetic, plantar flexion torque</keywords><publishedDay>11</publishedDay><publishedMonth>4</publishedMonth><publishedYear>2016</publishedYear><publishedDate>2016-04-11</publishedDate><doi/><url>http://www.comoc2016.org/wp-content/uploads/2016/03/COMOC-2016-Abstract-Book_download.pdf</url><notes/><college>COLLEGE NANME</college><department>Sport and Exercise Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>STSC</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2016-12-05T12:22:40.8555211</lastEdited><Created>2016-11-22T06:54:07.7815201</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences</level></path><authors><author><firstname>R D</firstname><surname>Macnair</surname><order>1</order></author><author><firstname>A M</firstname><surname>Hutchison</surname><order>2</order></author><author><firstname>R M</firstname><surname>Evans</surname><order>3</order></author><author><firstname>N J</firstname><surname>Owen</surname><order>4</order></author><author><firstname>C</firstname><surname>Topliss</surname><order>5</order></author><author><firstname>P R</firstname><surname>Williams</surname><order>6</order></author><author><firstname>Nicholas</firstname><surname>Owen</surname><orcid>0000-0002-7067-8082</orcid><order>7</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2016-12-05T12:22:40.8555211 v2 31184 2016-11-22 Delayed Achilles tendon ruptures. Does non-operative management work? 360b7822fd760c7d73a1b0ca5bce1c07 0000-0002-7067-8082 Nicholas Owen Nicholas Owen true false 2016-11-22 STSC Delayed Achilles tendon ruptures. Does non-operative management work?Authors: R.D. Macnair, AM Hutchison, R.M. Evans, N.J. Owen, C. Topliss, P.R.Williams Delayed Achilles tendon ruptures are difficult to manage, with surgical treatmentgenerally advised. The purpose of this study was to report the outcomes of patientswith a delayed presentation of an Achilles tendon rupture (2 weeks plus) treatedconservatively with a dedicated management programme.Methods. We identified all patients with a delayed presentation who had been treatedconservatively at our centre from 2008 – 2014. The conservative management wasthe same as for our acute Achilles ruptures: the Swansea Morriston Achilles RuptureTreatment (SMART protocol). This includes 1) an ultrasound examination followed byimmobilisation in a position which allowed the smallest gap between the tendon ends2) referral to a dedicated Achilles tendon clinic and 3) strict rehabilitation guidelines.Outcome measures included complication rates (re-rupture / venous thromboembolism);Achilles Tendon Total Rupture Score (ATRS) and Achilles Repair Score (ARS); andmuscle function dynamometry assessing plantarflexion torque of the ankle. MRI ofruptured and non-ruptured legs allowed measurement of Achilles tendon length.Comparisons between the two sides were made (2-tailed t-test).Results. 19 patients were assessed; 16 males, 3 females. The mean age was 60years (range 39-80). The mean delay from injury to starting treatment was 61 days(range 14-249) and the mean follow-up was 40 months (range 13-87). There wereno re-ruptures. One patient had a pulmonary embolus. One patient went on to surgery.The mean ATRS was 65/100 (17-100), and ARS 71/100 (30-100). The meanplantarflexion torque for the injured side was 19.5 newton metres (N.m) (6.3-34.2,SD 8.2) and for the uninjured side 25.7 N.m (12.2-43.3, SD 9.1). The differencebetween the two sides was significant (t = 3.816 p = 0.001). The mean length ofthe injured Achilles tendon was 104.9mm (51.4-155.2) and uninjured 97.306mm(42.9-138.7). No significant difference (t = 1.684, p= 0.111).Conclusion. This comprehensive review of a conservative management regime forpatients with a delayed presentation Achilles rupture using the dedicated SMARTrehabilitation programme supports a satisfactory outcome in the majority of cases.Proceedings of the 13th meeting of the combined orthopaedic associations, Cape Town, 2016 Conference Paper/Proceeding/Abstract Proceedings of the 13th meeting of the combined orthopaedic associations, Cape Town, 2016 13 325 325 Cape Town Achilles tendon, isokinetic, plantar flexion torque 11 4 2016 2016-04-11 http://www.comoc2016.org/wp-content/uploads/2016/03/COMOC-2016-Abstract-Book_download.pdf COLLEGE NANME Sport and Exercise Sciences COLLEGE CODE STSC Swansea University 2016-12-05T12:22:40.8555211 2016-11-22T06:54:07.7815201 Faculty of Science and Engineering School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences R D Macnair 1 A M Hutchison 2 R M Evans 3 N J Owen 4 C Topliss 5 P R Williams 6 Nicholas Owen 0000-0002-7067-8082 7
title Delayed Achilles tendon ruptures. Does non-operative management work?
spellingShingle Delayed Achilles tendon ruptures. Does non-operative management work?
Nicholas Owen
title_short Delayed Achilles tendon ruptures. Does non-operative management work?
title_full Delayed Achilles tendon ruptures. Does non-operative management work?
title_fullStr Delayed Achilles tendon ruptures. Does non-operative management work?
title_full_unstemmed Delayed Achilles tendon ruptures. Does non-operative management work?
title_sort Delayed Achilles tendon ruptures. Does non-operative management work?
author_id_str_mv 360b7822fd760c7d73a1b0ca5bce1c07
author_id_fullname_str_mv 360b7822fd760c7d73a1b0ca5bce1c07_***_Nicholas Owen
author Nicholas Owen
author2 R D Macnair
A M Hutchison
R M Evans
N J Owen
C Topliss
P R Williams
Nicholas Owen
format Conference Paper/Proceeding/Abstract
container_title Proceedings of the 13th meeting of the combined orthopaedic associations, Cape Town, 2016
container_volume 13
container_start_page 325
publishDate 2016
institution Swansea University
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences
url http://www.comoc2016.org/wp-content/uploads/2016/03/COMOC-2016-Abstract-Book_download.pdf
document_store_str 0
active_str 0
description Delayed Achilles tendon ruptures. Does non-operative management work?Authors: R.D. Macnair, AM Hutchison, R.M. Evans, N.J. Owen, C. Topliss, P.R.Williams Delayed Achilles tendon ruptures are difficult to manage, with surgical treatmentgenerally advised. The purpose of this study was to report the outcomes of patientswith a delayed presentation of an Achilles tendon rupture (2 weeks plus) treatedconservatively with a dedicated management programme.Methods. We identified all patients with a delayed presentation who had been treatedconservatively at our centre from 2008 – 2014. The conservative management wasthe same as for our acute Achilles ruptures: the Swansea Morriston Achilles RuptureTreatment (SMART protocol). This includes 1) an ultrasound examination followed byimmobilisation in a position which allowed the smallest gap between the tendon ends2) referral to a dedicated Achilles tendon clinic and 3) strict rehabilitation guidelines.Outcome measures included complication rates (re-rupture / venous thromboembolism);Achilles Tendon Total Rupture Score (ATRS) and Achilles Repair Score (ARS); andmuscle function dynamometry assessing plantarflexion torque of the ankle. MRI ofruptured and non-ruptured legs allowed measurement of Achilles tendon length.Comparisons between the two sides were made (2-tailed t-test).Results. 19 patients were assessed; 16 males, 3 females. The mean age was 60years (range 39-80). The mean delay from injury to starting treatment was 61 days(range 14-249) and the mean follow-up was 40 months (range 13-87). There wereno re-ruptures. One patient had a pulmonary embolus. One patient went on to surgery.The mean ATRS was 65/100 (17-100), and ARS 71/100 (30-100). The meanplantarflexion torque for the injured side was 19.5 newton metres (N.m) (6.3-34.2,SD 8.2) and for the uninjured side 25.7 N.m (12.2-43.3, SD 9.1). The differencebetween the two sides was significant (t = 3.816 p = 0.001). The mean length ofthe injured Achilles tendon was 104.9mm (51.4-155.2) and uninjured 97.306mm(42.9-138.7). No significant difference (t = 1.684, p= 0.111).Conclusion. This comprehensive review of a conservative management regime forpatients with a delayed presentation Achilles rupture using the dedicated SMARTrehabilitation programme supports a satisfactory outcome in the majority of cases.Proceedings of the 13th meeting of the combined orthopaedic associations, Cape Town, 2016
published_date 2016-04-11T03:38:04Z
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