Skip to main content
Top
Published in: Archives of Orthopaedic and Trauma Surgery 2/2018

01-02-2018 | Trauma Surgery

Incidence and risk factors for postoperative Achilles tendon calcifications after percutaneous repair

Authors: Atesch Ateschrang, Daniel Körner, Konrad Joisten, Marc-Daniel Ahrend, Steffen Schröter, Ulrich Stöckle, Stephan Riedmann

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 2/2018

Login to get access

Abstract

Introduction

Numerous publications are dealing with acute Achilles tendon rupture. To our knowledge, no systematic trial has been published analyzing the incidence, risk factors and the potential clinical impact of postoperative tendon calcifications (PTC) after percutaneous Achilles tendon repair. Therefore, the aim of this study was to analyze these relevant aspects.

Materials and methods

Between March 2003 and November 2010, a total of 126 patients with an acute, complete Achilles tendon rupture were treated with a percutaneous technique according to Ma and Griffith at a single university-based trauma department. The follow-up included a detailed clinical and sonographic examination. To assess the functional outcome and possible impact of PTC after percutaneous Achilles tendon repair, the Thermann and AOFAS scores were used. 81 patients (65 men and 16 women) with a median age of 46 years (range 24–76) were available for a follow-up examination. The median time of follow-up was 64 months (range 15–110 months).

Results

PTC occurred in nine out of 81 patients (11.1%). All patients with PTC were male with a median age of 52 years (range 26–76 years). In the group of patients with PTC, the median overall Thermann score was 94 (range 68–100) and the median overall AOFAS score was 97 (range 85–100). In the group of patients without PTC, the median overall Thermann score was 88.5 (range 60–100) and the median overall AOFAS score was 97 (range 85–100). No significant differences were detected between the group of patients with PTC and the group of patients without PTC and the clinical outcome according to the Thermann (p = 0.21) and the AOFAS scores (p = 0.37). None of the patients with PTC sustained a re-rupture. The overall re-rupture rate was 4.9%. PTC was no risk factor for wound and neurological complications.

Conclusion

The incidence of PTC after percutaneous Achilles tendon repair was 11.1%. Male gender and advanced age seem to be risk factors for PTC. In this study, PTC had no negative impact on the postoperative clinical outcome.
Literature
1.
go back to reference Wong J, Barrass V, Maffulli N (2002) Quantitative review of operative and nonoperative management of achilles tendon ruptures. Am J Sports Med 30:565–575CrossRefPubMed Wong J, Barrass V, Maffulli N (2002) Quantitative review of operative and nonoperative management of achilles tendon ruptures. Am J Sports Med 30:565–575CrossRefPubMed
2.
go back to reference Willits K, Amendola A, Bryant D et al (2010) Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Jt Surg Am 92:2767–2775. doi:10.2106/JBJS.I.01401 CrossRef Willits K, Amendola A, Bryant D et al (2010) Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Jt Surg Am 92:2767–2775. doi:10.​2106/​JBJS.​I.​01401 CrossRef
3.
go back to reference Jones MP, Khan RJ, Carey Smith RL (2012) Surgical interventions for treating acute Achilles tendon rupture: key findings from a recent Cochrane review. J Bone Jt Surg 94:CD003674. doi:10.2106/JBJS.J.01829 CrossRef Jones MP, Khan RJ, Carey Smith RL (2012) Surgical interventions for treating acute Achilles tendon rupture: key findings from a recent Cochrane review. J Bone Jt Surg 94:CD003674. doi:10.​2106/​JBJS.​J.​01829 CrossRef
5.
6.
go back to reference Holm C, Kjaer M, Eliasson P (2014) Achilles tendon rupture—treatment and complications: a systematic review. Scand J Med Sci Sports. doi:10.1111/sms.12209 Holm C, Kjaer M, Eliasson P (2014) Achilles tendon rupture—treatment and complications: a systematic review. Scand J Med Sci Sports. doi:10.​1111/​sms.​12209
8.
go back to reference Zhang H, Tang H, He Q et al (2015) Surgical versus conservative intervention for acute Achilles tendon rupture: a PRISMA-compliant systematic review of overlapping meta-analyses. Medicine (Baltimore) 94:e1951. doi:10.1097/MD.0000000000001951 CrossRef Zhang H, Tang H, He Q et al (2015) Surgical versus conservative intervention for acute Achilles tendon rupture: a PRISMA-compliant systematic review of overlapping meta-analyses. Medicine (Baltimore) 94:e1951. doi:10.​1097/​MD.​0000000000001951​ CrossRef
9.
go back to reference Porter MD, Shadbolt B (2015) Randomized controlled trial of accelerated rehabilitation versus standard protocol following surgical repair of ruptured Achilles tendon. ANZ J Surg 85:373–377. doi:10.1111/ans.12910 CrossRefPubMed Porter MD, Shadbolt B (2015) Randomized controlled trial of accelerated rehabilitation versus standard protocol following surgical repair of ruptured Achilles tendon. ANZ J Surg 85:373–377. doi:10.​1111/​ans.​12910 CrossRefPubMed
11.
go back to reference Ma GW, Griffith TG (1977) Percutaneous repair of acute closed ruptured achilles tendon: a new technique. Clin Orthop Relat Res 128:247–255 Ma GW, Griffith TG (1977) Percutaneous repair of acute closed ruptured achilles tendon: a new technique. Clin Orthop Relat Res 128:247–255
12.
go back to reference Haji A, Sahai A, Symes A, Vyas JK (2004) Percutaneous versus open tendo Achilles repair. Foot Ankle Int 25:215–218CrossRefPubMed Haji A, Sahai A, Symes A, Vyas JK (2004) Percutaneous versus open tendo Achilles repair. Foot Ankle Int 25:215–218CrossRefPubMed
15.
go back to reference Bleakney RR, Tallon C, Wong JK et al (2002) Long-term ultrasonographic features of the Achilles tendon after rupture. Clin J Sport Med 12:273–278CrossRefPubMed Bleakney RR, Tallon C, Wong JK et al (2002) Long-term ultrasonographic features of the Achilles tendon after rupture. Clin J Sport Med 12:273–278CrossRefPubMed
16.
go back to reference Kraus R, Stahl J-P, Meyer C et al (2004) Frequency and effects of intratendinous and peritendinous calcifications after open Achilles tendon repair. Foot Ankle Int 25:827–832CrossRefPubMed Kraus R, Stahl J-P, Meyer C et al (2004) Frequency and effects of intratendinous and peritendinous calcifications after open Achilles tendon repair. Foot Ankle Int 25:827–832CrossRefPubMed
18.
go back to reference Leppilahti J, Forsman K, Puranen J, Orava S (1998) Outcome and prognostic factors of achilles rupture repair using a new scoring method. Clin Orthop Relat Res 346:152–161CrossRef Leppilahti J, Forsman K, Puranen J, Orava S (1998) Outcome and prognostic factors of achilles rupture repair using a new scoring method. Clin Orthop Relat Res 346:152–161CrossRef
24.
go back to reference Thomas J, Taylor D, Crowell R, Assor D (1991) The effect of indomethacin on Achilles tendon healing in rabbits. Clin Orthop Relat Res 272:308–311 Thomas J, Taylor D, Crowell R, Assor D (1991) The effect of indomethacin on Achilles tendon healing in rabbits. Clin Orthop Relat Res 272:308–311
25.
go back to reference Dimmen S, Engebretsen L, Nordsletten L, Madsen JE (2009) Negative effects of parecoxib and indomethacin on tendon healing: an experimental study in rats. Knee Surg Sport Traumatol Arthrosc 17:835–839. doi:10.1007/s00167-009-0763-7 CrossRef Dimmen S, Engebretsen L, Nordsletten L, Madsen JE (2009) Negative effects of parecoxib and indomethacin on tendon healing: an experimental study in rats. Knee Surg Sport Traumatol Arthrosc 17:835–839. doi:10.​1007/​s00167-009-0763-7 CrossRef
26.
go back to reference Bhandari M, Guyatt GH, Siddiqui F et al (2002) Treatment of acute Achilles tendon ruptures: a systematic overview and metaanalysis. Clin Orthop Relat Res 400:190–200CrossRef Bhandari M, Guyatt GH, Siddiqui F et al (2002) Treatment of acute Achilles tendon ruptures: a systematic overview and metaanalysis. Clin Orthop Relat Res 400:190–200CrossRef
Metadata
Title
Incidence and risk factors for postoperative Achilles tendon calcifications after percutaneous repair
Authors
Atesch Ateschrang
Daniel Körner
Konrad Joisten
Marc-Daniel Ahrend
Steffen Schröter
Ulrich Stöckle
Stephan Riedmann
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 2/2018
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-017-2829-1

Other articles of this Issue 2/2018

Archives of Orthopaedic and Trauma Surgery 2/2018 Go to the issue