American Orthopaedic Foot & Ankle Society Annual Meeting
American Orthopaedic Foot & Ankle Society Annual Meeting
September 19, 2019
1 min read

High rate of return to sport seen after nonoperative treatment of acute Achilles tendon ruptures

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Fabian Krause

CHICAGO — According to a presenter at the American Orthopaedic Foot & Ankle Society Annual Meeting, nonoperative treatment of acute Achilles tendon ruptures yielded good functional outcomes, high patient satisfaction and a high return-to-sport rate.

“Two-third of patents were able to return to high levels activity and [this was] more than 90% in the low-level [activity] group,” Fabian Krause, MD, said during his presentation. “The subjective satisfaction rate was similar in both groups — about 93% and 95%.”

Researchers identified 171 consecutive patients treated nonoperatively for acute Achilles tendon ruptures. Of these, 89 patients responded to a questionnaire about sports activity. The nonoperative protocol included a combination of an equinus cast and rehabilitation boot that enabled immediate full weight-bearing and early functional rehabilitation. Investigators evaluated the clinical 1-year follow-up and follow-up questionnaires at 1 year and 5 years for the Tegner Activity Scale and Activity Rating Scale. Patients were categorized based on the Tegner Activity Scale into a low-level activity (score of less than five) and a high-level activity group (score of more than five).

The return-to-sport rate was compared between the two groups. At the 1-year follow-up, clinical assessment included testing of the plantarflexion strength and endurance, calf circumference and subjective parameters to calculate a modified Thermann score.

Results showed at the 5-year follow-up, more patients (91%) with low-level activity returned to their previous Tegner Activity score compared with patients with high-level activity (67%). There were 91% of low-activity level patients compared with 82% of high-level activity patients who returned to their previous Activity Rating Scale score at the 5-year follow-up. The two groups were not significantly different with regard to the mean Thermann score (84 vs. 82). In total, there was 17 complications including nine re-ruptures, five deep venous thromboses and one complex regional pain syndrome at the 1-year follow-up. – by Monica Jaramillo



Krause F, et al. Return to sport at 5-year follow-up after nonoperative treatment of acute Achilles tendon rupture. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting. Sept. 12-15, 2019; Chicago.


Disclosure: Krause reports no relevant financial disclosures.