Journal of Arthroscopy and Joint Surgery
Available online from 21 February 2018 @ Science Direct
Trauma & Orthopaedic Surgery, University Hospitals of Leicester, Leicester, United Kingdom
Randeep Aujla, Sarang Sapare & Maneesh Bhatia
Our objective was to review the current literature regarding acute Achilles tendon ruptures and provide a succinct summary of the use of clinicians treating Achilles tendon ruptures. We aim to provide guidance for treatment based upon current literature.
We reviewed current literature and subjectively assessed for quality and influence of studies in current practice.
The Achilles Tendon Rupture Score (ATRS) has become a vital tool in assessing functional outcome following interventions as re-rupture rates have balanced out for all treatment modalities. There remains continued debate between surgical and non-surgical treatment options. Both patterns have evolved over the past decade. Percutaneous fixation techniques are superseding traditional open surgery. Functional dynamic non-surgical regimes are also being developed to create the optimum environment for the Achilles tendon to heal and provide high functional outcomes. There even remains limited evidence that platelet-rich plasma aids healing, the significance of gap between tendon ends or of thromboprophylaxis lowering the incidence of symptomatic venous thromboembolism.
Acute Achilles tendon ruptures should either be managed in a functional rehabilitation regime or by percutaneous surgical repair. The decision depends upon both patient and clinician factors.