Surgical procedures to correct Achilles tendon ruptures resulted in a significant reduction in the likelihood of re-rupture compared to non-operative treatment, according to a study conducted by researchers at The State University of New York at Buffalo.
For their study, researchers analyzed multiple databases to discover how many patients suffered a re-rupture of their Achilles tendon. Once they isolated the data, researchers divided the cases into two groups based on whether the patient underwent a surgical procedure, or if they opted to let the rupture heal without surgery.
Findings
Researchers analyzed data from 677 patients who suffered a re-rupture of their Achilles tendon. They found:
- Patients who underwent a surgical operation to correct the rupture suffered a re-rupture 3.6% of the time. Patients who decided to forgo surgery suffered a re-rupture 8.8% of the time.
- Individuals who underwent an operation had a significantly higher likelihood of developing a deep infection in and around their tendon than those who didn’t have surgery, but the incident rate was still very low.
- Scar complaints and sural nerve sensory issues were also significantly higher for patients who opted to have the surgery compared to those who didn’t.
Obviously those individuals who undergo the surgery are more likely to have issues with their scar, as the other group wouldn’t have a mark, but the non-surgical group could end up with a scar if they elect for the surgery after a re-rupture. If you want to give yourself the best chance to prevent a re-rupture of the Achilles, go under the knife.
Dr. Silverman comments
I see Achilles tendon ruptures in my office all the time. I just fixed two men last week. Both had no symptoms, when they suddenly jumped up and BAM, the Achilles tendon ruptured.
Bewilderment at how this could happen is a common theme in my patients following Achilles tendon injuries. Why it happens and how to treat it are two complicated questions. This article supports my routine recommendation to surgical repair.
Non-operative treatment results in a re-rupture rate that is 2.5x higher. Strength returns slower, and sometimes incompletely.
Operative treatment will obviously have risks that non-operative treatment does not. That includes wound healing problems and infection, nerve injury, and cosmetic scar issues. I modify these surgical risks by several means, including:
- Using plastic surgery skin handling and suturing techniques, scars are minimized and my wound infection rates are much below the worldwide, national, and locally reported averages.
- Furthermore, I use a smaller incision placed further away from the sural nerve. Nerve irritation and entrapment is decreased through this technique.
With operative treatment, I can have patients bearing weight the day of the surgery, and out of a cast and into a boot after two weeks. Classical non-surgical treatment has up to two months of casting.
With older, less active individuals, non-surgical treatment is certainly an option, but it’s not my first choice with anyone who enjoys sports routinely. I like to say I treat patients as I would treat my own family; I would always tell my family to surgically fix an Achilles rupture to get the best results.
Related source: The State University of New York at Buffalo
