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Evidence summaries

Surgical Interventions for Treating Acute Achilles Tendon Ruptures

Open operative treatment of acute Achilles tendon ruptures significantly reduces the risk of rerupture compared to non-operative treatment but is associated with higher risk of other complications. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 12 studies with a total of 844 subjects. Several of the studies had poor methodology and inadequate reporting of outcomes. Open operative treatment compared with non-operative treatment (6 trials, n=536) was associated with a lower risk of rerupture (12/240, 5.0% versus 30/249, 12.0%; RR 0.41, 95% CI 0.21 to 0.77), but a higher risk of other complications including infection (RR 4.89, 95% CI 1.09 to 21.91), adhesions and disturbed skin sensibility. Functional status including sporting activity was variably and often incompletely reported, including frequent use of non standardised outcome measures, and the results were inconclusive.

Open surgical repair compared with percutaneous repair (4 studies, n=174) was associated with a higher risk of infection (RR 9.32, 95% CI 1.77 to 49.16). These figures should be interpreted with caution because of the small numbers involved. Similarly, no definitive conclusions could be made regarding different tendon repair techniques.

References

  • Khan RJ, Carey Smith RL. Surgical interventions for treating acute Achilles tendon ruptures. Cochrane Database Syst Rev 2010;(9):CD003674. [PubMed].

Primary/Secondary Keywords