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Briggs-Price S, Mangwani J, Houchen-Wolloff L, Modha G, Fitzpatrick E, Faizi M, Shepherd J, O’Neill S. Incidence, demographics, characteristics and management of acute Achilles tendon rupture: An epidemiological study. PLoS One 2024; 19:e0304197. [PMID: 38905182 PMCID: PMC11192343 DOI: 10.1371/journal.pone.0304197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 05/07/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Achilles tendon rupture (ATR) account for 10.7% of all tendon and ligament injuries and causes lasting muscular deficits and have a profound impact on patients' quality of life. The incidence, characteristics and management of ATR in the United Kingdom (UK) is poorly understood. This investigation aims to understand the incidence of ATR in the UK. METHODS Prospective data collection of ATR incidence from a United Kingdom Emergency department. Retrospective review of management protocols and immobilisation duration from electronic medical records. RESULTS ATR incidence is 8 per 100,000 people per annum. Participants were predominately male (79.2%) and primarily reported a sporting mechanism of injury (65.2%). Mean immobilisation duration was 63.1 days. 97.1% were non-surgically managed post ATR. 46.2% of participants had experienced a previous ATR or Achilles tendinopathy prior to their current ATR. CONCLUSION The incidence of ATR found was 8. cases per 100,000 people per annum. Most ATR were managed non-surgically in this cohort. The majority of ruptures occurred during sporting activity. Almost one quarter (23.3%) of individuals report Achilles pain prior to ATR.
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Affiliation(s)
| | - Jitendra Mangwani
- Orthopaedics, University Hospitals of Leicester, Leicester, United Kingdom
| | - Linzy Houchen-Wolloff
- Centre for Exercise and Rehabilitation Sciences, NIHR Biomedical Research Centre, Leicester, United Kingdom
| | - Gayatri Modha
- Emergency Care, University Hospitals of Leicester, Leicester, United Kingdom
| | - Emma Fitzpatrick
- Orthopaedics, University Hospitals of Leicester, Leicester, United Kingdom
| | - Murtaza Faizi
- Orthopaedics, University Hospitals of Leicester, Leicester, United Kingdom
| | - Jenna Shepherd
- Orthopaedics, University Hospitals of Leicester, Leicester, United Kingdom
| | - Seth O’Neill
- School of Healthcare, University of Leicester, Leicester, United Kingdom
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Bak BM, Seow D, Teo YZE, Hasan MY, Pearce CJ. Return to Play and Functional Outcomes Following Treatment of Acute Achilles Tendon Ruptures: A Systematic Review and Meta-Analysis. J Foot Ankle Surg 2024; 63:420-429. [PMID: 38296023 DOI: 10.1053/j.jfas.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/19/2023] [Accepted: 12/18/2023] [Indexed: 02/12/2024]
Abstract
Return to play (RTP) and functional outcomes are critical to treatment success for acute Achilles tendon rupture (AATR). This systematic review and meta-analysis explored treatment superiority essential in optimal treatment selection concerning individual patients and their expectations regarding RTP and functional outcomes. This study was in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines. The included studies were assessed regarding the level and quality of evidence. Fixed-effects models were employed for I2 < 25% and random-effects models for I2 ≥ 25%. The RTP rate meta-analysis of surgical vs conservative treatment revealed no significant difference. This was similar to the subgroup analysis of open repair and conservative treatment. The RTP rate and Achilles Tendon Total Rupture Score (ATRS) meta-analysis of open repair + earlier rehabilitation (ER) vs + later rehabilitation (LR) also revealed no significant differences. The mean time to RTP meta-analysis of open repair + ER vs + LR showed that open repair + ER was significantly favored (-4.19 weeks; p = .002). The ATRS meta-analysis of conservative treatment with ER vs with LR revealed no significant difference. This meta-analysis has revealed that the RTP rates following treatment of AATR are high. Therefore, the decision for surgical vs conservative treatment or open repair + ER vs + LR for AATR should not be selected based on the expectation of RTP. However, open repair + ER can be advocated over + LR for reduced mean time to RTP.
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Affiliation(s)
| | - Dexter Seow
- National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | | | | | - Christopher J Pearce
- National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Bano JM, Rate WR, Civilette MD, Wyand TJ, Samuelson ER, Bodendorfer BM, Gould HP, Hembree WC. The Top 100 Most Impactful Articles on the Achilles Tendon According to Altmetric Attention Score and Number of Citations. Orthop J Sports Med 2024; 12:23259671241232711. [PMID: 38444569 PMCID: PMC10913520 DOI: 10.1177/23259671241232711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 08/17/2023] [Indexed: 03/07/2024] Open
Abstract
Background Achilles tendon injuries often generate substantial discussion in the mainstream media. The Altmetric Attention Score (AAS) measures the online dialogue pertaining to Achilles tendon research that occurs outside scientific journals, which traditional citation-based metrics fail to capture. Purpose To characterize the top 100 most-cited Achilles tendon articles and compare them with the 100 Achilles tendon articles with the highest AAS. A secondary goal was to gain an improved understanding of the online dissemination and interpretation of Achilles tendon research through this comparison. Study Design Cross-sectional study. Methods The Web of Science Clarivate database was queried to isolate the 100 most-cited Achilles tendon articles, and the Altmetric database was queried to identify the Achilles tendon articles with the top 100 AAS values. Data elements were extracted for each article including study type, study topic, and geographic origin. Results The Web of Science Clarivate database search yielded 10,890 articles published between 1970 and 2021. The 100 most-cited articles were published in 35 journals, with the American Journal of Sports Medicine being the most prevalent. The mean (±SD) number of citations was 214.5 ± 86.47. The most prevalent study type was laboratory (28.0%). The most prevalent study topic was treatment (41.0%). Of these articles, 72.0% were European. The Altmetric database search yielded 3810 articles published between 1957 and 2021. The AAS of the top 100 articles ranged from 37 to 476 with a mean of 98.17 ± 85.53. The selected articles were published in 39 journals, with the British Journal of Sports Medicine being the most prevalent. The most prevalent study type was randomized controlled trial (25.0%). The most common study topic was treatment (40.0%). Of these articles, 46.0% were European. Conclusion Our findings suggest that, although the scientific community remains committed to high-impact journals with articles backed by high citation numbers, there is an increasing opportunity to consume Achilles tendon literature through social media.
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Affiliation(s)
- Joseph M. Bano
- Department of Orthopaedic Surgery, Summa Health Akron City Hospital, Akron, Ohio, USA
| | - William R. Rate
- Department of Orthopaedic Surgery, University of Miami/Jackson Health System, Miami, Florida, USA
| | - Matthew D. Civilette
- Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Trevor J. Wyand
- Georgetown University School of Medicine, Washington, DC, USA
| | | | | | - Heath P. Gould
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, Maryland, USA
| | - Walter C. Hembree
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, Maryland, USA
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Yu YH, Lee CH, Hsu YH, Chou YC, Hong BK, Huang CT, Liu SJ. Novel CO 2-encapsulated Pluronic F127 hydrogel for the treatment of Achilles tendon injury. Sci Rep 2023; 13:21895. [PMID: 38081952 PMCID: PMC10713641 DOI: 10.1038/s41598-023-49339-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
Nonsurgical treatment and surgical repairment of injured Achilles tendons seldom restore the wounded tendon to its original elasticity and stiffness. Therefore, we hypothesized that the surgically repaired Achilles tendon can achieve satisfactory regeneration by applying multi-drug encapsulated hydrogels. In this study, a novel bupivacaine-eluting carbon dioxide-encapsulated Pluronic F127 hydrogel (BC-hydrogel) was developed for the treatment of Achilles tendon injuries. The rheological properties of BC-hydrogel were measured. A high-performance liquid chromatography assay was used to assess the release characteristics of bupivacaine in both in vitro and in vivo settings. Furthermore, the effectiveness of BC-hydrogel in treating torn tendons was examined in a rat model, and histological analyses were conducted. Evidently, the degradable hydrogels continuously eluted bupivacaine for more than 14 days. The animal study results revealed that the BC-hydrogel improved the post-surgery mobility of the animals compared with pristine hydrogels. Histological assay results demonstrated a significant reaction to high vascular endothelial growth factor in the surrounding tissues and expression of collagen I within the repaired tendon. This demonstrates the potential of this novel BC-hydrogel as an effective treatment method for Achilles tendon injuries.
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Affiliation(s)
- Yi-Hsun Yu
- Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, 33305, Taiwan
| | - Chen-Hung Lee
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Chang Gung University College of Medicine, Tao-Yuan, 33305, Taiwan
| | - Yung-Heng Hsu
- Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, 33305, Taiwan
| | - Ying-Chao Chou
- Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, 33305, Taiwan
| | - Bo-Kui Hong
- Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, 33302, Taiwan
| | - Chao-Tsai Huang
- Department of Chemical and Materials Engineering, Tamkang University, New Taipei City, 251301, Taiwan
| | - Shih-Jung Liu
- Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, 33305, Taiwan.
- Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, 33302, Taiwan.
- Biomaterials Lab, Mechanical Engineering, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 33302, Taiwan.
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Fitzpatrick N, Balakrishnan T, Pillai A. Foreign Body Reaction Following Achilles Tendon Reconstruction With the Ligament Advanced Reconstructive System: Patient Outcomes and Clinical Course. Cureus 2023; 15:e48686. [PMID: 38024054 PMCID: PMC10655163 DOI: 10.7759/cureus.48686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2023] [Indexed: 12/01/2023] Open
Abstract
The Ligament Advanced Reinforcement System (LARS) is a common choice for ligament reconstruction in the lower limb due to its good functional and quality of life (QoL)-related outcomes. It is commonly used for Achilles tendon repair following a rupture. While it facilitates tissue ingrowth and boasts good biocompatibility, we report on multiple cases whereby foreign body reactions have led to the growth of granulomas requiring surgical excision and Flexor Hallucis Longus (FHL) transfer. Following these cases, patients have been shown to have excellent functional and QoL-related outcomes using the Manchester Oxford Foot Questionnaire (MOX-FQ) and Foot and Ankle Ability Measure (FAAM). Surgeons should consider FHL transfer as an alternative in patients undergoing Achilles tendon repair and be aware of the risk of foreign body reactions and the impact on ankle function and QoL post-operatively.
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Affiliation(s)
- Niall Fitzpatrick
- Trauma and Orthopaedics, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, GBR
| | - Theenesh Balakrishnan
- Trauma and Orthopaedics, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, GBR
| | - Anand Pillai
- Trauma and Orthopaedics, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, GBR
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Oesman I, Canintika AF. Absorbable vs Nonabsorbable Sutures for Achilles Tendon Repair: A Systematic Review and Meta-analysis. FOOT & ANKLE ORTHOPAEDICS 2023; 8:24730114231201842. [PMID: 37859827 PMCID: PMC10583531 DOI: 10.1177/24730114231201842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Background Nonabsorbable sutures are still the main choice for acute Achilles tendon rupture (AATR) repair due to strength provided. However, the rerupture rates, infection risks, foreign body reaction, and postsurgical recovery differences between absorbable and nonabsorbable suture materials in AATR repair have not been carefully reviewed. Methods A systematic review was done on PubMed, EBSCO, Cochrane Central Register of Controlled Trials, and Embase to find research studies in relation to complications associated with AATR repair using the PRISMA guidelines. The risk of bias from each study included will be assessed using the Cochrane Risk of Bias Tool for randomized study (RoB 2) and Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) for nonrandomized study. Results Five studies with a total of 255 patients, 105 in the absorbable suture group and 150 in the nonabsorbable suture group, were included for analysis. Risk of rerupture, infection, and foreign body reaction shown no significant difference between groups, and the mean difference of recovery scores were similar. Conclusion Existing literature shows that absorbable sutures appear to be associated with similar outcomes to nonabsorbable sutures regarding rates of rerupture, infection, foreign body reaction, and outcomes grading following surgical repair of acute Achilles tendon repair.
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Affiliation(s)
- Ihsan Oesman
- Department of Orthopaedics and Traumatology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Anissa Feby Canintika
- Department of Orthopaedics and Traumatology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Giacobazzi M, Hansen M, Gologram M, Mitchell R, Kasik C, Gritsiuta AI. Primary repair of complete Achilles tear augmented with amnion allograft wrap in college basketball player with a history of contralateral Achilles rupture: a case report. AME Case Rep 2023; 7:36. [PMID: 37942035 PMCID: PMC10628412 DOI: 10.21037/acr-23-61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/01/2023] [Indexed: 11/10/2023]
Abstract
Background The Achilles tendon is the thickest tendon in the human body and is responsible for plantar flexion with muscle contraction. It is able to withstand tensile loads as large as ten times the body's weight or greater at times of peak stress on the tendon. Due to the repetitive and massive stress inflicted on the Achilles tendon, it is prone to injuries, especially in running and jumping athletes. Ruptures typically present after unsustainable stress placed on the tendon from rapid contraction with classic presentation of a sudden "pop". These injuries tend to occur in middle-aged men after atypical physical exertion with complaints of immense pain in the posterior lower leg. Case Description This case examines a 20-year-old athlete presenting to the emergency department after sustaining a left calf injury while playing basketball. The patient suffered a full-thickness tear of the Achilles tendon with retraction and subsequent anterior and posterior tibiofibular ligament deficiency. This presentation is unique as he has a past medical history of an Achilles tear in the contralateral limb. Conclusions This study concluded that the bilateral Achilles tears in such a young patient were caused by anatomical blood supply watershed area to the Achilles tendon and anatomical ankle alignment abnormalities. This study provided a viable option to successfully repair complex Achilles tears via close reduction internal fixation (CRIF) with allograft matrix.
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Affiliation(s)
| | - Maxwell Hansen
- Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | | | | | - Connor Kasik
- St. Margaret’s Illinois Valley Orthopedics, Peru, IL, USA
| | - Andrei I. Gritsiuta
- Department of Surgical Services, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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8
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Wilder JH, Ofa SA, Lee OC, Gadinsky NE, Rodriguez RF, Sherman WF. Rates of Operative Management for Achilles Tendon Rupture Over the Last Decade and the Influence of Gender and Age. Foot Ankle Spec 2023; 16:377-383. [PMID: 35695472 DOI: 10.1177/19386400221102745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND With emerging evidence supporting functional rehabilitation for Achilles tendon ruptures (ATRs), this study sought to evaluate the treatment trends for patients sustaining an acute ATR and whether gender and age may influence the rates of operative repair. METHODS A retrospective database review identified ATRs from 2010 through 2019. Patients were then stratified into three cohorts based on age (18-30, 30-45, and 46 and older), separated by gender, and then assessed whether patients were treated operatively or not. Cochran-Armitage Trend test was performed to analyze the trends of operative management. Chi-square analyses were performed to assess whether the proportion of patients who received operative management in each age cohort differed from 2010 to 2019. Logistic regression analyses were performed to assess whether gender influenced treatment. RESULTS Over the previous decade, the total rates of operative treatment for ATR significantly decreased (18.3%-12.3%, P < .0001). Each individual age cohort experienced a proportional decrease in operative management when comparing 2010 with 2019 (all P < .0001). Within all age cohorts, males were significantly more likely to receive operative treatment for an ATR over the previous decade (odds ratios: 2.63-3.22). Conclusion. Overall rates of operative management for ATR decreased across all cohorts likely due to previous studies providing evidence of similar results between operative and nonoperative managements. Over the previous decade, males were demonstrated to be far more likely than females to undergo operative management. Why females are less likely to receive an operation for ATR is likely multi-factorial and requires further exploration. LEVEL OF EVIDENCE Level III: Retrospective comparative study.
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Affiliation(s)
- J Heath Wilder
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Sione A Ofa
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Olivia C Lee
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana
- Department of Orthopaedic Surgery, Louisiana State University School of Medicine and Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana
| | - Naomi E Gadinsky
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Ramon F Rodriguez
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - William F Sherman
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana
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Seow D, Islam W, Randall GW, Azam MT, Duenes ML, Hui J, Pearce CJ, Kennedy JG. Lower re-rupture rates but higher complication rates following surgical versus conservative treatment of acute achilles tendon ruptures: a systematic review of overlapping meta-analyses. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07411-1. [PMID: 37115231 DOI: 10.1007/s00167-023-07411-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/30/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE To systematically review and evaluate the current meta-analyses for the treatment of acute Achilles tendon rupture (AATR). This study can provide clinicians with a clear overview of the current literature to aid clinical decision-making and the optimal formulation of treatment plans for AATR. METHODS Two independent reviewers searched PubMed and Embase on June 2, 2022 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Assessment of evidence was twofold: level of evidence (LoE) and quality of evidence (QoE). LoE was evaluated using published criteria by The Journal of Bone and Joint Surgery and the QoE by the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) scale. Pooled complication rates were highlighted for significance in favour of one treatment arm or no significance. RESULTS There were 34 meta-analyses that met the eligibility criteria, with 28 studies of LoE 1, and the mean QoE was 9.8 ± 1.2. Significantly lower re-rupture rates were reported with surgical (2.3-5%) versus conservative treatment (3.9-13%), but conservative treatment was favoured in terms of lower complication rates. The re-rupture rates were not significantly different between percutaneous repair or minimally invasive surgery (MIS) compared to open repair, but MIS was favoured in terms of lower complication rates (7.5-10.4%). When comparing rehabilitation protocols following open repair (four studies), conservative treatment (nine studies), or combined (three studies), there was no significant difference in terms of re-rupture or obvious advantage in terms of lower complication rates between early versus later rehabilitation. CONCLUSION This systematic review found that surgical treatment was significantly favoured over conservative treatment for re-rupture, but conservative treatment had lower complication rates other than re-rupture, notably for infections and sural nerve injury. Open repair had similar re-rupture rates to MIS, but lower complication rates; however, the rate of sural nerve injuries was lower in open repair. When comparing earlier versus later rehabilitation, there was no difference in re-rupture rates or obvious advantage in complications between open repair, conservative treatment, or when combined. The findings of this study will allow clinicians to effectively counsel their patients on the postoperative outcomes and complications associated with different treatment approaches for AATR. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Dexter Seow
- NYU Langone Health, NYU Langone Orthopedic Hospital, 171 Delancey Street, New York, NY, 10002, USA
- National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wasif Islam
- NYU Langone Health, NYU Langone Orthopedic Hospital, 171 Delancey Street, New York, NY, 10002, USA
| | - Grace W Randall
- NYU Langone Health, NYU Langone Orthopedic Hospital, 171 Delancey Street, New York, NY, 10002, USA
| | - Mohammad T Azam
- NYU Langone Health, NYU Langone Orthopedic Hospital, 171 Delancey Street, New York, NY, 10002, USA
| | - Matthew L Duenes
- NYU Langone Health, NYU Langone Orthopedic Hospital, 171 Delancey Street, New York, NY, 10002, USA
| | - James Hui
- National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Christopher J Pearce
- National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - John G Kennedy
- NYU Langone Health, NYU Langone Orthopedic Hospital, 171 Delancey Street, New York, NY, 10002, USA.
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Wang C, Jiang Z, Pang R, Zhang H, Li H, Li Z. Global trends in research of achilles tendon injury/rupture: A bibliometric analysis, 2000–2021. Front Surg 2023; 10:1051429. [PMID: 37051567 PMCID: PMC10083236 DOI: 10.3389/fsurg.2023.1051429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/10/2023] [Indexed: 03/28/2023] Open
Abstract
BackgroundThe Achilles tendon is the strongest and most susceptible tendon in humans. Achilles tendon injuries and ruptures have gradually attracted research attention. However, a bibliometric analysis of global research in this field is lacking. This study involved a bibliometric analysis of the developmental trends and research hotspots in Achilles tendon injuries/ruptures from 2000 to 2021.MethodsArticles published between 2001 and 2021 were retrieved from an extended database of the Science Citation Index using Web of Science. VOSviewer and CiteSpace were used to analyze the relationships between publications, countries, institutions, journals, authors, references, and keywords.ResultsThis study included 3,505 studies of 73 countries, 3,274 institutions, and 12,298 authors and explored the cooperation between them and the relationships between citations. Over the past 22 years, the number of publications has significantly increased. Foot Ankle International has published the most papers on Achilles tendon injuries/ruptures, and British Journal of Sports Medicine is the most famous journal. Re-rupture, exosomes, acute Achilles tendon rupture, and tendon adhesions gradually become the research focus over the past few years.ConclusionAchilles tendon injury and rupture are important research topics. A vast number of newly published papers on this topic have demonstrated that clinicians and researchers are interested in their study. Over time, these recent studies will be widely cited; therefore, this bibliometric analysis should be constantly updated.
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Affiliation(s)
- Chenguang Wang
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhaohui Jiang
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Ran Pang
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Huafeng Zhang
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Hui Li
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Chinese & Western Medicine Hospital, Tianjin, China
- Correspondence: Zhijun Li Hui Li
| | - Zhijun Li
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
- Correspondence: Zhijun Li Hui Li
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The Neuromusculoskeletal Epidemiological Outcome (NEO) matrix: An innovative injury classification based on anatomical location and primary tissue type. Injury 2022; 53:3692-3696. [PMID: 36163202 DOI: 10.1016/j.injury.2022.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 06/29/2022] [Accepted: 09/19/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The purpose of this paper is to propose the Neuromusculoskeletal Epidemiological Outcome (NEO) Matrix, an injury classification based on anatomical location and primary tissue type to classify NMSKI of the trunk and extremities in orthopaedic and sports medicine epidemiological research. MATERIALS AND METHODS In the proposed NEO matrix, NMSKI diagnosis (International Classification of Disease) codes are classified by the anatomical complex affected. These regional anatomical complexes are frequently employed in orthopaedic and sports medicine disciplines in biomechanical and clinical research. The complexes are arranged from distal to proximal in the lower extremity, inferior to superior in the trunk and head, and proximal to distal in the upper extremity. Injuries are characterized by the primary tissue type affected (Osseous; Articular; Musculotendinous; Neural; Non-specific) based on classified using International Classification of Disease codes. DISCUSSION The expected patterns of impairment and healing rates of bone, cartilage, ligaments, muscles, tendons, and neural structures vary considerably by the tissue type based on the differences in function, perfusion, and metabolic physiology. Using knowledge of the function of the tissues, expected minimum healing times, and expected sequelae of residual body system impairments, an estimation of morbidity and expected recovery times can be made. While heterogeneity is certainly expected due to varying pathomechanics involved and intrinsic and environmental factors, the NEO matrix classifies the ICD diagnosis codes in framework that qualifies the expected patterns of impairment based on the body system type. CONCLUSION The NEO matrix provides an alternative approach for characterizing NMSKI in epidemiological research.
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The release of adhesions improves outcome following minimally invasive repair of Achilles tendon rupture. Knee Surg Sports Traumatol Arthrosc 2022; 30:1109-1117. [PMID: 34657973 PMCID: PMC8901518 DOI: 10.1007/s00167-021-06767-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 10/04/2021] [Indexed: 12/02/2022]
Abstract
PURPOSE Operative repair of Achilles tendon rupture may lead to complications, which influence outcome adversely. The aim of this study was to determine the incidence, impact and response to treatment of post-operative adhesions. METHODS From February 2009 to 2021, 248 patients operated on with percutaneous or minimally invasive surgical repair have been prospectively evaluated using the Achilles tendon Total Rupture Score (ATRS) and Heel-Rise Height Index (HRHI), following acute Achilles tendon rupture. RESULTS Fourteen (5.6%) patients were identified as having adhesions. Four patients reported superficial adhesions and ten patients reported a deeper tightness of the tendon. At a mean (SD) of 10.5 (2.3) months following repair, the overall ATRS was at a median (IQR) 65 (44.5-78) points and (HRHI) was mean (SD) 81.5 (13.5)%. Of those deemed to have deep adhesions the antero-posterior diameter of the tendon was at mean (SD) 15.6 (4.6) mm. Open release of superficial adhesions resulted in improved ATRS in all patients. Endoscopic debridement anterior to the Achilles tendon led to alleviation of symptoms of tightness and discomfort from deep adhesions and improved outcome in terms of the ATRS score. At a mean (SD) of 15.9 (3.3)-month follow-up from initial rupture and repair, the patients reported at median (IQR) ATRS scores of 85 (64.8-92.8) points, Tegner level 5 (3-9) and mean (SD) HRHI 86.2 (9.5)%. Patients significantly improved both ATRS and HRHI following release at median (IQR) of 16.5 (- 1.8-29.3) points (p = 0.041) and mean (SD) 5.6 (8.3)% (p = 0.043). CONCLUSIONS The incidence of patient-reported adhesions following minimally invasive repair of Achilles tendon rupture was estimated to be 5.6%. The occurrence of superficial adhesions was associated with a lower outcome scores as well as symptoms of anterior tendon tightness and stiffness were associated with a lower score in most patients. Surgical release of adhesions led to a significant improvement in outcome.
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Hoffman J, Gupta S, Amesur A, Anthony T, Winder RP, Chan H, Hoang V. Achilles Tendon Rip-Stop SpeedBridge Repair. Arthrosc Tech 2021; 10:e2113-e2120. [PMID: 34504750 PMCID: PMC8417224 DOI: 10.1016/j.eats.2021.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/18/2021] [Indexed: 02/03/2023] Open
Abstract
Achilles tendon injuries have been on the rise secondary to our increased participation in sports, increase in societal obesity rates, and the growing elderly population. There has been disagreement in recent years about whether to treat injuries such as Achilles tendon ruptures operatively or nonoperatively with aggressive functional rehabilitation. For those opting to surgically manage Achilles tendon ruptures, insertional Achilles tendonitis, or augment the described SpeedBridge Achilles tendon repair, we propose a modified rip-stop technique. The goal of this technique is to provide a biomechanical advantage to our current operative interventions for these injuries, a greater load-to-failure and a speedier, more reliable return to sport in our athletic populations.
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Affiliation(s)
| | | | | | - Taylor Anthony
- Touro University Nevada College of Osteopathic Medicine, Henderson
| | | | - Holman Chan
- Nevada Orthopedic & Spine Center, Henderson, Nevada, U.S.A
| | - Victor Hoang
- Valley Hospital Medical Center, Las Vegas,Address correspondence to Victor Hoang, D.O., Valley Hospital Medical Center, 620 Shadow Lane, Las Vegas, NV 89106.
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