Better results and fewer complications if Achilles tendon rupture is operated within 48 hours
New study shows that patients with acute Achilles tendon rupture who undergo surgery within 48 hours experience a considerably better result with a smaller number of complications compared to patients who undergo surgery after 72 hours. Researchers at the group Orthopaedics, Department of Molecular Medicine and Surgery demonstrate this in a study recently published in The American Journal of Sports Medicine.
According to patient-reported outcomes, the results after having suffered and being treated for an Achilles tendon rupture continues to be suboptimal and associated with great variation. Whether delayed time to surgery affects the outcome following an Achilles tendon rupture has been largely unknown. The aim of this study was to investigate whether the patient outcomes and whether complications associated with surgery after an Achilles tendon rupture, are related to delayed time to surgery.
285 patients with an Achilles tendon rupture who were treated with the same surgical protocol were examined. Neither surgeon nor patient could influence the time to surgery, which was dependent on the availability of an operating theatre. The patients were divided into three groups based in the time to surgery; short (<48 hours), medium (48-72 hours) and long (> 72 hours) waiting times for surgery. After one year, the level of function experienced by patients was collected using a validated questionnaire and the number of complications compiled.
”Shorter times to surgery are associated with improved results and reduced risk of complications,” says Paul Ackermann, research group leader for the Orthopaedics Group at the Department of Molecular Medicine and Surgery, which led the study. 71% of the patients with a short time to surgery had a good outcome compared to 44% of the patients with a long time to surgery and 63% in the medium group. The presence of complications was 1.4% in patients with a short time to surgery, compared to 14.8% for patients with long times to surgery.
Patients with acute Achilles tendon rupture who underwent surgery within 48 hours report a considerably better result and significantly smaller number of complications compared to the patients who underwent surgery after 72 hours. This data is consistent with evidence-based recommendations from other surgical disciplines and should be used as guidelines for optimising the treatment protocol in the event of Achilles tendon rupture.
Others from the research group Orthopaedic who have contributed to the study in addition to Paul Ackermann are first author Simon Svedman, PhD and Robin Juthberg, student.
Publication
Reduced Time to Surgery Improves Patient-Reported Outcome After Achilles Tendon Rupture.
Svedman S, Juthberg R, Edman G, Ackermann P
Am J Sports Med 2018 Oct;46(12):2929-2934