Published: 26-02-2025 13:37 | Updated: 27-02-2025 11:57

New thesis on acute Achilles tendon rupture

Simon Svedman. Photo: n/a

Simon Svedman from the research group Orthopaedics at the Department of Molecular Medicine and Surgery, will defend his thesis "Acute Achilles tendon rupture : predictors for outcome and plan for intervention" on 14 March 2025.

Main supervisor is Paul Ackermann.

What's the main focus of your thesis?

”My thesis investigates acute Achilles tendon ruptures (ATR) and complications in the immediate aftermath of rupture. We’ve both updated the current knowledge regarding incidence and treatment trends in Sweden in the last 20 years, and investigated novel factors that might impact the outcomes after ATR: time to surgical treatment, blood clots and muscle fat infiltration and muscle atrophy,” says Simon Svedman, PhD student at the Department of Molecular Medicine and Surgery.

Which are the most important results?

"The number of ATR have dramatically increased over the last 20 years, and since 2017 the number of injuries has increased by 25 per cent, meaning that around 3,500 people suffer an Achilles tendon rupture each year. 85 per cent of ATR are treated non-surgically. If surgical treatment is chosen, the time between injury and surgery has a negative impact on treatment outcomes."

"Suffering a deep venous thrombosis (DVT) after ATR is common, where almost 50 per cent are diagnosed at ultrasound screening within six weeks of injury, which is an important factor as to why patient have lingering symptoms of pain, swelling and lower quality of life at one year after ATR."

"Previous studies have demonstrated that using low-molecular weight heparins to prevent DVT is ineffective, probably due to the insufficient blood circulation during lower leg immobilization. Lower leg immobilization also causes increase muscle fat infiltration (MFI) within six weeks of injury, which is a strongly negative factor for muscle strength one year after ATR. It is known that when MFI exists in the muscles, it persists long after injury."

"In summary, the number of ruptures have increased and there are challenges in preventing both DVT and MFI in the weeks following ATR."

How can this new knowledge contribute to improved public health?

"As Achilles tendon injuries become more common, with non-operative treatment being the most popular treatment modality, treatment recommendations must be grounded in scientific evidence. Currently, there is a lack of clear treatment guidelines, leading to significant variation in how hospitals manage patients with Achilles tendon injuries. In our research, we highlight several factors that negatively impact patient outcomes."

"Additionally, the present thesis includes a protocol for an ongoing randomized multicenter study (the STOP Leg Clots-trial) aiming to address the occurrence of DVT and MFI through intermittent pneumatic compression (IPC) therapy. In short, patients apply calf pumps and use the device at home to stimulate blood flow. By doing so, we hope to reduce the complications described in the other sub-studies, ultimately leading to better outcomes for patients."

What are your future ambitions?

"We will continue enrolling patients in the STOP Leg Clots trial until the end of 2025, followed by a one-year follow-up period before data analysis begins. Several studies are already planned for the postdoctoral phase!"