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J Am Podiatr Med Assoc 2021 May;111(3)

Achilles tendon rupture is a common athletic injury that results in a painful and antalgic gait. Flexor hallucis longus tendon transfer through arthroscopic, single-incision, or double-incision techniques is used as a treatment approach to address this rupture; however, no studies have compared postoperative complications between these three techniques. A systematic search of published articles was conducted using keywords "Achilles rupture," "flexor hallucis tendon," "transfer," and "recovery. Read More

Foot Ankle Spec 2021 Jun 18:19386400211009360. Epub 2021 Jun 18.

Steadman Philippon Research Institute, Vail, Colorado.

Background: The percutaneous knotless repair technique for Achilles tendon ruptures utilizes a Percutaneous Achilles Repair System (PARS) device for suturing the proximal tendon and 2 suture anchors for fixing the sutures into the calcaneus. Determining the best position of the suture anchors may optimize the strength of this repair.

Methods: Twelve pairs of human ankle cadaveric specimens were randomly assigned to receive suture anchors placed at 45°, 90°, or 135° from the sagittal plane. Read More

Regen Ther 2021 Dec 28;18:112-116. Epub 2021 May 28.

Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya City, Hyogo, 663-8501, Japan.

Background: Achilles tendon rupture is one of the most common serious injuries in athletes. Various studies to accelerate the healing process of the Achilles tendon have been performed as it takes a longer time to repair the tissue compared to other tendons. Here, we report a case of an acute Achilles tendon rupture in a male basketball player treated by a combination of an intra-tissue injection of freeze-dried platelet-derived factor concentrate, which included a platelet-derived growth factor with an early rehabilitation protocol after the operative treatment to facilitate the biological healing of the injured tendon tissue. Read More

Clin Case Rep 2021 Jun 9;9(6):e04335. Epub 2021 Jun 9.

Department of Medicine UPMC East Monroeville PA USA.

Achilles tendon rupture is a well-documented adverse effect of Fluoroquinolones; however, herein we present a case of complete iliopsoas and Achilles, and partial semimembranosus tendon rupture secondary to Levofloxacin. Read More

J Foot Ankle Surg 2021 May 18. Epub 2021 May 18.

Inanami Spine and Joint Hospital, Shinagawa-ku, Tokyo, Japan.

The purpose of this study was to clarify the morphology of acute Achilles tendon rupture (ATR) according to intraoperative evaluation. The morphology of 220 cases was evaluated retrospectively from intraoperative findings from June 2014 to December 2015. We noted 3 characteristics of rupture. Read More

Indian J Orthop 2021 May 9;55(Suppl 1):149-156. Epub 2020 Oct 9.

Shree Krishna Hospital, Anand, India.

Background: Management of complex wounds of the lower extremity with concomitant Achilles tendon injury is a challenging situation for orthopaedic surgeons and plastic surgeons. The objective of the current study was to evaluate the clinical outcome of chronic open defects of the Achilles tendon with composite tissue loss. We have performed single stage reconstruction using the central segment of the proximal part of the Achilles tendon as turn-down flap and was covered immediately with reverse sural flap. Read More

Am J Sports Med 2021 Jun 11:3635465211019436. Epub 2021 Jun 11.

Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.

Background: Deficits in sporting performance after Achilles tendon repair may be due to changes in musculotendinous unit structure, including tendon elongation and muscle fascicle shortening.

Purpose/hypothesis: The purpose was to discern whether Achilles tendon rupture reduces triceps surae muscle force generation, alters functional ankle range of motion, or both during sports-related tasks. We hypothesized that individuals who have undergone Achilles tendon repair lack the functional ankle range of motion needed to complete sports-related tasks. Read More

J Foot Ankle Surg 2021 Apr 30. Epub 2021 Apr 30.

Fellowship-Trained Foot and Ankle Surgeon, Orthopedic Foot and Ankle Center, Worthington, OH.

Various techniques of surgical detachment for treatment of insertional Achilles tendinopathy have been described, including lateral release, medial release, central tendon splitting (CTS), and complete detachment. A systematic review of electronic databases was performed, encompassing 17 studies involving 703 patients and 746 feet, to compare outcomes associated with surgical takedown techniques. Observed results include wound complication rates (CTS 2. Read More

Orthop J Sports Med 2021 Mar 22;9(3):2325967121989982. Epub 2021 Mar 22.

Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA.

Background: Women's National Basketball Association (WNBA) players have a greater incidence of lower extremity injury compared with male players, yet no data exist on functional outcomes after Achilles tendon rupture (ATR).

Purpose: To evaluate the effect of Achilles tendon repair on game utilization, player performance, and career longevity in WNBA athletes.

Study Design: Cohort study; Level of evidence, 3. Read More

Int Orthop 2021 Jun 5. Epub 2021 Jun 5.

Department of Trauma and Orthopaedic Surgery, University Hospitals Leicester NHS Trust, University Hospitals of Leicester Headquarters, Balmoral Building, Level 3, Leicester, UK.

Purpose: This scoping review aims to systematically map and summarise the available evidence on the management of chronic Achilles ruptures, whilst identifying prognostic factors and areas of future research.

Methods: A scoping review was performed according to the frameworks of Arksey and O'Malley, Levac and Peters. A computer-based search was performed in PubMed, Embase, EmCare, CINAHL, ISI Web of Science and Scopus, for articles reporting treatment of chronic Achilles ruptures. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Jun 5. Epub 2021 Jun 5.

Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Purpose: Current treatment recommendations emphasize early loading, with preservation of tendon length and physiologic tension. The objective of this systematic review and network meta-analysis was to compare failure load and elongation after cyclic loading of Achilles tendon repair techniques at time-zero.

Methods: The databases PubMed, CENTRAL and Web of Science were searched for all published in-vitro studies comparing Achilles tendon repair techniques, or augmentation with autografts/biomaterials, and reports of failure load or elongation after cyclic loading. Read More

Wien Klin Wochenschr 2021 Jun 3;133(11-12):560-567. Epub 2021 Jun 3.

High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.

Objective: The purpose was to introduce the Vienna morphological Achilles tendon score (VIMATS), to evaluate its reproducibility and to assess its clinical application.

Methods: In 38 patients a total number of 40 painful ATs and 20 volunteers were examined on a 3T magnetic resonance imaging (MRI) scanner using a standard MRI protocol. In 20 patients clinical scoring according to the Achilles tendon rupture score was available. Read More

J Clin Med 2021 May 28;10(11). Epub 2021 May 28.

Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery, University of Medical Sciences, 61-701 Poznan, Poland.

Percutaneous acute Achilles tendon rupture suturing has become a leading treatment option in recent years. A common complication after this mini-invasive procedure is sural nerve injury, which can reduce the patients' satisfaction and final outcomes. High-resolution ultrasound is a reliable method for localizing the sural nerve, and it can be performed intra-operatively; however, the long-term results are yet unknown. Read More

Bone Joint J 2021 Jun;103-B(6):1021-1030

Beijing Sport University, Beijing, China.

Aims: The aim of this meta-analysis was to assess the prognosis after early functional rehabilitation or traditional immobilization in patients who underwent operative or nonoperative treatment for rupture of the Achilles tendon.

Methods: PubMed, Embase, Web of Science, and Cochrane Library were searched for randomized controlled trials (RCTs) from their inception to 3 June 2020, using keywords related to rupture of the Achilles tendon and rehabilitation. Data extraction was undertaken by independent reviewers and subgroup analyses were performed based on the form of treatment. Read More

JBJS Case Connect 2021 05 21;11(2). Epub 2021 May 21.

Department of Orthopaedic Surgery, University of California, San Diego, California.

Case: Although rare, a medial malleolus fracture plus ipsilateral Achilles tendon rupture has been described in previous case reports. We present a unique case of an open bimalleolar fracture dislocation with ipsilateral Achilles tendon rupture after a motorcycle crash. His Achilles injury was diagnosed intraoperatively during external fixator placement. Read More

Skeletal Radiol 2021 May 21. Epub 2021 May 21.

Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA.

Objective: To determine the safety and efficacy of image-guided retrocalcaneal bursa corticosteroid injection for retrocalcaneal bursitis.

Materials And Methods: After IRB approval, all fluoroscopically guided and ultrasound-guided retrocalcaneal bursa injections (2013-2019) were retrospectively evaluated. Pre-procedure US and radiographs were scored by 2 blinded radiologists in consensus for Achilles tendinosis and retrocalcaneal bursitis (0-3 scale), Achilles enthesopathy (present/absent), and Haglund deformity (present/absent). Read More

BMJ Open 2021 05 20;11(5):e044103. Epub 2021 May 20.

Department of Orthopedic Surgery, Karolinska University Hospital, Stockholm, Sweden

Introduction: Leg immobilisation in a cast or an orthosis after lower limb injuries is associated with a high risk of complications of venous thromboembolism (VTE) and hampered healing. Current pharmacoprophylaxes of VTE are inefficient and associated with adverse events. Intermittent pneumatic compression (IPC) could represent a novel, efficient and safe VTE-prophylactic alternative that may enhance injury healing. Read More

Phys Sportsmed 2021 Jun 4:1-7. Epub 2021 Jun 4.

Division of Orthopedic Surgery, McMaster University, Hamilton, ON, Canada.

: Achilles tendon ruptures are devastating injuries for National Basketball Association (NBA) players: prior studies have demonstrated decreased performance following return-to-play, but none have evaluated the effect of injury on rate-adjusted contextual statistics to assess the true change in performance. Additionally, there exists a paucity of data on the independent impact on defensive performance following return.: Compared to both control-matched peers and preoperative careers, we hypothesize that player production based on rate-adjusted contextual statistics will significantly decline following Achilles tendon rupture. Read More

JBJS Case Connect 2021 05 18;11(2). Epub 2021 May 18.

Department of Orthopaedic Surgery, University of Colorado and Children's Hospital Colorado, Aurora, Colorado.

Case: Our patient was born with bilateral congenital clubfeet and underwent standard Ponseti treatment. At 8 months of age, bilateral percutaneous Achilles tenotomies were performed, with an excellent outcome. At 16 years, he suffered a unilateral Achilles tendon rupture, and at 18 years, he suffered a contralateral Achilles rupture, both of which were successfully repaired. Read More

Pediatrics 2021 Jun 14;147(6). Epub 2021 May 14.

Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and.

Objectives: To estimate the association between fluoroquinolone use and tendon injury in adolescents.

Methods: We conducted an active-comparator, new-user cohort study using population-based claims data from 2000 to 2018. We included adolescents (aged 12-18 years) with an outpatient prescription fill for an oral fluoroquinolone or comparator broad-spectrum antibiotic. Read More

J Mater Chem B 2021 05;9(20):4154-4168

Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China.

Peritendinous blood circulation improvement is a challenge to promote the healing of ruptured tendons in clinical treatment. Although electrospun membranes or scaffolds enable the reduction of complications such as adhesion, however, low efficiency, toxicity issues, the loss of biological activity, and complex electrospinning techniques are all bottlenecks of these systems. Improving the blood supply is crucial for their successful use, which involves promoting the metabolism and nutrient absorption in tendons. Read More

Heliyon 2021 Apr 19;7(4):e06845. Epub 2021 Apr 19.

Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Pará, Brazil.

Astrocyte reactivity in the spinal cord may occur after peripheral neural damage. However, there is no data to report such reactivity after Achilles tendon injury. We investigate whether changes occur in the spinal cord, mechanical sensitivity and gait in two phases of repair after Achilles tendon injury. Read More

Sports Med Arthrosc Rev 2021 Jun;29(2):130-145

MedStar Union Memorial Hospital, Baltimore, MD.

The optimal postoperative management of Achilles tendon (AT) rupture remains unknown. The past 2 decades have witnessed a trend toward less rigid immobilization, earlier weightbearing, and accelerated functional rehabilitation postoperatively. The objective of this study was to identify all high-quality studies pertaining to rehabilitation after AT repair and characterize the various rehabilitation protocols that have been described. Read More

Foot (Edinb) 2021 Jun 13;47:101769. Epub 2021 Jan 13.

Orthopaedic Research Unit, Aalborg University Hospital, Aalborg, Denmark; Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. Electronic address:

Background: Patients struggle to fully recover after an Achilles tendon rupture. Although several studies has investigated surgical and non-surgical treatment, the best treatment is still uncertain. The aim of this study was to investigate long-term patient-reported outcomes and objective measures 4 years after acute Achilles tendon rupture and compare whether outcomes differed between patients treated on basis of the previous regimen preferring surgical treatment and the new regimen preferring functional rehabilitation. Read More

ANZ J Surg 2021 May 6. Epub 2021 May 6.

Orthopaedic department, Fremantle Hospital, Fremantle, Western Australia, Australia.

Background: Chronic Achilles tendon rupture is commonly defined as a rupture presenting 6 weeks after the time of injury and operative management is recommended. This research aims to describe a novel modified surgical technique in the repair of chronic Achilles tendon rupture and to report the result of this technique.

Methods: This is a retrospective study performed between January 2007 and January 2017, and a novel modification of El Shewy et al. Read More

J Foot Ankle Surg 2021 Mar 31. Epub 2021 Mar 31.

Rosalind Franklin University, Scholl College, Chicago IL.

We report on the outcome of acute Achilles tendon ruptures by a single surgeon using open and percutaneous techniques was performed. This prospective study included 186 patients with 188 ruptured Achilles tendons. A traditional open technique was primarily performed on patients from January 2001 to December 2011. Read More

J Am Acad Orthop Surg Glob Res Rev 2021 May 4;5(5):e21.00008. Epub 2021 May 4.

From the Foot and Ankle Center, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Greene and J. T. Smith); the Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S. E. Smith); and the STRATUS Center for Simulation in Medical Education, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S. E. Smith).

Pathology associated with the plantaris includes rupture of the tendon and an association with mid-substance Achilles tendinopathy in some patients. There have only been two previous case reports in the literature in English language describing snapping of the plantaris tendon. We present a case report of a 15-year-old female competitive dancer who described pain and an audible popping at the medial margin of the Achilles tendon while squatting. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Apr 30. Epub 2021 Apr 30.

Fortius Clinic, 17 Fitzhardinge Street, London, W1H 6EQ, UK.

Purpose: The biarticular anatomy of the gastrocnemii is an important mechanism of knee-ankle coupling and differential elongation may affect this function leading to weakness of the push-off phase during the gait. Achilles tendon ruptures may cause detachment of the gastrocnemius tendon from the soleus aponeurosis with subsequent differential elongation of the individual subtendons. This study investigated the effects of such detachment by investigating tendon fusion levels of the two muscle groups, and the effect of sequential differential elongation of the gastrocnemius on the Achilles tendon resting angle (ATRA) and to the knee-ankle coupling. Read More

Clin Biomech (Bristol, Avon) 2021 May 23;85:105366. Epub 2021 Apr 23.

Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain. Electronic address:

Background: The aim of this study was to describe the differences in structural and mechanical properties between operated and non-injured Achilles tendons in senior badminton players who had had Achilles tendon surgery and had returned to play.

Methods: Eighteen players (age = 48.9(10. Read More

Injury 2021 Jul 7;52(7):1985-1992. Epub 2021 Apr 7.

Acibadem Mehmet Ali Aydinlar University School of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Istanbul, Turkey.

Introduction: Achilles tendon rupture and soft tissue infections with wound dehiscence and tendon exposure following the tendon repair are not infrequent. Various procedures have been described for the reconstruction of soft tissue defects at the Achilles tendon region, yet there is lack of consensus on the ideal method. In this article we report our experience using the distally based peroneal artery perforator flap in reconstruction of combined defects of the Achilles tendon and overlying soft tissue. Read More