Skip to main content

Acute Achilles Tendon Rupture

  • Chapter
  • First Online:
The Ankle in Football

Abstract

Total Achilles tendon ruptures are most common in racket sports, and the incidence in football is low. Most footballers who sustain a total Achilles tendon rupture are recreational players around 40 years of age. This injury also occurs in top-level players, although not frequent. The diagnosis is made by clinical evaluation, and only in few cases MRI and/or ultrasonography are needed to establish the diagnosis. Treatment can be either nonsurgical or surgical, and in active football players surgical treatment is recommended. The main reason for surgical treatment is restoration of tendon length and improved muscle strength. The recommended surgical treatment is mini-invasive approach, with end-to-end suture using stable sutures and local adaptation of the tendon gap. Early range of motion (in some cases, even without plaster or brace) is recommended. A recent study revealed a rerupture rate of 0 % using this technique. During the last decade, major improvements in terms of rehabilitation have shown promising results.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Arner O, Lindholm A (1959) Subcutaneous rupture of the Achilles tendon; a study of 92 cases. Acta Chir Scand Suppl 116(Supp 239):1–51

    CAS  PubMed  Google Scholar 

  2. Aspenberg P (2007) Stimulation of tendon repair: mechanical loading, GDFs and platelets. A mini-review. Int Orthop 31(6):783–789

    Article  PubMed Central  PubMed  Google Scholar 

  3. Bhandari M, Guyatt GH, Siddiqui F et al (2002) Treatment of acute Achilles tendon ruptures: a systematic overview and metaanalysis. Clin Orthop Relat Res 400:190–200

    Article  PubMed  Google Scholar 

  4. Bring DK, Kreicbergs A, Renstrom PA, Ackermann PW (2007) Physical activity modulates nerve plasticity and stimulates repair after Achilles tendon rupture. J Orthop Res 25(2):164–172

    Article  PubMed  Google Scholar 

  5. Cetti R, Christensen SE, Ejsted R, Jensen NM, Jorgensen U (1993) Operative versus nonoperative treatment of Achilles tendon rupture. A prospective randomized study and review of the literature. Am J Sports Med 21(6):791–799

    Article  CAS  PubMed  Google Scholar 

  6. Cetti R, Henriksen LO, Jacobsen KS (1994) A new treatment of ruptured Achilles tendons. A prospective randomized study. Clin Orthop Relat Res 308:155–165

    PubMed  Google Scholar 

  7. Eliasson P, Andersson T, Aspenberg P (2012) Achilles tendon healing in rats is improved by intermittent mechanical loading during the inflammatory phase. J Orthop Res 30(2):274–279

    Article  PubMed  Google Scholar 

  8. Ingvar J, Tagil M, Eneroth M (2005) Nonoperative treatment of Achilles tendon rupture: 196 consecutive patients with a 7% re-rupture rate. Acta Orthop 76(4):597–601

    Article  PubMed  Google Scholar 

  9. Jozsa L, Kannus P (1997) Histopathological findings in spontaneous tendon ruptures. Scand J Med Sci Sports 7(2):113–118

    Article  CAS  PubMed  Google Scholar 

  10. Kangas J, Pajala A, Ohtonen P, Leppilahti J (2007) Achilles tendon elongation after rupture repair: a randomized comparison of 2 postoperative regimens. Am J Sports Med 35(1):59–64

    Article  PubMed  Google Scholar 

  11. Kannus P (2000) Structure of the tendon connective tissue. Scand J Med Sci Sports 10(6):312–320

    Article  CAS  PubMed  Google Scholar 

  12. Kearney RS, Achten J, Lamb SE, Parsons N, Costa ML (2012) The Achilles tendon total rupture score: a study of responsiveness, internal consistency and convergent validity on patients with acute Achilles tendon ruptures. Health Qual Life Outcomes 10:24

    Article  PubMed Central  PubMed  Google Scholar 

  13. Kerkhoffs GM, Struijs PA, Raaymakers EL, Marti RK (2002) Functional treatment after surgical repair of acute Achilles tendon rupture: wrap vs walking cast. Arch Orthop Trauma Surg 122(2):102–105

    Article  CAS  PubMed  Google Scholar 

  14. Khan RJ, Fick D, Keogh A, Crawford J, Brammar T, Parker M (2005) Treatment of acute achilles tendon ruptures. A meta-analysis of randomized, controlled trials. J Bone Joint Surg Am 87(10):2202–2210

    Article  PubMed  Google Scholar 

  15. Kjaer M (2004) Role of extracellular matrix in adaptation of tendon and skeletal muscle to mechanical loading. Physiol Rev 84(2):649–698

    Article  CAS  PubMed  Google Scholar 

  16. Kocher MS, Bishop J, Marshall R, Briggs KK, Hawkins RJ (2002) Operative versus nonoperative management of acute Achilles tendon rupture: expected-value decision analysis. Am J Sports Med 30(6):783–790

    PubMed  Google Scholar 

  17. Leppilahti J, Forsman K, Puranen J, Orava S (1998) Outcome and prognostic factors of Achilles rupture repair using a new scoring method. Clin Orthop Relat Res 346:152–161

    Article  PubMed  Google Scholar 

  18. Lo IK, Kirkley A, Nonweiler B, Kumbhare DA (1997) Operative versus nonoperative treatment of acute Achilles tendon ruptures: a quantitative review. Clin J Sport Med 7(3):207–211

    Article  CAS  PubMed  Google Scholar 

  19. Ma GW, Griffith TG (1977) percutaneous repair of acute closed ruptured achilles tendon: a new technique. Clin Orthop Relat Res 128:247–255

    PubMed  Google Scholar 

  20. Maffulli N (1998) The clinical diagnosis of subcutaneous tear of the Achilles tendon. A prospective study in 174 patients. Am J Sports Med 26(2):266–270

    CAS  PubMed  Google Scholar 

  21. Maffulli N (1999) Rupture of the Achilles tendon. J Bone Joint Surg Am 81(7):1019–1036

    CAS  PubMed  Google Scholar 

  22. Maffulli N, Tallon C, Wong J, Lim KP, Bleakney R (2003) Early weightbearing and ankle mobilization after open repair of acute midsubstance tears of the achilles tendon. Am J Sports Med 31(5):692–700

    PubMed  Google Scholar 

  23. Moller M, Movin T, Granhed H, Lind K, Faxen E, Karlsson J (2001) Acute rupture of tendon Achilles. A prospective randomised study of comparison between surgical and non-surgical treatment. J Bone Joint Surg Br 83(6):843–848

    Article  CAS  PubMed  Google Scholar 

  24. Nilsson-Helander KN-K (2008) A new surgical method to treat chronic ruptures and reruptures of the Achilles tendon. Knee Surg Sports Traumatol Arthrosc 16(6):614

    Article  PubMed  Google Scholar 

  25. Nilsson-Helander K, Silbernagel KG, Thomee R et al (2010) Acute achilles tendon rupture: a randomized, controlled study comparing surgical and nonsurgical treatments using validated outcome measures. Am J Sports Med 38(11):2186–2193

    Article  PubMed  Google Scholar 

  26. Nilsson-Helander K, Thomee R, Gravare-Silbernagel K et al (2007) The Achilles tendon Total Rupture Score (ATRS): development and validation. Am J Sports Med 35(3):421–426

    Article  PubMed  Google Scholar 

  27. Nilsson-Helander K, Thurin A, Karlsson J, Eriksson BI (2009) High incidence of deep venous thrombosis after Achilles tendon rupture: a prospective study. Knee Surg Sports Traumatol Arthrosc 17(10):1234–1238

    Article  PubMed  Google Scholar 

  28. Nistor L (1981) Surgical and non-surgical treatment of Achilles Tendon rupture. A prospective randomized study. J Bone Joint Surg Am 63(3):394–399

    CAS  PubMed  Google Scholar 

  29. Olsson N, Nilsson-Helander K, Karlsson J et al (2011) Major functional deficits persist 2 years after acute Achilles tendon rupture. Knee Surg Sports Traumatol Arthrosc 19(8):1385–1393

    Article  PubMed  Google Scholar 

  30. Olsson N, Silbernagel KG, Eriksson BI, et al. (2013) Stable surgical repair with accelerated rehabilitation versus nonsurgical treatment for acute achilles tendon ruptures: a randomized controlled study. Am J Sports Med. 41(12):2867–2876

    Google Scholar 

  31. Schepull T, Kvist J, Andersson C, Aspenberg P (2007) Mechanical properties during healing of Achilles tendon ruptures to predict final outcome: a pilot Roentgen stereophotogrammetric analysis in 10 patients. BMC Musculoskelet Disord 8:116

    Article  PubMed Central  PubMed  Google Scholar 

  32. Silbernagel KG, Nilsson-Helander K, Thomee R, Eriksson BI, Karlsson J (2010) A new measurement of heel-rise endurance with the ability to detect functional deficits in patients with Achilles tendon rupture. Knee Surg Sports Traumatol Arthrosc 18(2):258–264

    Article  PubMed  Google Scholar 

  33. Soroceanu A, Sidhwa F, Aarabi S, Kaufman A, Glazebrook M (2012) Surgical versus nonsurgical treatment of acute achilles tendon rupture: a meta-analysis of randomized trials. J Bone Joint Surg Am 94(23):2136–2143

    Article  PubMed Central  PubMed  Google Scholar 

  34. Thermann H, Zwipp H, Tscherne H (1995) Functional treatment concept of acute rupture of the Achilles tendon. 2 years results of a prospective randomized study. Unfallchirurg 98(1):21–32

    CAS  PubMed  Google Scholar 

  35. van Dijk CN, van Sterkenburg MN, Wiegerinck JI, Karlsson J, Maffulli N (2011) Terminology for Achilles tendon related disorders. Knee Surg Sports Traumatol Arthrosc 19(5):835–841

    Article  PubMed Central  PubMed  Google Scholar 

  36. Willits K, Amendola A, Bryant D et al (2010) Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg Am 92(17):2767–2775

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jon Karlsson MD, PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag France

About this chapter

Cite this chapter

Karlsson, J., Olsson, N., Helander, K.N. (2014). Acute Achilles Tendon Rupture. In: d'Hooghe, P., Kerkhoffs, G. (eds) The Ankle in Football. Sports and Traumatology. Springer, Paris. https://doi.org/10.1007/978-2-8178-0523-8_18

Download citation

  • DOI: https://doi.org/10.1007/978-2-8178-0523-8_18

  • Published:

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0522-1

  • Online ISBN: 978-2-8178-0523-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics