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Age is a risk factor for contralateral tendon rupture in patients with acute Achilles tendon rupture

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Rupture of the contralateral Achilles tendon following Achilles tendon rupture can lead to devastating outcomes. However, despite the clinical importance, the risk factors and incidence of contralateral Achilles tendon rupture have not been well studied. This study aimed to determine the incidence of contralateral tendon rupture after Achilles tendon rupture and to identify associated patient characteristics.

Methods

Medical records for 226 consecutive patients with Achilles tendon rupture were retrospectively reviewed. The occurrence of contralateral Achilles tendon rupture and patient characteristics were determined through review of medical records and telephone surveys.

Results

The cumulative incidences of contralateral Achilles tendon rupture at 1, 3, 5, and 7 years after Achilles tendon rupture were 0.4%, 1.8%, 3.4%, and 5.1%, respectively. The only statistically significant risk factor was age between 30 and 39 years at the time of initial Achilles tendon rupture (hazard ratio = 4.9).

Conclusions

Patients who sustain Achilles tendon rupture in their 30 s have significantly increased risk for contralateral tendon rupture.

Level of evidence

III.

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References

  1. Aröen A, Helgo D, Granlund OG, Bahr R (2004) Contralateral tendon rupture risk is increased in individuals with a previous Achilles tendon rupture. Scand J Med Sci Sports 14:30–33

    Article  Google Scholar 

  2. El Khoury L, Ribbans WJ, Raleigh SM (2016) MMP3 and TIMP2 gene variants as predisposing factors for Achilles tendon pathologies: attempted replication study in a British case-control cohort. Meta Gene 9:52–55

    Article  Google Scholar 

  3. Ganestam A, Kallemose T, Troelsen A, Barfod KW (2016) Increasing incidence of acute Achilles tendon rupture and a noticeable decline in surgical treatment from 1994 to 2013. A nationwide registry study of 33,160 patients. Knee Surg Sports Traumatol Arthrosc 24:3730–3737

    Article  Google Scholar 

  4. Gwynne-Jones DP, Sims M, Handcock D (2011) Epidemiology and outcomes of acute Achilles tendon rupture with operative or nonoperative treatment using an identical functional bracing protocol. Foot Ankle Int 32:337–343

    Article  Google Scholar 

  5. Halasi T, Kynsburg A, Tallay A, Berkes I (2004) Development of a new activity score for the evaluation of ankle instability. Am J Sports Med 32:899–908

    Article  Google Scholar 

  6. Houshian S, Tscherning T, Riegels-Nielsen P (1998) The epidemiology of Achilles tendon rupture in a Danish county. Injury 29:651–654

    Article  CAS  Google Scholar 

  7. Kannus P, Jozsa L (1991) Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. J Bone Joint Surg Am 73:1507–1525

    Article  CAS  Google Scholar 

  8. 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 Jt Surg Am 87:2202–2210

    Article  Google Scholar 

  9. Kim SK, Roos TR, Roos AK, Kleimeyer JP, Ahmed MA, Goodlin GT, Fredericson M, Ioannidis JP, Avins AL, Dragoo JL (2017) Genome-wide association screens for Achilles tendon and ACL tears and tendinopathy. PLoS One 12:e0170422

    Article  Google Scholar 

  10. Maffulli N, Ewen SW, Waterston SW, Reaper J, Barrass V (2000) Tenocytes from ruptured and tendinopathic achilles tendons produce greater quantities of type III collagen than tenocytes from normal achilles tendons. An in vitro model of human tendon healing. Am J Sports Med 28:499–505

    Article  CAS  Google Scholar 

  11. Maffulli N, Waterston SW, Squair J, Reaper J, Douglas AS (1999) Changing incidence of Achilles tendon rupture in Scotland: a 15-year study. Clin J Sport Med 9:157–160

    Article  CAS  Google Scholar 

  12. Moller A, Astron M, Westlin N (1996) Increasing incidence of Achilles tendon rupture. Acta Orthop Scand 67:479–481

    Article  CAS  Google Scholar 

  13. Nilsson-Helander K, Silbernagel KG, Thomee R, Faxen E, Olsson N, Eriksson BI, Karlsson J (2010) Acute achilles tendon rupture: a randomized, controlled study comparing surgical and nonsurgical treatments using validated outcome measures. Am J Sports Med 38:2186–2193

    Article  Google Scholar 

  14. Nyyssonen T, Luthje P, Kroger H (2008) The increasing incidence and difference in sex distribution of Achilles tendon rupture in Finland in 1987–1999. Scand J Surg 97:272–275

    Article  CAS  Google Scholar 

  15. Park YH, Jeong SM, Choi GW, Kim HJ (2017) How early must an acute Achilles tendon rupture be repaired? Injury 48:776–780

    Article  Google Scholar 

  16. Raikin SM, Garras DN, Krapchev PV (2013) Achilles tendon injuries in a United States population. Foot Ankle Int 34:475–480

    Article  Google Scholar 

  17. Reito A, Logren HL, Ahonen K, Nurmi H, Paloneva J (2018) Risk factors for failed nonoperative treatment and rerupture in acute achilles tendon rupture. Foot Ankle Int. https://doi.org/10.1177/10711007177540421071100717754042

    Article  PubMed  Google Scholar 

  18. Rettig AC, Liotta FJ, Klootwyk TE, Porter DA, Mieling P (2005) Potential risk of rerupture in primary achilles tendon repair in athletes younger than 30 years of age. Am J Sports Med 33:119–123

    Article  Google Scholar 

  19. Salmon L, Russell V, Musgrove T, Pinczewski L, Refshauge K (2005) Incidence and risk factors for graft rupture and contralateral rupture after anterior cruciate ligament reconstruction. Arthroscopy 21:948–957

    Article  Google Scholar 

  20. Webster KE, Feller JA, Leigh WB, Richmond AK (2014) Younger patients are at increased risk for graft rupture and contralateral injury after anterior cruciate ligament reconstruction. Am J Sports Med 42:641–647

    Article  Google Scholar 

  21. Willits K, Amendola A, Bryant D, Mohtadi NG, Giffin JR, Fowler P, Kean CO, Kirkley A (2010) Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Jt Surg Am 92:2767–2775

    Article  Google Scholar 

  22. Yasui Y, Tonogai I, Rosenbaum AJ, Shimozono Y, Kawano H, Kennedy JG (2017) The risk of achilles tendon rupture in the patients with achilles tendinopathy: healthcare database analysis in the United States. Biomed Res Int 2017:7021862

    Article  Google Scholar 

  23. Young SW, Patel A, Zhu M, van Dijck S, McNair P, Bevan WP, Tomlinson M (2014) Weight-bearing in the nonoperative treatment of acute achilles tendon ruptures: a randomized controlled trial. J Bone Jt Surg Am 96:1073–1079

    Article  Google Scholar 

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Funding

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Author notes

  1. Tae Jin Kim and Gi Won Choi are co-authors.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea

    Young Hwan Park, Tae Jin Kim & Hak Jun Kim

  2. Department of Orthopaedic Surgery, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan, 15355, South Korea

    Gi Won Choi

Authors
  1. Young Hwan Park
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  2. Tae Jin Kim
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  4. Hak Jun Kim
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Contributions

YHP: lead investigator and first author. TJK: data analysis and manuscript review. GWC: data analysis and manuscript review. HJK: corresponding author, primary surgeon. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the contents of this study.

Corresponding author

Correspondence to Hak Jun Kim.

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Park, Y.H., Kim, T.J., Choi, G.W. et al. Age is a risk factor for contralateral tendon rupture in patients with acute Achilles tendon rupture. Knee Surg Sports Traumatol Arthrosc 28, 1625–1630 (2020). https://doi.org/10.1007/s00167-019-05380-y

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  • DOI: https://doi.org/10.1007/s00167-019-05380-y

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