Key takeaways:
- Patients had a significant increase in outcome scores and decrease in pain scores 6 months after Achilles tendon repair.
- Results showed 61% of patients thought the symptomatic state at 6 months was acceptable.
Patients who underwent Achilles tendon repair were pain free, had good functional outcomes and experienced meaningful improvement at 6 months postoperatively, according to results.
“It is a reasonable expectation that, at 6 months following an Achilles tendon rupture and repair, patients will be able to get back to the majority of their daily activities and exertional activities,” MaCalus V. Hogan, MD, MBA, David Silver professor and chair, chief of the University of Pittsburgh Medical Center (UPMC) Orthopaedic Service Line, and co-director of the Foot and Ankle Injury Research Group — part of the Orland Bethel Family Musculoskeletal Research Center — at the University of Pittsburgh School of Medicine, told Healio.
Hogan along with Rachit Saggar, MBBS, and colleagues at UPMC and the Orland Bethel Family Musculoskeletal Research Center retrospectively analyzed data from 101 patients (mean age, 38.6 years; 77% men) with 124 Achilles ruptures who underwent Achilles repair.
“A few of the major outcomes that we decided to collect were the Foot and Ankle Ability Measure activity of daily living score, the VAS pain score and the [Patient-Reported Outcomes Measurement Information System (PROMIS)] physical and mental health questionnaires,” Saggar, an orthopedic surgery research fellow at UPMC, said in his presentation at the American Orthopaedic Foot & Ankle Society Annual Meeting.
Saggar also said they collected patient acceptable symptomatic state and the Global Rating of Change.
At 6-month follow-up, Saggar said 87% of patients reported feeling much better, 10% reported feeling a little or somewhat better, and 3% reported feeling the same or worse. Patients also experienced a significant increase in PROMIS physical health scores and Foot and Ankle Measure ADL scores, as well as a significant decrease in VAS pain scores. PROMIS mental health scores remained stable throughout the 6-month period.
“Regarding how many patients thought the symptomatic state at 6 months was acceptable, that was 61% compared with 39% who thought their current state was not acceptable,” Saggar said. “Pain is something that they are not likely to face at 6 months because 90% of patients reported no to mild pain and there were only nine or 10 patients who had some degree of pain at 6 months.”
Although previous research has focused on patient outcomes at 1 to 2 years postoperatively, Hogan said these results provide patients with what they can expect at 6 months postoperatively.
“Do I envision we are going to advise people to go back to high impact or club sports at 6 months? I do not see that, but I do not have a crystal ball,” Hogan said. “I do envision this study helping to drive that conversation and drive that expectation management and partnership with the patient during shared decision making with Achilles repair and also with Achilles treatment in general.”
For more information:
MaCalus V. Hogan, MD, MBA, can be reached at hoganmv@upmc.edu.
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