Page 158 - Athletic Health Handbook
P. 158
and colleagues found that in all in older athletes, and current studies no differences in rerupture risk or
patients there was a relative risk reflect that, with an average age functional outcomes with or without
of 0.4 for rerupture in the surgical typically around 40. Outcome data surgery. When an early rehabilitation
group compared to the non-operative in younger athletes is scarce due program is not employed, surgical
group. When the patients were to the lower incidence of this injury repair is the preferred treatment due
stratified based on an early, accelerated in this population. In a prospective to the lower rerupture rate. Evidence
rehabilitation protocol, operative and study of 363 patients either treated is weaker in younger athletes, but
non-operative rerupture rates were operatively or non-operatively with currently favors surgical repair.
equal. The surgical groups returned an accelerated rehabilitation protocol, An Achilles injury can be career
to work 20 days sooner. All other authors found a significantly lower ending in a professional athlete, and
outcome measures were similar rerupture rate in the non-operative functional deficits often persist with
amongst the groups. The authors group over 40 (4.1%) compared either treatment. Treating physicians
concluded that non-operative to those under 40 (13.1%). The should consider all available evidence
management should be considered authors concluded that surgery should when discussing treatment options
when an accelerated rehabilitation be considered in younger patients with their patients.
program can be employed. In due to the higher rerupture rate.13
situations in which an accelerated
program is not possible, surgical Conclusions
intervention should be considered.12
Recent evidence demonstrates that
When deciding on a treatment an early, accelerated rehabilitation
plan, there are many factors that program can be safely and successfully
must be considered. Comorbidities utilized in the treatment of Achilles
such as smoking, diabetes, and age tendon injuries. When an early
can all impact treatment outcomes. rehabilitation program is utilized
Achilles ruptures are more common appropriately, there appears to be

ACHILLES TENDON RUPTURES 158
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