Tendoachilles rupture has recently seen an increase in frequency, accounting for up to 40% of all tendon ruptures. However, an acute segmental rupture of the Achilles tendon is very rare with only one case caused by predisposing factors, such as steroid injection. In this report, we highlight an unusual clinical presentation of a segmental rupture of the Achilles tendon without any underling predisposing factor and without direct trauma. Herein, we discuss its mechanism. Twelve months after surgical repair with open technique, this patient became fully functional again in daily activity.
Achilles Tendon* ; Causality ; Humans ; Rupture* ; Sports* ; Tendon Injuries ; Tendons

Achilles Tendon ; Humans ; Rupture ; Tendon Injuries ; Treatment Outcome

Achilles tendon rupture is thought to be increasing with participation in sports activities. Both operative and non-operative treatments of Achilles tendon rupture include a period of immobilization. Complications following treatment of the Achilles tendon rupture include recurrence of rupture, flexor weakness, infection, and wound problems. However, deep vein thrombosis (DVT) after operative treatment of the Achilles tendon has not been reported. We report on a case of DVT after Achilles tendon repair.
Achilles Tendon* ; Immobilization ; Recurrence ; Rupture ; Sports ; Venous Thrombosis* ; Wounds and Injuries

Achilles tendon rupture is a common sports injury encountered in younger populations. Various treatment methods are used for acute and chronic rupture. Several treatments for each condition are available, each having their advantages and disadvantages. In an acute rupture, surgical treatment may be a priority for younger patients or those wishing a quick return to play, but the long-term functional outcome is similar to non-surgical treatment. In addition, the re-rupture rate shows a slight difference between the two treatments. The clinical outcomes are similar regardless of the surgical treatment, but an accelerated rehabilitation program should be accompanied by good results. In chronic and neglected rupture, surgical treatment is preferred over non-surgical treatment. Treatments are chosen based on the size of the tendon defect. This article reviews the current updates in the treatment of Achilles tendon rupture that will help clinicians choose the appropriate treatment.
Achilles Tendon ; Athletic Injuries ; Humans ; Rehabilitation ; Return to Sport ; Rupture ; Tendons

Achilles Tendon ; Ankle Injuries ; Humans ; Rupture ; Tendon Injuries/therapy* ; Treatment Outcome

PURPOSE: Autologous platelet rich plasma (PRP) has been known to enhance tendon healing and improve tensile strength after tendon injury. This study investigated the dosage of PRP to increase the tensile strength. METHODS: PRP was harvested from peripheral bloods of the rabbits. Direct injury model was adopted using 60 achilles tendons in 30 rabbits. The autologous PRP was infiltrated into the Achilles tendon repair site of four groups (control, 0.1, 0.2, 0.4 mL) with different dosages. Tendons were harvested at 2, 4 and 8 weeks and subjected to measuring mechanical tensile strength and dosage of collagen content. RESULTS: At 2, 4, and 8 weeks, PRP administration following experimental achilles tendon repair resulted in an overall higher average tensile strength and collagen content compared to these of the control. Also, the lengthen the time, tensile strength and collagen content was increased. CONCLUSION: Autologous PRP enhanced tendon healing in rabbits. Within the PRP dosage setted by the author, more dosage of the infiltrated PRP increases the strength of the tendon and the dosage of collagen content. Further studies will be essential to determine the optimal dosage of PRP in clinical practice.
Achilles Tendon ; Blood Platelets* ; Collagen ; Platelet-Rich Plasma* ; Rabbits* ; Tendon Injuries ; Tendons* ; Tensile Strength

OBJECTIVETo explore the operative technique of repair and its curative effect of old rupture of the Achilles tendon with flexor digitorum (hallucis)longus tendon transfer.

METHODSFrom Nov 2001 to May 2005, 13 patients who had old rupture of the Achilles tendon were treated with this operative technique. Five of them were treated with flexor digitorum longus tendon transfer and 8 with flexor hallucis longus tendon. All patients had the history of closed injury of Achilles tendon(9 male and 4 female, 8 left feet and 5 right feet). The age ranged from 32 to 69 years(mean 41 years).

OPERATIVE TECHNIQUEflexor digitorum (hallucis)longus tendon was cut down alternatively. The distal end of flexor digitorum longus tendon should be sutured to flexor hallucis longus tendon if the flexor digitorum longus tendon was cut. The distal end of flexor hallucis longus tendon should be sutured to flexor digitorum longus tendon if the flexor hallucis longus tendon was cut. The proximal end of tendon to be cut down was sew up a suture line and pulled out from the incision to reveal the Achilles tendon. A transverse hole was drilled through the anterior aspect of the insertion of the tendon of the calcareous, and then drilled upward perpendicularly. The two holes were cross-connected by towel clamp. The flexor digitorum (hallucis)longus tendon to be transferred was pulled through the first hole from wall outward and upward, and then pulled through superior extremity of the second hole. The end of tendon was sutured firmly with the Achilles tendon.

RESULTSAll patients have no infection or re-rupture during follow-up (average 24 months;range 11 to 54 months). There was no subsequent hammer-toe deformity. Dorsiflexion at least to neutral and normal plantar flexion were obtained in all patients. According to Arner-Lindholm standard,the final results were excellent in 9 patients(6 cases were used flexor hallucis langus tendon, and 3 cases were used flexor digitorum longus tendon),good in 3 patients(2 cases were used flexor hallucis longus tendon and 1 case was used flexor digitorum longus tendon) and poor in 1 patient used with flexor digitorum longus tendon.

CONCLUSIONThe repair of old rupture of the Achilles tendon with flexor digitorum (hallucis) longus tendon transfer is an ideal and effective method. Furthermore, the use of flexor hallucis longus muscle tendon tends to be more reasonable.

Achilles Tendon ; injuries ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Rupture ; Tendon Transfer ; methods

PURPOSE: Previous studies have confirmed that Achilles tendon occurs Achilles thickening after repair surgery of the rupture. Although this mechanism has been elucidated in the laboratory, there are few reports on its impact on clinical function. We designed a retrospective study to investigate the Achilles thickening after Achilles tendon rupture repair and its correlation between the elasticity and postoperative function. METHODS: In this retrospective analysis, patients who underwent surgical treatment for acute Achilles tendon rupture from April 2016 to April 2020 were included. All the patients were regularly followed up at 3 months, 1 year, and 2 years after surgery. American Orthopaedic Foot Ankle Surgeon (AOFAS) scale and Leppilahti score were used to evaluate functional outcomes. Achilles elasticity was measured by ultrasound shear wave of elasticity. Achilles thickening was calculated as maximal transverse and longitudinal diameter in cross-sectional plane of magnetic resonance scan. Sample t-tests was used for different follow-up periods. Correlation between Achilles thickening and other factors were analyzed using Pearson's method. p < 0.05 indicates a statistically significant difference. RESULTS: AOFAS scale and Leppilahti score at 1 year were significantly higher than at 3 months postoperatively (both p < 0.001). These functional scales were also improved at 2-year follow-up significantly (both p < 0.001). The dorsiflexion difference showed gradually recovery in each follow-up period (t = -17.907, p < 0.001). The elasticity of the Achilles appeared to continuously decreases during the postoperative follow-up period in all position sets (p < 0.001). In thickening evaluation, the cross-sectional area of the thickest plane of Achilles was significantly higher at 1 year postoperatively (310.5 ± 25.2) mm² than that at 3 months postoperatively ((278.0 ± 26.2) mm², t = -8.219, p < 0.001) and became thinner in 2-year magnetic resonance scan ((256.1 ± 15.1) mm², t = 16.769, p < 0.001). The correlations between Achilles thickening, elasticity, and functional outcome did not show statistical significance (p > 0.05) in every follow-up period. CONCLUSION Achilles tendon thickens after surgery in the 1st year, but begins to gradually return to thinning about 2 years after surgery. There was no significant correlation between the increase and decrease of thickening and the patients' clinical function scores, Achilles elasticity, and bilateral ankle dorsiflexion difference.
Humans ; Achilles Tendon/surgery* ; Retrospective Studies ; Treatment Outcome ; Elasticity ; Tendon Injuries/surgery* ; Rupture/surgery*

Achilles tendon injuries are one of the most common tendon injuries in the lower extremities, but spontaneous bilateral achilles tendon rupture without any external force is extremely rare. We present a case of a patient who had spontaneous bilateral achilles tendon rupture related to multiple steroid injections for carpal tunnel syndrome in diabetes. According to this case, we suggest that we should take special precaution to use steroid to the diabetes though it is not applied to the achilles tendon directly.
Achilles Tendon ; Carpal Tunnel Syndrome ; Diabetes Mellitus ; Humans ; Lower Extremity ; Rupture ; Tendon Injuries

OBJECTIVE: The purpose of this study was to evaluate the effects of the prolotherapy on the healing of the tendon tissue and the proliferation of fibroblasts in the injured Achilles tendons. METHOD: The tendons of twenty eight Sprague-Dawley rats were transected at 2 mm above the calcaneal insertion in the right Achilles tendon and sutured. Then they were allocated randomly into two groups: prolotherapy group and control group. We injected 20% dextrose 0.1 ml on injured tendon area of prolotherapy group immediately after transection. After 2 and 4 weeks, the diameters of tendons were measured on both the injured and uninjured tendon. The number of fibroblasts and the ratio of fibroblast to fibrocyte on the injured tendon tissues were measured by the image analyzer. RESULTS: The diameters of the injured tendons of the prolotherapy group were not significantly different with that of the control group. However, the number of fibroblasts and the ratio of fibroblast to fibrocyte in the prolotherapy group showed significantly larger and more increased than the control group (p<0.05). CONCLUSION: This result showed the additional regeneration effect of the prolotherapy on the healing of the injured tendon tissue. Therefore, the prolotherapy would be an effective treatment on the tendon injury.
Achilles Tendon* ; Animals ; Fibroblasts ; Glucose ; Models, Animal* ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Tendon Injuries ; Tendons