PMID- 38154754 OWN - NLM STAT- MEDLINE DCOM- 20240415 LR - 20240415 IS - 2059-7762 (Electronic) IS - 2059-7754 (Linking) VI - 9 IP - 2 DP - 2024 Apr TI - Musculotendinous ruptures of the achilles tendon had greater heel-rise height index compared with mid-substance rupture with non-operative management: A retrospective cohort study. PG - 148-152 LID - S2059-7754(23)00618-1 [pii] LID - 10.1016/j.jisako.2023.12.006 [doi] AB - INTRODUCTION: Achilles tendon ruptures (ATRs) may occur at varying locations with ruptures at the mid-substance (MS) of the tendon most common, followed tears at the musculotendinous (MT) junction. There is scant literature about the outcome of MT ATR. This study compared the outcome of patients with a MT ATR with patients following a MS ATR. METHODS: The diagnostic features and clinical outcome of 37 patients with a MT ATR were compared with a cohort of 19 patients with a MS ATR. Patients in both groups were managed non-operatively and received the same rehabilitation protocol with weight-bearing rehabilitation in protective functional brace. RESULTS: From February 2009 to August 2023, 556 patients presented with an ATR. Of these, 37 (6.7 ​%) patients were diagnosed with a MT tear. At final follow-up, at 12 months following injury, the MT group reported an Achilles tendon total rupture score (ATRS) of mean (standard deviation (SD)) of 83.6 (3.5) (95 ​% confidence interval (CI) 81.8, 85.4) and median (inter-quartile range (IQR)) ATRS of 86 points (78-95.5) and the MS group mean (SD) of 80.3 (8.5) (95%CI) 76.1, 80.5) and median (IQR) of 87 points (59-95) (p ​= ​0.673). Functional evaluation, however, revealed statistically significant differences in mean (SD) heel-rise height index MT group 79 ​% (25) (95%CI 65.9, 92.1) and MS group 59 ​% (13) (95%CI 51.9, 67.1) (p ​= ​0.019). In the MT rupture group, there were considerably less complications than the MS rupture group. CONCLUSIONS: When managed non-operatively, with only a 6 weeks period of brace protection, patients have little limitation although have some residual reduction of single heel-rise at the one-year following MT ATR. LEVEL OF EVIDENCE: IV. CI - Copyright (c) 2023 The Author(s). Published by Elsevier Inc. All rights reserved. FAU - Carmont, Michael R AU - Carmont MR AD - Department of Trauma & Orthopaedic Surgery, Shrewsbury & Telford Hospital NHS Trust, Shropshire, TF1 6TF, United Kingdom; University of Keele, Staffordshire, ST5 5BG, United Kingdom; The Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, 413 90, Sweden. Electronic address: mcarmont@hotmail.com. FAU - Gunnarsson, Baldvin AU - Gunnarsson B AD - Department of Orthopaedic Surgery, Molndal Hospital, University of Gothenburg, 431 60, Sweden; The Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, 413 90, Sweden. FAU - Brorsson, Annelie AU - Brorsson A AD - Department of Orthopaedic Surgery, Molndal Hospital, University of Gothenburg, 431 60, Sweden; The Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, 413 90, Sweden. FAU - Nilsson-Helander, Katarina AU - Nilsson-Helander K AD - Department of Orthopaedic Surgery, Molndal Hospital, University of Gothenburg, 431 60, Sweden; The Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, Gothenburg University, 413 90, Sweden. LA - eng PT - Journal Article DEP - 20231227 PL - England TA - J ISAKOS JT - Journal of ISAKOS : joint disorders & orthopaedic sports medicine JID - 101680867 SB - IM MH - Humans MH - *Achilles Tendon/surgery/injuries MH - Heel MH - Retrospective Studies MH - Treatment Outcome MH - Recovery of Function MH - Rupture/therapy MH - *Tendon Injuries/epidemiology/surgery OTO - NOTNLM OT - Achilles OT - Musculotendinous OT - Rupture COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The Authors declare that they have no competing interests. Mr Carmont has received bursaries from the British Orthopaedic Foot Ankle Society and the British Association of Sport and Exercise Medicine. EDAT- 2023/12/29 00:42 MHDA- 2024/04/15 06:43 CRDT- 2023/12/28 19:29 PHST- 2023/09/04 00:00 [received] PHST- 2023/12/19 00:00 [revised] PHST- 2023/12/22 00:00 [accepted] PHST- 2024/04/15 06:43 [medline] PHST- 2023/12/29 00:42 [pubmed] PHST- 2023/12/28 19:29 [entrez] AID - S2059-7754(23)00618-1 [pii] AID - 10.1016/j.jisako.2023.12.006 [doi] PST - ppublish SO - J ISAKOS. 2024 Apr;9(2):148-152. doi: 10.1016/j.jisako.2023.12.006. Epub 2023 Dec 27.