doiSerbia

Prognostic model of clinical scores in evaluation of treatment outcome in patients with acute Achilles tendon rupture - surgery vs. immobilization

Ille Mihailo (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic for Orthopaedic Surgery and Traumatology, Belgrade, Serbia)
Milošević Ivan (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic for Orthopaedic Surgery and Traumatology, Belgrade, Serbia)
Ilić Marko (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic for Orthopaedic Surgery and Traumatology, Belgrade, Serbia)
Matić Slađana (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic for Orthopaedic Surgery and Traumatology, Belgrade, Serbia)
Tabaković Dejan (University of Priština, Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia)
Elbors Dušan (Clinical Center of Serbia, Clinic for Orthopaedic Surgery and Traumatology, Belgrade, Serbia)
Parapid Biljana (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Division of Cardiology, Belgrade, Serbia)
Lugonja Sofija (Đorđe Joanović General Hospital, Zrenjanin, Serbia)

Introduction/Objective. When choosing the appropriate treatment for Achilles tendon rupture, there may be a dilemma when choosing the optimal treatment. The objective of this study was analyzing groups of patients with acute closed Achilles tendon injury, comparing early recovery and functional parameters in relation to treatment and first choice treatment suggestion. Methods. The prospective study included 80 patients with acute Achilles tendon rupture. The treatment was surgery or immobilization. Results. There is a difference in the mechanism of injury between surgically and non-surgically treated (p = 0.026). In total, 50 (62.5%) patients were operated and 30 (37.5%) patients were treated with circular plaster. The difference (p = 0.000) between the groups in the duration of treatment, The American Orthopaedic Foot and Ankle Society (AOFAS) score and Visual Analogue Scale of pain (VAS) was shown. Patients undergoing surgery in the first two days had better clinical results in terms of The Achilles tendon Total Rupture score (ATRS), AOFAS and VAS. Higher satisfaction was achieved in younger people (p = 0.036). Patients whose treatment lasted shorter were more satisfied with their status (p = 0.001). ATRS and AOFAS score are higher in patients who are more satisfied with their own status (ATRS p = 0.301; AOFAS score p = 0.001). Six months after the treatment, 78.75% (63/80) of patients were fully functional. Conclusion. The therapy of choice in the treatment of acute Achilles tendon rupture is surgical, as surgical treatment is shorter; rehabilitation is faster and shorter, and the total costs associated with treatment and absence from work are lower.

Keywords: Achilles tendon, scores, ATRS, AOFAS score, VAS pain