Management of acute Achilles tendon ruptures in the United Kingdom.

Abstract

PURPOSE: To survey the management of acute Achilles tendon ruptures in the United Kingdom. METHODS: A questionnaire with 4 different Achilles tendon rupture scenarios affecting patients of different ages and activity levels was sent to orthopaedic consultants specialised in sports trauma, foot and ankle surgery. Their treatment methods including surgical techniques, immobilisation and rehabilitation regimens were surveyed. RESULTS: The response rate was 22% (51/231). Among the 51 respondents, 25 had managed less than 6 such patients in the preceding year. 26 (51%) used clinical examination (e.g. calf squeeze test) to make the diagnosis, 16 (31%) used ultrasonography, and 4 (8%) used magnetic resonance imaging. Surgical management was preferred for younger and more functionally demanding individuals. Open repairs were used more often than percutaneous repairs (72 vs 19%). Across the 4 scenarios, the mean time to return to full activity was 17 (range, 12-32) weeks for conservative to 19 (range, 10-40) weeks for surgical management. CONCLUSION: Variation in opinion among respondents was wide. Randomised controlled trials are needed to assess optimal treatment.