![]() ![]() When deciding to perform surgical repair after acute AT rupture, there are several surgical techniques: Open repair using variations of end-to-end Kessler suture, augmented repairs, different techniques of mini-open or percutaneous repair, and anatomical reconstruction have been described. ![]() Especially in an athletic population, it is necessary to maintain the end-range plantarflexion strength in order to allow for the full range of performance as for example during sprinting and jumping. In a clinical setting, this end-range deficit is often evaluated by heel-rise height and heel-rise work, which has been shown to correlate with patient-reported outcome (PRO) and physical performance. However, also in surgical treatment there is a relevant postoperative deficit in plantarflexion strength ranging from 12 to 30%. Regarding lower leg performance, it was recently shown that soleus atrophy is more common in non-surgical treatment resulting in greater strength deficits, especially in end-range plantarflexion. Summarizing the latest evidence, there is a strong tendency toward surgical treatment with accelerated rehabilitation in the young athlete, due to a quicker return to sports, less muscle atrophy, and improved functional performance coupled with a lower risk of re-rupture. Few recent randomized controlled studies have compared surgical to nonoperative treatment and also conservative to accelerated rehabilitation. With the Achilles tendon (AT) ruptures showing a steady increase in incidence over the past decades, there is ongoing debate on the optimal treatment algorithm. Anatomical reconstruction is associated with an improved functional performance potentially due to a more symmetric strength during end-range plantarflexion which transfers into a higher satisfaction during athletic activities.Level of evidenceIII, retrospective cohort study. 29.9%, p ConclusionIn summary, there are persisting functional deficits at > 3 years following Achilles tendon repair which range from strength deficits to specific impairments of functional performance e.g. AR results in a significantly smaller deficit at 10° of plantarflexion compared to CR (13.9 vs. Moreover, analysis of maximum peak torque angle and strength deficits according to the plantarflexion angle revealed that these deficits are not equally distributed across the range of motion. The testing included isokinetic strength testing, a novel setup of heel-rise testing using a marker-based 3D motion analysis system and a gait analysis.ResultsAt an average 3.5 years post-surgery, there is a persisting deficit in plantarflexion strength of 10.2%. conventional repair = CR) were compared in a subanalysis. Two different surgical techniques (anatomical repair = AR vs. The aim of this study was to assess the functional performance at midterm following open surgical repair.Materials and methodsThis cross-sectional study includes n = 52 patients which were tested on average 3.5 ± 1.4 years postoperatively using three different functional performance tests and patient-reported outcome measures. ![]() IntroductionVarious impairments such as soleus atrophy and consecutive functional deficits in end-range plantarflexion have been described in surgical repair of acute Achilles tendon rupture.
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