Achilles Tendon Rupture – The Impact on Athlete Performance

Ankle osteoarthritis is a condition that causes pain and stiffness in the ankle joint. Traditional treatments like joint fusion can limit mobility. An alternative procedure called ankle distraction arthroplasty has been gaining some traction, but how well does it hold up in the long term? 

A recent study by Greenfield et al. (2019) investigated this very question. They conducted a survival analysis of ankle distraction arthroplasty for ankle osteoarthritis. Their findings suggest that this procedure may be a viable option for some patients. 

Key takeaways from the study: 

  • Ankle distraction arthroplasty showed promising results, with an 84% survival rate at 5 years. This is better than some previously reported outcomes. 
  • The study also identified factors that can influence the success of the procedure. Avascular necrosis of the talus (bone death) was associated with a lower survival rate. Additionally, sex may play a role, with the study suggesting potential gender differences in long-term outcomes. 

What this means for patients: 

Ankle distraction arthroplasty offers a potential option for preserving joint mobility in patients with ankle osteoarthritis. This study provides valuable data for surgeons and patients to consider when making treatment decisions. 

Important to note: 

  • This was a retrospective study, meaning researchers analyzed past data. More robust research designs are needed to confirm these findings. 
  • The study involved a relatively small group of patients. Larger studies are necessary to draw more definitive conclusions. 

Overall, this research suggests that ankle distraction arthroplasty may be a valuable tool for treating ankle osteoarthritis. However, more research is needed to solidify its place as a standard treatment option. 

ReferenceGreenfield, S., Matta, K. M., McCoy, T. H., Rozbruch, S. R., & Fragomen, A. (2019). Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies in trauma and limb reconstruction, 14(2), 65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376580/#:~:text=In%20a%20significantly%20larger%20series,and%2037%25%20within%205%20years

Disclaimer:

This blog is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional to discuss your individual treatment options.
 

Image Credit: Inova Newsroom

Article Author: Gordon Slater| Tandose Sambo 

“Your health is what you make of it. Everything you do and think either adds to the vitality, energy and spirit you possess or takes away from it.”- Ann Wigmore

What is Achilles Tendon Rupture? 

Achilles Tendon Rupture is a condition that occurs when the Achilles tendon separates into two parts after the introduction to a stress. With the application of physics, one can see that the induced stress causes the tendon to shear, then break. It is usually associated with hearing a loud “pop” in the feet once there’s a vigorous blow to the heel area. The variation in ankle conditions is expansive, ranging from minor conditions to debilitating conditions where patients cannot walk. 

While the symptom list can be variable, the symptoms of Achilles tendon rupture can be mistaken for additional ailments, so consult with your foot and ankle surgeon in order to determine what the root cause of your ankle pain is! Your condition could be benign, and investigation will be the key to appropriate treatment methods. 

What are the symptoms of Achilles Tendon Rupture? 

An Achilles Tendon Rupture is an injury of the lower leg, and with an impactful blow to the area, the odds of occurrence of the injury are increased. Sports activity is the primary cause of this injury, from a statistical perspective. As a ligament, the Achilles tendon facilitates the flexibility of the ankle joint. Athletes are the number one sufferers from Achilles tendon rupture because of the demands that they have on their feet for mobility. Additionally, risk factors such as age, gender, antibiotic usage, obesity, and steroid usage have proven to increase the odds of Achilles tendon rupture. 

As a strong fibrous cord, via the laws of physics, if stretched to the limit…the Achilles tendon will definitely break. Orthopaedics has identified two different types of rupture of the Achilles tendon: 

  1. Complete rupture: This results in the tearing of the tendon into two segments. 
  2. Partial Rupture: This results in the partial tearing of the tendon. There will still be a joining of the tendon at one phase of the defect, but a separation at one stage. 

Sports Study in Achilles Tendon Rupture and Athlete Performance 

A 2019 study on the Achilles tendon injury, identified the significant impact that the injury had on professional athletes. The sport of focus in the study was American Football, particularly with players in the National Football League. With the majority of players treated via surgical procedures and extensive post surgery physiotherapy, only 61% of the players who were treated for Achilles Tendon Injury were actually able to return to full time play. These statistics indicate that the career impact of the Achilles tendon rupture is notably significant. 

Statistically, 18 out of every 100,000 orthopaedic cases are Achilles tendon ruptures. With the rise in professional sports and athletics in general, the number of Achilles tendon ruptures is expected to increase. While several factors are at play in the induction of an Achilles tendon rupture, the primary impactors are genetics and sports activities. The three positions that induce tendon rupture in patients are: 

1)dorsiflexion of the foot with triceps surae contraction

2) pushing off the weight bearing foot during knee extension

3)dorsiflexion on a plantar flexed ankle

90-100% of Achilles tendon ruptures are induced by these possibilities. Sports, embedded with its rapid accelerations in the players’ speeds, rapid changes in direction and load stresses on the feet, is a primary cause of the Achilles tendon rupture. 

For players in the National Football League, the ability of a player to return to work, was impacted by the level of surgical reconstruction and rehabilitation activities. With a recovery time of 6 to 11 months, the best way to ensure that players remain in the game is to minimize the odds of occurrence of an Achilles tendon rupture. There are space limitations in the league, and an extensive waiting list, so current players should take great care in order to sustain their careers. Medical studies have identified that there are specific positions that impact the type of injury that is incurred. Coaches should then inform the players of their level of risk. Full details of the study are highlighted in the journal article linked below. 

What are the treatment options for Achilles Tendon Rupture?

With an excruciating pain that affects your ability to walk, the most common treatment for Achilles Tendon rupture is a minimally invasive surgical procedure. Surgery is the ideal way to engineer the tendon back to its former glory. As with all surgery, your orthopaedic surgeon will assess the area, usually with a scan like an X-ray in order to determine where the problem is. Post surgery, you will be prescribed a recovery plan, to facilitate your healing. 

While there are non-surgical treatments for Achilles tendon rupture, minimally invasive procedures have proven effective for healing the root cause, particularly for an internal tear. For maintenance of the ankle, stretching exercises have proven effective in facilitating the healing of the ankle regions. An appropriate physiotherapy will aid in the restoration. 

References: 

Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/achilles-tendon-rupture/symptoms-causes/syc-20353234
Washington University School of Medicine Journal Article: https://core.ac.uk/download/pdf/212867768.pdf

Like this article?

Share on Facebook
Share on Twitter
Share on Linkdin
Share on Pinterest

Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

Leave a comment

Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

Copyright © 2022 orthopaedic-surgeon.com.au