Achilles tendon rupture

NewsBot · Nov 7, 2025

Retrospective Epidemiological Study of Achilles
Tendon Ruptures
Edmond F. Iradukunda , Abdul Hadi Kafagi , Mustafa Farooqi , Anand Pillai
Source

Whilst the epidemiology of Achilles tendon ruptures (ATRs) is well known in the context of other countries,
not many epidemiological studies have been conducted in the UK, demonstrating the lack of recent, reliable
data relevant to our population context.
The approach taken was retrospective data collection of ATRs and relevant history from participants’
electronic patient records (EPR), followed by a telephone interview to confirm and investigate data points
not included in patient notes.
From a sample of 88 participants, 76% were male, and the median age was 44. The most prevalent activity
and mechanism of injury was playing football (39%), and accelerating from a stationary position (30%). ATRs
were predominantly sports-related (67%), and the incidence of sports-related ATRs and total ATRs was
greatest during summer (34%), followed by spring (30%). The median (IQR) age of participants with sports-
related ATRs was 40.0 (35.0 - 45.5) years, compared to 65.5 (54.0 - 73.5) years for non-sports-related ATRs.
In this sample, ATRs most commonly occur in middle-aged men in a sporting context during the spring and
summer seasons. Non-sports-related ATR incidence is greater in older age groups. These results are
consistent with both local British studies and international studies, but limitations to this study highlight
the need for further research with a similar methodology and greater scale, which would aid in identifying
high-risk groups that could benefit from tailored injury prevention strategies
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NewsBot · Nov 11, 2025

Return to Running After Achilles Tendon Repair: How Do US Navy Service Members’ Physical Readiness Tests Change After Undergoing an Achilles Tendon Repair?
Vitha, Anneliese et al
Clinical Orthopaedics and Related Research 483(11) 2012-2018, November 2025. | DOI: 10.1097/CORR.0000000000003590

Background

Achilles tendon ruptures are common injuries among adults that can cause substantial pain and disability. While prior studies have reported on return-to-play rates in athletes, limited data exist regarding functional outcomes in both runners and within a military population; such data may also help inform care for active civilian patients.
Questions/purposes

(1) How do US Navy service members undergoing Achilles tendon repairs perform on the cardiovascular section of their physical readiness test preoperatively compared with postoperatively? (2) How do US Navy service members undergoing Achilles tendon repairs perform on the cardiovascular section of their physical readiness test on consecutive postoperative physical readiness tests?
Methods

This was a retrospective analysis of data from 2014 to 2020 from the outpatient Military Health System Medical Data Repository and Physical Readiness Information Management System. Achilles tendon rupture was identified using a procedure code from the Medical Data Repository (code 27650). The Physical Readiness Information Management System has electronic records of all the physical readiness tests completed by Navy personnel. As such, the study was limited to Navy personnel. The study cohort included 1057 Navy personnel who sustained an Achilles tendon rupture and underwent operative repair. Service members who underwent more than one operative repair during the study period (9.8% [104 of 1057]) were excluded. Another 41.7% (441 of 1057) were excluded for not having a valid cardiovascular physical readiness test within 30 to 730 days before or 90 to 730 days after operative repair. Forty-three percent (451 of 1057) of Navy personnel were included in the analyzed cohort. These service members underwent one Achilles tendon repair and had cardiovascular physical readiness test assessments from before and after the operative repair. The cardiovascular component was stratified into four subgroups: individuals who biked before and after Achilles tendon rupture (35% [156 of 451]), those who ran (28% [127]), those who ran before Achilles tendon rupture but transitioned to another cardiovascular test after operative repair (32% [144]), and those who performed an alternative cardiovascular test (5% [24]). Cardiovascular assessments performed 30 to 730 days before were utilized to capture all patients who had completed an assessment within the 2 years prior to sustaining the Achilles tendon rupture. Postoperatively, cardiovascular assessments would not typically be recommended by the orthopaedic surgeon until at least 90 days after the procedure. Postoperative cardiovascular assessments were included up to 2 years postoperatively to evaluate initial performance after surgical repair and subsequent performances if numerous physical readiness tests were completed after the repair. The study cohort was predominantly male (94.4%) with a mean age of 33 years. Differences in physical readiness test scores before and after Achilles tendon repair for the bike and run subgroups were compared while adjusting for age, time since procedure, and sex. Changes in physical readiness test categories before and after Achilles tendon rupture were evaluated by converting the categories into discrete scores (outstanding = 5, excellent = 4, good = 3, satisfactory = 2, probationary = 1, failure = 0) and using a paired t-test for all cardiovascular subgroups. For example, a US Navy male age 30 to 35 years would receive an outstanding (discrete score = 5) if his 1.5-mile run time was < 10 minutes, while he would receive a failure, discrete score of 0, if his 1.5-mile run time was > 14 minutes and 30 seconds. The proportions of individuals who improved, decreased, or maintained fitness categories were reported. The analysis described was repeated for a subgroup of individuals who completed two postoperative cardiovascular physical readiness tests.
Results

We found that individuals performed worse on their physical readiness tests after Achilles tendon rupture compared with their preinjury scores for the biking subgroup (10 seconds; p = 0.02) and the 1.5-mile running subgroup (41 seconds; p < 0.001). When analyzing the changes in fitness category levels, there was no difference for the biking subgroup. Eighty-five percent (132 of 156) of individuals maintained or improved their physical readiness test scores after Achilles tendon rupture for the biking subgroup, in contrast to 74% (106 of 144) for the run-to-another subgroup and 69% (88 of 127) for the running subgroup. There were between 0% (0) and 1.5% (2) first-time physical readiness test failures after Achilles tendon repair. Last, 165 members underwent additional analysis with two postoperative physical readiness test scores available for the biking and running subgroup. Participants improved their running scores (18 seconds; p = 0.004) but not their biking scores.
Conclusion

Our findings can help orthopaedic surgeons to counsel active individuals, especially male runners. Runners undergoing Achilles tendon repair may run more slowly (approximately 41 seconds on a 1.5-mile run); however, these times will tend to improve over time even 1 year after Achilles tendon repair. Still, numerous unanswered questions remain regarding whether these changes in run times persist when compared with nonoperatively treated Achilles tendon ruptures, the specific type of surgical procedures performed, and the postoperative protocol utilized, which are all avenues for future research.
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NewsBot · Nov 22, 2025

Does Suture Configuration Matter in Achilles Tendon Repairs?
Nathan Benner et al
Cureus. 2025 Oct 20;17(10):e94982.

Background: The human Achilles tendon is functionally important for dynamic activities and is a common site of tendon rupture, resulting in pain, weakness, and removal from sport. While treatment options vary and the opinions regarding optimal management are not uniform, percutaneous repair through commercially available guides is one option that has been used in the United States.

Hypothesis/purpose: The purpose of this study was to test the mechanical properties of four common suture configurations in the repair of Achilles tendon ruptures.

Study design: This biomechanical study utilized porcine toe flexor tendons as an analogue for the human Achilles tendon.

Methods: Simulated rupture was performed, and tendons were repaired using a percutaneous guide. The technique was uniform with predetermined allotment into one of four groups based on suture configuration (single or double locked) and type (round or flat), with a total of 10 specimens in each group. Specimens then underwent a static creep test, a dynamic load creep test, and finally a load-to-failure test. An analysis of variance was performed to test for differences between the variables, followed by pairwise comparisons using independent t-tests to assess inter-group differences if significant effects were found, adjusted for multiple comparisons.

Results: No significant differences were seen between conditions for the creep tests. The suture configuration used was determined to have a significant effect on the maximum load to failure of the constructs (p = 0.018) and maximum stress in the construct during the load-to-failure test (p = 0.019). Double tape had a significantly greater load to failure than the single round and single conditions and reached greater stresses before failure (respectively). No significant differences were found between the double tape and double round techniques, nor between the double round and either of the single techniques for any of the load-to-failure variables.

Conclusion: The results of this study, using a porcine model to simulate a minimally invasive technique for Achilles tendon repairs, suggest that the use of a double-locked tape suture configuration leads to a stronger overall construct.
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NewsBot · Dec 1, 2025

Suspected Achilles Tendon Ruptures and the Course of Action: Assessing Compliance With Local Protocols
Hassan Imtiaz et al
Cureus. 2025 Oct 23;17(10):e95225.

Introduction: Achilles tendon rupture is a significant injury that can cause prolonged disability and impact quality of life. It typically occurs during sports or activities involving sudden loading of the tendon, most often in active adults. Early recognition and appropriate management are vital to reduce complications, optimise healing, and support timely return to function. Clinical pathways provide structured guidance for consistent care, including immobilisation, prophylaxis, imaging, and specialist follow-up. Variation in adherence to such pathways may compromise outcomes. Clinical audit provides a means to evaluate current practice against pathway standards, while closed-loop audits allow assessment of targeted interventions aimed at improving compliance.

Methods: A closed-loop audit was performed at a large district general hospital to assess compliance with a locally developed Achilles tendon rupture pathway. The first cycle reviewed 138 patients between October 2022 and September 2023. Following the dissemination of results, display of posters in relevant areas, and introduction of a dedicated "Ultrasound Achilles" request form, a second cycle reviewed 44 patients between March and June 2024. Standards included venous thromboembolism (VTE) prophylaxis, weight-bearing advice, immobilisation, ultrasound imaging within 14 days, and referral to a virtual fracture clinic (VFC). Data were analysed using chi-squared tests.

Results: In cycle 1 (n = 138), compliance was as follows: VTE prophylaxis 110/138 (80%); immobilisation in boot 110/138 (80%); ultrasound within 14 days 59/138 (43%); non-weight-bearing advice 91/138 (66%); and VFC referral 132/138 (96%). In cycle 2 (n = 44), after interventions including pathway dissemination and the introduction of a dedicated "Ultrasound Achilles" request form, compliance improved in several domains: VTE prophylaxis 35/44 (80.5%, p = 0.91); immobilisation 38/44 (86%, p = 0.04); ultrasound within 14 days 26/44 (59%, p = 0.03); non-weight-bearing advice 29/44 (66%, p = 0.99); and VFC referral 44/44 (100%, p = 0.01). No re-ruptures or venous thromboembolic events were recorded in either cycle.

Conclusion: Targeted interventions improved compliance with several aspects of the pathway, though VTE prophylaxis prescribing showed little progress. Ongoing education, structured pathways, and regular re-audits are essential to sustain improvement and ensure optimal outcomes.
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NewsBot · Dec 2, 2025

Management and Functional Outcomes After Postoperative Achilles Tendon Infection: A Retrospective Case Series
Saanchi K. Kukadia, et al
Source

Background:
Achilles tendon repairs and reconstructions have historically been associated with high infection rates because of poor vascularity. However, newer surgical infection control strategies can reduce morbidity associated with infection. We hypothesized that with appropriate treatment and management of these infections, patients can reach high levels of physical function with minimal pain comparable to those without postoperative infection.
Methods:
Chart review was conducted for all patients who underwent Achilles tendon surgery at our institution between 2011 and 2020. We identified patients who experienced postoperative wound infection requiring return to the operating room. Clinical outcomes, antibiotic type, and duration were recorded. Patient-Reported Outcomes Measurement Information System (PROMIS) surveys were sent to all patients at a minimum of 1 year postoperatively.
Results:
A total of 1148 patients underwent Achilles tendon surgery, of whom 23 patients (2.0%) experienced a postoperative wound infection requiring surgical intervention. Ten patients who presented from outside institutions with an existing Achilles infection were included for management/outcome descriptions but excluded from risk-factor incidence analyses because of missing index-procedure details, increasing the overall cohort to 33. Among 604 acute repairs, 8 patients (1.32%) developed infections, compared with 15 of 544 chronic tendinopathy cases (2.75%). In chronic cases, graft use was associated with higher infection rate (8.96% vs 0.73%, P < .0001). Patients with postoperative infection demonstrated significantly worse in physical function (46.9 vs 51.6, P = .01) and pain interference (52.1 vs 48.1, P = .03) PROMIS scores. No other PROMIS domains showed significant difference between the 2 cohorts. By 18 months postoperatively, 26 of the 33 patients (78.78%) could toe-walk on the affected side with little to no difficulty.
Conclusion:
Early, aggressive management yields good recovery after postoperative infection; however, residual deficits in function and pain persist compared with uninfected peers in our cohort at 2-year follow-up.
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Achilles tendon rupture

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Achilles tendon rupture

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Depression folowing surgery for an achilles tendon rupture

Are bacteria involved in achilles tendon ruptures?

Past ruptured achilles tendon

Achilles Tendon rupture and Plantar Fasciitis

Relief and Recovery: How Atlas Biomechanics Cork Heel Lifts Treat Achilles Tendonitis

Testosterone replacement therapy is associated with increased odds of Achilles tendon injury

Achilles Tendon and Femoral Cartilage Thickness in Flatfoot

Share This Page

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