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PMID: 20675643 J Am Acad Orthop Surg. 2010 Aug;18(8):503-10.

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Diagnosis and treatment of acute Achilles tendon rupture.

Chiodo CP Glazebrook M Bluman EM Cohen BE Femino JE Giza E Watters WC 3rd Goldberg MJ Keith M Haralson RH 3rd Turkelson CM Wies JL Raymond L Anderson S Boyer K Sluka P.

Chiodo CP, JAAOS 2010

Pubmed

This clinical practice guideline is based on a series of systematic reviews of published studies in the available literature on the diagnosis and treatment of acute Achilles tendon rupture. None of the 16 recommendations made by the work group was graded as strong; most are graded inconclusive; four are graded weak; two are graded as moderate strength; and two are consensus statements. The two moderate-strength recommendations include the suggestions for early postoperative protective weight bearing and for the use of protective devices that allow for postoperative mobilization.

Polls results

¹

On a scale of 1 to 10, rate how much this article will change your clinical practice?

NO change

BIG change

78% Article relates to my practice (40/51)

9% Article does not relate to my practice (5/51)

11% Undecided (6/51)

²

Will this article lead to more cost-effective healthcare?

62% Yes (32/51)

27% No (14/51)

9% Undecided (5/51)

³

Was this article biased? (commercial or personal)

5% Yes (3/51)

88% No (45/51)

5% Undecided (3/51)

⁴

What level of evidence do you think this article is?

11% Level 1 (6/51)

23% Level 2 (12/51)

31% Level 3 (16/51)

15% Level 4 (8/51)

17% Level 5 (9/51)

Cards

1 of 0

(OBQ10.36) A 58-year-old golfer fell stepping into a sand trap and ruptured his Achilles tendon one year ago. He initially chose non-operative treatment, but became unsatisfied with a tender fullness behind his ankle and ankle weakness noticeable during his tee shots. At the time of surgery, a large disorganized fibrous mass is found at the site of rupture. Following extensive debridement there is a 5 cm gap between viable tissue ends. Which of the following surgical techniques provides the greatest likelihood of a successful clinical outcome?

QID: 3124

Type & Select Correct Answer

Type in at least one full word to see suggestions list

Gastocnemius turndown repair augmented with transfer of the posterior tibial tendon

5%

(171/3297)

Gastocnemius turndown repair augmented with transfer of the extensor digitorum longus

3%

(90/3297)

Gastocnemius turndown repair augmented with transfer of the flexor hallucis longus

85%

(2789/3297)

Reconstruction with hamstring autograft

6%

(200/3297)

Primary repair with the foot in maximal plantarflexion followed by a gradual stretching program

1%

(31/3297)

Select Answer to see Preferred Response

SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic

(OBQ04.136) A 41-year-old female feels a pop in her ankle while playing tennis. She is diagnosed with an acute Achilles tendon rupture and elects to undergo nonoperative management. Which of the following is the expected outcome seen with nonoperative management with early functional rehabilitation as compared with operative treatment?

QID: 1241

Type & Select Correct Answer

Type in at least one full word to see suggestions list

Decreased incidence of deep venous thrombosis

7%

(124/1870)

No significant difference in functional outcomes

51%

(962/1870)

Increased rate of re-rupture

24%

(450/1870)

Earlier return to sport

9%

(173/1870)

Increased rate of complications

8%

(148/1870)

Select Answer to see Preferred Response

SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic