CME OnDemand: 2022 AOFAS Annual Meeting-Time to Surgery and Technique as Predictors of Complications after Surgical Treatment of Achilles Ruptures: A Retrospective Study

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This retrospective study aimed to determine if the time to surgery and the surgical technique used were predictors of complications after surgical treatment of Achilles ruptures. A total of 361 patients who underwent Achilles rupture repair surgery (ARRS) from October 2016 to November 2020 were analyzed. The patients were divided into three categories based on the time to surgery: acute (<2 weeks), sub-acute (2-6 weeks), and chronic (>6 weeks).<br /><br />Complications were categorized as minor or major, re-rupture, venous thromboembolism (VTE), and others. The study found that there was no statistically significant relationship between time to surgery, surgical technique, or functional outcomes scores with post-surgical complications. However, complications and re-ruptures were more frequent in patients who underwent surgery more than 6 weeks after the injury.<br /><br />The study also compared the average operating time between open and percutaneous (perc) surgical techniques and found that open ARRS had a significantly longer operating time. There was a trend towards increased complications in the chronic group, especially Achilles tendon re-rupture. However, no statistical differences were determined between time to surgery or surgical technique and complications among the groups.<br /><br />In terms of functional outcomes, there were no statistically significant differences between the groups. Only 101 out of 361 patients completed follow-up surveys, and no statistical differences in functional outcomes scores were found between the groups.<br /><br />Overall, this study did not demonstrate any statistically significant relationship between time to surgery, surgical technique, or functional outcomes scores with post-surgical complications following ARRS. However, an increased time to surgery may be a predictor of increased risk for complications. Further analysis is needed to identify significant variables affecting ARRS outcomes.<br /><br />The study concluded that time to surgery and the choice of surgical technique did not significantly predict complications or functional outcomes after surgical treatment of Achilles ruptures. However, increased time to surgery may increase the risk of postoperative complications.

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Jeremy J. Kalma, MD, Michael A. Hewitt, BA, Sara E. Buckley, DO, Katherine D. Drexelius, Daniel K. Moon, MD, MS, MBA, Joshua A. Metzl, MD, Courtney Grimsrud, MD, Kenneth J. Hunt, MD

Keywords

retrospective study

time to surgery

surgical technique

complications

Achilles ruptures

Achilles rupture repair surgery

acute

sub-acute

chronic

functional outcomes scores