Podium (Sports) 08

Achilles Tendon Rupture in athletes Where are we now?

Muhammad Hannan H. Elias, MD
Resident Orthopedic Hospital Kuala Lumpur

Achilles tendon ruptures mainly occur during sports activities, and their incidence has increased over the last few decades due to the increase of demands, high publicity and increase of monetary aspect of the sports industry. An Achilles tendon tears necessitate a prolonged recovery time, sometimes leaving long-term functional limitations. Treatment options include conservative treatment and surgical repair. The diagnosis relies on clinical examination, and imaging techniques can be useful in providing additional clinical information. Acute Achilles tendon rupture usually occurs in its mid-portion which is 2 to 6 cm proximal from the insertion on the calcaneus. The poor vascularity in the main body of the Achilles tendon may play an important role in the pathogenesis of the rupture and determining the prognosis. Because there is conclusive evidence that outcomes after surgical and non-surgical treatment of Achilles tendon rupture are comparable and the optimal treatment is continuously debated hence methods of rehabilitation are becoming increasingly significant. Return to sport is crucial for all the athletes who suffered from an Achilles tendon tear. This kind of injury is significant and severely affects the ability of athletes to play at a highest level. Surgical intervention has been noted to provide improved strength compared with functional rehabilitation, and even if this might not be critical for most individuals, for elite athletes it could be career ending, therefore, surgical intervention is a gold standard recommendation for all elite athletes wishing to return to sport at the highest level. Post-operatively, we recommend for two weeks the ankle is immobilized in plantar flexion with brace or slab to facilitate healing of the tendon. At 3 week we start patient on full weight bearing and allow neutral dorsiflexion. At 6 weeks full range of movement was allowed.