“The Achilles tendon, if bruised or cut, causes the most acute fevers, induces choking, deranges the mind, and at length brings death.” (Hippocrates)
Current Concepts in Achilles Tendon Rupture
|The first work in DJO Publications “Current Concepts in Orthopaedics” series - Current Concepts in Achilles Tendon Rupture was launched at ESSKA in May 2008. The book is the culmination of the work of The Achilles Tendon Study Group (AT Study Group) which has, over the last fifteen months, gathered to discuss the best available evidence and expert opinion on the aetiology, diagnosis and treatment of Achilles tendon ruptures. Having examined in depth the international achievements and directions taken by this distinguished group of authors, the AT Study Group will present their findings in a special 60 minute symposium at ESSKA.
Achilles tendon ruptures are relatively common. Although the Achilles tendon, formed by the merging of the tendons of gastrocnemius and soleus, is the thickest and strongest tendon in the human body, it remains susceptible to injury. During the last two decades, the incidence of spontaneous ruptures has been rising, probably because of the increasing keep-fit culture. Approximately 75% of Achilles tendon ruptures occur during sports activities. Several aetiological hypotheses have been proposed, including the adverse influence of corticosteroids, fluoroquinolone antibiotics, exercise-induced hyperthermia and mechanical abnormalities of the foot. The diagnosis of an acute rupture can usually be made clinically.
Recently, several meta-analyses on management were published but there is still a lack of consensus on the best management of the acute Achilles tendon rupture. Management can be broadly classified into operative and non-operative treatment. Generally, open operative management has been used in athletes and young, fit patients, percutaneous operative in those who do not wish to have an open repair, and non-operative management in the elderly. Recent systematic reviews have concluded that operative management has a lower re-rupture rate, but must be balanced by the risks associated with surgery. Recent studies have demonstrated the beneficial effect of functional after-treatment in a mobile cast or brace.
The Achilles Tendon Study Group
In 2007, the Achilles Tendon Study Group was founded to promote the research and scientific study of injuries to the Achilles tendon. The Study Group meets over one day every year. In the even years, the meeting takes place in the same venue of and immediately before the biannual ESSKA 2000 Congress. The other years, the meeting takes place in the same venue of and immediately before the biannual ISAKOS Congress. Current Concepts in Achilles Tendon Rupture is the first product of the group, and is part of an upcoming current concepts series on ailments of the Achilles tendon.
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