Brake Response Time Recovery After Achilles Tendon Repair

Background. This study evaluated when patients' brake response time (BRT) recovers after right Achilles repair. Methods. Institutional review board-approved prospective study of 60 patients. Assessments included visual analogue scale pain (VAS) score, Achilles Tendon Total Rupture Score (ATRS), and a driver readiness survey. Emergent brake pedal operation was simulated at 6 weeks postoperatively and repeated until patients achieved a passing BRT. Results. Fifty-seven patients completed the study. At 6 weeks, 54 of 59 (91.5%) patients had a passing BRT with a mean of 0.60 seconds (SD 0.08 seconds). Five (8.5%) patients had a failing BRT with a significantly higher mean of 0.95 seconds (SD 0.13 seconds, P = .01). At first testing, all patients were ambulating in a walking boot with removable heel wedges. Those who passed were using significantly fewer wedges (mean 1.9 vs 2.6 wedges, P = .04). Mean VAS pain scores (Passed: 1.1, SD 1.57, vs Failed: 2.8, SD 3.35, P = .32) were not significantly different. The mean ATRS was significantly lower among those who passed (63.7, SD 16.7, vs 85.4, SD 11.1, P = .01. Three patients repeated testing at a mean 7.3 weeks (range 6.7-8). All achieved passing times (mean 0.68 seconds, range 0.55 to 0.77 seconds). The driving readiness survey was 100% sensitive but 31.3% specific for passing BRT. Its positive predictive value was 80%, and its negative predictive value was 100%. Conclusion. BRT normalizes around 6 to 7 weeks after open right Achilles tendon repair. The ATRS and driver readiness questionnaire corresponded to achieving a passing BRT. Levels of Evidence: Prognostic Level II: Prospective Cohort Study.