Midterm Outcomes of Operatively and Nonoperatively Managed Achilles Tendon Ruptures in Young Adults

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Musculoskeletal Research

Background:

• Controversy exists regarding optimal treatment for Achilles tendon ruptures (ATR).
• Young adults (18-30 years) represent a distinct demographic for ATR management.
• Previous studies have not specifically evaluated outcomes in this age group.

Purpose of the Study:

• To compare outcomes of operative versus nonoperative management for acute Achilles tendon ruptures in young adults.
• To evaluate differences in deep venous thrombosis (DVT) and rerupture rates.
• To assess patient-reported physical function and pain interference using PROMIS scores.

Main Methods:

• Retrospective cohort study of patients aged 18-30 years with acute ATR.
• Data collected included demographics, BMI, smoking status, CCI, DVT, and rerupture rates.
• PROMIS physical function (PF) and pain interference (PI) questionnaires were administered.

Main Results:

• Operative (n=28) and nonoperative (n=14) cohorts showed no significant differences in age, BMI, DVT rates (6.1% vs 5.4%), or rerupture rates (3.0% vs 2.7%).
• PROMIS PF scores were similar (mean 60.4 vs 62.9, P=.33).
• PROMIS PI scores were also similar (mean 44.6 vs 43.9, P=.59).

Conclusions:

• Young adults with ATR can be considered for either operative or nonoperative management.
• No significant differences were observed in DVT rates, rerupture rates, or PROMIS scores between the two treatment groups.
• Findings should be interpreted considering the study's significant loss to follow-up rate.