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Related Experiment Video

Updated: Sep 20, 2025

Author Spotlight: Effectiveness of Extracorporeal Shockwave Therapy in Achilles Tendinopathy Treatment

Author Spotlight: Effectiveness of Extracorporeal Shockwave Therapy in Achilles Tendinopathy Treatment

Published on: August 2, 2024

PROMIS Outcomes After Operative vs Nonoperative Treatment of Achilles Rupture.

Philomena Burger¹, Mina Botros², Zein El-Zein^2,3

¹University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.

Foot & Ankle International

|May 26, 2025

Summary

Operative and nonoperative treatments for Achilles tendon rupture yield similar patient-reported physical function outcomes. Surgery increases wound complications and shows slower initial improvements in pain and depression.

Keywords:

Achilles rupture Achilles tendon rehabilitation surgery

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Last Updated: Sep 20, 2025

Author Spotlight: Effectiveness of Extracorporeal Shockwave Therapy in Achilles Tendinopathy Treatment

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Published on: August 2, 2024

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Author Spotlight: Exploring the Complexities of Achilles Tendon Injuries — Research and Future Directions

Author Spotlight: Exploring the Complexities of Achilles Tendon Injuries — Research and Future Directions

Published on: October 27, 2023

Area of Science:

Orthopedic Surgery
Sports Medicine
Rehabilitation Science

Background:

Achilles tendon rupture is a common injury in adults.
The optimal management strategy (operative vs. nonoperative) remains debated.
Patient-reported outcomes are crucial for evaluating treatment effectiveness.

Purpose of the Study:

To compare patient-reported outcomes using the Patient-Reported Outcomes Measurement Information System (PROMIS) after operative and nonoperative treatment of acute Achilles rupture.
To evaluate differences in physical function, pain interference, and depression between treatment groups.
To assess secondary outcomes including complications and re-rupture rates.

Main Methods:

A retrospective cohort study included 216 patients with Achilles ruptures (115 nonoperative, 101 operative).
PROMIS physical function (PF), pain interference (PI), and depression scores were prospectively collected.
Minimal clinically important difference (MCID) was determined using a distribution-based method (½ SD).

Main Results:

Both operative and nonoperative treatments improved PROMIS PF, PI, and depression scores.
No statistically significant difference was found in PROMIS scores at 6 months or final follow-up between groups.
Operative management led to increased wound complications (scarring, infection, delayed healing) compared to nonoperative care.

Conclusions:

Operative management of Achilles tendon rupture was not associated with statistically meaningful differences in patient-reported physical function compared to nonoperative treatment.
Surgery resulted in higher rates of wound complications.
Nonoperative treatment may offer advantages regarding initial pain and depression symptom improvement.