Management and Functional Outcomes After Postoperative Achilles Tendon Infection: A Retrospective Case Series.

Area of Science:

• Orthopedic Surgery
• Infectious Disease Management
• Musculoskeletal Health

Background:

• Achilles tendon surgery historically has high infection rates due to poor vascularity.
• Newer surgical infection control strategies can mitigate associated morbidity.
• Effective management of postoperative infections may allow patients to achieve high functional levels with minimal pain.

Purpose of the Study:

• To evaluate the functional outcomes and pain levels in patients who develop postoperative infections after Achilles tendon surgery.
• To compare outcomes of infected patients with a cohort of uninfected patients.
• To identify risk factors for infection in Achilles tendon surgery.

Main Methods:

• Retrospective chart review of Achilles tendon surgeries (2011-2020).
• Identification of patients with postoperative wound infections requiring reoperation.
• Assessment of clinical outcomes, antibiotic use, and PROMIS (Patient-Reported Outcomes Measurement Information System) scores at least 1 year postoperatively.

Main Results:

• 2.0% of 1148 patients developed postoperative infections; graft use in chronic cases significantly increased infection risk (8.96%).
• Infected patients reported significantly worse PROMIS physical function (46.9 vs 51.6) and pain interference (52.1 vs 48.1) scores.
• By 18 months, 78.78% of infected patients could toe-walk with little difficulty.

Conclusions:

• Early and aggressive management of postoperative Achilles tendon infections leads to good recovery.
• Despite effective treatment, patients with infections experience persistent deficits in physical function and increased pain compared to uninfected peers at 2-year follow-up.