Epidemiology of Achilles tendon ruptures in the United States: 2019 to 2024

The Achilles tendon (AT) is the strongest tendon in the human body; however, the incidence of Achilles tendon ruptures (ATRs) continues to rise. This study aimed to update the epidemiology of ATRs in the United States from 2019 to 2024, with emphasis on demographic patterns and mechanisms of injury.

Patients presenting to the emergency department with ATRs from 2019 to 2024 were identified using the National Electronic Injury Surveillance System database. Demographic variables including age, sex, and race were extracted, and national incidence estimates were calculated. Injury mechanisms were analyzed overall and in subgroup analyses stratified by demographic characteristics.

An estimated 31,549 ATRs occurred in the United States during the study period, with significant variation over time (p < 0.001). Males accounted for 86.31% of all ruptures (p < 0.001). The highest incidence occurred in the 20-39-year age group for both males and females, with incidence rates of 6.10 (95% CI, 6.01-6.19) and 0.89 (95% CI, 0.86-0.93) per 100,000 person-years, respectively. White (38.21%) and Black (29.28%) individuals comprised the largest proportion of reported cases. Basketball was the most common sport leading to ATRs for men, ages <60 years, and most races included in this study.

Young male patients (20 to 39-years-old) who participate in recreational sports continue to be at the highest risk for ATRs. Basketball was associated with most of the ATRs for males and individuals between ages <60 years, while ball sports/other (ie, pickleball, etc.) was popular among individuals 60+ years and females. The results of this study emphasize the need for raising awareness among high-risk individuals to promote injury prevention.

Clinical Research IV: epidemiology study.