Postoperative complications and care requirements following Achilles tendon repair: A retrospective cohort study

Achilles tendon rupture is a common injury in orthopedic and sports medicine practice. Although surgical repair is widely performed, postoperative complications remain clinically relevant and may increase postoperative care burden. This study aimed to investigate postoperative complications and care requirements following Achilles tendon repair and to identify factors associated with postoperative complications. This single-center retrospective cohort study included patients who underwent surgical repair for acute Achilles tendon rupture between January 2021 and December 2024. Demographic characteristics, comorbidities, perioperative variables, postoperative complications, and postoperative care indicators were collected from electronic medical records. The primary outcome was the occurrence of any postoperative complication within 3 months after surgery. Secondary outcomes included length of hospital stay, number of dressing changes, outpatient follow-up visits, unplanned readmission, reoperation, and outpatient secondary wound procedures. Univariate and multivariable logistic regression analyses were performed to identify factors associated with postoperative complications. A total of 86 patients were included, and postoperative complications occurred in 16 patients (18.6%). Wound-related complications were the most common adverse events, including delayed wound healing in 6 patients (7.0%), superficial surgical site infection in 4 (4.7%), deep infection requiring operative debridement in 1 (1.2%), and chronic wound problems requiring prolonged outpatient care in 2 (2.3%). Compared with patients without complications, those with complications had significantly higher body mass index, a higher prevalence of smoking history, and a longer interval from injury to surgery. They also had significantly longer hospital stay, more dressing changes, more outpatient visits, and higher rates of readmission and reoperation. In multivariable analysis, smoking history (odds ratio 3.21, 95% confidence interval 1.07-9.61, P = .037) and interval from injury to surgery (odds ratio 1.36, 95% confidence interval 1.08-1.71, P = .010) remained independently associated with postoperative complications. Postoperative complications following Achilles tendon repair were relatively common and were predominantly wound-related. Patients who developed complications required substantially greater postoperative care. Smoking history and a longer interval from injury to surgery were independently associated with postoperative complications.