Is surgery the best option for ruptured Achilles tendons in young adults?

There continues to be debate regarding the optimal treatment of acute Achilles tendon rupture (ATR). Over the past 15 years, a growing number of studies have compared nonoperative vs operative treatment of ATR, providing clinicians with estimates of treatment success and complication rates for these approaches. 

An Achilles tendon rupture typically means surgery for many patients.

A research team led by Laurence Ge, M.D., an orthopaedic surgery resident mentored by Paul Talusan, M.D. at University of Michigan Health looked at the difference in outcomes of those treated with and without surgical procedures for their Achilles tendon ruptures in young adults.

While surgical Achilles tendon repairs reattach the torn tendon to help the torn pieces fuse together again, there is a rehab protocol that can avoid surgery. This protocol involves the patient flexing their foot down to help bring the pieces of the tendon close together during scarring, creating the same effect a surgical procedure would have.

The study looked at patients between the ages of 18 and 30 who are not athletes to assess their outcomes from both types of treatment for ruptured Achilles tendons.

“Patients under 30 years of age will typically receive a surgical repair when their Achilles tendon is ruptured due to being more physically active,” said Ge.

“However, our research showed that there is little difference between surgical repair and rehabbing the ruptured Achilles tendon when it comes to ability to function.”

The findings provide more treatment options for these patients.

“We hope that this will help reassure patients and physicians about the outcomes of non-surgical repairs for ruptured Achilles tendons,” said Ge.

“Regardless, it is always important to discuss with your physician what is best for you when it comes to these types of injuries.”

Reference:

Ge L, Saunders N, Betts D, Holmes JR, Walton DM, Talusan PG. Midterm Outcomes of Operatively and Nonoperatively Managed Achilles Tendon Ruptures in Young Adults. Foot Ankle Orthop. 2023 Sep 26;8(3):24730114231198849.

doi: 10.1177/24730114231198849