Insertional versus non-insertional tendoachilles tears: a comparative analysis of various predisposing factors and outcome following a repair
Background Association of tendon degeneration, pre-existing posterior heel pain, Haglund’s bump, retrocalcaneal spur, and mode of injury varies for the insertional and non-insertional type of tendoachilles tears (TA). Purpose The study compares the various predisposing factors that determine the dis...
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| Veröffentlicht in: | International orthopaedics 2022-05, Vol.46 (5), p.1009-1017 |
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| creator | Ramakanth, Rajagopalakrishnan Sundararajan, Silvampatti Ramasamy Goud, B. Harshavardhan Dsouza, Terence Rajasekaran, Shanmuganathan |
| description | Background
Association of tendon degeneration, pre-existing posterior heel pain, Haglund’s bump, retrocalcaneal spur, and mode of injury varies for the insertional and non-insertional type of tendoachilles tears (TA).
Purpose
The study compares the various predisposing factors that determine the distinct type of TA tear and the outcome following a repair.
Methods
This is a retrospective study of the patients who underwent tendoachilles repair during January 2012–June 2018. Patients above 18 years with a minimum follow-up of two years were included. Patients with calcaneal tuberosity avulsions, prior surgeries, and open injuries were excluded. Patients were divided into groups 1 (insertional tears (IT)) and 2 (non-insertional tears (NIT)), and further subdivided based on the tendon degeneration (as D-degenerative and N-normal sub types) from ultrasound findings. AOFAS score and predisposing factors like degeneration, posterior heel pain, Haglund’s bump, spur, and mechanism of injury were compared between the groups.
Results
The study included
N
= 146 with a mean age of 51.6 years and mean follow-up of 38.6 (range 24 to 96) months. IT associated with degeneration (IT-D) had a trivial fall as the predominant mechanism (
P
|
| doi_str_mv | 10.1007/s00264-022-05337-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2629056801</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2629056801</sourcerecordid><originalsourceid>FETCH-LOGICAL-c347t-92574b7b16a1a587d7637d17e380030e5d05e9f337332f9d1f3a73655642cdc83</originalsourceid><addsrcrecordid>eNp9kU9v1DAQxS1ERbeFL8AB-cjF4D-xnXBDFS2VKnEpZ2s2nhRX2Th4kl31Q_CdcdlSceI08szvPVnvMfZWyQ9KSv-RpNSuEVJrIa0xXhxesI1qjBZWdfYl20jTKKFdZ0_ZGdG9lMq7Vr1ip8YqZ33rN-zX9URYlpQnGPkeC63EpzyJ9M96wSlm6H-kcUSqLyj0iQPv826GAkvaI4fKPVAinge-h5JytZkLxkRzpjTd8QH6JReqYOR5XaoW-ZDHMR8er8ALzpDKa3YywEj45mmes--XX24vvoqbb1fXF59vRG8av4hOW99s_VY5UGBbH70zPiqPppXSSLRRWuyGGokxeuiiGgx446x1je5j35pz9v7oO5f8c0Vawi5Rj-MIE9avB-10J61rpaqoPqJ9yUQFhzCXtIPyEJQMjzWEYw2h1hD-1BAOVfTuyX_d7jA-S_7mXgFzBKiepjss4T6vpYZI_7P9DfH7lp0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2629056801</pqid></control><display><type>article</type><title>Insertional versus non-insertional tendoachilles tears: a comparative analysis of various predisposing factors and outcome following a repair</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Ramakanth, Rajagopalakrishnan ; Sundararajan, Silvampatti Ramasamy ; Goud, B. Harshavardhan ; Dsouza, Terence ; Rajasekaran, Shanmuganathan</creator><creatorcontrib>Ramakanth, Rajagopalakrishnan ; Sundararajan, Silvampatti Ramasamy ; Goud, B. Harshavardhan ; Dsouza, Terence ; Rajasekaran, Shanmuganathan</creatorcontrib><description>Background
Association of tendon degeneration, pre-existing posterior heel pain, Haglund’s bump, retrocalcaneal spur, and mode of injury varies for the insertional and non-insertional type of tendoachilles tears (TA).
Purpose
The study compares the various predisposing factors that determine the distinct type of TA tear and the outcome following a repair.
Methods
This is a retrospective study of the patients who underwent tendoachilles repair during January 2012–June 2018. Patients above 18 years with a minimum follow-up of two years were included. Patients with calcaneal tuberosity avulsions, prior surgeries, and open injuries were excluded. Patients were divided into groups 1 (insertional tears (IT)) and 2 (non-insertional tears (NIT)), and further subdivided based on the tendon degeneration (as D-degenerative and N-normal sub types) from ultrasound findings. AOFAS score and predisposing factors like degeneration, posterior heel pain, Haglund’s bump, spur, and mechanism of injury were compared between the groups.
Results
The study included
N
= 146 with a mean age of 51.6 years and mean follow-up of 38.6 (range 24 to 96) months. IT associated with degeneration (IT-D) had a trivial fall as the predominant mechanism (
P
< 0.001). All patients had significant postoperative improvement of scores with no significant difference between the groups (
P
= 0.59) and subgroups (
P
= 0.27).75.34% had degenerative tendon, of which 64.5% were in the IT group and the rest in the NIT group (
P
= 0.02). 51.4% patients had a Haglund bump in the IT group and n.s. (
P
= 0.9). Forty-seven percent of patients had pre-existing posterior heel pain, 68% in IT and 32% in NIT (
P
= 0.04). Subgroup analysis revealed 65% of patients were in the IT-D subgroup (
P
< 0.001).
Conclusion
Predisposing factors like posterior heel pain, tendon degeneration, and trivial trauma have a strong propensity for insertional TA tear. In contrast, the prominence of Haglund’s bump does not predispose to a distinct type of TA tears. The outcome following a surgical repair–yields good results with no difference between the two groups.</description><identifier>ISSN: 0341-2695</identifier><identifier>EISSN: 1432-5195</identifier><identifier>DOI: 10.1007/s00264-022-05337-w</identifier><identifier>PMID: 35165787</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Achilles Tendon - injuries ; Achilles Tendon - surgery ; Calcaneus - injuries ; Calcaneus - surgery ; Causality ; Child ; Child, Preschool ; Foot Diseases ; Humans ; Lacerations ; Medicine ; Medicine & Public Health ; Original Paper ; Orthopedics ; Pain ; Retrospective Studies ; Rupture - surgery ; Tendinopathy - complications ; Tendinopathy - epidemiology</subject><ispartof>International orthopaedics, 2022-05, Vol.46 (5), p.1009-1017</ispartof><rights>The Author(s) under exclusive licence to SICOT aisbl 2022</rights><rights>2022. The Author(s) under exclusive licence to SICOT aisbl.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-92574b7b16a1a587d7637d17e380030e5d05e9f337332f9d1f3a73655642cdc83</citedby><cites>FETCH-LOGICAL-c347t-92574b7b16a1a587d7637d17e380030e5d05e9f337332f9d1f3a73655642cdc83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00264-022-05337-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00264-022-05337-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35165787$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ramakanth, Rajagopalakrishnan</creatorcontrib><creatorcontrib>Sundararajan, Silvampatti Ramasamy</creatorcontrib><creatorcontrib>Goud, B. Harshavardhan</creatorcontrib><creatorcontrib>Dsouza, Terence</creatorcontrib><creatorcontrib>Rajasekaran, Shanmuganathan</creatorcontrib><title>Insertional versus non-insertional tendoachilles tears: a comparative analysis of various predisposing factors and outcome following a repair</title><title>International orthopaedics</title><addtitle>International Orthopaedics (SICOT)</addtitle><addtitle>Int Orthop</addtitle><description>Background
Association of tendon degeneration, pre-existing posterior heel pain, Haglund’s bump, retrocalcaneal spur, and mode of injury varies for the insertional and non-insertional type of tendoachilles tears (TA).
Purpose
The study compares the various predisposing factors that determine the distinct type of TA tear and the outcome following a repair.
Methods
This is a retrospective study of the patients who underwent tendoachilles repair during January 2012–June 2018. Patients above 18 years with a minimum follow-up of two years were included. Patients with calcaneal tuberosity avulsions, prior surgeries, and open injuries were excluded. Patients were divided into groups 1 (insertional tears (IT)) and 2 (non-insertional tears (NIT)), and further subdivided based on the tendon degeneration (as D-degenerative and N-normal sub types) from ultrasound findings. AOFAS score and predisposing factors like degeneration, posterior heel pain, Haglund’s bump, spur, and mechanism of injury were compared between the groups.
Results
The study included
N
= 146 with a mean age of 51.6 years and mean follow-up of 38.6 (range 24 to 96) months. IT associated with degeneration (IT-D) had a trivial fall as the predominant mechanism (
P
< 0.001). All patients had significant postoperative improvement of scores with no significant difference between the groups (
P
= 0.59) and subgroups (
P
= 0.27).75.34% had degenerative tendon, of which 64.5% were in the IT group and the rest in the NIT group (
P
= 0.02). 51.4% patients had a Haglund bump in the IT group and n.s. (
P
= 0.9). Forty-seven percent of patients had pre-existing posterior heel pain, 68% in IT and 32% in NIT (
P
= 0.04). Subgroup analysis revealed 65% of patients were in the IT-D subgroup (
P
< 0.001).
Conclusion
Predisposing factors like posterior heel pain, tendon degeneration, and trivial trauma have a strong propensity for insertional TA tear. In contrast, the prominence of Haglund’s bump does not predispose to a distinct type of TA tears. The outcome following a surgical repair–yields good results with no difference between the two groups.</description><subject>Achilles Tendon - injuries</subject><subject>Achilles Tendon - surgery</subject><subject>Calcaneus - injuries</subject><subject>Calcaneus - surgery</subject><subject>Causality</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Foot Diseases</subject><subject>Humans</subject><subject>Lacerations</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Paper</subject><subject>Orthopedics</subject><subject>Pain</subject><subject>Retrospective Studies</subject><subject>Rupture - surgery</subject><subject>Tendinopathy - complications</subject><subject>Tendinopathy - epidemiology</subject><issn>0341-2695</issn><issn>1432-5195</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9v1DAQxS1ERbeFL8AB-cjF4D-xnXBDFS2VKnEpZ2s2nhRX2Th4kl31Q_CdcdlSceI08szvPVnvMfZWyQ9KSv-RpNSuEVJrIa0xXhxesI1qjBZWdfYl20jTKKFdZ0_ZGdG9lMq7Vr1ip8YqZ33rN-zX9URYlpQnGPkeC63EpzyJ9M96wSlm6H-kcUSqLyj0iQPv826GAkvaI4fKPVAinge-h5JytZkLxkRzpjTd8QH6JReqYOR5XaoW-ZDHMR8er8ALzpDKa3YywEj45mmes--XX24vvoqbb1fXF59vRG8av4hOW99s_VY5UGBbH70zPiqPppXSSLRRWuyGGokxeuiiGgx446x1je5j35pz9v7oO5f8c0Vawi5Rj-MIE9avB-10J61rpaqoPqJ9yUQFhzCXtIPyEJQMjzWEYw2h1hD-1BAOVfTuyX_d7jA-S_7mXgFzBKiepjss4T6vpYZI_7P9DfH7lp0</recordid><startdate>202205</startdate><enddate>202205</enddate><creator>Ramakanth, Rajagopalakrishnan</creator><creator>Sundararajan, Silvampatti Ramasamy</creator><creator>Goud, B. Harshavardhan</creator><creator>Dsouza, Terence</creator><creator>Rajasekaran, Shanmuganathan</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202205</creationdate><title>Insertional versus non-insertional tendoachilles tears: a comparative analysis of various predisposing factors and outcome following a repair</title><author>Ramakanth, Rajagopalakrishnan ; Sundararajan, Silvampatti Ramasamy ; Goud, B. Harshavardhan ; Dsouza, Terence ; Rajasekaran, Shanmuganathan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-92574b7b16a1a587d7637d17e380030e5d05e9f337332f9d1f3a73655642cdc83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Achilles Tendon - injuries</topic><topic>Achilles Tendon - surgery</topic><topic>Calcaneus - injuries</topic><topic>Calcaneus - surgery</topic><topic>Causality</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Foot Diseases</topic><topic>Humans</topic><topic>Lacerations</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Paper</topic><topic>Orthopedics</topic><topic>Pain</topic><topic>Retrospective Studies</topic><topic>Rupture - surgery</topic><topic>Tendinopathy - complications</topic><topic>Tendinopathy - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ramakanth, Rajagopalakrishnan</creatorcontrib><creatorcontrib>Sundararajan, Silvampatti Ramasamy</creatorcontrib><creatorcontrib>Goud, B. Harshavardhan</creatorcontrib><creatorcontrib>Dsouza, Terence</creatorcontrib><creatorcontrib>Rajasekaran, Shanmuganathan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ramakanth, Rajagopalakrishnan</au><au>Sundararajan, Silvampatti Ramasamy</au><au>Goud, B. Harshavardhan</au><au>Dsouza, Terence</au><au>Rajasekaran, Shanmuganathan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Insertional versus non-insertional tendoachilles tears: a comparative analysis of various predisposing factors and outcome following a repair</atitle><jtitle>International orthopaedics</jtitle><stitle>International Orthopaedics (SICOT)</stitle><addtitle>Int Orthop</addtitle><date>2022-05</date><risdate>2022</risdate><volume>46</volume><issue>5</issue><spage>1009</spage><epage>1017</epage><pages>1009-1017</pages><issn>0341-2695</issn><eissn>1432-5195</eissn><abstract>Background
Association of tendon degeneration, pre-existing posterior heel pain, Haglund’s bump, retrocalcaneal spur, and mode of injury varies for the insertional and non-insertional type of tendoachilles tears (TA).
Purpose
The study compares the various predisposing factors that determine the distinct type of TA tear and the outcome following a repair.
Methods
This is a retrospective study of the patients who underwent tendoachilles repair during January 2012–June 2018. Patients above 18 years with a minimum follow-up of two years were included. Patients with calcaneal tuberosity avulsions, prior surgeries, and open injuries were excluded. Patients were divided into groups 1 (insertional tears (IT)) and 2 (non-insertional tears (NIT)), and further subdivided based on the tendon degeneration (as D-degenerative and N-normal sub types) from ultrasound findings. AOFAS score and predisposing factors like degeneration, posterior heel pain, Haglund’s bump, spur, and mechanism of injury were compared between the groups.
Results
The study included
N
= 146 with a mean age of 51.6 years and mean follow-up of 38.6 (range 24 to 96) months. IT associated with degeneration (IT-D) had a trivial fall as the predominant mechanism (
P
< 0.001). All patients had significant postoperative improvement of scores with no significant difference between the groups (
P
= 0.59) and subgroups (
P
= 0.27).75.34% had degenerative tendon, of which 64.5% were in the IT group and the rest in the NIT group (
P
= 0.02). 51.4% patients had a Haglund bump in the IT group and n.s. (
P
= 0.9). Forty-seven percent of patients had pre-existing posterior heel pain, 68% in IT and 32% in NIT (
P
= 0.04). Subgroup analysis revealed 65% of patients were in the IT-D subgroup (
P
< 0.001).
Conclusion
Predisposing factors like posterior heel pain, tendon degeneration, and trivial trauma have a strong propensity for insertional TA tear. In contrast, the prominence of Haglund’s bump does not predispose to a distinct type of TA tears. The outcome following a surgical repair–yields good results with no difference between the two groups.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35165787</pmid><doi>10.1007/s00264-022-05337-w</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0341-2695 |
| ispartof | International orthopaedics, 2022-05, Vol.46 (5), p.1009-1017 |
| issn | 0341-2695 1432-5195 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Achilles Tendon - injuries Achilles Tendon - surgery Calcaneus - injuries Calcaneus - surgery Causality Child Child, Preschool Foot Diseases Humans Lacerations Medicine Medicine & Public Health Original Paper Orthopedics Pain Retrospective Studies Rupture - surgery Tendinopathy - complications Tendinopathy - epidemiology |
| title | Insertional versus non-insertional tendoachilles tears: a comparative analysis of various predisposing factors and outcome following a repair |
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