Older Age Predicts Worse Function 1 Year After an Acute Achilles Tendon Rupture: A Prognostic Multicenter Study on 391 Patients
Background: There is limited evidence regarding the patient-related factors that influence treatment outcomes after an acute Achilles tendon rupture. Purpose/Hypothesis: The purpose of this study was to determine the predictors of functional and patient-reported outcomes 1 year after an acute Achill...
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| Veröffentlicht in: | ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE 2018-12, Vol.6 (12), p.2325967118813904-2325967118813904 |
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| creator | Westin, Olof Svedman, Simon Senorski, Eric Hamrin Svantesson, Eleonor Nilsson-Helander, Katarina Karlsson, Jón Ackerman, Paul Samuelsson, Kristian |
| description | Background:
There is limited evidence regarding the patient-related factors that influence
treatment outcomes after an acute Achilles tendon rupture.
Purpose/Hypothesis:
The purpose of this study was to determine the predictors of functional and
patient-reported outcomes 1 year after an acute Achilles tendon rupture using a
multicenter cohort and to determine patient characteristics for reporting within the top
and bottom 10% of the Achilles tendon Total Rupture Score (ATRS) and heel-rise height
outcomes. The hypothesis was that older age, greater body mass index (BMI), and female
sex would lead to inferior outcomes.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Patients were selected by combining 5 randomized controlled trials from 2 different
centers in Sweden. Functional outcomes were assessed using validated heel-rise tests
(height, number of repetitions, total work, and concentric power) for muscular endurance
and strength, and the relationship between injured and uninjured legs was calculated as
the limb symmetry index (LSI). Patient-reported outcomes were measured using the ATRS.
All outcomes were collected at the 1-year follow-up. Independent predictors included
were patient sex, smoking, BMI, age, and surgical versus nonsurgical treatment.
Results:
Of the 391 included patients, 307 (79%) were treated surgically. The LSI of heel-rise
height at the 1-year follow-up decreased by approximately 4% for every 10-year increment
in age (beta, –3.94 [95% CI, –6.19 to –1.69]; P = .0006). In addition,
every 10-year increment in age resulted in a 1.79-fold increase in the odds of being in
the lowest 10% of the LSI of heel-rise height. Moreover, a nonsignificant superior LSI
of heel-rise height was found in patients treated surgically compared with nonsurgical
treatment (beta, –4.49 [95% CI, –9.14 to 0.16]; P = .058). No
significant predictor was related to the ATRS. Smoking, patient sex, and BMI did not
significantly affect the 1-year results for the LSI of the heel-rise tests.
Conclusion:
Older age at the time of injury negatively affected heel-rise height 1 year after an
Achilles tendon rupture. Irrespective of age, a nonsignificant relationship toward the
superior recovery of heel-rise height was seen in patients treated surgically. None of
the factors studied affected patient-reported outcomes. |
| doi_str_mv | 10.1177/2325967118813904 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_482905</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_2325967118813904</sage_id><sourcerecordid>2179339797</sourcerecordid><originalsourceid>FETCH-LOGICAL-c510t-f285d1bc7293a278708c9f68d29c9be8e49a824b96f9f66443d27bc14ce230033</originalsourceid><addsrcrecordid>eNp9kk1v1DAQhi0EotXSOyfkI5eAP5LY5oC0qiggFbWCIsTJcpxJ6pKNF3-AeuKv42iXaosEPtij18-845EHoaeUvKBUiJeMs0a1glIpKVekfoCOF6latIcH8RE6ifGGlCUbqrh4jI44aZlopDhGvy6mHgJej4AvA_TOpoi_-BABn-XZJudnTPFXMAUZUgHNjNc2Jyj7tZsmiPgK5r5QH_M25QCv8LoY-XH2MTmLP-SpHDAvqZ9S7m9xQbmi-NIkV-T4BD0azBThZH-u0OezN1en76rzi7fvT9fnlW0oSdXAZNPTzgqmuGFCCiKtGlrZM2VVBxJqZSSrO9UORW7rmvdMdJbWFhgnhPMVqna-8Sdsc6e3wW1MuNXeOL2XvpUIdC2ZIs1_-TFvdZHGvPBMtE0psEKvd3yBN9AvLQcz3Uu7fzO7az36H7rllDaiLQbP9wbBf88Qk964aGGazAw-R82oUJwroURByQ61wccYYLgrQ4leRkP_PRol5dnh8-4S_gzCQb9mBH3jc5jLd_zb8Df6BcHV</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2179339797</pqid></control><display><type>article</type><title>Older Age Predicts Worse Function 1 Year After an Acute Achilles Tendon Rupture: A Prognostic Multicenter Study on 391 Patients</title><source>DOAJ Directory of Open Access Journals</source><source>Sage Journals GOLD Open Access 2024</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>SWEPUB Freely available online</source><source>PubMed Central</source><creator>Westin, Olof ; Svedman, Simon ; Senorski, Eric Hamrin ; Svantesson, Eleonor ; Nilsson-Helander, Katarina ; Karlsson, Jón ; Ackerman, Paul ; Samuelsson, Kristian</creator><creatorcontrib>Westin, Olof ; Svedman, Simon ; Senorski, Eric Hamrin ; Svantesson, Eleonor ; Nilsson-Helander, Katarina ; Karlsson, Jón ; Ackerman, Paul ; Samuelsson, Kristian</creatorcontrib><description>Background:
There is limited evidence regarding the patient-related factors that influence
treatment outcomes after an acute Achilles tendon rupture.
Purpose/Hypothesis:
The purpose of this study was to determine the predictors of functional and
patient-reported outcomes 1 year after an acute Achilles tendon rupture using a
multicenter cohort and to determine patient characteristics for reporting within the top
and bottom 10% of the Achilles tendon Total Rupture Score (ATRS) and heel-rise height
outcomes. The hypothesis was that older age, greater body mass index (BMI), and female
sex would lead to inferior outcomes.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Patients were selected by combining 5 randomized controlled trials from 2 different
centers in Sweden. Functional outcomes were assessed using validated heel-rise tests
(height, number of repetitions, total work, and concentric power) for muscular endurance
and strength, and the relationship between injured and uninjured legs was calculated as
the limb symmetry index (LSI). Patient-reported outcomes were measured using the ATRS.
All outcomes were collected at the 1-year follow-up. Independent predictors included
were patient sex, smoking, BMI, age, and surgical versus nonsurgical treatment.
Results:
Of the 391 included patients, 307 (79%) were treated surgically. The LSI of heel-rise
height at the 1-year follow-up decreased by approximately 4% for every 10-year increment
in age (beta, –3.94 [95% CI, –6.19 to –1.69]; P = .0006). In addition,
every 10-year increment in age resulted in a 1.79-fold increase in the odds of being in
the lowest 10% of the LSI of heel-rise height. Moreover, a nonsignificant superior LSI
of heel-rise height was found in patients treated surgically compared with nonsurgical
treatment (beta, –4.49 [95% CI, –9.14 to 0.16]; P = .058). No
significant predictor was related to the ATRS. Smoking, patient sex, and BMI did not
significantly affect the 1-year results for the LSI of the heel-rise tests.
Conclusion:
Older age at the time of injury negatively affected heel-rise height 1 year after an
Achilles tendon rupture. Irrespective of age, a nonsignificant relationship toward the
superior recovery of heel-rise height was seen in patients treated surgically. None of
the factors studied affected patient-reported outcomes.</description><identifier>ISSN: 2325-9671</identifier><identifier>EISSN: 2325-9671</identifier><identifier>DOI: 10.1177/2325967118813904</identifier><identifier>PMID: 30627587</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Achilles tendon ; ATRS ; compression ; deep-vein thrombosis ; deficits ; endurance ; heel-rise height ; Orthopaedics ; Orthopedics ; Ortopedi ; predictor ; rupture ; smoking-cessation ; Sport Sciences ; surgery ; treatment</subject><ispartof>ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE, 2018-12, Vol.6 (12), p.2325967118813904-2325967118813904</ispartof><rights>The Author(s) 2018</rights><rights>The Author(s) 2018 2018 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c510t-f285d1bc7293a278708c9f68d29c9be8e49a824b96f9f66443d27bc14ce230033</citedby><cites>FETCH-LOGICAL-c510t-f285d1bc7293a278708c9f68d29c9be8e49a824b96f9f66443d27bc14ce230033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311576/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311576/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,550,723,776,780,860,881,21946,27832,27903,27904,44924,45312,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30627587$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://gup.ub.gu.se/publication/276500$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:139876002$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Westin, Olof</creatorcontrib><creatorcontrib>Svedman, Simon</creatorcontrib><creatorcontrib>Senorski, Eric Hamrin</creatorcontrib><creatorcontrib>Svantesson, Eleonor</creatorcontrib><creatorcontrib>Nilsson-Helander, Katarina</creatorcontrib><creatorcontrib>Karlsson, Jón</creatorcontrib><creatorcontrib>Ackerman, Paul</creatorcontrib><creatorcontrib>Samuelsson, Kristian</creatorcontrib><title>Older Age Predicts Worse Function 1 Year After an Acute Achilles Tendon Rupture: A Prognostic Multicenter Study on 391 Patients</title><title>ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE</title><addtitle>Orthop J Sports Med</addtitle><description>Background:
There is limited evidence regarding the patient-related factors that influence
treatment outcomes after an acute Achilles tendon rupture.
Purpose/Hypothesis:
The purpose of this study was to determine the predictors of functional and
patient-reported outcomes 1 year after an acute Achilles tendon rupture using a
multicenter cohort and to determine patient characteristics for reporting within the top
and bottom 10% of the Achilles tendon Total Rupture Score (ATRS) and heel-rise height
outcomes. The hypothesis was that older age, greater body mass index (BMI), and female
sex would lead to inferior outcomes.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Patients were selected by combining 5 randomized controlled trials from 2 different
centers in Sweden. Functional outcomes were assessed using validated heel-rise tests
(height, number of repetitions, total work, and concentric power) for muscular endurance
and strength, and the relationship between injured and uninjured legs was calculated as
the limb symmetry index (LSI). Patient-reported outcomes were measured using the ATRS.
All outcomes were collected at the 1-year follow-up. Independent predictors included
were patient sex, smoking, BMI, age, and surgical versus nonsurgical treatment.
Results:
Of the 391 included patients, 307 (79%) were treated surgically. The LSI of heel-rise
height at the 1-year follow-up decreased by approximately 4% for every 10-year increment
in age (beta, –3.94 [95% CI, –6.19 to –1.69]; P = .0006). In addition,
every 10-year increment in age resulted in a 1.79-fold increase in the odds of being in
the lowest 10% of the LSI of heel-rise height. Moreover, a nonsignificant superior LSI
of heel-rise height was found in patients treated surgically compared with nonsurgical
treatment (beta, –4.49 [95% CI, –9.14 to 0.16]; P = .058). No
significant predictor was related to the ATRS. Smoking, patient sex, and BMI did not
significantly affect the 1-year results for the LSI of the heel-rise tests.
Conclusion:
Older age at the time of injury negatively affected heel-rise height 1 year after an
Achilles tendon rupture. Irrespective of age, a nonsignificant relationship toward the
superior recovery of heel-rise height was seen in patients treated surgically. None of
the factors studied affected patient-reported outcomes.</description><subject>Achilles tendon</subject><subject>ATRS</subject><subject>compression</subject><subject>deep-vein thrombosis</subject><subject>deficits</subject><subject>endurance</subject><subject>heel-rise height</subject><subject>Orthopaedics</subject><subject>Orthopedics</subject><subject>Ortopedi</subject><subject>predictor</subject><subject>rupture</subject><subject>smoking-cessation</subject><subject>Sport Sciences</subject><subject>surgery</subject><subject>treatment</subject><issn>2325-9671</issn><issn>2325-9671</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>D8T</sourceid><recordid>eNp9kk1v1DAQhi0EotXSOyfkI5eAP5LY5oC0qiggFbWCIsTJcpxJ6pKNF3-AeuKv42iXaosEPtij18-845EHoaeUvKBUiJeMs0a1glIpKVekfoCOF6latIcH8RE6ifGGlCUbqrh4jI44aZlopDhGvy6mHgJej4AvA_TOpoi_-BABn-XZJudnTPFXMAUZUgHNjNc2Jyj7tZsmiPgK5r5QH_M25QCv8LoY-XH2MTmLP-SpHDAvqZ9S7m9xQbmi-NIkV-T4BD0azBThZH-u0OezN1en76rzi7fvT9fnlW0oSdXAZNPTzgqmuGFCCiKtGlrZM2VVBxJqZSSrO9UORW7rmvdMdJbWFhgnhPMVqna-8Sdsc6e3wW1MuNXeOL2XvpUIdC2ZIs1_-TFvdZHGvPBMtE0psEKvd3yBN9AvLQcz3Uu7fzO7az36H7rllDaiLQbP9wbBf88Qk964aGGazAw-R82oUJwroURByQ61wccYYLgrQ4leRkP_PRol5dnh8-4S_gzCQb9mBH3jc5jLd_zb8Df6BcHV</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>Westin, Olof</creator><creator>Svedman, Simon</creator><creator>Senorski, Eric Hamrin</creator><creator>Svantesson, Eleonor</creator><creator>Nilsson-Helander, Katarina</creator><creator>Karlsson, Jón</creator><creator>Ackerman, Paul</creator><creator>Samuelsson, Kristian</creator><general>SAGE Publications</general><scope>AFRWT</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>F1U</scope><scope>D8T</scope><scope>ZZAVC</scope></search><sort><creationdate>20181201</creationdate><title>Older Age Predicts Worse Function 1 Year After an Acute Achilles Tendon Rupture: A Prognostic Multicenter Study on 391 Patients</title><author>Westin, Olof ; Svedman, Simon ; Senorski, Eric Hamrin ; Svantesson, Eleonor ; Nilsson-Helander, Katarina ; Karlsson, Jón ; Ackerman, Paul ; Samuelsson, Kristian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c510t-f285d1bc7293a278708c9f68d29c9be8e49a824b96f9f66443d27bc14ce230033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Achilles tendon</topic><topic>ATRS</topic><topic>compression</topic><topic>deep-vein thrombosis</topic><topic>deficits</topic><topic>endurance</topic><topic>heel-rise height</topic><topic>Orthopaedics</topic><topic>Orthopedics</topic><topic>Ortopedi</topic><topic>predictor</topic><topic>rupture</topic><topic>smoking-cessation</topic><topic>Sport Sciences</topic><topic>surgery</topic><topic>treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Westin, Olof</creatorcontrib><creatorcontrib>Svedman, Simon</creatorcontrib><creatorcontrib>Senorski, Eric Hamrin</creatorcontrib><creatorcontrib>Svantesson, Eleonor</creatorcontrib><creatorcontrib>Nilsson-Helander, Katarina</creatorcontrib><creatorcontrib>Karlsson, Jón</creatorcontrib><creatorcontrib>Ackerman, Paul</creatorcontrib><creatorcontrib>Samuelsson, Kristian</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Göteborgs universitet</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Westin, Olof</au><au>Svedman, Simon</au><au>Senorski, Eric Hamrin</au><au>Svantesson, Eleonor</au><au>Nilsson-Helander, Katarina</au><au>Karlsson, Jón</au><au>Ackerman, Paul</au><au>Samuelsson, Kristian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Older Age Predicts Worse Function 1 Year After an Acute Achilles Tendon Rupture: A Prognostic Multicenter Study on 391 Patients</atitle><jtitle>ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE</jtitle><addtitle>Orthop J Sports Med</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>6</volume><issue>12</issue><spage>2325967118813904</spage><epage>2325967118813904</epage><pages>2325967118813904-2325967118813904</pages><issn>2325-9671</issn><eissn>2325-9671</eissn><abstract>Background:
There is limited evidence regarding the patient-related factors that influence
treatment outcomes after an acute Achilles tendon rupture.
Purpose/Hypothesis:
The purpose of this study was to determine the predictors of functional and
patient-reported outcomes 1 year after an acute Achilles tendon rupture using a
multicenter cohort and to determine patient characteristics for reporting within the top
and bottom 10% of the Achilles tendon Total Rupture Score (ATRS) and heel-rise height
outcomes. The hypothesis was that older age, greater body mass index (BMI), and female
sex would lead to inferior outcomes.
Study Design:
Cohort study; Level of evidence, 2.
Methods:
Patients were selected by combining 5 randomized controlled trials from 2 different
centers in Sweden. Functional outcomes were assessed using validated heel-rise tests
(height, number of repetitions, total work, and concentric power) for muscular endurance
and strength, and the relationship between injured and uninjured legs was calculated as
the limb symmetry index (LSI). Patient-reported outcomes were measured using the ATRS.
All outcomes were collected at the 1-year follow-up. Independent predictors included
were patient sex, smoking, BMI, age, and surgical versus nonsurgical treatment.
Results:
Of the 391 included patients, 307 (79%) were treated surgically. The LSI of heel-rise
height at the 1-year follow-up decreased by approximately 4% for every 10-year increment
in age (beta, –3.94 [95% CI, –6.19 to –1.69]; P = .0006). In addition,
every 10-year increment in age resulted in a 1.79-fold increase in the odds of being in
the lowest 10% of the LSI of heel-rise height. Moreover, a nonsignificant superior LSI
of heel-rise height was found in patients treated surgically compared with nonsurgical
treatment (beta, –4.49 [95% CI, –9.14 to 0.16]; P = .058). No
significant predictor was related to the ATRS. Smoking, patient sex, and BMI did not
significantly affect the 1-year results for the LSI of the heel-rise tests.
Conclusion:
Older age at the time of injury negatively affected heel-rise height 1 year after an
Achilles tendon rupture. Irrespective of age, a nonsignificant relationship toward the
superior recovery of heel-rise height was seen in patients treated surgically. None of
the factors studied affected patient-reported outcomes.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>30627587</pmid><doi>10.1177/2325967118813904</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE, 2018-12, Vol.6 (12), p.2325967118813904-2325967118813904 |
| issn | 2325-9671 2325-9671 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_482905 |
| source | DOAJ Directory of Open Access Journals; Sage Journals GOLD Open Access 2024; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SWEPUB Freely available online; PubMed Central |
| subjects | Achilles tendon ATRS compression deep-vein thrombosis deficits endurance heel-rise height Orthopaedics Orthopedics Ortopedi predictor rupture smoking-cessation Sport Sciences surgery treatment |
| title | Older Age Predicts Worse Function 1 Year After an Acute Achilles Tendon Rupture: A Prognostic Multicenter Study on 391 Patients |
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