Achilles Tendon Rupture in Athletes

Achilles tendon ruptures commonly affect middle-aged athletes and can result in considerable functional impairment. While the cause is multifactorial, the greatest risk is present for athletes involved in sports that involve sudden acceleration and deceleration. A thorough history and physical examination can accurately yield a diagnosis, but when question remains, magnetic resonance imaging is superior to ultrasound-guided evaluation. The best evidence available suggests that operative treatment has a lower rate of rerupture, a higher rate of return to the same level of sport participation, and a higher complication rate, if an open technique is used. Percutaneous methods of fixation have lower complication rates without an increase in the rate of rerupture when compared with open methods. Augmentation of an Achilles tendon repair has demonstrated no clinical benefit. Rehabilitation with early mobilization leads to improved patient-reported outcomes. (Journal of Surgical Orthopaedic Advances 18(3):115–121, 2009)