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Delayed Achilles tendon rupture presentation: Non-operative management may be the SMART choice
The Foot, Volume: 46, Start page: 101724
Swansea University Author:
Nicholas Owen
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DOI (Published version): 10.1016/j.foot.2020.101724
Abstract
IntroductionThis biomechanical study aims to assess the function of patients who were treated non-operatively for delayed diagnosis Achilles tendon rupture. Patients were treated using the Swansea Morriston Achilles Rupture Treatment protocol (SMART), which is a physiotherapy led non-operative treat...
Published in: | The Foot |
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ISSN: | 0958-2592 |
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Elsevier BV
2021
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URI: | https://cronfa.swan.ac.uk/Record/cronfa54942 |
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<?xml version="1.0"?><rfc1807><datestamp>2021-04-27T16:03:17.8930347</datestamp><bib-version>v2</bib-version><id>54942</id><entry>2020-08-11</entry><title>Delayed Achilles tendon rupture presentation: Non-operative management may be the SMART choice</title><swanseaauthors><author><sid>360b7822fd760c7d73a1b0ca5bce1c07</sid><ORCID>0000-0002-7067-8082</ORCID><firstname>Nicholas</firstname><surname>Owen</surname><name>Nicholas Owen</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2020-08-11</date><deptcode>STSC</deptcode><abstract>IntroductionThis biomechanical study aims to assess the function of patients who were treated non-operatively for delayed diagnosis Achilles tendon rupture. Patients were treated using the Swansea Morriston Achilles Rupture Treatment protocol (SMART), which is a physiotherapy led non-operative treatment program.Methods19 patients (16 M:3F) were enrolled and prospectively assessed using ARS/ATRS (PROMS), Ankle ROM and isokinetic peak torque for plantarflexion of the ankle. MRI scans of both the injured and uninjured TA were performed to compare both AP diameter and length.ResultsBoth ATRS and ARS improved between short and long-term follow-up. The mean difference in plantar torque between the injured and uninjured leg was 21.9%. There was no significant difference in ankle plantarflexion or dorsiflexion. There was no significant difference in length of the injured and uninjured TA on MRI. 3 patients failed the SMART protocol requiring surgical fixation.DiscussionThe SMART protocol can be an effective method of treatment even in younger and active patients especially if delay to treatment is less than 12 weeks. It may still be preferable for patients with a large gap size or high functional demand to elect for surgical intervention, but clinicians should consider the SMART protocol as an alternative to surgery and discuss it with some patients as a viable alternative.KeywordsTendoachillesConservativeChronicDelayedAbbreviationsTATendoachillesSMARTSwansea Morriston Achilles Rupture Treatment</abstract><type>Journal Article</type><journal>The Foot</journal><volume>46</volume><journalNumber/><paginationStart>101724</paginationStart><paginationEnd/><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0958-2592</issnPrint><issnElectronic/><keywords>Tendoachilles; Conservative; Chronic; Delayed</keywords><publishedDay>1</publishedDay><publishedMonth>3</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-03-01</publishedDate><doi>10.1016/j.foot.2020.101724</doi><url/><notes/><college>COLLEGE NANME</college><department>Sport and Exercise Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>STSC</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2021-04-27T16:03:17.8930347</lastEdited><Created>2020-08-11T10:22:47.7164133</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences</level></path><authors><author><firstname>Daniel M.G.</firstname><surname>Winson</surname><order>1</order></author><author><firstname>Rory</firstname><surname>MacNair</surname><order>2</order></author><author><firstname>Anne-Marie</firstname><surname>Hutchinson</surname><order>3</order></author><author><firstname>Nicholas</firstname><surname>Owen</surname><orcid>0000-0002-7067-8082</orcid><order>4</order></author><author><firstname>Rhodri</firstname><surname>Evans</surname><order>5</order></author><author><firstname>Paul</firstname><surname>Williams</surname><order>6</order></author></authors><documents><document><filename>54942__19006__78a46fa7ec0148c3830a35db5ae63f54.pdf</filename><originalFilename>54942.pdf</originalFilename><uploaded>2021-01-08T16:29:14.0804953</uploaded><type>Output</type><contentLength>407137</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><embargoDate>2021-08-08T00:00:00.0000000</embargoDate><documentNotes>Released under the terms of a Creative Commons Attribution Non-Commercial No Derivatives License (CC-BY-NC-ND)</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by-nc-nd/4.0/</licence></document></documents><OutputDurs/></rfc1807> |
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2021-04-27T16:03:17.8930347 v2 54942 2020-08-11 Delayed Achilles tendon rupture presentation: Non-operative management may be the SMART choice 360b7822fd760c7d73a1b0ca5bce1c07 0000-0002-7067-8082 Nicholas Owen Nicholas Owen true false 2020-08-11 STSC IntroductionThis biomechanical study aims to assess the function of patients who were treated non-operatively for delayed diagnosis Achilles tendon rupture. Patients were treated using the Swansea Morriston Achilles Rupture Treatment protocol (SMART), which is a physiotherapy led non-operative treatment program.Methods19 patients (16 M:3F) were enrolled and prospectively assessed using ARS/ATRS (PROMS), Ankle ROM and isokinetic peak torque for plantarflexion of the ankle. MRI scans of both the injured and uninjured TA were performed to compare both AP diameter and length.ResultsBoth ATRS and ARS improved between short and long-term follow-up. The mean difference in plantar torque between the injured and uninjured leg was 21.9%. There was no significant difference in ankle plantarflexion or dorsiflexion. There was no significant difference in length of the injured and uninjured TA on MRI. 3 patients failed the SMART protocol requiring surgical fixation.DiscussionThe SMART protocol can be an effective method of treatment even in younger and active patients especially if delay to treatment is less than 12 weeks. It may still be preferable for patients with a large gap size or high functional demand to elect for surgical intervention, but clinicians should consider the SMART protocol as an alternative to surgery and discuss it with some patients as a viable alternative.KeywordsTendoachillesConservativeChronicDelayedAbbreviationsTATendoachillesSMARTSwansea Morriston Achilles Rupture Treatment Journal Article The Foot 46 101724 Elsevier BV 0958-2592 Tendoachilles; Conservative; Chronic; Delayed 1 3 2021 2021-03-01 10.1016/j.foot.2020.101724 COLLEGE NANME Sport and Exercise Sciences COLLEGE CODE STSC Swansea University 2021-04-27T16:03:17.8930347 2020-08-11T10:22:47.7164133 Faculty of Science and Engineering School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences Daniel M.G. Winson 1 Rory MacNair 2 Anne-Marie Hutchinson 3 Nicholas Owen 0000-0002-7067-8082 4 Rhodri Evans 5 Paul Williams 6 54942__19006__78a46fa7ec0148c3830a35db5ae63f54.pdf 54942.pdf 2021-01-08T16:29:14.0804953 Output 407137 application/pdf Accepted Manuscript true 2021-08-08T00:00:00.0000000 Released under the terms of a Creative Commons Attribution Non-Commercial No Derivatives License (CC-BY-NC-ND) true eng https://creativecommons.org/licenses/by-nc-nd/4.0/ |
title |
Delayed Achilles tendon rupture presentation: Non-operative management may be the SMART choice |
spellingShingle |
Delayed Achilles tendon rupture presentation: Non-operative management may be the SMART choice Nicholas Owen |
title_short |
Delayed Achilles tendon rupture presentation: Non-operative management may be the SMART choice |
title_full |
Delayed Achilles tendon rupture presentation: Non-operative management may be the SMART choice |
title_fullStr |
Delayed Achilles tendon rupture presentation: Non-operative management may be the SMART choice |
title_full_unstemmed |
Delayed Achilles tendon rupture presentation: Non-operative management may be the SMART choice |
title_sort |
Delayed Achilles tendon rupture presentation: Non-operative management may be the SMART choice |
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360b7822fd760c7d73a1b0ca5bce1c07 |
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360b7822fd760c7d73a1b0ca5bce1c07_***_Nicholas Owen |
author |
Nicholas Owen |
author2 |
Daniel M.G. Winson Rory MacNair Anne-Marie Hutchinson Nicholas Owen Rhodri Evans Paul Williams |
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Journal article |
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The Foot |
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46 |
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101724 |
publishDate |
2021 |
institution |
Swansea University |
issn |
0958-2592 |
doi_str_mv |
10.1016/j.foot.2020.101724 |
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Elsevier BV |
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Faculty of Science and Engineering |
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School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences |
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description |
IntroductionThis biomechanical study aims to assess the function of patients who were treated non-operatively for delayed diagnosis Achilles tendon rupture. Patients were treated using the Swansea Morriston Achilles Rupture Treatment protocol (SMART), which is a physiotherapy led non-operative treatment program.Methods19 patients (16 M:3F) were enrolled and prospectively assessed using ARS/ATRS (PROMS), Ankle ROM and isokinetic peak torque for plantarflexion of the ankle. MRI scans of both the injured and uninjured TA were performed to compare both AP diameter and length.ResultsBoth ATRS and ARS improved between short and long-term follow-up. The mean difference in plantar torque between the injured and uninjured leg was 21.9%. There was no significant difference in ankle plantarflexion or dorsiflexion. There was no significant difference in length of the injured and uninjured TA on MRI. 3 patients failed the SMART protocol requiring surgical fixation.DiscussionThe SMART protocol can be an effective method of treatment even in younger and active patients especially if delay to treatment is less than 12 weeks. It may still be preferable for patients with a large gap size or high functional demand to elect for surgical intervention, but clinicians should consider the SMART protocol as an alternative to surgery and discuss it with some patients as a viable alternative.KeywordsTendoachillesConservativeChronicDelayedAbbreviationsTATendoachillesSMARTSwansea Morriston Achilles Rupture Treatment |
published_date |
2021-03-01T04:08:48Z |
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11.021648 |