Achilles tendon ruptures are uncommon and occur in approximately 5-10 people out of 10,000. Authors report this injury is most likely in males between the ages of 20-30 and 40-50 who play recreational sports. Individuals often report a sudden jolt or pain during a jumping or accelerating movement followed by an inability to walk and/or rise up onto their toes. Previous treatment has involved either surgical or percutaneous repair of the injured tendon followed by Physical Therapy. More recently patients have also been treated non surgically with immobilization followed by Physical Therapy. A recent review compared outcomes between surgical and conservative interventions.
The New England Journal of Medicine recently published a multi center, randomized, controlled trial on the differences between surgery and conservative care for patients with a ruptured achilles tendon (Myhrvold et al. 2022). Authors randomized over 500 patients with this injury to one of three groups: conservative care, minimally invasive surgery, or open surgical repair. Authors tracked individuals over the course of 12 months. They noted a higher re injury rate among the patients treated conservatively (6.2% vs. .6%), but a lower rate of nerve injuries compared to the surgical group. Importantly, authors found no difference in outcomes between surgical and conservatively treated patients for achilles tendon rupture at 12 month follow up.