# Successful functional outcomes and return to sport rate can be achieved after surgery for acute Achilles tendon rupture: A systematic review

## TL;DR

This review shows that surgery for acute Achilles tendon rupture leads to good recovery and a 77% return to sports rate.

## Contribution

The study provides a systematic analysis of functional outcomes and return to sport rates after surgical repair of acute Achilles tendon ruptures.

## Key findings

- 77.4% of patients returned to sports after surgery.
- Postoperative AOFAS and Tegner scores exceeded normative values.
- Infection and re-rupture were the most common complications.

## Abstract

Achilles tendon disorders are frequently seen in sports, and its rupture is one of the most common and debilitating injury. Among the most used surgical techniques there are traditional open surgeries, minimally invasive, and percutaneous techniques. The choice of technique often depends on the nature of the injury, the athlete's profile, and the surgeon's preferences. This systematic review aimed to analyze the functional outcomes, return to sport (RTS) rate and time, and complications in patients who underwent surgical repair for acute Achilles tendon lesions.

The PubMed, MEDLINE, Scopus, and Cochrane Central databases were used for the research, and 9 studies were included. The first author, journal name, year of publication, patient demographics, type of sports, level of play, dominant limb and follow‐up period were recorded for each article. Data extracted for quantitative analysis included different types of lesions, types of surgical repair, RTS rate and time, the visual analog scale (VAS) for pain, the AOFAS score, the Tegner score, and the ATRS score, and the number and types of complications.

A total of 748 patients who underwent surgical repair of Achilles tendon were identified. Male patients represented 84% of the cases. The frequency‐weighted mean age at the time of the operation was 40.7 ± 11.8 years, and the frequency‐weighted mean follow‐up was 40.9 ± 11.7 months. The postoperative functional outcomes improved. A total of 579 patients (77.4%) returned to sport. Postoperative infection was reported in 25 patients (3.3%) and Achilles tendon re‐rupture was reported in 17 patients (2.3%).

Patients who underwent Achilles tendon surgical repair reported successful functional outcomes and low postoperative pain scores after a mean 3.5‐year follow‐up. Postoperative AOFAS and Tegner scores higher than the normative values can be achieved. The RTS rate was 77% with a mean time of 8.1 months. Postoperative infection and tendon re‐rupture were the most common reported complications.

Level III.