High BMI and old age result in increased risks after Achilles tendon injury
August 6, 2014
Topic: foot injury, physical therapy
A study found that patients of older age or a higher BMI tend to fare worse after sustaining a foot injury such as an Achilles tendon rupture than younger patients or patients with a lower BMI. The findings were published in the American Journal of Sports Medicine.
The American Academy of Orthopaedic Surgeons stated that the Achilles tendon is the largest tendon in the human body. It connects to the calf muscle and helps people walk, run and jump. An Achilles tendon rupture is when the fibers tear and separate so that the it can no longer function normally. Acute rupture often happens between the ages of 30 and 50.
The researchers investigated 93 patients with an average age of 40, who had sustained an Achilles tendon rupture. The study authors measured their results using the Achilles tendon Total Rupture Score and maximum heel-rise height. The group also noted variables like sex, age, gender, BMI, treatment, physical activity level, symptoms and quality of life. The participants followed up with the study at three, six and 12 months after their operation.
Non-surgical treatment vs. surgical treatment
Non-surgical and surgical treatments predicted symptoms, but neither treatment predicted heel-rise height symptoms. Six months after treatment, a larger heel-rise height was associated with surgical treatment. However, the complete opposite was found six months later - a larger heel-rise was associated with non-surgical treatment. Lead researcher Nicklas Olsson, M.D., Ph.D, stated the results revealed that surgical treatment was associated with less symptoms later on.
Non-surgical treatment often involves immobilizing the ankle and calf and performing physical therapy. Young and middle-aged patients often have surgical treatment. The two ends of the torn tendon are mobilized and sewn back together. The leg is then placed into a cast, walking boot or splint. After the tendon begins to heal, surgical patients complete physical therapy. Patients' complete recovery takes between four and six months.
The data also showed that, as age increased, the heel-rise height decreased. An age increase of 10 years resulted in an 8 percent decrease in heel-rise height. Patients with a higher BMI also had more symptoms. A BMI that was five units higher than average was correlated to reducing ATRS values by 10 points.
The researchers concluded that, despite considering multiple variables, the results did not predict one final single outcome. They realized their models predicted functionality better than overall outcomes.
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