Tendo achilles management optimisation
Research type
Research Study
Full title
A study investigating the influence of gap distance in acute tendo achilles rupture treated non-operatively on clinical and radiological outcomes
IRAS ID
149780
Contact name
Jitendra Mangwani
Contact email
Sponsor organisation
University Hospitals Leicester
Duration of Study in the UK
0 years, 6 months, 1 days
Research summary
A previous study has investigated the effects of knee and ankle position on the gap distance between the tendon edges following acute rupture using ultrasound. Twenty six patients with unilateral complete tendo achilles (TA) ruptures were prospectively recruited and underwent ultrasound imaging within a week of injury. The results demonstrated a statistically significant reduction in gap distance with each of the successive positions following on from the knee extended and ankle in neutral: - maximum equinus (ME), ME + 30 degrees knee flexion, ME + 60 degrees knee flexion and ME + 90 degrees knee flexion. The largest reduction was seen with maximal equinus alone with smaller reductions with each increment of knee flexion. Although, the results would suggest no anatomical benefit to immobilization of the knee in slight flexion, the clinical relevance of these findings are unknown.Current limitations in predicting outcome following treatment reflect a lack of knowledge regarding the nature of the tissue that forms between the intervening tendon ends and how this is influenced by the gap distance between the torn tendon ends and the mechanical environment. Elucidating the nature of tendon healing in different gap distances and how this affects clinical outcome is essential to establishing the importance of gap closure as a primary treatment aim. The aim of the current study is to assess the outcomes of the previously studied cohort of patients greater than 1 year from injury. Tendon healing will be assessed using ultrasound imaging. Clinical outcome will be assessed using validated outcome measures - the Leppilahti score and the Achilles Rupture outcome Score, in addition to clinical assessment.
REC name
South West - Central Bristol Research Ethics Committee
REC reference
15/SW/0139
Date of REC Opinion
7 May 2015
REC opinion
Favourable Opinion