Comparison of Primary Repair Versus Gastrocnemius Turn-down Flaps of Acute Achilles Tendon Rupture

Completed

• Conditions: Acute Rupture of Achilles Tendon (Disorder)
• Interventions: Procedure: gastrocnemius turn-down flaps

• Registration Number: NCT04465994
• Lead Sponsor: Peking University Third Hospital

Brief Summary

This retrospective study includes 74 patients with acute Achilles tendon rupture from March 2012 to September 2018, aiming to compare the mid-term curative effect of primary repair and gastrocnemius turn-down flaps and guide clinical decision.

Detailed Description

Objective: To explore the surgical methods and observe the med-term curative effect of primary repair and gastrocnemius turn-down flaps for acute Achilles tendon rupture, so as to guide clinical decision. Methods: This retrospective study includes 74 patients with acute Achilles tendon rupture from March 2012 to September 2018, whose surgeries was completed by the sponsor with either primary repair or gastrocnemius turn-down flaps. The recovery and motor function of the patients were followed up by outpatient clinic and telephone at 3 months, 6 months, 12 months and 24 months after operation, respectively, so as to statistically analyze the med-term curative effects of two surgeries. Specific indicators include: Visual Analogue Scale, American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score, The Victorian Institute of Sport Assessment-Achilles, The Achilles tendon Total Rupture Score, the Tegner Activity Score, Biodex isokinetic dynamometer system, Postoperative rehabilitation index and complications.

Study Timeline

• Study Start: 2020-01-05
• Primary Completion: 2020-02-05
• Study Completion: 2020-05-05
• Status Verified: 2020-06
• Study First Submitted: 2020-06-27
• Study First Submitted QC: 2020-07-09
• Last Update Submitted: 2020-07-09
• Study First Posted: 2020-07-10
• Last Update Posted: 2020-07-10

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 74

Inclusion Criteria

• history of Achilles tendon injury
• within two weeks of injury
• inability to single heel rise
• more than one year of follow-up
• age under 65

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Exclusion Criteria

• open Achilles tendon rupture
• Achilles tendon terminal disease
• rerupture of Achilles tendon
• history of local corticosteroid injection around the Achilles tendon
• accompanied by fracture, vascular or nerve damage
• not available for regular follow-up

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
gastrocnemius turn-down flaps	gastrocnemius turn-down flaps	Patients with acute achilles tendon ruptures who received the treatment of gastrocnemius turn-down flaps.

Primary Outcome Measures

Name	Time	Method
change of the Tegner Activity Score	from pre-surgery to two years after surgery	The Tegner activity scale was first described in 1985 and initially designed for physician administration after ACL and meniscal injuries. To date, the Tegner activity score has been a frequently used patient-administered activity rating system for patients with various knee disorders. The Tegner activity scale is a one-item score that graded activity based on work and sports activities on a scale of 0 to 10. Zero represents disability because of knee problems and 10 represents national or international level soccer.
Biodex	through study completion, an average of 2 years	Biodex isokinetic dynamometer system
change of Visual Analogue Scale	from pre-surgery to two years after surgery	The Visual Analogue Scale (VAS) is designed to present to the respondent a rating scale with minimum constraints. Respondents mark the location on the 10-centimeter line corresponding to the amount of pain they experienced. This gives them the greatest freedom to choose their pain's exact intensity. It also gives the maximum opportunity for each respondent to express a personal response style. The minimum and maximum values of VAS are 10 and 0, respectively. And higher scores mean a worse outcome.
change of American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score	from pre-surgery to two years after surgery	The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score combines subjective scores of pain and function provided by the patient with objective scores based on the surgeon's physical examination of the patient (to assess sagittal motion, hindfoot motion, ankle-hindfoot stability and alignment of the ankle-hindfoot). The scale includes nine items that can be divided into three subscales (pain, function and alignment). The minimum and maximum values of AOFAS are 100 and 0, respectively. And higher scores mean a better outcome.
change of The Victorian Institute of Sport Assessment-Achilles	from pre-surgery to two years after surgery	The VISA-A questionnaire displayed construct validity when used in two populations of patients with Achilles tendinopathy and control subjects. The questionnaire avoids the redundant components of non-specific scoring systems such as that developed for hind foot problems by the American Orthopaedic Society, and those devised for Achilles tendon rupture. Results range from 0 to 100, where 100 represents the perfect score.
change of The Achilles tendon Total Rupture Score	from pre-surgery to two years after surgery	The VISA-A questionnaire displayed construct validity when used in two populations of patients with Achilles tendinopathy and control subjects. The questionnaire avoids the redundant components of non-specific scoring systems such as that developed for hind foot problems by the American Orthopaedic Society, and those devised for Achilles tendon rupture. Results range from 0 to 100, where 100 represents the perfect score.

Secondary Outcome Measures

Name	Time	Method
complications	through study completion, an average of 2 years	rerupture, infection, wound scar

Trial Locations

Locations (1)

Peking Univerisity Third Hospital; 🇨🇳 Beijing, Beijing, China