Ten-year follow-up of functional and biomechanical outcomes after open double-Tajima repair for acute Achilles tendon rupture in non-competitive adults
Joint Diseases and Related Surgery, cilt.37, sa.3, ss.756-767, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 37 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.52312/jdrs.2026.2866
- Dergi Adı: Joint Diseases and Related Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.756-767
- Anahtar Kelimeler: Achilles tendon, biomechanical phenomenon, muscle strength, rehabilitation, tendon injuries, treatment outcome
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objectives: This study aims to evaluate the clinical and objective biomechanical outcomes at a minimum 10-year follow-up following open double-Tajima repair combined with a structured functional loading protocol. Patients and methods: Between January 2011 and December 2014, a total of 47 consecutive non-competitive adults (Tegner Activity Scale ≤ 4) with acute unilateral Achilles tendon rupture treated with open double-Tajima repair and an eight-week functional loading protocol were included in this retrospective cohort study. The primary outcome was the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. Secondary outcomes included isokinetic dynamometry (peak torque at 30% and total work at 120% for plantar flexion and dorsiflexion), joint position sense, and ankle/calf circumference. Between-limb comparisons were performed. Results: Of the patients, 35 were male and 12 were female with a mean age at the time of surgery of 36.7 ± 6.6 (range, 22 to 55) years. The mean follow-up was 132.4 ± 13.5 (range, 120 to 168) months. The rupture involved the dominant limb in 29 patients (61.7%) and the non-dominant limb in 18 patients (38.3%). The primary outcome (AOFAS score) showed no statistically significant between-limb difference: the median score was 91.0 (IQR, 91.0 to 93.0) on the operated limb versus 93.0 (IQR, 91.0 to 93.0) on the contralateral limb (median difference: 0.00 points; 95% confidence interval [CI]: -1.00 to 1.00; p = 0.92). No statistically significant between-limb differences were detected across the secondary outcomes, including peak torque at 30%, total work at 120%, joint position sense, and ankle/calf circumference (p ≥ 0.09 for all). The complication rate was 4.3% (2/47): one partial rerupture managed conservatively and one superficial wound infection treated with oral antibiotics. No complete reruptures were observed. Conclusion: Open double-Tajima repair combined with a structured functional loading protocol seems to be associated with clinically acceptable long-term outcomes in this cohort of non-competitive adults. However, given the retrospective, single-cohort design without an independent comparison group or formal equivalence framework, these findings should be interpreted as descriptive long-term observations.