Acute Achilles Tendon Ruptures: Incidence of Injury and Surgery in Sweden Between 2001 and 2012

• Published in: The American journal of sports medicine 2014-10, Vol.42 (10), p.2419-2423
• Main Authors: Huttunen, Tuomas T., Kannus, Pekka, Rolf, Christer, Felländer-Tsai, Li, Mattila, Ville M.
• Format: Article
• Language: English
• Subjects: Achilles Tendon - injuries; Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Ambulatory Surgical Procedures - statistics & numerical data; Ambulatory Surgical Procedures - trends; Clinical trials; Epidemiology; Female; Health risk assessment; Humans; Incidence; Length of Stay - statistics & numerical data; Male; Medicin och hälsovetenskap; Meta-analysis; Middle Aged; Patients; Registries; Rupture - surgery; Sex Distribution; Sports injuries; Sports medicine; Studies; Sweden - epidemiology; Tendons; Trends; Young Adult
• ISSN: 0363-5465; 1552-3365; 1552-3365
• DOI: 10.1177/0363546514540599

Background: Population-based incidence rates and trends of acute Achilles tendon ruptures are not known. It is also not known whether recent high-quality randomized controlled trials not favoring surgery have had an effect on treatment protocols. Purpose: To assess the incidence of acute Achilles tendon ruptures in Sweden and to examine the trends in surgical treatment. Study Design: Descriptive epidemiology study. Methods: We conducted a nationwide registry-based study including all adult (≥18 years of age) inpatient and outpatient hospital visits because of an acute Achilles tendon rupture in Sweden between 2001 and 2012. Results: We identified a total of 27,702 patients (21,979 men, 79%) with acute Achilles tendon ruptures between 2001 and 2012. In 2001, the sex-specific incidence of acute Achilles tendon ruptures was 47.0 (per 100,000 person-years) in men and 12.0 in women. In 2012, the corresponding values were 55.2 in men and 14.7 in women, with an increase of 17% in men and 22% in women. The proportion of surgically treated patients declined from 43% in 2001 to 28% in 2012 in men and from 34% in 2001 to 22% in 2012 in women. Conclusion: The incidence of acute Achilles tendon ruptures in Sweden is increasing. The most probable reason for this increase is the rise in the number of older adults participating in high-demand sports. The proportion of surgically treated patients is decreasing most likely because of recent high-quality randomized controlled trials and their meta-analyses supporting similar results between surgical and nonsurgical approaches.