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. 2018 Nov 26;6(11):2325967118808238.
doi: 10.1177/2325967118808238. eCollection 2018 Nov.

Epidemiology of Achilles Tendon Ruptures in the United States: Athletic and Nonathletic Injuries From 2012 to 2016

Nicholas J Lemme  1 , Neill Y Li  1 , Steven F DeFroda  1 , Justin Kleiner  1 , Brett D Owens  1
Affiliations

Epidemiology of Achilles Tendon Ruptures in the United States: Athletic and Nonathletic Injuries From 2012 to 2016

Nicholas J Lemme et al. Orthop J Sports Med. .

Abstract

Background: Achilles tendon (AT) ruptures are one of the most common tendon ruptures, but there have been no studies investigating these injuries in the United States (US) using data representative of the entire US population.

Purpose/hypothesis: The purpose of this study was to determine the incidence and risk factors for AT ruptures in the US. We hypothesized that male sex, older age, and sport participation would increase the risk for AT ruptures.

Study design: Descriptive epidemiology study.

Methods: All patients presenting to an emergency department with ruptured AT in the US from 2012 through 2016 were selected from the National Electronic Injury Surveillance System (NEISS) database. Incidence was calculated for sex, race, and age. AT ruptures were characterized based on the mechanism of injury, with subanalyses performed on sport-related AT ruptures to examine sex-, race-, and age-related differences.

Results: From 2012 to 2016, a significant increase in the incidence of AT ruptures was observed, from 1.8 per 100,000 person-years in 2012 to 2.5 per 100,000 person-years in 2016 (P < .01), for an overall incidence of 2.1 per 100,000 person-years. The majority of AT ruptures occurred in male compared with female patients, with an incidence rate ratio of 3.5 (P < .01). The largest overall incidence of AT ruptures occurred in those aged 20-39 years for male patients (5.6/100,000 person-years) and in those aged 40-59 years for female patients (1.2/100,000 person-years). The largest rise in the incidence of AT ruptures during the study period was observed in patients aged 40-59 years (78% increase). The most common injury mechanism was participation in a sport or recreational activity (81.9% of all injuries), with basketball being the most common overall cause of AT ruptures.

Conclusion: While AT ruptures in the US most commonly occur in young male patients (20-39 years old), the largest rise in the incidence was observed in middle-aged patients (40-59 years old), with participation in recreational sports being the most likely mechanism. Recognizing high-risk patients can help physicians counsel them and recommend strategies for injury prevention.

Keywords: Achilles tendon; NEISS; basketball; database; epidemiology; tendon rupture.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: B.D.O. is a paid consultant for DePuy, Medical Device Business Services, Rotation Medical, Sanofi-Aventis, Linvatec, and the Musculoskeletal Transplant Foundation; has received honoraria from Vericel; has received hospitality payments from DePuy, Medical Device Business Services, and Linvatec; and is a paid associate editor for The American Journal of Sports Medicine. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Annual incidence of Achilles tendon (AT) ruptures from 2012 to 2016 by sex.
Figure 2.
Figure 2.
Overall incidence of Achilles tendon (AT) ruptures from 2012 to 2016 by age group.
Figure 3.
Figure 3.
Annual incidence of Achilles tendon (AT) ruptures from 2012 to 2016 by age group.
Figure 4.
Figure 4.
Distribution of Achilles tendon ruptures in the United States from 2012 to 2016 by race.
See this image and copyright information in PMC

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