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. 2022 Nov 8;10(11):23259671221131536.
doi: 10.1177/23259671221131536. eCollection 2022 Nov.

Incidence and Treatment Trends of Achilles Tendon Ruptures in Finland: A Nationwide Study

Oskari Leino  1   2 , Heli Keskinen  1   2 , Inari Laaksonen  1   2 , Keijo Mäkelä  1   2 , Eliisa Löyttyniemi  1   2 , Elina Ekman  1   2
Affiliations

Incidence and Treatment Trends of Achilles Tendon Ruptures in Finland: A Nationwide Study

Oskari Leino et al. Orthop J Sports Med. .

Abstract

Background: Global reports indicate rising Achilles tendon rupture (ATR) incidence. In recent decades, the optimal treatment for this injury has been widely studied. Alongside the cumulating comparative evidence regarding the optimal method of treatment, nonoperative treatment has increased in popularity compared with operative treatment.

Purpose: To determine the current incidence of ATRs and their treatment in Finland and how these have changed from 1997 to 2019.

Study design: Descriptive epidemiology study.

Methods: Two national registers (the National Hospital Discharge Register and the Finnish Register of Primary Health Care Visits) were used to identify all ATR cases and operations to treat them; the incidence was calculated based on the annual adult population size.

Results: During the study period, ATR incidence increased from 17.3 to 32.3 per 100,000 person-years. The increase in incidence seemed to plateau starting in the second half of the study period. The rise in ATR incidence occurred in both sexes and all age groups but most markedly among the elderly. The incidence of operative treatment decreased from 13.6 to 4.9 per 100,000 person-years. This decline was observed from 2008 onward and in all age groups.

Conclusion: The incidence of ATRs increased and the use of operative treatment decreased. The decreasing trend of operative treatment is in line with other international reports and resonates with the current literature about the optimal treatment of ATRs.

Keywords: Achilles tendon; ankle; epidemiology; general sports trauma.

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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: Support for this study was received from a grant from the Finnish state research fund. 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.
Patient-inclusion flowchart. ATR, Achilles tendon rupture; NCSP, Nordic Classification of Surgical Procedures; NHDR, National Hospital Discharge Register; NHL10, PHCR, Finnish Register of Primary Health Care Visits.
Figure 2.
Figure 2.
Frequency of Achilles tendon rupture (ATR). NHDR, National Hospital Discharge Register; PHCR, Finnish Register of Primary Health Care Visits.Vertical line indicates the introduction of the PHCR and its data.
Figure 3.
Figure 3.
(A) Overall and sex-adjusted incidence of Achilles tendon rupture (ATR). (B) Incidence of operative and nonoperative treatment for ATR. (C) Age-adjusted incidence of ATR. (D) Age-adjusted incidence of operative treatment for ATR.
See this image and copyright information in PMC

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References

    1. Costa ML, Achten J, Marian IR, et al. Plaster cast versus functional brace for non-surgical treatment of Achilles tendon rupture (UKSTAR): a multicentre randomised controlled trial and economic evaluation. Lancet. 2020;395(10222):441–448. doi:10.1016/S0140-6736(19)32942-3 - PMC - PubMed
    1. Deng S, Sun Z, Zhang C, Chen G, Li J. Surgical treatment versus conservative management for acute Achilles tendon rupture: a systematic review and meta-analysis of randomized controlled trials. J Foot Ankle Surg. 2017;56(6):1236–1243. doi:10.1053/J.JFAS.2017.05.036 - PubMed
    1. Erickson BJ, Cvetanovich GL, Nwachukwu BU, et al. Trends in the management of Achilles tendon ruptures in the United States Medicare population, 2005-2011. Orthop J Sports Med. 2014;2(9):2325967114549948. doi:10.1177/2325967114549948 - PMC - PubMed
    1. Erickson BJ, Mascarenhas R, Saltzman BM, et al. Is operative treatment of Achilles tendon ruptures superior to nonoperative treatment? A systematic review of overlapping meta-analyses. Orthop J Sports Med. 2015;3(4):23259 67115579188. doi:10.1177/2325967115579188 - PMC - PubMed
    1. Ganestam A, Kallemose T, Troelsen A, Barfod K. Increasing incidence of acute Achilles tendon rupture and a noticeable decline in surgical treatment from 1994 to 2013. A nationwide registry study of 33,160 patients. Knee Surg Sports Traumatol Arthrosc. 2016;24(12):3730–3737. doi:10.1007/S00167-015-3544-5 - PubMed

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