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Predictors of Primary Achilles Tendon Ruptures

  • Systematic Review
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Abstract

Background

The Achilles tendon is the strongest tendon in the human body. The incidence of Achilles tendon ruptures appears to be increasing.

Objectives

The aim of this review was to systematically summarize predictors influencing Achilles tendon rupture (ATR) risk.

Methods

A systematic literature search was performed of reported determinants influencing the ATR risk. Studies were eligible if there was: (i) description of determinants predicting ATR; (ii) an outcome defined as ATR; (iii) any study design with at least ten adults included with ATR; (iv) use of statistical tests regarding differences between patients with an ATR and healthy controls; (v) a full text article available; (vi) an article written in English, German or Dutch. Quality assessment was done using a standardized criteria set. Best-evidence synthesis was performed.

Results

We included 31 studies, of which two (6.5 %) were considered high-quality studies. Moderate evidence was found for increased ATR risk and decreased fibril size of Achilles tendon.

Conclusion

Based on the results of this systematic review there is moderate evidence that decreased tendon fibril size increases the ATR risk. There is limited evidence for many other factors, some of which are modifiable, such as increased body weight, oral corticosteroid use and quinolone use and living in an urban area, and therefore may be of interest in future studies. Furthermore, these results showed that more high-quality studies are needed for evaluating the determinants influencing the ATR risk.

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Acknowledgment

The authors thank G.B. de Jonge and W. Bramer, medical librarians of the Erasmus Medical Center in Erasmus MC, for assistance in performing the literature search.

No sources of funding were used to assist in the preparation of this review. The authors have no potential conflicts of interest that are directly relevant to the content of this review.

Contributions

Femke Claessen, Duncan Meuffels, and Robert-Jan de Vos contributed to the conception and design of the study and to interpretation of the data. Femke Claessen drafted the article. Duncan Meuffels, Max Reijman and Robert-Jan de Vos revised the article for important intellectual comment. All authors gave final approval of the version to be submitted.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands

    Femke M. A. P. Claessen, Robert-Jan de Vos, Max Reijman & Duncan E. Meuffels

  2. Department of Sports Medicine, The Hague Medical Centre, Leidschendam, The Netherlands

    Robert-Jan de Vos

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  1. Femke M. A. P. Claessen
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  2. Robert-Jan de Vos
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  4. Duncan E. Meuffels
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Correspondence to Duncan E. Meuffels.

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Claessen, F.M.A.P., de Vos, RJ., Reijman, M. et al. Predictors of Primary Achilles Tendon Ruptures. Sports Med 44, 1241–1259 (2014). https://doi.org/10.1007/s40279-014-0200-z

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