PROMIS Outcomes After Operative vs Nonoperative Treatment of Achilles Rupture.

Document Type

Article

Publication Date

7-1-2025

Publication Title

Foot & ankle international

Abstract

BACKGROUND: Achilles tendon rupture is a common injury in the adult population. The role of operative and nonoperative management remains controversial. The purpose of this study is to evaluate and compare patient-reported outcomes using Patient-Reported Outcomes Measurement Information System (PROMIS) after operative and nonoperative treatment of acute Achilles rupture.

METHODS: Patients with Achilles ruptures were identified as either undergoing surgical repair or nonoperative functional rehabilitation. The primary outcomes were PROMIS physical function (PF), pain interference (PI), and depression scores. These were routinely collected prospectively during the initial office visit and follow-up appointments. A distribution-based method was used to determine the minimal clinically important difference (MCID), which was ½ SD of each PROMIS domain. These values were further used to calculate the percentage of patients who returned to population mean PROMIS scores at final follow-up. Secondary outcomes included deep vein thrombosis (DVT), wound healing, infections, and reruptures.

RESULTS: A total of 216 patients were included (115 nonoperative, 101 operative). Patients treated operatively were younger (35.6 vs 45.1 years,

CONCLUSION: In our patients with an Achilles tendon rupture, on average, operative management was not associated with statistically meaningful differences in patient-reported physical function compared with nonoperative treatment. Surgery also comes at the cost of increased wound/complication rates and was associated with modestly slower improvement in pain and depression scores.

LEVEL OF EVIDENCE: Level III, retrospective cohort study.

Volume

46

Issue

7

First Page

715

Last Page

722

DOI

10.1177/10711007251336756

ISSN

1944-7876

PubMed ID

40415501

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