Acute achilles tendon ruptures: incidence of injury and surgery in Sweden between 2001 and 2012

Am J Sports Med. 2014 Oct;42(10):2419-23. doi: 10.1177/0363546514540599. Epub 2014 Jul 23.

Abstract

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.

Keywords: Achilles tendon; epidemiology; incidence; injury; surgical treatment.

MeSH terms

  • Achilles Tendon / injuries*
  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Ambulatory Surgical Procedures / statistics & numerical data
  • Ambulatory Surgical Procedures / trends
  • Female
  • Humans
  • Incidence
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Registries
  • Rupture / surgery
  • Sex Distribution
  • Sweden / epidemiology
  • Young Adult