PURPOSE The aim of this study was to investigate whether patient subjective and functional outcomes after Achilles tendon rupture (ATR) are related to deep venous thrombosis (DVT) during leg immobilization. METHODS A cohort study with prospectively collected randomized data was conducted between 2010 and 2017. Two-hundred and fifty-one Patients with an Achilles tendon rupture (mean age = 41 ± 8), treated with uniform surgical techniques, were retrospectively analyzed. DVT incidence at 2 and 6 weeks was assessed using compression duplex ultrasound. At 12 months patient-reported outcomes were assessed using the Achilles tendon Total Rupture Score (ATRS), Foot- and Ankle Outcome Score (FAOS), Physical Activity Scale (PAS) and functional outcome with the calf-muscle endurance test. ANOVA analyses were used and adjusted for assumed confounding factors (patient age, sex, BMI and rehabilitation). RESULTS The total DVT incidence was 122 out of 251 (49%). Patients suffering a DVT exhibited significantly lower ATRS at 1 year compared to patients without DVT (mean 76 vs 83, 95% CI 71-79 vs 80-87; p < 0.01). Sixty-seven percent (95% CI 57-77%) of the patients devoid of DVT reported a good outcome (ATRS > 80) compared to 51% (95% CI 41-61%) of the patients sustaining a DVT (p < 0.05). Quality of life displayed significantly better outcome in the non-DVT versus DVT patients (mean = 75 (95% CI 71-79) vs. mean = 68 (95% CI 64-72); p < 0.05). A significant difference in total concentric work was observed between non-DVT and DVT patients (median = 1.9 kJ (IQR = 0.9 kJ) vs. median = 1.6 kJ (IQR = 1.0 kJ); p < 0.01). CONCLUSION Sustaining a DVT during leg immobilization significantly impairs patient-reported outcome at 1 year after surgical repair of ATR. LEVEL OF EVIDENCE III.

中文翻译：

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跟腱断裂后的深静脉血栓形成与患者报告的不良结局有关。

目的本研究的目的是调查在固定小腿时跟腱断裂（ATR）后的患者主观和功能结局是否与深静脉血栓形成（DVT）有关。方法于2010年至2017年进行了一项前瞻性研究，收集了前瞻性收集的随机数据。回顾性分析了采用统一外科手术技术治疗的200例跟腱断裂（平均年龄= 41±8）的患者。使用压缩双工超声评估2和6周时DVT的发生率。在12个月时，使用跟腱总断裂评分（ATRS），足踝结果评分（FAOS），身体活动量表（PAS）和小腿肌肉耐力测试对功能结果进行评估，以评估患者报告的结果。使用ANOVA分析并针对假设的混杂因素（患者年龄，性别，BMI和康复）进行了调整。结果DVT的总发生率为251的122（49％）。与没有DVT的患者相比，患有DVT的患者在1年时的ATRS显着降低（平均值76 vs 83，95％CI 71-79 vs 80-87； p <0.01）。缺乏DVT的患者中有67％（95％CI 57-77％）表现出良好的预后（ATRS> 80），而接受DVT的患者中有51％（95％CI 41-61％）（P < 0.05）。非DVT患者的生活质量显着优于DVT患者（平均数= 75（95％CI 71-79），平均值= 68（95％CI 64-72）； p <0.05）。在非DVT和DVT患者之间观察到总同心功的显着差异（中位数= 1.9 kJ（IQR = 0.9 kJ）与中位数= 1.6 kJ（IQR = 1.0 kJ）； p <0.01）。结论在固定ATR期间维持DVT会严重损害ATR手术修复后1年患者报告的结局。证据级别III。