Late versus early repair of Achilles tendon rupture. Clinical and biomechanical evaluation.
Eleven patients who had late reconstruction for Achilles tendon rupture were compared with 10 patients who had immediate repair. The followup period averaged 8 years for both groups. Results, based on a clinical score, were successful (excellent or good) for all but 1 patient. Although manual testing demonstrated normal plantar flexion strength in all but 1 patient, significant differences were seen in isometric and isokinetic plantar flexion strength of the involved sides as compared with the uninvolved sides of these patients. The patient with the unsuccessful result had abnormalities in vertical, foreaft, and medial-lateral force components of the ground reaction force. Three-dimensional motion analysis showed decreased total motion in the sagittal plane on the operated side as compared with the unoperated side in this patient. The data indicated that patients with late reconstruction of Achilles tendon rupture have successful clinical results comparable with those of early repair.