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Joint Diseases and
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Original Article · Open access

Ten-year follow-up of functional and biomechanical outcomes after open double-Tajima repair for acute Achilles tendon rupture in non-competitive adults

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Ahmet Aybar

Department of Orthopedics and Traumatology, University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, İstanbul, Türkiye

ORCID: 0000-0002-4847-610X

Kemal Gökkuş

Department of Orthopedics and Traumatology, Başkent University School of Medicine, Alanya Research and Practice Center, Antalya, Türkiye

ORCID: 0000-0002-4916-3471

Abdullah Şükün

Department of Radiology, Başkent University School of Medicine, Alanya Research and Practice Center, Antalya, Türkiye

ORCID: 0000-0003-0047-0857

Canan Gönen Aydın

Department of Sports Medicine, University of Health Sciences Baltalimani Bone Diseases Training and Research Hospital, İstanbul, Türkiye

ORCID: 0000-0002-0926-1317

Erdem Özden

Department of Orthopedics and Traumatology, University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, İstanbul, Türkiye

ORCID: 0000-0003-0765-5635

Celal Bozkurt

Department of Orthopedics and Traumatology, University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, İstanbul, Türkiye

ORCID: 0000-0001-8747-1996

Abstract

Objectives: This study aims to evaluate the clinical and objective biomechanical outcomes at a minimum 10-year follow-up following open double-Tajima repair combined with a structured functional loading protocol.

Patients and methods: Between January 2011 and December 2014, a total of 47 consecutive non-competitive adults (Tegner Activity Scale ≤ 4) with acute unilateral Achilles tendon rupture treated with open double-Tajima repair and an eight-week functional loading protocol were included in this retrospective cohort study. The primary outcome was the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. Secondary outcomes included isokinetic dynamometry (peak torque at 30°/s and total work at 120°/s for plantar flexion and dorsiflexion), joint position sense, and ankle/calf circumference. Between-limb comparisons were performed.

Results: Of the patients, 35 were male and 12 were female with a mean age at the time of surgery of 36.7 ± 6.6 (range, 22 to 55) years. The mean follow-up was 132.4 ± 13.5 (range, 120 to 168) months. The rupture involved the dominant limb in 29 patients (61.7%) and the non-dominant limb in 18 patients (38.3%). The primary outcome (AOFAS score) showed no statistically significant between-limb difference: the median score was 91.0 (IQR, 91.0 to 93.0) on the operated limb versus 93.0 (IQR, 91.0 to 93.0) on the contralateral limb (median difference: 0.00 points; 95% confidence interval [CI]: −1.00 to 1.00; p = 0.92). No statistically significant between-limb differences were detected across the secondary outcomes, including peak torque at 30°/s, total work at 120°/s, joint position sense, and ankle/calf circumference (p ≥ 0.09 for all). The complication rate was 4.3% (2/47): one partial rerupture managed conservatively and one superficial wound infection treated with oral antibiotics. No complete reruptures were observed.

Conclusion: Open double-Tajima repair combined with a structured functional loading protocol seems to be associated with clinically acceptable long-term outcomes in this cohort of non-competitive adults. However, given the retrospective, single-cohort design without an independent comparison group or formal equivalence framework, these findings should be interpreted as descriptive long-term observations.

Declarations

Author Contributions

A.A.: Idea/concept, design; K.G., C.G.A.: Control/supervision; A.A., C.G.A., E.Ö.: Data collection and/or processing; A.A., A.Ş., C.G.A.: Analysis and/or interpretation; A.Ş.: Literature review; A.A., K.G.: Writing the article; K.G., C.B.: Critical review; A.A., A.Ş.: References and fundings references.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Acknowledgments

The authors thank Merve Evren for preparing the original medical illustrations of the double-Tajima technique used in this study (Figures 2 and 3).

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

AI Disclosure

The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.

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