Surgical management of chronic ruptures of the Achilles tendon remains unclear : a systematic review of the management options

Background Chronic ruptures of the Achilles tendon cause marked functional impairment. Given the different repair techniques used, there is a need for a systematic review of the literature to investigate whether these procedure are comparable with one another when performed by experienced surgeons. Sources of data A systematic literature search using the Medline (Pubmed), EMBASE and CINHAL databases. Areas of agreement Provided there are no contraindications, surgery is regarded the best management option. Areas of controversy Most reports are case series with small sample sizes using non-validated measures. Growing points Long-term results of surgical repair procedures are now available. Areas timely for developing research The current literature does not allow clinicians to definitively determine the optimal management modality for chronic rupture of the Achilles tendon. There is a need for randomized controlled trials which use validated functional outcome measures