Long-term effects of functional recovery based on emergency and late repair with Achilles tendon rupture: A retrospective study

Background Repair for total Achilles tendon ruptures is sometimes delayed, despite the recommendation for early repair. Objective To investigate patient recovery scores, and ankle strength and function according to the timing of Achilles tendon rupture repair. Methods We conducted a retrospective analysis by categorizing repair: emergency (ER, n = 38), late (LR, n = 16), and very late (VLR, n = 13). Patients were evaluated based on the Achilles Tendon Total Rupture Score (ATRS), dorsiflexion range of motion, ankle strength, hop tests, and balance. Results All groups showed consistent improvement in the ATRS, heel-raise, plantarflexion strength, hop tests, and balance up to 6 and 9 months post-surgery. At 3 months, the ER and LR groups had significantly better values in the ATRS, heel raise, plantarflexion strength, and single-hop test compared with the VLR group (p < 0.05); by 12 months, there were no significant between-group differences (p > 0.05). The ER group outperformed the VLR group in the crossover hop test, and in posteromedial and lateral balance at 12 months (p < 0.05). Conclusion Twelve months after Achilles tendon rupture repair, VLR induced similar improvement in the ATRS, and ankle strength and function compared to ER and LR. Therefore, despite being very late, the repair was significantly effective in improving ankle function.