Traumatic vs. Pathological Achilles Tendon Ruptures: A Look into the Importance of the Collagen Matrix and the Preferred Method of Repair

The Achilles tendon is the largest, strongest, and thickest tendon in the human body. While it may be the strongest, the Achilles tendon is also among one of the most frequently ruptured. These lower limb injuries arise as a result of athletically induced trauma or pathologically and steroidal induced trauma. While the manner in which athletic ruptures occurs can be determined on a case to case basis through the use of clinical examination, ultrasonography, and magnetic resonance imaging (MRI), the method in which the injury should be treated remains controversial. The two main methods of repair include a conservative approach and a surgical approach. Such requirements including lower re-rupture rates, earlier return to activity, lower rates of complications, restoration of normal length and tension to the tendon, and maximization of the strength and function of the calf muscle produce a debated standpoint between the two methods. Pathologically induced ruptures, on the other hand, are not well-understood. As a matter of fact, the actual effects of corticosteroids and fluoroquinolones on the tendon remain controversial. The aim of the present study, therefore, was to gather data from various researchers on Achilles tendon ruptures, induced both athletically and pathologically, and determine both the preferred repair method for athletically induced ruptures and the impact of steroids on pathologically induced ruptures. Studies reporting data regarding the surgical versus conservative methods were analyzed on a broad scale while the effect of specific surgical techniques was excluded.