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Akillesseneruptur

Sist oppdatert: Sist revidert:
Sist revidert av:

Definisjon:
Avrivning av akillessenen, helt eller delvis
Forekomst:
I en norsk studie var insidens av akillesseneruptur 16,8 per 100.000 innbyggere
Symptomer:
Akutte smerter i leggen og ofte et hørbart smell
Funn:
Ømhet i leggmuskulatur, sterkt svekket kraft ved plantarfleksjon
Diagnostikk:
Ultralyd eller MR er unntaksvis aktuelt ved usikkerhet om diagnosen
Behandling:
Konservativ behandling med gips initialt, deretter funksjonell ortose med gradvis økende belastning er standard. Kirurgisk behandling dersom pasienten kommer sent til behandling, eller etter individuell vurdering
  1. Maughan KL Boggess BR. Achilles tendinopathy and tendon rupture. UpToDate, last updated Jun 06, 2019. UpToDate  
  2. Gudmundsson B, Gote TB. Achillessenerupturer. Prosedyrer.no. Sist oppdatert 08.05.2020. www.prosedyrer.no  
  3. Borchgrevink G, Grøntvedt T. Reruptur etter operasjon for total akillesseneruptur. Tidsskr Nor Lægeforen 2005; 125: 2488-90. PubMed  
  4. Kujala UM, Sarna S, Kaprio J. Cumulative incidence of achilles tendon rupture and tendinopathy in male former elite athletes. Clin J Sport Med 2005; 15:133. PubMed  
  5. Asplund CA, Best TM. Achilles tendon disorders. BMJ. 2013 Mar 12. 346:f1262.
  6. Park SH, Lee HS, Young KW, Seo SG. Treatment of Acute Achilles Tendon Rupture. Clin Orthop Surg. 2020 Mar;12(1):1-8. PMID: 32117532. PubMed  
  7. Keene DJ, Alsousou J, Harrison P, et al. Platelet rich plasma injection for acute Achilles tendon rupture: PATH-2 randomised, placebo controlled, superiority trial. BMJ 2019; 367: l6132. pmid:31748208 PubMed  
  8. Nilsson-Helander K, Silbernagel KG, Thomeé R, Faxén E, Olsson N, Eriksson BI, et al. Acute achilles tendon rupture: a randomized, controlled study comparing surgical and nonsurgical treatments using validated outcome measures. Am J Sports Med. 2010 Nov. 38(11):2186-93.
  9. Chan AP, Chan YY, Fong DT, Wong PY, Lam HY, Lo CK, et al. Clinical and biomechanical outcome of minimal invasive and open repair of the Achilles tendon. Sports Med Arthrosc Rehabil Ther Technol. 2011 Dec 20. 3(1):32.
  10. Wegrzyn J, Luciani JF, Philippot R, et al. Chronic Achilles tendon rupture reconstruction using a modified flexor hallucis longus transfer. Int Orthop. 2009 Aug 21.
  11. Willits K, Amendola A, Bryant D, et al. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg Am 2010; 92: 2767-75. PubMed  
  12. Costa ML, Achten J, Marian IR, et al. Plaster cast versus functional brace for non-surgical treatment of Achilles tendon rupture (UKSTAR): a multicentre randomised controlled trial and economic evaluation. Lancet 2020. doi:10.1016/S0140-6736(19)32942-3 DOI  
  13. Metz R, Verleisdonk EJ, van der Heijden GJ, Clevers GJ, Hammacher ER, Verhofstad MH, et al. Acute Achilles tendon rupture: minimally invasive surgery versus nonoperative treatment with immediate full weightbearing--a randomized controlled trial. Am J Sports Med. 2008 Sep. 36(9):1688-94.
  14. Khan RJ, Fick D, Keogh A, Crawford J, Brammar T, Parker M. Treatment of acute Achilles tendon ruptures. A meta-analysis of randomized, controlled trials. J Bone Joint Surg Am 2005; 87: 2202-10. PubMed  
  15. Groetelaers RP, Janssen L, van der Velden J, et al. Functional Treatment or Cast Immobilization After Minimally Invasive Repair of an Acute Achilles Tendon Rupture: Prospective, Randomized Trial. Foot Ankle Int. 2014 May 21.
  16. Myhrvold SB, Brouwer EF, Andresen TKM, et al. Nonoperative or Surgical Treatment of Acute Achilles' Tendon Rupture. N Engl J Med. 2022;386(15):1409-1420. PubMed  
  17. Hawkins D, Lum C, Gaydos D, et al. Dynamic creep and pre-conditioning of the Achilles tendon in-vivo. J Biomech. 2009 Dec 11;42(16):2813-7. doi: 10.1016/j.jbiomech.2009.08.023 DOI  
  18. Ochen Y, Beks RB, van Heijl M, et al. Operative treatment versus nonoperative treatment of Achilles tendon ruptures: systematic review and meta-analysis. BMJ 2019; 364:k5120. BMJ (DOI)  
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Stig Fossum, fysioterapeut, Moholt fysikalske institutt, Trondheim
  • Arild Aamodt, overlege/professor, Ortopedisk avdeling, Lovisenberg Sykehus, Oslo