{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T01:24:24Z","timestamp":1780449864400,"version":"3.54.1"},"reference-count":41,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,5,26]],"date-time":"2024-05-26T00:00:00Z","timestamp":1716681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim of the study was to examine the impact of a deep venous thrombosis (DVT) on patient outcomes 3 years after Achilles tendon rupture (ATR) repair and if there were continued improvements between 1 and 3 years after surgery. A secondary aim was to determine risk factors associated with impaired patient outcomes in the long term.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cohort study consisted of 181 ATR\u2010repaired patients, from two large randomized clinical trials, who attended a 3\u2010year follow\u2010up evaluation. Patients were postoperatively randomized to two different weight\u2010bearing interventions compared with immobilization in a below\u2010knee plaster cast for 2 weeks. During immobilization, screening for DVT was performed with Doppler ultrasound. At 1 and 3 years postoperatively, functional\u2010 and patient\u2010reported outcomes were evaluated by the validated heel\u2010rise test and self\u2010reported questionnaire, Achilles tendon Total Rupture Score (ATRS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 76 out of 181 (42%) patients exhibited a DVT at the 2\u2010 or 6\u2010week screening after ATR surgery. Suffering from a DVT during immobilization resulted at 3 years in a worse limb symmetry index (LSI) of heel\u2010rise total work compared to patients without DVT, adjusted for age (DVT mean LSI 68% vs. no DVT 78%, <jats:italic>p<\/jats:italic>\u2009=\u20090.027). At 3 years, patients with a DVT during immobilization displayed lower ATRS (DVT median 88 vs. no DVT 93, <jats:italic>p<\/jats:italic>\u2009=\u20090.046), which was not significant after adjustment for age. However, patients with DVT exhibited an improvement in ATRS, LSI total work, and LSI maximum height between 1 and 3 years, which was not seen among patients without DVT. Independent risk factors for reduced patient functional outcomes at 3 years were older age, greater calf muscle hypotrophy, and suffering a DVT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>DVT during immobilization affects patients' long\u2010term functional outcomes 3 years after ATR repair. Clinicians should adequately address risk factors contributing to impaired patient outcomes in the long term, including calf muscle hypotrophy, DVT, and older age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level \u2162.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ksa.12240","type":"journal-article","created":{"date-parts":[[2024,5,26]],"date-time":"2024-05-26T04:03:55Z","timestamp":1716696235000},"page":"2184-2193","source":"Crossref","is-referenced-by-count":5,"title":["Long\u2010term patient outcome is affected by deep venous thrombosis after Achilles tendon rupture repair"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8795-105X","authenticated-orcid":false,"given":"Susanna","family":"Aufwerber","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden"},{"name":"Women's Health and Allied Health Professionals Theme, Medical Unit Occupational 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