Abstract
Objectives:
Achilles tendon ruptures are one of the most common types of tendon ruptures, and over the decades have increased in prevalence, a phenomenon credited to increasing levels of athletic activities in adults.1,2 Heavy loading and high-speed eccentric muscle action, such as sudden acceleration in running or jumping, put the Achilles tendon under stress and can lead to rupture. Sports and athletic activities are the cause of 68-80% of all Achilles tendon ruptures.2,3 Pickleball is regarded as America’s fastest growing sport, with participation in the sport doubling and membership in USA Pickleball, the sport’s national governing body, increasing by 30% in 2022.4,5 This study aims to examine the functional outcomes of Achilles tendon ruptures sustained while playing Pickleball and treated through surgical intervention.
Methods:
A retrospective chart review of Achilles tendon ruptures was conducted at a single institution. Those patients who sustained an Achilles tendon rupture injury while playing pickleball and had a minimum of one-year follow-up were included. Dates of surgery were between January 2016 and August 2023. Data reviewed were demographics, comorbidities, surgical technique, and complications. Review of patient reported outcome measures (PROMs) included Veterans-Rand 12 (VR-12) General Health Survey, Foot and Ankle Ability Measure (FAAM), Visual Analog Scale (VAS) scores, patient satisfaction and a return to play survey.
Results:
Of 1,968 patient charts reviewed, 127 patients were identified and used for final analysis. The average age was 54.3 years old (SD 11.5) are 77% (98) were males. The average Body Mass Index was 27.0 and 91 were not tobacco users, 10 were current, 22 were former and 4 use marijuana. The average follow-up time was 28.3 months (12-73.7). All PROMs were statistically significant except VR-12 Mental, see table 1. At the time of this report, the average return to play was 18.4 months and 50% have returned to pre-injury play. The differences between pre-operative and post-operative results of PROMs were analyzed with sample t-tests, with a P<0.05 to determine significance.
There were 11 complications noted: 4 minor [wound (2), persistent swelling at 5 months (1) and worsening pain (1)], 3 irrigation and debridement surgeries after wound infections, one deep vein thrombosis that resolved with anticoagulation and 3 re-ruptures, 2 were treated surgically at an average of 3.7 months after the initial date of repair.
Conclusions:
Over a 7.5-year time frame, 6.5% of Achilles Tendon ruptures were Pickleball related. 97.7% of patients were satisfied with their Achilles repair, and the majority returned to play about one and a half years after the injury. Continued follow-up with these patients is warranted to further validate these findings.
