Incidence of venous thromboembolism following achilles tendon rupture. Data from the UK foot and ankle thrombo-embolism (UK-FATE) audit

Introduction

Achilles tendon rupture (ATR) carries a high risk of venous thrombo-embolism (VTE) whether the injury is managed surgically or non-operatively. This study reports symptomatic VTE rate following ATR. The influence of patient demographics, treatment type and use of chemical thromboprophylaxis is examined.

Materials and Methods

Observational cohort study. The data is from a multi-centre, prospective, national audit of patients from 68 participating United Kingdom centres. Data was prospectively collected from hospital records. The study was conducted between June and November 2022, with a 3-month follow up.

Results

Of 11,363 participants in the National Audit, 9.5 % (n = 1084) had experienced an ATR. Management strategies included both non-surgical (74 %) and surgical (26 %). Following ATR, the VTE rate was 3.69 % (n = 40) compared to 0.57 % (n = 59) for other foot and ankle surgeries.

Participants who developed symptomatic VTE after ATR were older than those who did not (mean age 54 years (95 %CI 50.5 - 54.7) vs 48 years (95 %CI 47.3 - 49.1)). There was no significant difference in VTE events due to participant sex, ethnicity or number of comorbidities. Differences in treatment regimen, such as weight-bearing status and immobilisation strategy, showed no significant difference in symptomatic VTE events between groups.

Conclusion

After ATR, patients are 6.5-times more likely to experience symptomatic VTE than those recovering from surgery for other foot and ankle pathology. There was no significant difference in symptomatic VTE rate after ATR with specific chemical prophylaxis or early mobilisation strategies.