Ahmet AYBAR, Kemal GÖKKUŞ, Abdullah ŞÜKÜN, Canan GÖNEN AYDIN, Erdem ÖZDEN, Celal BOZKURT
Joint Diseases and Related Surgery - 2026;37(3):756-767
Objectives: This study aims to evaluate the clinical and objective biomechanical outcomes at a minimum 10-year follow-up following open double-Tajima repair combined with a structured functional loading protocol. Patients and methods: Between January 2011 and December 2014, a total of 47 consecutive non-competitive adults (Tegner Activity Scale <= 4) with acute unilateral Achilles tendon rupture treated with open double-Tajima repair and an eight-week functional loading protocol were included in this retrospective cohort study. The primary outcome was the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. Secondary outcomes included isokinetic dynamometry (peak torque at 30 derece/s and total work at 120 derece/s for plantar flexion and dorsiflexion), joint position sense, and ankle/calf circumference. Between-limb comparisons were performed. Results: Of the patients, 35 were male and 12 were female with a mean age at the time of surgery of 36.7 +/- 6.6 (range, 22 to 55) years. The mean follow-up was 132.4 +/- 13.5 (range, 120 to 168) months. The rupture involved the dominant limb in 29 patients (61.7%) and the non-dominant limb in 18 patients (38.3%). The primary outcome (AOFAS score) showed no statistically significant between-limb difference: the median score was 91.0 (IQR, 91.0 to 93.0) on the operated limb versus 93.0 (IQR, 91.0 to 93.0) on the contralateral limb (median difference: 0.00 points; 95% confidence interval [CI]: -1.00 to 1.00; p = 0.92). No statistically significant between-limb differences were detected across the secondary outcomes, including peak torque at 30 derece/s, total work at 120 derece/s, joint position sense, and ankle/calf circumference (p >= 0.09 for all). The complication rate was 4.3% (2/47): one partial rerupture managed conservatively and one superficial wound infection treated with oral antibiotics. No complete reruptures were observed. Conclusion: Open double-Tajima repair combined with a structured functional loading protocol seems to be associated with clinically acceptable long-term outcomes in this cohort of non-competitive adults. However, given the retrospective, single-cohort design without an independent comparison group or formal equivalence framework, these findings should be interpreted as descriptive long-term observations.
