Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Gino M.M.J. Kerkhoffs, Amsterdam University Medical Centers
- Second opponent: Associate Professor Katarina Nilsson Helander, University of Gothenburg
- Third member and chair of the evaluation committee: Professor II Jens Ivar Brox, University of Oslo
Chair of the Defence
Professor Emeritus, Knut Strømsøe, University of Oslo
Principal Supervisor
Sigurd Erik Hoelsbrekken, Cand.med, PhD
Summary
The Achilles´ tendon is the strongest tendon in the human body. A rupture may lead to gait abnormalities caused by tendon elongation. Treatment options are non-operative and surgical including open, minimally invasive, and percutaneous techniques.
We performed the world’s largest randomized controlled trial (RCT) comparing three treatments of acute Achilles´ tendon ruptures. 554 patients from four centers were randomly assigned to receive non-operative treatment, open repair, or minimally invasive surgery. 526 patients were included in the analyses. The main outcome was patient satisfaction measured by the only available injury specific patient reported outcome measure for acute Achilles´ tendon rupture – the acute Achilles´ tendon Total Rupture Score (ATRS). The validity and reliability of the Norwegian translation of the ATRS was found acceptable.
We also compared measurement methods for measuring the length of the Achilles´ tendon using ultrasound and found that the best agreement and most reliable measures were produced using measurements from the distal medial musculo-tendinous junction to the tendon´s insertion on the back of the heel using skin markings and a measuring tape.
In the RCT we found that despite a higher risk of re-rupture after non-operative treatment, patient satisfaction and physical performance were similar comparing the three treatment groups after 1 year.
Additional information
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