Review ArticlesAcute Ruptures of the Achilles TendonLongo, Umile Giuseppe MD*; Ronga, Mario MD†; Maffulli, Nicola MD, MS, PhD, FRCS(Orth)‡Author Information *Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Via Alvaro del Portillo, Rome †Department of Orthopaedics and Traumatology, University of Insubria Ospedale di Circolo, Varese, Italy ‡Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, UK Reprints: Nicola Maffulli, MD, MS, PhD, FRCS (Orth), Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, North Staffordshire Hospital, Thornburrow Drive, Hartshill, Stoke on Trent, Staffordshire, ST4 7QB, UK (e-mail: firstname.lastname@example.org). Sports Medicine and Arthroscopy Review: June 2009 - Volume 17 - Issue 2 - p 127-138 doi: 10.1097/JSA.0b013e3181a3d767 Buy Metrics Abstract The Achilles tendon (AT) is the most frequently ruptured tendon in the human body, but the etiology of AT ruptures is still not completely understood. Percutaneous repair and conservative management are viable alternatives to open surgery, which carries higher complication rates and is the most costly of the 3 management options. Individual patients will have different needs due to their age, occupation, or level of sporting activity. If the studies reporting a rising incidence of AT rupture are accurate, the field of AT surgery will become an increasingly important one for orthopedic surgeons. A major problem in the evaluation of the outcome of management of AT ruptures has been the lack of a universally accepted scoring system for the evaluation of results of management of AT rupture. The AT Total Rupture Score is a self-administered instrument with high clinical utility, and it can be used for measuring the outcome, related to symptoms and physical activity, after treatment in patients with a total AT rupture. Future developments may include the use of adhesives in tendon surgery. An understanding of the role, which cytokines play in tendon healing may also lead to the advent of new treatments, possibly based on gene therapy. However, such novel interventions are unlikely to be in routine clinical use for some time. © 2009 Lippincott Williams & Wilkins, Inc.