Brake Response Time Recovery After Achilles Tendon Repair

Background. This study evaluated when patients’ brake response time (BRT) recovers after right Achilles repair. Methods. Institutional review board–approved prospective study of 60 patients. Assessments included visual analogue scale pain (VAS) score, Achilles Tendon Total Rupture Score (ATRS), and a driver readiness survey. Emergent brake pedal operation was simulated at 6 weeks postoperatively and repeated until patients achieved a passing BRT. Results. Fifty-seven patients completed the study. At 6 weeks, 54 of 59 (91.5%) patients had a passing BRT with a mean of 0.60 seconds (SD 0.08 seconds). Five (8.5%) patients had a failing BRT with a significantly higher mean of 0.95 seconds (SD 0.13 seconds, P =.01). At first testing, all patients were ambulating in a walking boot with removable heel wedges. Those who passed were using significantly fewer wedges (mean 1.9 vs 2.6 wedges, P =.04). Mean VAS pain scores (Passed: 1.1, SD 1.57, vs Failed: 2.8, SD 3.35, P =.32) were not significantly different. The mean ATRS was significantly lower among those who passed (63.7, SD 16.7, vs 85.4, SD 11.1, P =.01. Three patients repeated testing at a mean 7.3 weeks (range 6.7-8). All achieved passing times (mean 0.68 seconds, range 0.55 to 0.77 seconds). The driving readiness survey was 100% sensitive but 31.3% specific for passing BRT. Its positive predictive value was 80%, and its negative predictive value was 100%. Conclusion. BRT normalizes around 6 to 7 weeks after open right Achilles tendon repair. The ATRS and driver readiness questionnaire corresponded to achieving a passing BRT. Levels of Evidence: Prognostic Level II: Prospective Cohort Study.