No effects of early functional mobilization on gait patterns after acute Achilles tendon rupture repair

Aufwerber, Susanna; Naili, Josefine E.; Silbernagel, Karin Grävare; Ackermann, Paul W.

doi:10.1002/jor.25199

Cited by 4 publications

(5 citation statements)

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“…For example, researchers have established a rat model of ATI to examine the mechanism of ectopic ossification; the endothelium–mesenchymal transition is central to the pathological process ( 28 ). In animal studies and basic medical research, the development of computer hardware has greatly contributed to the study of heel ATI, allowing for a more comprehensive assessment of Achilles tendon repair and function in terms of the gait analysis ( 29 ) and elastography. Shear wave elastography (SWE) is a powerful tool for estimating tissue stiffness and sensitive to the early detection or monitoring of the tendinopathy ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

Global trends in research of achilles tendon injury/rupture: A bibliometric analysis, 2000–2021

et al. 2023

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BackgroundThe Achilles tendon is the strongest and most susceptible tendon in humans. Achilles tendon injuries and ruptures have gradually attracted research attention. However, a bibliometric analysis of global research in this field is lacking. This study involved a bibliometric analysis of the developmental trends and research hotspots in Achilles tendon injuries/ruptures from 2000 to 2021.MethodsArticles published between 2001 and 2021 were retrieved from an extended database of the Science Citation Index using Web of Science. VOSviewer and CiteSpace were used to analyze the relationships between publications, countries, institutions, journals, authors, references, and keywords.ResultsThis study included 3,505 studies of 73 countries, 3,274 institutions, and 12,298 authors and explored the cooperation between them and the relationships between citations. Over the past 22 years, the number of publications has significantly increased. Foot Ankle International has published the most papers on Achilles tendon injuries/ruptures, and British Journal of Sports Medicine is the most famous journal. Re-rupture, exosomes, acute Achilles tendon rupture, and tendon adhesions gradually become the research focus over the past few years.ConclusionAchilles tendon injury and rupture are important research topics. A vast number of newly published papers on this topic have demonstrated that clinicians and researchers are interested in their study. Over time, these recent studies will be widely cited; therefore, this bibliometric analysis should be constantly updated.

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Section: Discussionmentioning

confidence: 99%

Global trends in research of achilles tendon injury/rupture: A bibliometric analysis, 2000–2021

et al. 2023

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“…The cohort, and the results of repeated gait analyses, has been described previously. 8 In total, 47 patients were included, 29 who were treated with a dynamic orthosis (EFM) and 18 with ST 8 (Figure 1). Patient demographics are presented in Table 1.…”

Section: Methodsmentioning

confidence: 99%

“…40 However, early weightbearing has not been found to be superior to standard care in the recovery of gait patterns early after ATR surgery. 2,8 Nevertheless, Costa et al 15 reported that early weightbearing after operative repair of an ATR resulted in a faster return to normal walking and stair climbing compared with immobilization. Deficits in calf muscle function are common after an ATR.…”

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confidence: 99%

Comparable Recovery and Compensatory Strategies in Heel-Rise Performance After a Surgically Repaired Acute Achilles Tendon Rupture: An In Vivo Kinematic Analysis Comparing Early Functional Mobilization and Standard Treatment

et al. 2022

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Background: Deficits in calf muscle function and heel-rise performance are common after an Achilles tendon rupture (ATR) and are related to tendon elongation and calf muscle atrophy. Whether early functional mobilization (EFM) can improve calf muscle function compared with standard treatment (ST) with 2 weeks of immobilization and unloading in a plaster cast is unknown. Hypothesis: EFM would lead to superior recovery of heel-rise performance, as demonstrated by more symmetrical side-to-side ankle and knee joint kinematics, compared with ST. Study Design: Cohort study; Level of evidence, 2. Methods: In total, 47 patients with an ATR were prospectively included and treated with open surgical repair and randomized 2:1 postoperatively to either EFM or ST. Overall, 29 patients were treated with a dynamic orthosis (EFM), and 18 underwent ST. At 8 weeks and 6 months after ATR repair, 3-dimensional motion analysis of heel-rise performance was conducted. At 6 months, tendon length and muscle volume were assessed with ultrasound imaging, calf muscle function with the heel-rise test, and patient-reported outcomes with the Achilles tendon Total Rupture Score. Results: At 8 weeks and 6 months, there were no significant group differences between the EFM and ST groups in heel-rise performance, but significant side-to-side differences in ankle and knee kinematics were detected. At 8 weeks and 6 months, both the EFM and ST groups showed a significantly decreased peak ankle plantarflexion angle and increased knee flexion angle on the injured limb compared with the uninjured limb during bilateral heel raises. Linear regression demonstrated that greater atrophy of the medial gastrocnemius muscle ( P = .008) and higher body weight ( P < .001) were predictors of a decreased maximum peak ankle plantarflexion angle on the injured limb at 6 months. Conclusion: EFM after an ATR repair did not lead to superior recovery of calf muscle function, as assessed by heel-rise performance, compared with ST. Increased knee flexion seemed to be a compensatory strategy for decreased ankle plantarflexion. Medial gastrocnemius atrophy and increased body weight were additional factors associated with a decreased ankle plantarflexion angle. Registration: NCT02318472 (ClinicalTrials.gov identifier).

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“…There has been a general trend toward more patients being treated nonoperatively over the past decade or so as the advent of functional rehabilitation has improved on traditional results with nonoperative treatment 15 . However, much of the recent data on this subject have been highly variable, with differences in follow‐up time, rehabilitation techniques, outcome measures, and cohort size 17–24 . Furthermore, additional studies have shown no significant difference in rerupture and complication rates between the treatments 25 …”

Section: Introductionmentioning

confidence: 99%

“…15 However, much of the recent data on this subject have been highly variable, with differences in follow-up time, rehabilitation techniques, outcome measures, and cohort size. [17][18][19][20][21][22][23][24] Furthermore, additional studies have shown no significant difference in rerupture and complication rates between the treatments. 25 This systematic review focused on ATR treatment outcomes, with a specific focus on rerupture and complication rates, most notably wound issues.…”

Section: Introductionmentioning

confidence: 99%

Rerupture and wound complications following Achilles tendon repair: A systematic review

Shoap

Bäcker

Freibott

et al. 2022

Journal Orthopaedic Research

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Despite the relatively high frequency of Achilles ruptures, there is no general consensus on the optimal treatment method. A general trend toward more patients being treated nonoperatively has emerged recently with the advent of functional rehabilitation. However, much of the recent data on this subject has been highly variable. This systematic review focused on Achilles tendon rupture (ATR) treatment outcomes, with a focus on rerupture and complication rates. This systematic review specifically focused on articles regarding ATR treatment that also included rerupture and complication rates. Treatments were divided into three categories: open minimally invasive, open standard, and nonoperative. Bivariate analyses were performed to compare complication and rerupture rates among pairs of treatment options, as well as between early weight bearing versus immobilization. There was significantly higher complications for minimally invasive compared to nonoperative treatment (risk ratio [RR] = 4.4154; p < 0.05), lower complication rates for minimally invasive compared to open treatment (RR = 0.3231; p < 0.05), and higher complications for open standard compared to nonoperative treatment (RR = 5.6350; p < 0.001). There were significantly lower rerupture rates in minimally invasive compared to nonoperative treatment (RR = 0.4085; p < 0.001), a significantly lower rerupture rate in nonoperative treatment compared to open treatment (RR = 0.2282; p < 0.001), and no significant difference in rerupture rates when comparing minimally invasive to open standard treatment. We found that operative treatment is associated with fewer reruptures and more complications than a nonoperative approach. Minimally invasive surgery appears to be associated with a lower rate of complications than open operative treatment.

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No effects of early functional mobilization on gait patterns after acute Achilles tendon rupture repair

Cited by 4 publications

References 43 publications

Global trends in research of achilles tendon injury/rupture: A bibliometric analysis, 2000–2021

Global trends in research of achilles tendon injury/rupture: A bibliometric analysis, 2000–2021

Comparable Recovery and Compensatory Strategies in Heel-Rise Performance After a Surgically Repaired Acute Achilles Tendon Rupture: An In Vivo Kinematic Analysis Comparing Early Functional Mobilization and Standard Treatment

Rerupture and wound complications following Achilles tendon repair: A systematic review

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