Postoperative rehabilitation after percutaneous Achilles tendon repair: Early functional therapy versus cast immobilization

Majewski, M.; Schaeren, Stefan; Kohlhaas, U.; Ochsner, P. E.

doi:10.1080/09638280701786831

Cited by 42 publications

(39 citation statements)

References 30 publications

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“…Percutaneous treatment was situated in between the two. When compared to other studies, days off work have been reported to be in the same range [18,25].…”

Section: Discussionmentioning

confidence: 71%

Long-term outcomes of muscle volume and Achilles tendon length after Achilles tendon ruptures

Rosso

Vavken

Polzer

et al. 2013

Knee Surg Sports Traumatol Arthrosc

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Purpose The best treatment for Achilles tendon (AT) ruptures remains controversial. Long-term follow-up with radiological and clinical measurements is needed. Methods In this retrospective multicentre cohort study, patients (n = 52) were assessed at a mean of 91 months follow-up after unilateral AT rupture treated by open, percutaneous or conservative (non-surgical) treatment. Demographic parameters, time off work, maximum calf circumference and clinical scores (ATRS, Hannover, AOFAS) were evaluated. Muscle volume and cross-sectional area of the calf and AT length were measured on MR images and were compared between groups and to each patient's healthy contralateral leg. Results Reduced muscle volume was found across all groups with a higher muscle volume in the conservative (729.9 ± 130.3 cm 3 ) compared to the percutaneous group (675.9 ± 207.4 cm 3 , p = 0.04). AT length was longer in the affected leg (198.4 ± 24.1 vs. 180.6 ± 25.0 mm, p \ 0.0001) without difference in subgroup analysis. Clinically measured ankle dorsiflexion showed poor correlation with AT length (R 2 = 0.07, p = 0.008). Muscle volume strongly correlated with the cross-sectional area (R 2 = 0.6, p \ 0.0001) but showed a weak correlation with the Hannover score (R 2 = 0.08, p = 0.048). Maximum calf circumference correlated with muscle volume (R 2 = 0.42, p \ 0.0001). Conclusions No significant difference between the treatment groups was found in muscle volume, AT length, clinical measures or days off work. Cross-sectional area and maximum calf circumference are cost-effective measurements and a good approximation of muscle volume and can thus be used in a clinical setting while clinical dorsiflexion should not be used. Level of evidence III.

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“…Percutaneous treatment was situated in between the two. When compared to other studies, days off work have been reported to be in the same range [18,25].…”

Section: Discussionmentioning

confidence: 71%

Long-term outcomes of muscle volume and Achilles tendon length after Achilles tendon ruptures

Rosso

Vavken

Polzer

et al. 2013

Knee Surg Sports Traumatol Arthrosc

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“…Six studies did not report patient sex[38,61,75,85,102,126] and five studies did not report patient age[45,62,73,75,80]. Eighty-five of the studies reported RTP measure (RTP methodology sub-group 1) and 23 were classified as lacking RTP measure (methodology sub-group 2).…”

Section: Resultsmentioning

confidence: 99%

Return to play post-Achilles tendon rupture: a systematic review and meta-analysis of rate and measures of return to play

2016

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Aim This systematic review and meta-analysis sought to identify return to play (RTP) rates following Achilles tendon rupture and evaluate what measures are used to determine RTP. Design Systematic review and meta-analysis. Studies were assessed for risk of bias and grouped based on repeatability of their measure of RTP determination. Data Sources PubMed, CINAHL, Web of Science, and Scopus databases were searched to identify potentially relevant articles. Eligibility criteria for selecting studies Studies reporting return to play/sport/sport activity in acute, closed Achilles tendon rupture were included. Results A total of 108 studies encompassing 6,506 patients were included for review. Eighty-five studies included a measure for determining RTP. The rate of RTP in all studies was 80% (CI95%: 75 – 85%). Studies with measures describing determination of RTP reported lower rates than studies without metrics described, with rates being significantly different between groups (p < 0.001). Conclusions Eighty percent of patients returned to play following Achilles tendon rupture, however, the return to play rates are dependent on the quality of the method used to measure RTP. To further understand RTP after Achilles tendon rupture, a standardised, reliable, and valid method is required.

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“…35 Early rehabilitation is preferred to cast immobilisation after percutaneous Achilles tendon repair. 36 Isokinetic calf muscle strength is better in patients allowed to mobilise the ankle between neutral and plantar-flexion, compared with those immobilised in tension. 16 Patients who are allowed early weight bearing achieve higher health-related quality of life in the early postoperative period, compared with those with non-weight bearing.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Repair Followed by Accelerated Rehabilitation for Acute Achilles Tendon Ruptures

Al-Mouazzen

Rajakulendran

Najefi

et al. 2015

J Orthop Surg (Hong Kong)

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Purpose. To evaluate the outcome after percutaneous repair followed by accelerated rehabilitation for acute Achilles tendon ruptures. Methods. 21 men and 9 women (mean age, 41 years) underwent percutaneous repair by a single senior surgeon for acute Achilles tendon ruptures, followed by early weight bearing and accelerated rehabilitation. Outcome measures included the Achilles tendon rerupture rate, the Achilles tendon total rupture score (ATRS) at 3 and 6 months, the incidence of sural nerve injury, wound infection, wound dehiscence, patient satisfaction, and the time to return to prerupture activity. Results. The mean follow-up period was 12.5 months. The mean ATRS score improved from 57.65 at 3 months to 86.95 at 6 months (p<0.001). No patient had intra-operative complications, tendon re-rupture, sural nerve injury, wound dehiscence, or deep infection. Two patients developed a superficial wound infection, which was resolved with oral Percutaneous repair followed by accelerated rehabilitation for acute Achilles tendon ruptures

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Postoperative rehabilitation after percutaneous Achilles tendon repair: Early functional therapy versus cast immobilization

Abstract: Early mobilization in a special shoe is preferable to postoperative immobilization after percutaneous Achilles tendon repair. It provides a good clinical outcome and shortens the time for return to work and sports.

Cited by 42 publications

References 30 publications

Long-term outcomes of muscle volume and Achilles tendon length after Achilles tendon ruptures

Long-term outcomes of muscle volume and Achilles tendon length after Achilles tendon ruptures

Return to play post-Achilles tendon rupture: a systematic review and meta-analysis of rate and measures of return to play

Percutaneous Repair Followed by Accelerated Rehabilitation for Acute Achilles Tendon Ruptures

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