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Functional rehabilitation of patients with acute Achilles tendon rupture: a meta-analysis of current evidence

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The optimal treatment for acute Achilles tendon rupture (ATR) is continuously debated. Recent studies have proposed that the choice of either operative or non-operative treatment may not be as important as rehabilitation, suggesting that functional rehabilitation should be preferred over traditional immobilization. The purpose of this meta-analysis of randomized controlled trials (RCTs) was to compare functional rehabilitation to immobilization in the treatment of ATR.

Method

This meta-analysis was conducted using the databases: PubMed, EMBASE, Rehabilitation and Sports Medicine Source, AMED, CINAHL, Cochrane Library and PEDro using the search terms: “Achilles tendon,” “rupture,” “mobilization” and “immobilization”. Seven RCTs involving 427 participants were eligible for inclusion, with a total of 211 participants treated with functional rehabilitation and 216 treated with immobilization.

Results

Re-rupture rate, other complications, strength, range of motion, duration of sick leave, return to sport and patient satisfaction were examined. There were no statistically significant differences between groups. A trend favoring functional rehabilitation was seen regarding the examined outcomes.

Conclusion

Functional rehabilitation after acute Achilles tendon rupture does not increase the rate of re-rupture or other complications. A trend toward earlier return to work and sport, and increased patient satisfaction was found when functional rehabilitation was used. The present literature is of low-to-average quality, and the basic constructs of the examined treatment and study protocols vary considerably. Larger, randomized controlled trials using validated outcome measures are needed to confirm the findings.

Level of evidence

II.

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Acknowledgments

We thank Mr. Anders Mark-Christensen for his grammatical and statistical assistance.

Conflict of interest

None.

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Authors and Affiliations

  1. Physiotherapist at Fysiocenter Århus, Brendstrupgaardsvej 9B 1.005, 8200, Aarhus N, Denmark

    Troels Mark-Christensen

  2. Department of Orthopedic Surgery, Clinical Orthopedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, 2650, Hvidovre, Denmark

    Anders Troelsen, Thomas Kallemose & Kristoffer Weisskirchner Barfod

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  1. Troels Mark-Christensen
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  2. Anders Troelsen
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Correspondence to Troels Mark-Christensen.

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Mark-Christensen, T., Troelsen, A., Kallemose, T. et al. Functional rehabilitation of patients with acute Achilles tendon rupture: a meta-analysis of current evidence. Knee Surg Sports Traumatol Arthrosc 24, 1852–1859 (2016). https://doi.org/10.1007/s00167-014-3180-5

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  • DOI: https://doi.org/10.1007/s00167-014-3180-5

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