Troels Mark-Christensen1, Anders Troelsen2, Thomas Kallemose2, Kristoffer Weisskirchner Barfod2. 1. Physiotherapist at Fysiocenter Århus, Brendstrupgaardsvej 9B 1.005, 8200, Aarhus N, Denmark. t.m.christensen@hotmail.com. 2. Department of Orthopedic Surgery, Clinical Orthopedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Kettegård Alle 30, 2650, Hvidovre, Denmark.
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.
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.
Authors: H Zwipp; H Thermann; N Südkamp; H Tscherne; H Milbradt; P Reimer; P Heintz Journal: Sportverletz Sportschaden Date: 1990-03 Impact factor: 1.077
Authors: Nicklas Olsson; Karin Grävare Silbernagel; Bengt I Eriksson; Mikael Sansone; Annelie Brorsson; Katarina Nilsson-Helander; Jón Karlsson Journal: Am J Sports Med Date: 2013-09-06 Impact factor: 6.202
Authors: Katarina Nilsson-Helander; Karin Grävare Silbernagel; Roland Thomeé; Eva Faxén; Nicklas Olsson; Bengt I Eriksson; Jon Karlsson Journal: Am J Sports Med Date: 2010-08-27 Impact factor: 6.202
Authors: Amar A Suchak; Geoff P Bostick; Lauren A Beaupré; D'Arcy C Durand; Nadr M Jomha Journal: J Bone Joint Surg Am Date: 2008-09 Impact factor: 5.284
Authors: Mareen Braunstein; Sebastian F Baumbach; Wolfgang Boecker; Mike R Carmont; Hans Polzer Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-09-26 Impact factor: 4.342
Authors: B Frankewycz; A Penz; J Weber; N P da Silva; F Freimoser; R Bell; M Nerlich; E M Jung; D Docheva; C G Pfeifer Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-11-16 Impact factor: 4.342
Authors: J F Maempel; T O White; S P Mackenzie; C McCann; N D Clement Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-01-12 Impact factor: 4.342
Authors: Brandon J Erickson; Randy Mascarenhas; Bryan M Saltzman; David Walton; Simon Lee; Brian J Cole; Bernard R Bach Journal: Orthop J Sports Med Date: 2015-04-17