Immediate mobilization after repair of Achilles tendon rupture may increase the incidence of re-rupture: a systematic review and meta-analysis of randomized controlled trials

Review written by Dr Seth O’Neill info

Key Points

  1. Early weight bearing and mobilization post Achilles tendon rupture reduces re-rupture rates.
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BACKGROUND & OBJECTIVE

Achilles Tendon Ruptures (ATRs) are a common condition with a rising frequency worldwide. ATRs more frequently affect men but this is probably due to sporting participation in between 35-60yrs and with the significant surge in women’s sport this gender split is likely to change.

There has always been controversy about ATR management and whether surgery is superior to conservative care with the debate centring around re-rupture rates. Thankfully the debate has now started to move towards the rehabilitation which is something very close to our interest area.

The key issues around post rupture rehabilitation are:

  • When to weigh bear?
  • When to do range of motion (ROM) exercises?
  • When to do resistance training and how do we progress this?

This can often get grouped into programmes that involve accelerated rehabilitation (AR).

The objective of this review was to systematically review the literature and complete a meta-analysis to determine the re-rupture risks for early post operative management.

Achilles Tendon Ruptures (ATRs) are a common condition with a rising frequency worldwide.
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Managing Achilles tendon rupture patients surgically, followed by a period of accelerated rehabilitation with or without a short period of immobilization seems to offer the best approach.

METHODS

This is a systematic review with a meta-analysis. The authors clearly registered with PROSPERO and provided the registration number - something that helps reduce waste in the research world as other reviewers can ensure they don’t duplicate work already underway.

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