March 2012

Surgical, nonsurgical Achilles care lead to similar one-year outcomes

In the moment: Surgery

In a study of acute Achilles tendon rupture published this month in the Clinical Journal of Sport Medicine, some strength and endurance measures improved earlier in those who underwent surgical versus nonsurgical care, but rerupture rates and patient-reported function were similar one year after treatment.

Orthopedic surgeons from the Sahlgrenska University Hospital in Gothenburg, Sweden, randomized 97 patients (18 wo­men) with acute ruptures to surgical or nonsurgical care. Surgeon operated on 49 patients using the modified Kessler suture technique and then applied a below-the-knee cast; the nonsurgical group (n = 48) received a similar cast. All patients wore the cast for two weeks, followed by six weeks of brace wear and an identical rehabilitation protocol.

The rate of rereupture was 4.08% in the surgical group and 12.5% in the nonsurgical group. Both groups’ Achilles tendon rupture scores improved equivalently during rehabilitation, and no differences were found in physical activity scores. After six months, the surgical group performed better on hopping and strength tests than the nonsurgical group, but, except for heel-rise work, outcomes were equivalent at 12 months.

Donaldson PR. Surgical versus nonsur­gical treatment of acute Achilles tendon rupture. Clin J Sport Med 2012;22(2):169-170.

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