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C Holm, M Kjaer, P Eliasson
Achilles tendon rupture is a frequent injury with an increasing incidence. Until now, there is no consensus regarding optimal treatment. The aim of this review was to illuminate and summarize randomized controlled trials comparing surgical and non-surgical treatment of Achilles tendon ruptures during the last 10 years. Seven articles were found and they were all acceptable according to international quality assessment guidelines. Primary outcomes were re-ruptures, other complications, and functional outcomes...
February 2015: Scandinavian Journal of Medicine & Science in Sports
Annunziato Amendola
OBJECTIVE: To compare the outcomes (reruptures and other complications, strength, and return to work) of open surgical repair of acute Achilles tendon ruptures with nonoperative management, by means of a meta-analysis of the results of randomized controlled trials (RCTs). DATA SOURCES: The online search using words related to management of Achilles tendon rupture included MEDLINE, PubMed, the Cochrane Database of Systematic Reviews, and the American College of Physicians Journal Club...
January 2014: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Ryan Wilkins, Leslie J Bisson
BACKGROUND: Despite several randomized controlled trials comparing operative to nonoperative management of Achilles tendon ruptures, the optimal management of this condition remains the subject of significant debate. Rerupture is a known complication, but most level I studies have not shown a significant difference in the incidence of reruptures when comparing operative to nonoperative management. PURPOSE: The goal of this systematic review was to identify all randomized controlled trials comparing operative and nonoperative management of Achilles tendon ruptures and to meta-analyze the data with reruptures being the primary outcome...
September 2012: American Journal of Sports Medicine
Katarina Nilsson-Helander, Karin Grävare Silbernagel, Roland Thomeé, Eva Faxén, Nicklas Olsson, Bengt I Eriksson, Jon Karlsson
BACKGROUND: There is no consensus regarding the optimal treatment for patients with acute Achilles tendon rupture. Few randomized controlled studies have compared outcomes after surgical or nonsurgical treatment with both groups receiving early mobilization. PURPOSE: This study was undertaken to compare outcomes of patients with acute Achilles tendon rupture treated with or without surgery using early mobilization and identical rehabilitation protocols. STUDY DESIGN: Randomized, controlled trial; Level of evidence, 1...
November 2010: American Journal of Sports Medicine
Hugo Henríquez, Roberto Muñoz, Giovanni Carcuro, Christian Bastías
BACKGROUND: Open repair of Achilles tendon rupture has been associated with higher levels of wound complications than those associated with percutaneous repair. However, some studies suggest there are higher rerupture rates and sural nerve injuries with percutaneous repair. QUESTIONS/PURPOSES: We compared the two types of repairs in terms of (1) function (muscle strength, ankle ROM, calf and ankle perimeter, single heel rise tests, and work return), (2) cosmesis (length scar, cosmetic appearance), and (3) complications...
April 2012: Clinical Orthopaedics and related Research
M R Carmont, C Heaver, A Pradhan, O Mei-Dan, K Gravare Silbernagel
PURPOSE: Recent meta-analyses have shown reduced re-rupture rates for the surgical management of Achilles ruptures. However, percutaneous repair has been demonstrated to lead to improved function and patient satisfaction but greater complications than open repair. In the current economic climate, it is reasonable to consider the financial cost of rupture management for both the patient and the provider. The cost-effectiveness of operative treatment of ruptures of the Achilles tendon was determined based upon theatre occupancy, clinic attendance and cast changes, operative complications and functional assessment score...
June 2013: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Kristoffer Weisskirchner Barfod, Jesper Bencke, Hanne Bloch Lauridsen, Ilija Ban, Lars Ebskov, Anders Troelsen
BACKGROUND: Dynamic rehabilitation has been suggested to be an important part of nonoperative treatment of acute Achilles tendon rupture that results in functional outcome and rerupture rates comparable with those of operative treatment. However, the optimal role of weight-bearing during early rehabilitation remains unclear. The purpose of this study was to compare immediate weight-bearing with non-weight-bearing in a nonoperative dynamic treatment protocol for Achilles tendon rupture...
September 17, 2014: Journal of Bone and Joint Surgery. American Volume
René P T G C Groetelaers, Loes Janssen, Jolanda van der Velden, Arvid W J Wieland, Angelique G F M Amendt, Peter H J Geelen, Heinrich M J Janzing
BACKGROUND: Operative repair of an acute Achilles tendon rupture (ATR) reduces the risk of re-rupture and has therefore gained popularity as a standard treatment for ATR, especially in the young and physically active patient. There is ongoing controversy over the best surgical technique and postoperative treatment. In this prospective, randomized trial, we compared cast immobilization and functional treatment with early mobilization and weightbearing after using a minimally invasive surgical technique in patients with ATR...
May 21, 2014: Foot & Ankle International
Kevin Willits, Annunziato Amendola, Dianne Bryant, Nicholas G Mohtadi, J Robert Giffin, Peter Fowler, Crystal O Kean, Alexandra Kirkley
BACKGROUND: To date, studies directly comparing the rerupture rate in patients with an Achilles tendon rupture who are treated with surgical repair with the rate in patients treated nonoperatively have been inconclusive but the pooled relative risk of rerupture favored surgical repair. In all but one study, the limb was immobilized for six to eight weeks. Published studies of animals and humans have shown a benefit of early functional stimulus to healing tendons. The purpose of the present study was to compare the outcomes of patients with an acute Achilles tendon rupture treated with operative repair and accelerated functional rehabilitation with the outcomes of similar patients treated with accelerated functional rehabilitation alone...
December 1, 2010: Journal of Bone and Joint Surgery. American Volume
Andrew R Hsu, Carroll P Jones, Bruce E Cohen, W Hodges Davis, J Kent Ellington, Robert B Anderson
BACKGROUND: Limited incision techniques for acute Achilles tendon ruptures have been developed in recent years to improve recovery and reduce postoperative complications compared with traditional open repair. The purpose of this retrospective cohort study was to analyze the clinical outcomes and postoperative complications between acute Achilles tendon ruptures treated using a percutaneous Achilles repair system (PARS [Arthrex, Inc, Naples, FL]) versus open repair and evaluate the overall outcomes for operatively treated Achilles ruptures...
November 2015: Foot & Ankle International
James R McWilliam, Gordon Mackay
UNLABELLED: The efficient and effective function of the Achilles tendon is essential for normal gait and sporting performance. The optimal technique for the operative repair of the Achilles midsubstance rupture remains controversial. Suboptimal outcomes are common even after successful Achilles repair. Factors contributing to poor outcomes include a tenuous soft tissue envelope (leading to wound complications, peritendinous adhesions, and poor tendon healing,) as well as failure to maintain appropriate musculotendinous length, even after successful repair...
July 2016: Foot & Ankle International
Hakan Sarman, Umit Sefa Muezzinoglu, Kaya Memisoglu, Adem Aydin, Halil Atmaca, Tuncay Baran, Bahar Odabas Ozgur, Turgay Ozgur, Cengizhan Kantar
The goal of the present study was to evaluate the semi-invasive "internal splinting" (SIIS) method for repair of Achilles tendon rupture relative to open repair with Krakow sutures. Efficacy was evaluated based on the clinical and functional outcomes, postoperative magnetic resonance imaging measurements, isokinetic results, and surgical complication rates. Functional measurements included the Thermann and American Orthopaedic Foot and Ankle Society (AOFAS) ankle scores, bilateral ankle dorsiflexion, and plantar flexion measurements...
September 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Ersin Taşatan, Tuluhan Yunus Emre, Demet Tekdöş Demircioğlu, Bahtiyar Demiralp, Vecihi Kırdemir
An ideal surgical treatment of acute Achilles tendon rupture includes restoring the original length of the tendon, minimizing possible adhesions with the surrounding tissues, minimizing the risk of repeat rupture, alleviating wound problems, and providing an acceptable cosmetic outcome. In the mini-open repair technique, unlike the percutaneous repair technique, the quality of the tenodesis can be visualized without disturbing the healing potential of the surrounding tissues, thus minimizing wound problems...
September 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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