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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2013

01-06-2013 | Ankle

What is the effect of the early weight-bearing mobilisation without using any support after endoscopy-assisted Achilles tendon repair?

Author: Mahmut Nedim Doral

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2013

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Abstract

Purpose

The aim of this study was to assess the effect of immediate weight-bearing mobilisation with intensive rehabilitation on muscle strength and lower extremity functional level after endoscopy-assisted Achilles tendon repairs.

Methods

After warming up for 5 min at a self-selected intensity on a stationary bike 32 male patients were tested for bilateral peak concentric isokinetic ankle dorsi- and plantar-flexor torque, passive range of motion for ankle joint, one-leg hop for distance, single-leg vertical jump height, Achilles Tendon Total Rupture Score, and perceived function using the Foot and Ankle Outcome Score (FAOS). A series of paired sample t tests were used to compare side-to-side differences (p < 0.05).

Results

There were no significant differences in hop and jump tests, dorsi- and plantar-flexor isokinetic muscle strength, and dorsi- and plantar-flexion range of motion between the affected and unaffected side of the patients. Pain score of FAOS was 95 ± 8, other symptoms score was 92 ± 11, function in daily living score was 95 ± 6, function in sport and recreation was 85 ± 16, and Quality of Life score was 85 ± 12. The mean of the Achilles Tendon Rupture Score was 86.

Conclusions

There was no significant difference in both ankle muscle strength and lower extremity functional level between the endoscopy-assisted repairs and the unaffected sides. The early tolerated weight-bearing mobilisation without cast-brace and/or special shoe at the first day after the surgery may easily provide to return the daily living activities. It improves muscle strength, functional level, and range of motion. Further comprehensive and prospective studies on large patients should be warranted to analyse and compare the clinical and functional results in patients with endoscopy-assisted Achilles tendon repair.

Level of evidence

IV.
Literature
1.
go back to reference Bolgla LA, Keskula DR (1997) Reliability of lower extremity functional performance tests. J Orthop Sports Phys Ther 26:138–142PubMed Bolgla LA, Keskula DR (1997) Reliability of lower extremity functional performance tests. J Orthop Sports Phys Ther 26:138–142PubMed
2.
go back to reference Carmont M, Maffulli N (2008) Modified percutaneous repair of ruptured Achilles tendon. Knee Surg Sports Traumatol Arthrosc 16:199–203PubMedCrossRef Carmont M, Maffulli N (2008) Modified percutaneous repair of ruptured Achilles tendon. Knee Surg Sports Traumatol Arthrosc 16:199–203PubMedCrossRef
3.
go back to reference Cetti R, Henriksen LO, Jacobsen KS (1994) A new treatment of ruptured Achilles tendons. A prospective randomized study. Clin Orthop Relat Res 308:155–165PubMed Cetti R, Henriksen LO, Jacobsen KS (1994) A new treatment of ruptured Achilles tendons. A prospective randomized study. Clin Orthop Relat Res 308:155–165PubMed
4.
go back to reference Doral MN, Bozkurt M, Turhan E, Ayvaz M, Atay OA, Uzumcügil A, Leblebicioglu G, Kaya D, Aydoğ T (2009) Percutaneous suturing of the ruptured Achilles tendon with endoscopic control. Arch Orthop Trauma Surg 129:1093–1101PubMedCrossRef Doral MN, Bozkurt M, Turhan E, Ayvaz M, Atay OA, Uzumcügil A, Leblebicioglu G, Kaya D, Aydoğ T (2009) Percutaneous suturing of the ruptured Achilles tendon with endoscopic control. Arch Orthop Trauma Surg 129:1093–1101PubMedCrossRef
5.
go back to reference Fortis AP, Dimas A, Lamprakis AA (2008) Repair of achilles tendon rupture under endoscopic control. Arthroscopy 24:683–688PubMedCrossRef Fortis AP, Dimas A, Lamprakis AA (2008) Repair of achilles tendon rupture under endoscopic control. Arthroscopy 24:683–688PubMedCrossRef
6.
go back to reference Gigante A, Moschini A, Verdenelli A, Del Torto M, Ulisse S, de Palma L (2008) Open versus percutaneous repair in the treatment of acute Achilles tendon rupture: a randomized prospective study. Knee Surg Sports Traumatol Arthrosc 16:204–209PubMedCrossRef Gigante A, Moschini A, Verdenelli A, Del Torto M, Ulisse S, de Palma L (2008) Open versus percutaneous repair in the treatment of acute Achilles tendon rupture: a randomized prospective study. Knee Surg Sports Traumatol Arthrosc 16:204–209PubMedCrossRef
7.
go back to reference Göksel Karatepe A, Günaydın R, Kaya T, Karlıbaş U, Ozbek G (2009) Validation of the Turkish version of the foot and ankle outcome score. Rheumatol Int 30:169–173CrossRef Göksel Karatepe A, Günaydın R, Kaya T, Karlıbaş U, Ozbek G (2009) Validation of the Turkish version of the foot and ankle outcome score. Rheumatol Int 30:169–173CrossRef
8.
go back to reference Goren D, Ayalon M, Nysska M (2005) Isokinetic strength and endurance after percutaneous and open surgical repair of Achilles tendon ruptures. Foot Ankle Int 26:286–290PubMed Goren D, Ayalon M, Nysska M (2005) Isokinetic strength and endurance after percutaneous and open surgical repair of Achilles tendon ruptures. Foot Ankle Int 26:286–290PubMed
10.
go back to reference Henriquez H, Munoz R, Carcuro G, Bastias C (2012) Is percutaneous repair better than open repair in acute Achilles tendon rupture? Clin Orthop Relat Res 470:998–1003PubMedCrossRef Henriquez H, Munoz R, Carcuro G, Bastias C (2012) Is percutaneous repair better than open repair in acute Achilles tendon rupture? Clin Orthop Relat Res 470:998–1003PubMedCrossRef
11.
go back to reference Iwaniec UT, Wronski TJ, Amblard D, Nishimura Y et al (2005) Effects of disrupted beta1-integrin function on the skeletal response to short-term hindlimb unloading in mice. J Appl Physiol 98:690–696PubMedCrossRef Iwaniec UT, Wronski TJ, Amblard D, Nishimura Y et al (2005) Effects of disrupted beta1-integrin function on the skeletal response to short-term hindlimb unloading in mice. J Appl Physiol 98:690–696PubMedCrossRef
12.
go back to reference Järvinen TA, Kannus P, Mafulli N, Khan KM (2005) Achilles tendon disorders: etiology and epidemiology. Foot Ankle Clin 10:255–266PubMedCrossRef Järvinen TA, Kannus P, Mafulli N, Khan KM (2005) Achilles tendon disorders: etiology and epidemiology. Foot Ankle Clin 10:255–266PubMedCrossRef
13.
go back to reference Kangas J, Pajala A, Ohtonen P, Leppilahti J (2007) Achilles tendon elongation after rupture repair: a randomized comparison of 2 postoperative regimens. Am J Sports Med 35:59–64PubMedCrossRef Kangas J, Pajala A, Ohtonen P, Leppilahti J (2007) Achilles tendon elongation after rupture repair: a randomized comparison of 2 postoperative regimens. Am J Sports Med 35:59–64PubMedCrossRef
14.
go back to reference Kangas J, Pajala A, Siira P, Hamalainen M, Leppilahti J (2003) Early functional treatment versus early immobilization in tension of the musculotendinous unit after Achilles rupture repair: a prospective, randomized, clinical study. J Trauma 54:1171–1180PubMedCrossRef Kangas J, Pajala A, Siira P, Hamalainen M, Leppilahti J (2003) Early functional treatment versus early immobilization in tension of the musculotendinous unit after Achilles rupture repair: a prospective, randomized, clinical study. J Trauma 54:1171–1180PubMedCrossRef
15.
go back to reference Kaya D, Doral MN, Nyland J, Toprak U, Turhan E, Donmez G, Citaker S, Atay OA, Callaghan MJ (2012) Proprioception level after endoscopically guided percutaneous Achilles tendon. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-012-2007-5 Kaya D, Doral MN, Nyland J, Toprak U, Turhan E, Donmez G, Citaker S, Atay OA, Callaghan MJ (2012) Proprioception level after endoscopically guided percutaneous Achilles tendon. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-012-2007-5
16.
go back to reference Kerkhoffs GM, Struijs PA, Raaymakers EL, Marti RK (2002) Functional treatment after surgical repair of acute Achilles tendon rupture: wrap versus walking cast. Arch Orthop Trauma Surg 122:102–105PubMedCrossRef Kerkhoffs GM, Struijs PA, Raaymakers EL, Marti RK (2002) Functional treatment after surgical repair of acute Achilles tendon rupture: wrap versus walking cast. Arch Orthop Trauma Surg 122:102–105PubMedCrossRef
17.
go back to reference Khan RJ, Fick D, Keogh A, Crawford J, Brammar T, Parker M (2005) Treatment of acute Achilles tendon ruptures: a meta-analysis of randomized, controlled trials. J Bone Joint Surg Am 87:2202–2210PubMedCrossRef Khan RJ, Fick D, Keogh A, Crawford J, Brammar T, Parker M (2005) Treatment of acute Achilles tendon ruptures: a meta-analysis of randomized, controlled trials. J Bone Joint Surg Am 87:2202–2210PubMedCrossRef
18.
go back to reference Lui TH (2007) Endoscopic-assisted Achilles tendon repair with plantaris tendon augmentation. Arthroscopy 23:556.e1–556.e5CrossRef Lui TH (2007) Endoscopic-assisted Achilles tendon repair with plantaris tendon augmentation. Arthroscopy 23:556.e1–556.e5CrossRef
19.
go back to reference Maffulli N, Longo UG, Ronga M, Khanna A, Denaro V (2010) Favorable outcome of percutaneous repair of Achilles tendon ruptures in the elderly. Clin Orthop Relat Res 468:1039–1046PubMedCrossRef Maffulli N, Longo UG, Ronga M, Khanna A, Denaro V (2010) Favorable outcome of percutaneous repair of Achilles tendon ruptures in the elderly. Clin Orthop Relat Res 468:1039–1046PubMedCrossRef
20.
go back to reference Maffulli N, Tallon C, Wong J, Lim KP, Bleakney R (2003) Early weightbearing and ankle mobilization after open repair of acute midsubstance tears of the Achilles tendon. Am J Sports Med 31:692–700PubMed Maffulli N, Tallon C, Wong J, Lim KP, Bleakney R (2003) Early weightbearing and ankle mobilization after open repair of acute midsubstance tears of the Achilles tendon. Am J Sports Med 31:692–700PubMed
21.
go back to reference Maffulli N, Tallon C, Wong J, Peng Lim K, Bleakney R (2003) No adverse effect of early weight bearing following open repair of acute tears of the Achilles tendon. J Sports Med Phys Fitness 43:367–379PubMed Maffulli N, Tallon C, Wong J, Peng Lim K, Bleakney R (2003) No adverse effect of early weight bearing following open repair of acute tears of the Achilles tendon. J Sports Med Phys Fitness 43:367–379PubMed
22.
go back to reference Mafulli N (1999) Current concepts review: rupture of the Achilles tendon. J Bone Joint Surg Am 81:1019–1036 Mafulli N (1999) Current concepts review: rupture of the Achilles tendon. J Bone Joint Surg Am 81:1019–1036
23.
go back to reference Majewski M, Schaeren S, Kohlhaas U, Ochsner PE (2008) Postoperative rehabilitation after percutaneous Achilles tendon repair: early functional therapy versus cast immobilization. Disabil Rehabil 30:1726–1732PubMedCrossRef Majewski M, Schaeren S, Kohlhaas U, Ochsner PE (2008) Postoperative rehabilitation after percutaneous Achilles tendon repair: early functional therapy versus cast immobilization. Disabil Rehabil 30:1726–1732PubMedCrossRef
24.
go back to reference Mortensen HM, Skov O, Jensen PE (1999) Early motion of the ankle after operative treatment of a rupture of the Achilles tendon. A prospective, randomized clinical and radiographic study. J Bone Joint Surg Am 81:983–990PubMed Mortensen HM, Skov O, Jensen PE (1999) Early motion of the ankle after operative treatment of a rupture of the Achilles tendon. A prospective, randomized clinical and radiographic study. J Bone Joint Surg Am 81:983–990PubMed
25.
go back to reference Navidi M, Evans J, Wolinsky I, Arnaud SB (2004) Calcium balance in mature male rats with unloaded hindlimbs. Aviat Space Environ Med 75:483–488PubMed Navidi M, Evans J, Wolinsky I, Arnaud SB (2004) Calcium balance in mature male rats with unloaded hindlimbs. Aviat Space Environ Med 75:483–488PubMed
26.
go back to reference Nilsson-Helander K, Thomeé R, Silbernagel KG, Thomeé P, Faxén E, Eriksson BI, Karlsson J (2007) The Achilles tendon Total Rupture Score (ATRS): development and validation. Am J Sports Med 35:421–426PubMedCrossRef Nilsson-Helander K, Thomeé R, Silbernagel KG, Thomeé P, Faxén E, Eriksson BI, Karlsson J (2007) The Achilles tendon Total Rupture Score (ATRS): development and validation. Am J Sports Med 35:421–426PubMedCrossRef
27.
go back to reference Roos EM, Brandsson MD, Karlsson J (2001) Validation of the foot and ankle outcome score. Foot Ankle Int 22:788–794PubMed Roos EM, Brandsson MD, Karlsson J (2001) Validation of the foot and ankle outcome score. Foot Ankle Int 22:788–794PubMed
28.
go back to reference Rouvillain JL, Navarre T, Labrada-Blanco O, Garron E, Daoud W (2010) Percutaneous suture of acute Achilles tendon rupture. A study of 60 cases. Acta Orthop Belg 76:237–242PubMed Rouvillain JL, Navarre T, Labrada-Blanco O, Garron E, Daoud W (2010) Percutaneous suture of acute Achilles tendon rupture. A study of 60 cases. Acta Orthop Belg 76:237–242PubMed
29.
go back to reference Simoneau GG, Derr JA, Ulbrecht JS, Becker MB, Cavanagh PR (1996) Diabetic sensory neuropathy effect on ankle joint movement perception. Arch Phys Med Rehabil 77:453–460PubMedCrossRef Simoneau GG, Derr JA, Ulbrecht JS, Becker MB, Cavanagh PR (1996) Diabetic sensory neuropathy effect on ankle joint movement perception. Arch Phys Med Rehabil 77:453–460PubMedCrossRef
30.
go back to reference Suchak AA, Spooner C, Reid DC, Jomha NM (2006) Postoperative rehabilitation protocols for Achilles tendon ruptures: a metaanalysis. Clin Orthop Relat Res 445:216–221PubMed Suchak AA, Spooner C, Reid DC, Jomha NM (2006) Postoperative rehabilitation protocols for Achilles tendon ruptures: a metaanalysis. Clin Orthop Relat Res 445:216–221PubMed
31.
go back to reference Tang KL, Thermann H, Dai G, Chen GX, Guo L, Yang L (2007) Arthroscopically assisted percutaneous repair of fresh closed Achilles tendon rupture by Kessler’s suture. Am J Sports Med 35:589–596PubMedCrossRef Tang KL, Thermann H, Dai G, Chen GX, Guo L, Yang L (2007) Arthroscopically assisted percutaneous repair of fresh closed Achilles tendon rupture by Kessler’s suture. Am J Sports Med 35:589–596PubMedCrossRef
32.
go back to reference Tenenbaum S, Dreiangel N, Segal A, Herman A, Israeli A, Chechik A (2010) The percutaneous surgical approach for repairing acute Achilles tendon rupture: a comprehensive outcome assessment. J Am Podiatr Med Assoc 100:270–275PubMed Tenenbaum S, Dreiangel N, Segal A, Herman A, Israeli A, Chechik A (2010) The percutaneous surgical approach for repairing acute Achilles tendon rupture: a comprehensive outcome assessment. J Am Podiatr Med Assoc 100:270–275PubMed
Metadata
Title
What is the effect of the early weight-bearing mobilisation without using any support after endoscopy-assisted Achilles tendon repair?
Author
Mahmut Nedim Doral
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2013
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-012-2222-0

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