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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2016

01-06-2016 | Ankle

Functional rehabilitation of patients with acute Achilles tendon rupture: a meta-analysis of current evidence

Authors: Troels Mark-Christensen, Anders Troelsen, Thomas Kallemose, Kristoffer Weisskirchner Barfod

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2016

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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.
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Metadata
Title
Functional rehabilitation of patients with acute Achilles tendon rupture: a meta-analysis of current evidence
Authors
Troels Mark-Christensen
Anders Troelsen
Thomas Kallemose
Kristoffer Weisskirchner Barfod
Publication date
01-06-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3180-5

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