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Systematic Reviews
Published in: Systematic Reviews 1/2018

Open Access 01-12-2018 | Protocol

Protocol for treatment of Achilles tendon ruptures; a systematic review with network meta-analysis

Authors: Brad Meulenkamp, Dawn Stacey, Dean Fergusson, Brian Hutton, Risa Shorr MLIS, Ian D. Graham

Published in: Systematic Reviews | Issue 1/2018

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Abstract

Background

Achilles tendon ruptures are a common injury and are increasing in incidence. Several management strategies exist for both non-operative and operative care, with each strategy offering unique risks and benefits. Traditional pairwise meta-analyses have been performed to compare management strategies; however, all treatment options have never been integrated in a single analysis. Network meta-analysis (NMA) is a generalization of pairwise meta-analysis, which allows for the comparison of multiple interventions based on all available direct and indirect evidence. The objectives of this review are to synthesize the evidence on the management options for acute Achilles tendon rupture and identify which treatment gives the best functional outcomes.

Methods

A systematic review with NMA is planned. An electronic literature search will be performed in conjunction with an experienced information specialist in MEDLINE, EMBASE, CINAHL, PEDro, and the Cochrane Central Register of Controlled Trials. We will include randomized controlled trials with a minimum 6-month follow-up. Two independent reviewers will screen citations for eligibility, extract study data, and perform risk of bias assessments. The primary outcome will be disease-specific functional outcome scores (AOFAS, Leppilahti, modified Leppilahti) at 1 year. Secondary outcomes will include complications (re-rupture, sural nerve injury, wound complications, deep infection, secondary surgeries), strength, range of motion, return to work, return to sport, and quality-of-life measures (including the SF-36 questionnaire). Traditional pairwise meta-analyses will be performed for all direct comparisons where evidence is available, and NMAs will subsequently be performed where possible to compare all management strategies.

Discussion

The data generated from this review will provide health-care providers with a clear evidence synthesis of all Achilles tendon rupture management strategies. Additionally, these data will be incorporated into the development of a patient decision aid to assist patients and clinicians in making a preference-based decision when faced with an Achilles tendon rupture.

Systematic review registration

PROSPERO CRD42018093033.
Appendix
Available only for authorised users
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Metadata
Title
Protocol for treatment of Achilles tendon ruptures; a systematic review with network meta-analysis
Authors
Brad Meulenkamp
Dawn Stacey
Dean Fergusson
Brian Hutton
Risa Shorr MLIS
Ian D. Graham
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2018
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-018-0912-5

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