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Randomized controlled trial of accelerated rehabilitation versus standard protocol following surgical repair of ruptured A chilles tendon
Author(s) -
Porter Mark D.,
Shadbolt Bruce
Publication year - 2015
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12910
Subject(s) - medicine , tendon , rehabilitation , randomized controlled trial , surgery , heel , clinical trial , physical therapy , anatomy
Abstract Background There is no consensus regarding the optimal management of the acutely ruptured A chilles tendon ( TA ). Functional bracing alone achieves outcomes similar to those of surgical repair. Surgical repair combined with immediate mobilization may improve the clinical outcome further. The purpose of our study was to determine if an accelerated rehabilitation programme following surgical repair of the ruptured TA could improve clinical outcome, relative to the standard protocol. Methods Patients with an acutely ruptured TA were randomly allocated to undergo an accelerated programme ( AP ) or standard programme ( SP ), following surgery. Outcome was assessed at 12 months post‐surgery using the A chilles tendon T otal R upture S core ( ATRS ), the heel‐raise height and the time taken to return to running. Results Fifty‐one patients completed the study, 25 in the AP group and 26 in the SP group. At 12 months post‐surgery, the ATRS results were similar in the two treatment groups (87.46 in AP with standard error (SE) of 0.735 versus 87.12 in SP with SE of 0.75) while the AP group had less lengthening of the TA (0.385 cm, SE 0.166 versus 1.00 cm, SE 0.169) and a more rapid return to running (17.231 weeks, SE 0.401 versus 21.08 weeks, SE 0.409), than the SP group. Conclusion The accelerated rehabilitation programme resulted in less tendon lengthening, more rapid return to running, but similar ATRS relative to the standard rehabilitation. Immobilization following TA repair may prolong recovery.