Operative versus nonoperative treatment for acute Achilles tendon rupture: a meta-analysis based on current evidence

Jiang, Nan; Wang, Bowei; Chen, Anfu; Fang, Dong; Yu, Bin

doi:10.1007/s00264-011-1431-3

Cited by 143 publications

(156 citation statements)

References 47 publications

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“…11 21.91) or percutaneous repair (RR=9.32; 95% CI, 1.77-49.16). 12 Nonetheless, other randomised controlled trials report no significant difference in the re-rupture rate between conservative and surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Repair Followed by Accelerated Rehabilitation for Acute Achilles Tendon Ruptures

Al-Mouazzen

Rajakulendran

Najefi

et al. 2015

J Orthop Surg (Hong Kong)

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Purpose. To evaluate the outcome after percutaneous repair followed by accelerated rehabilitation for acute Achilles tendon ruptures. Methods. 21 men and 9 women (mean age, 41 years) underwent percutaneous repair by a single senior surgeon for acute Achilles tendon ruptures, followed by early weight bearing and accelerated rehabilitation. Outcome measures included the Achilles tendon rerupture rate, the Achilles tendon total rupture score (ATRS) at 3 and 6 months, the incidence of sural nerve injury, wound infection, wound dehiscence, patient satisfaction, and the time to return to prerupture activity. Results. The mean follow-up period was 12.5 months. The mean ATRS score improved from 57.65 at 3 months to 86.95 at 6 months (p<0.001). No patient had intra-operative complications, tendon re-rupture, sural nerve injury, wound dehiscence, or deep infection. Two patients developed a superficial wound infection, which was resolved with oral Percutaneous repair followed by accelerated rehabilitation for acute Achilles tendon ruptures

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Section: Discussionmentioning

confidence: 99%

Percutaneous Repair Followed by Accelerated Rehabilitation for Acute Achilles Tendon Ruptures

Al-Mouazzen

Rajakulendran

Najefi

et al. 2015

J Orthop Surg (Hong Kong)

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“…Los resultados de los estudios 32 confirman que en el tratamiento de la ruptura aguda del tendón de Aquiles, la cirugía puede reducir eficazmente el riesgo de rotura recurrente, pero es difícil evitar una alta tasa de complicaciones.…”

Section: Discussionunclassified

“…En el estudio de Jiang y col. 32 fueron seleccionados un total de 894 pacientes con una edad media de 41 años, los cuales se dividieron en dos grupos: uno tratado mediante tratamiento quirúrgico y otro mediante tratamiento conservador, diferenciando entre hombres y mujeres y el miembro lesionado (lado derecho/lado izquierdo). El tiempo medio de seguimiento en un rango de 1-5 años fue de 2.5, y en un rango de 0.5-1 años fue de 0.67.…”

Section: Descripción De Los Estudiosunclassified

Tratamiento quirúrgico frente al conservador para la ruptura aguda del tendón de Aquiles

Olivera

2018

Rev. Int. Cienc. Podol.

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Resumen. Introducción: La reparación quirúrgica es un método común para el tratamiento de la ruptura aguda del tendón de Aquiles, ya que, a pesar de presentar un mayor riesgo de complicaciones, ofrece un menor riesgo de rotura recurrente. Sin embargo, análisis recientes basados en el empleo de rehabilitación funcional temprana, han cuestionado esta creencia. El objetivo de este estudio consiste en evaluar la efectividad clínica de ambos tratamientos. Metodología: Se han empleado cuatro bases de datos (Medline, CINAHL, PubMed y Cochrane Library) para la búsqueda de estudios que comparen el tratamiento quirúrgico y el conservador para la ruptura aguda del tendón de Aquiles. La selección de los artículos se realizó en función de los criterios de inclusión y exclusión. Resultados: Los estudios mostraron que el tratamiento quirúrgico presenta una tasa inferior de rotura recurrente (P=0.002) en comparación con el conservador, pero aumenta el riesgo de otras complicaciones (P=0.004). Un análisis de subgrupos reveló una tasa significativamente más alta en relación con la adherencia cicatricial (P<0.00001), la infección superficial (P=0.05) y la perturbación de la sensibilidad (P=0.0003) en el grupo sometido a cirugía. Conclusiones: El tratamiento quirúrgico, en comparación con el conservador, puede reducir eficazmente el riesgo de rotura recurrente, pero incrementa la probabilidad de complicaciones, lo cual suele estar asociado a la cirugía de reparación abierta. No obstante, no hay pruebas suficientes de estudios actuales que apoyen la creencia de que la cirugía puede conducir a una mejor recuperación funcional. Palabras clave: ruptura aguda tendón Aquiles; tratamiento conservador; tratamiento quirúrgico.[en] Surgical versus Conservative Treatment for Acute Achilles Tendon Rupture Abstract. Background: Surgical repair is a common method of treatment of acute Achilles tendon rupture because, despite a higher risk of overall complications,it has been believed to offer a reduced risk of rerupture. However, recent analysis based on using early functional rehabilitation, have challenged this belief. The aim of this study is to evaluate the clinical effectiveness of both treatments. Methods: The search was performed using the following electronic bibliography databases (Medline, CINAHL, PubMed and Cochrane Library) to find studies comparing surgical and conservative treatment for acute Achilles tendon rupture. The selection of items was based on inclusion and exclusion criteria. Results: The studies showed that surgical treatment has a lower rate of rerupture (P=0.002) compared with nonsurgical treatment, but increases the risk of other complications (P=0.004). Subgroup analyses revealed significant differences in relation to scar adhesion (P<0.00001), superficial infection (P=0.05) and sensibility disturbance (P=0.0003) in the group undergoing surgery. Conclusions: Compared with conservative treatment, operative treatment can effectively reduce the risk of rerupture but increase the probability of complications, which is us...

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“…Wilkins et al [54•] reported a reduced risk of re-rupture with surgical repair although surgery resulted in other complications, such as deep infections, scar complaints, and sural nerve injury, which were not seen with nonoperative treatment. Similarly, Jiang et al [55] concluded that operative treatment can effectively reduce the risk of re-rupture but increase complication risk with open repair. They emphasized that no sufficient evidence is available from current studies to support the theory that operative repair can lead to better functional outcomes.…”

Section: Operative Vs Nonoperative Treatmentmentioning

confidence: 97%

Achilles tendon ruptures

Pedowitz

Kirwan²

2013

Curr Rev Musculoskelet Med

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The incidence of acute Achilles tendon ruptures is on the rise. This is thought to be due to the increasing number of middle-aged persons participating in athletic and/or strenuous activity. Ruptures of the Achilles tendon can be severely debilitating, with deficits seen years after the initial incident. Also, these injuries can have substantial socioeconomic impacts regardless of the treatment selected. Debate continues over the optimal treatment of Achilles tendon ruptures, especially the argument whether to treat patients nonoperatively or surgically. Newer evidence shows that functional rehabilitation, including early weight-bearing, should be an integral part of successful treatment of acute Achilles ruptures. Further research is needed to further investigate the ideal treatment and rehabilitation protocols.

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Operative versus nonoperative treatment for acute Achilles tendon rupture: a meta-analysis based on current evidence

Cited by 143 publications

References 47 publications

Percutaneous Repair Followed by Accelerated Rehabilitation for Acute Achilles Tendon Ruptures

Percutaneous Repair Followed by Accelerated Rehabilitation for Acute Achilles Tendon Ruptures

Tratamiento quirúrgico frente al conservador para la ruptura aguda del tendón de Aquiles

Achilles tendon ruptures

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