Outcomes of early versus late functional weight-bearing after the acute Achilles tendon rupture repair with minimally invasive surgery: a randomized controlled trial

Deng, Zhibo; Li, Zhi; Shen, Chen; Sun, Xianding; Wang, Ting; Nie, Mao; Tang, Kaiying

doi:10.1007/s00402-022-04535-w

Cited by 6 publications

(1 citation statement)

References 34 publications

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“…Nevertheless, based on research on the healing process of connective tissues, some scholars suggest early utilization of AROM to minimize the detrimental repercussions of immobilization 67 , 68 . In recent years, there have been many RCTs that compare different postoperative techniques such as traditional fixation, early ROM, and early weight-bearing to determine which methods are best for promoting speedy recovery of preoperative motor function 9 , 19 , 20 , 24 , 25 , 27 , 40 , 42 , 44 , 45 , 47 , 58 . In addition to early weight-bearing and ROM, there are also several AR programs that have been shown to be effective in promoting faster recovery after surgery.…”

Section: Discussionmentioning

confidence: 99%

Immediate mobilization after repair of Achilles tendon rupture may increase the incidence of re-rupture: a systematic review and meta-analysis of randomized controlled trials

Wang,

Huang,

Jiang

et al. 2024

International Journal of Surgery

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Background: Achilles tendon rupture (ATR) is a significant injury that can require surgery and can have the risk of re-rupture even after successful treatment. Consequently, to minimize this risk, it is important to have a thorough understanding of the rehabilitation protocol and the impact of different rehabilitation approaches on preventing re-rupture. Materials and Methods: Two independent team members searched several databases (PubMed, EMBASE, Web of Science, Cochrane Library, and CINAHL) to identify randomized controlled trials (RCTs) on operative treatment of ATR. We included articles that covered open or minimally invasive surgery for ATR, with a detailed rehabilitation protocol and reports of re-rupture. The study protocol has been registered at PROSPERO and has been reported in the line with PRISMA Guidelines, Supplemental Digital Content 1, http://links.lww.com/JS9/C85, Supplemental Digital Content 2, http://links.lww.com/JS9/C86 and assessed using AMSTAR Tool, Supplemental Digital Content 3, http://links.lww.com/JS9/C87. Results: A total of 43 RCTs were eligible for the meta-analysis, encompassing a combined cohort of 2553 patients. Overall, the postoperative incidence of ATR patients developing re-rupture was 3.15% (95% CI: 2.26-4.17; I 2=44.48%). Early immobilization group patients who had ATR had a 4.07% (95% CI: 1.76-7.27; I 2=51.20%) postoperative incidence of re-rupture; Early immobilization + active range of motion (AROM) group had an incidence of 5.95% (95% CI: 2.91-9.99; I 2=0.00%); Early immobilization + weight-bearing group had an incidence of 3.49% (95% CI: 1.96-5.43; I 2=20.06%); Early weight-bearing + AROM group had an incidence of 3.61% (95% CI: 1.00-7.73; I 2= 64.60%); Accelerated rehabilitation (immobilization) group had an incidence of 2.18% (95% CI: 1.11-3.59; I 2=21.56%); Accelerated rehabilitation (non-immobilization) group had a rate of 1.36% (95% CI: 0.12-3.90; I 2=0.00%). Additionally, patients in the immediate AROM group had a postoperative re-rupture incidence of 3.92% (95% CI: 1.76-6.89; I 2=33.24%); Non-immediate AROM group had an incidence of 2.45% (95% CI: 1.25-4.03; I 2=22.09%). Conclusions: This meta-analysis suggests the use of accelerated rehabilitation intervention in early postoperative rehabilitation of the Achilles tendon. However, for early ankle joint mobilization, it is recommended to apply after one to two weeks of immobilization.

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Section: Discussionmentioning

confidence: 99%

Immediate mobilization after repair of Achilles tendon rupture may increase the incidence of re-rupture: a systematic review and meta-analysis of randomized controlled trials

Wang,

Huang,

Jiang

et al. 2024

International Journal of Surgery

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Panda Rope Bridge Technique promoted Achilles tendon regeneration in a novel rat tendon defect model

Shen,

Sun,

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThis study aimed to determine whether the Achilles tendon tissue can undergo the pathological process of Achilles tendon regeneration after the Panda Rope Bridge Technique (PRBT).MethodsRats (n = 120) that operated with Achilles tendon rupture were divided into three treatment groups: Defect group (D group), PRBT group and Defect + Fix group (DF group). The D group represented natural healing with no treatment, the PRBT group represented healing receiving PRBT treatment and the DF group represented healing through conservative treatment by ankle fixation. The morphological, histological and biomechanical properties of the defective Achilles tendon were assessed at 7, 10, 12, 14, 28 and 56 days postoperatively.ResultsCompared to that observed in the other two groups, defected rat Achilles tendons that underwent PRBT recruited more cells earlier, eventually forming mature tendons, as revealed by histological analysis. PRBT also enabled defected tendons to regain stronger mechanical properties, thereby improving the prognosis. This improvement may be related to the earlier polarization of macrophages.ConclusionBy establishing and using a novel surgical model of Achilles tendon rupture in rats, most injured Achilles tendons can regenerate and regain normal histological properties, whereas tendons with other interventions formed fibrotic scar tissue. The strong regenerative capacity of tendon tissue enabled us to describe the pathological process of tendon regeneration after PRBT surgery in detail, which would aid in the treatment of tendon injuries. PRBT promotes Achilles tendon regeneration and has the potential to become a standard treatment.Level of EvidenceNot applicable.

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Acute rupture of the Achilles tendon

Fischer

2024

Unfallchirurgie

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Outcomes of early versus late functional weight-bearing after the acute Achilles tendon rupture repair with minimally invasive surgery: a randomized controlled trial

Cited by 6 publications

References 34 publications

Immediate mobilization after repair of Achilles tendon rupture may increase the incidence of re-rupture: a systematic review and meta-analysis of randomized controlled trials

Immediate mobilization after repair of Achilles tendon rupture may increase the incidence of re-rupture: a systematic review and meta-analysis of randomized controlled trials

Panda Rope Bridge Technique promoted Achilles tendon regeneration in a novel rat tendon defect model

Acute rupture of the Achilles tendon

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