4.6 Review

Rehabilitation regimen for non-surgical treatment of Achilles tendon rupture: A systematic review and meta-analysis of randomised controlled trials

Journal

JOURNAL OF SCIENCE AND MEDICINE IN SPORT
Volume 24, Issue 6, Pages 536-543

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.jsams.2020.12.005

Keywords

Achilles tendon; Rupture; Conservative treatment; Rehabilitation; Early weight bearing; Early functional ankle motion

Categories

Funding

  1. Natural Science Foundation of Guangdong Province [2018A030310621]

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This study compared the effects of different rehabilitation regimens on non-surgically treated patients with Achilles tendon rupture. The results showed no significant differences in re-rupture rate, return to sports and work, functional outcome, and complication rate between different rehabilitation protocols. Clinicians may consider early weight bearing in functional brace as a safe and cost-effective alternative to traditional immobilisation with non-weight bearing.
Objectives: To compare re-rupture rate, functional and quality-of-life outcomes, return to sports and work, complications, and resource use in patients treated non-surgically with different rehabilitation regimens for Achilles tendon rupture. Design: Systematic review and meta-analysis. Methods: We performed a systematic literature search in PubMed, Embase, Scopus and the Cochrane Library through May 2020 to identify randomized controlled trials (RCTs) that included patients treated non-surgically for Achilles tendon rupture. All analyses were stratified according to rehabilitation protocols. Results: Eight RCTs with a total of 978 patients were included. There was no significant difference about re rupture rate (P = 0.38), return to sports (P = 0.85) and work (P = 0.33), functional outcome (P = 0.34), quality of life (P = 0.50), and complication rate (P = 0.29) between early weight bearing with functional ankle motion and traditional ankle immobilisation with non-weight bearing. Similarly, no significant difference in re-rupture rate (P = 0.88), return to sports (P = 0.45) and work (P = 0.20), functional outcome (P = 0.26), and complication rate (P = 0.49) was seen between ankle immobilisation with non-weight bearing and early weight bearing without functional ankle motion. Conclusions: Traditional ankle immobilisation with non-weight bearing was not found to be superior to early weight bearing with or without functional ankle motion for patients treated non-surgically for Achilles tendon rupture. Clinicians may consider early weight bearing in functional brace as a safe and cost-effective alternative to non-weight bearing with plaster casting. (c) 2020 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

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