TY - JOUR

T1 - Early weight-bearing in nonoperative treatment of acute Achilles tendon rupture did not influence mid-term outcome

T2 - a blinded, randomised controlled trial

AU - Kastoft, Rasmus

AU - Bencke, Jesper

AU - Speedtsberg, Merete B

AU - Penny, Jeannette Ø

AU - Barfod, Kristoffer

PY - 2019/9

Y1 - 2019/9

N2 - PURPOSE: Acute Achilles tendon rupture leads to impaired outcome at short term, but little is known concerning medium-term results. The aim of the present study was to investigate the influence of early weight-bearing on clinical outcome 4.5 years after nonoperative treatment of acute Achilles tendon rupture.METHOD: The study was performed as a medium-term follow-up on patients included in a randomised controlled trial. Both groups were treated with nonoperative management and controlled early motion. The intervention group was allowed full weight-bearing from day 1, and the control group was non-weight-bearing for 6 weeks. 60 patients were randomised 1:1. Of those, 56 were eligible for inclusion in the medium-term follow-up and 37 participated (18 control, 19 intervention). The outcomes were Achilles tendon Total Rupture Score (ATRS) and heel raise work performed at an average of 4.5 years after the initial injury. Statistical analysis was performed using paired t tests and linear regression.RESULTS: No differences were found between control and intervention groups at 4.5 years. ATRS scores consistently improved in both the intervention and the control groups from 0.5 to 1 year and from 1 to 4.5 years, ending up at 80.5 on average after 4.5 years. Heel raise height kept improving from 0.5 to 4.5 years, reaching a limb symmetry index of 82.4%. The heel raise work improvement from 0.5 to 1 year did not continue. No significant change was found from 1 to 4.5 years, ending at a limb symmetry index of 60%.CONCLUSION: Early weight-bearing did not influence outcome 4.5 years after nonoperative treatment of acute Achilles tendon rupture. The calf muscle of the injured limb performs 40% less work, when compared to the healthy limb, though lifting height recovers better.LEVEL OF EVIDENCE: II.CLINICAL TRIALS IDENTIFIER: NCT02760784.

AB - PURPOSE: Acute Achilles tendon rupture leads to impaired outcome at short term, but little is known concerning medium-term results. The aim of the present study was to investigate the influence of early weight-bearing on clinical outcome 4.5 years after nonoperative treatment of acute Achilles tendon rupture.METHOD: The study was performed as a medium-term follow-up on patients included in a randomised controlled trial. Both groups were treated with nonoperative management and controlled early motion. The intervention group was allowed full weight-bearing from day 1, and the control group was non-weight-bearing for 6 weeks. 60 patients were randomised 1:1. Of those, 56 were eligible for inclusion in the medium-term follow-up and 37 participated (18 control, 19 intervention). The outcomes were Achilles tendon Total Rupture Score (ATRS) and heel raise work performed at an average of 4.5 years after the initial injury. Statistical analysis was performed using paired t tests and linear regression.RESULTS: No differences were found between control and intervention groups at 4.5 years. ATRS scores consistently improved in both the intervention and the control groups from 0.5 to 1 year and from 1 to 4.5 years, ending up at 80.5 on average after 4.5 years. Heel raise height kept improving from 0.5 to 4.5 years, reaching a limb symmetry index of 82.4%. The heel raise work improvement from 0.5 to 1 year did not continue. No significant change was found from 1 to 4.5 years, ending at a limb symmetry index of 60%.CONCLUSION: Early weight-bearing did not influence outcome 4.5 years after nonoperative treatment of acute Achilles tendon rupture. The calf muscle of the injured limb performs 40% less work, when compared to the healthy limb, though lifting height recovers better.LEVEL OF EVIDENCE: II.CLINICAL TRIALS IDENTIFIER: NCT02760784.

KW - ATRS

KW - Achilles Tendon Total Rupture Score

KW - Achilles tendon rupture

KW - Conservative

KW - Early weight-bearing

KW - Heel raise height

KW - Heel raise work

KW - Nonoperative

KW - Achilles Tendon/injuries

KW - Acute Disease

KW - Follow-Up Studies

KW - Heel

KW - Humans

KW - Middle Aged

KW - Male

KW - Treatment Outcome

KW - Tendon Injuries/therapy

KW - Recovery of Function

KW - Rupture/surgery

KW - Adult

KW - Female

KW - Weight-Bearing

KW - Muscle, Skeletal/physiology

UR - http://www.scopus.com/inward/record.url?scp=85050369549&partnerID=8YFLogxK

U2 - 10.1007/s00167-018-5058-4

DO - 10.1007/s00167-018-5058-4

M3 - Journal article

VL - 27

SP - 2781

EP - 2788

JO - Knee Surgery, Sports Traumatology, Arthroscopy

JF - Knee Surgery, Sports Traumatology, Arthroscopy

SN - 0942-2056

IS - 9

ER -