Effect of Early Versus Late Weightbearing in Conservatively Treated Acute Achilles Tendon Rupture: A Meta‐Analysis

@article{ElAkkawi2018EffectOE,
  title={Effect of Early Versus Late Weightbearing in Conservatively Treated Acute Achilles Tendon Rupture: A Meta‐Analysis},
  author={Ali Imad El-Akkawi and Rajzan Joanroy and Kristoffer Weisskirchner Barfod and Thomas Kallemose and S. S. Kristensen and Bjarke Viberg},
  journal={Journal of Foot \& Ankle Surgery},
  year={2018},
  volume={57},
  pages={346–352}
}
&NA; Achilles tendon ruptures can be either surgically or conservatively treated with either early functional mobilization or cast immobilization. The purpose of the present study was to conduct a meta‐analysis comparing the effect of early versus late weightbearing in conservatively treated adult patients, including only randomized controlled trials (RCTs). The primary endpoint was rerupture, and the secondary endpoints were strength, quality of life during treatment, range of motion, deep… 

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References

SHOWING 1-10 OF 24 REFERENCES

Functional rehabilitation of patients with acute Achilles tendon rupture: a meta-analysis of current evidence

TLDR
Functional rehabilitation after acute Achilles tendon rupture does not increase the rate of re-rupture or other complications, and a trend toward earlier return to work and sport, and increased patient satisfaction was found when functional rehabilitation was used.

Nonoperative dynamic treatment of acute achilles tendon rupture: the influence of early weight-bearing on clinical outcome: a blinded, randomized controlled trial.

TLDR
Immediate weight-bearing can be recommended as an option in the nonoperative treatment of Achilles tendon rupture, and both groups had substantial functional deficits in the injured limb compared with the uninjured limb.

Early weight-bearing in nonoperative treatment of acute Achilles tendon rupture did not influence mid-term outcome: a blinded, randomised controlled trial

TLDR
Early weight-bearing did not influence outcome 4.5 years after nonoperative treatment of acute Achilles tendon rupture, and the calf muscle of the injured limb performs 40% less work, when compared to the healthy limb, though lifting height recovers better.

Weight-Bearing in the Nonoperative Treatment of Acute Achilles Tendon Ruptures: A Randomized Controlled Trial.

TLDR
The overall rerupture rate in this study was low, supporting the continued use of initial nonoperative management for the treatment of acute Achilles tendon ruptures.

Surgical interventions for treating acute Achilles tendon ruptures.

TLDR
Open surgical treatment of acute Achilles tendon ruptures significantly reduces the risk of rerupture compared with non-surgical treatment, but produces significantly higher risks of other complications, including wound infection.

Achilles Tendon Rupture: Effect of Early Mobilization in Rehabilitation After Surgical Repair

TLDR
Surgery combined with early mobilization reduces range of motion loss, increases blood supply, and reduces the degree of muscle atrophy that typically occurs after Achilles tendon rupture, thereby decreasing the time to resumption of normal activities.

Persistent Disability Despite Sufficient Calf Muscle Strength After Rerupture of Surgically Treated Acute Achilles Tendon Ruptures

TLDR
Although reruptures did not affect ultimate resumption of professional life, the relative risk for quitting sport or resuming sport at a lower level after a rerupture is higher than expected and the plantar flexion strength deficit is higher in the reruptured group than in the reference group.

The Sheffield splint for controlled early mobilisation after rupture of the calcaneal tendon. A prospective, randomised comparison with plaster treatment.

Forty patients with acute complete rupture of the calcaneal tendon were managed conservatively and randomly allocated to treatment groups using either cast immobilisation for eight weeks, or cast

Weight bearing the same day versus non-weight bearing for 4 weeks in Achilles tendon rupture

TLDR
This study showed that a well-conducted early-weight-bearing treatment has good clinical outcomes, with a complication rate no higher than non-weight bearing treatment.

Long-term outcomes of muscle volume and Achilles tendon length after Achilles tendon ruptures

TLDR
Cross-sectional area and maximum calf circumference are cost-effective measurements and a good approximation of muscle volume and can thus be used in a clinical setting while clinical dorsiflexion should not be used.