Nonoperative vs. Surgical Treatment of Acute Achilles’ Tendon Rupture
- RRS Education
Rupture of the Achilles tendon is a major injury, but what is the best way to manage these patients? This week’s Review looks at a very important randomized trial on nonoperative versus surgical management that was published this year...
Acute Achilles tendon ruptures are one of the most common musculoskeletal injuries and can result in severe disability. This injury is more common in individuals who are male, older, and more active. Randomized clinical trials (RCTs) assessing nonoperative treatment compared to open repair of acute Achille’s tendon ruptures have demonstrated similar patient-reported outcomes and physical performance with both approaches. A recent systematic review of 10 RCTs and 19 observational studies demonstrated a higher risk of re-rupture after nonoperative treatment, whereas surgical treatment was associated with increased risks of postoperative complications such as infection and nerve injuries. However, the trials reviewed were relatively small and protocols of treatment varied or were incompletely described. Studies have suggested that accelerated functional rehab protocols that emphasize early mobilization and weight bearing may lessen the risk of re-rupture after nonoperative treatment. To better inform clinical decision making for acute Achille’s tendon rupture, these authors conducted a multicenter randomized trial comparing non-operative treatment, open repair, and minimally invasive surgery.
THIS WEEK'S RESEARCH REVIEW: “Nonoperative vs. Surgical Treatment of Acute Achilles’ Tendon Rupture”
This paper was published in the New England Journal of Medicine(2022) and this Review is posted in Recent Reviews, Ankle-Foot, Surgery and the 2022 Archive.