Frankewycz, B., Krutsch, W., Weber, J., Ernstberger, A., Nerlich, M. and Pfeifer, Christian G.
(2017)
Rehabilitation of Achilles tendon ruptures: is early functional rehabilitation daily routine?
Archives of Orthopaedic and Trauma Surgery 137 (3), pp. 333-340.
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Other URL: http://doi.org/10.1007/s00402-017-2627-9
Abstract
Ruptures of the Achilles tendon are the most common tendon injuries of the lower extremities. Besides the initial operative or non-operative treatment, rehabilitation of patients plays a crucial role for tendon healing and long-term outcome. As only limited evidence is available for optimized rehabilitation regimen and guidelines for the initial (e.g., first 6 weeks) rehabilitation are limited, ...
Abstract
Ruptures of the Achilles tendon are the most common tendon injuries of the lower extremities. Besides the initial operative or non-operative treatment, rehabilitation of patients plays a crucial role for tendon healing and long-term outcome. As only limited evidence is available for optimized rehabilitation regimen and guidelines for the initial (e.g., first 6 weeks) rehabilitation are limited, this study investigated the current rehabilitation concepts after Achilles tendon rupture. We analyzed 213 written rehabilitation protocols that are provided by orthopedic and trauma surgery institutions throughout Germany in terms of recommendations for weight-bearing, range of motion (ROM), physiotherapy, and choice of orthosis. All protocols for operatively and non-operatively treated Achilles tendon ruptures were included. Descriptive analysis was carried out and statistical analysis applied where appropriate. Of 213 institutions, 204 offered rehabilitation protocols for Achilles tendon rupture and, therefore, 243 protocols for operative and non-operative treatment could be analyzed. While the majority of protocols allowed increased weight-bearing over time, significant differences were found for durations of fixed plantar flexion between operative (o) and non-operative (n) treatments [fixed 30A degrees (or 20)A degrees to 15A degrees (or 10)A degrees: 3.6 weeks (+/- 0.1; o) vs 4.7 weeks (+/- 0.3; n) (p <= 0.0001) and fixed 15A degrees (or 10)A degrees to 0A degrees: 5.8 weeks (+/- 0.1; o) vs 6.6 weeks (+/- 0.2; n) (p <= 0.001)]. The mean time of the recommended start of physiotherapy is at 2.9 weeks (+/- 0.2; o) vs 3.3 weeks (+/- 0.4; n), respectively. Our study shows that a huge variability in rehabilitation after Achilles tendon rupture exists. This study shows different strategies in rehabilitation of Achilles tendon ruptures using a convertible vacuum brace system. To improve patient care, further clinical as well as biomechanical studies need to be conducted. This study might serve as basis for prospective randomized controlled trials to optimize rehabilitation for Achilles tendon ruptures.
Export bibliographical data
| Item type: | Article |
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| Date: | 2017 |
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| Institutions: | Medicine > Lehrstuhl für Unfallchirurgie |
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| Identification Number: | | Value | Type |
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| 10.1007/s00402-017-2627-9 | DOI |
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| Keywords: | RANDOMIZED CONTROLLED-TRIALS; ACCELERATED REHABILITATION; NONSURGICAL TREATMENT; SURGICAL REPAIR; WEIGHT-BEARING; EARLY MOBILIZATION; CALCANEAL TENDON; MUSCLE ATROPHY; IMMOBILIZATION; METAANALYSIS; Achilles tendon rupture; Non-operative treatment; Post-operative rehabilitation; Immobilization; Early function; Orthosis |
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| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine |
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| Status: | Published |
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| Refereed: | Yes, this version has been refereed |
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| Created at the University of Regensburg: | Yes |
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| Item ID: | 38668 |
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