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Outcomes of early versus late functional weight-bearing after the acute Achilles tendon rupture repair with minimally invasive surgery: a randomized controlled trial

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Optimal postoperative rehabilitation regimen for acute Achilles tendon rupture (AATR) remains unclear. It is important to evaluate whether early functional weight-bearing rehabilitation program after minimally invasive repair results in an earlier return to pre-injury activity but increases the risk of re-rupture.

Materials and methods

This was a prospective randomized controlled trial involving 68 AATR patients undergoing minimally invasive surgery. 34 patients were enrolled in early weight‑bearing mobilization accelerated rehabilitation group (AR group); 34 patients were enrolled in the traditional rehabilitation (TR) group. Outcomes measures included American Orthopaedic Foot and Ankle Society Score (AOFAS) score and Achilles Tendon Total Rupture Score (ATRS) score before surgery and 3, 6, and 12 months after surgery, incidence rate of Achilles tendon re-rupture and total complications, length of hospital stay, time return to work and sports.

Results

There was no significant difference in preoperative basic data between the two groups. However, AOFAS score and ATRS score were better in AR group than TR group at 3 months postoperatively (92.4 ± 3.5 vs 88.3 ± 4.5, P < 0.01; 91.1 ± 4.4 vs 88.9 ± 3.4, P = 0.03, respectively), the mean length of hospital stay (4.7 ± 1.5 vs 7.6 ± 2.0 days, P < 0.01) and time return to work (4.5 ± 1.0 vs 7.5 ± 1.6 weeks, P < 0.01) were shorter in AR group than in TR group. No statistical significance was calculated in patient-reported outcomes during the rest of the follow-up time and complications.

Conclusion

Early accelerated rehabilitation with weight-bearing in patients with AATR after minimally invasive surgery results in better early functional outcomes and shows similar security and feasibility.

Registration No.: ChiCTR2100043398.

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Availability of data and materials

This is a clinical study. The original operation reports, imaging studies, and outpatient clinic record are retained within the medical records of our hospital.

Abbreviations

AATR:

Acute Achilles tendon rupture

AR:

Accelerated rehabilitation

TR:

Traditional rehabilitation

RCT:

Randomized controlled trial

PRBT:

Panda rope bridge technique

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Funding

This study was supported by research grants from the Chongqing science and Technology Commission and Health Commission project (2021MSXM058).

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Author notes

  1. Zhibo Deng and Zhi Li contributed equally to this work.

Authors and Affiliations

  1. Center for Joint Surgery, Department of Orthopedic, The Second Affiliated Hospital of Chongqing Medical University, Linjiang Road No.76, Yuzhong District, Chongqing, 400010, China

    Zhibo Deng, Zhi Li, Chen Shen, Xianding Sun, Ting Wang, Mao Nie & Kaiying Tang

Authors
  1. Zhibo Deng
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  2. Zhi Li
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  3. Chen Shen
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  4. Xianding Sun
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  5. Ting Wang
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  6. Mao Nie
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  7. Kaiying Tang
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Contributions

KYT contributed the central idea, ZBD and ZL collected and analyzed most of the data. CS and XDS wrote the initial draft of the paper. TW made the figure and tables. ZL took charge of the revised process. All authors contributed to refining the ideas, carrying out additional analyses and finalizing this paper. The surgery was done by KYT and MN.

Corresponding author

Correspondence to Kaiying Tang.

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All authors have read the journal’s policy on disclosure of potential conflicts of interest and no author has conflict of interest to declare.

Ethical approval

The authors are accountable for all aspects of the work. This study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). This study was approved by the Ethics Committee of our hospital and registered in the International Clinical Trial Registry (Registration number: ChiCTR2100043398).

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Deng, Z., Li, Z., Shen, C. et al. Outcomes of early versus late functional weight-bearing after the acute Achilles tendon rupture repair with minimally invasive surgery: a randomized controlled trial. Arch Orthop Trauma Surg 143, 2047–2053 (2023). https://doi.org/10.1007/s00402-022-04535-w

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  • DOI: https://doi.org/10.1007/s00402-022-04535-w

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