Calf muscle function after Achilles tendon rupture. A prospective, randomised study comparing surgical and non-surgical treatment.
In a prospective, randomised, multicentre study, 112 patients with Achilles tendon rupture (ATR) were allocated to surgical treatment (n=59), followed by early functional rehabilitation using a brace, and non-surgical treatment (n=53), i.e. eight weeks of plaster treatment. In this study, the results of the isokinetic muscle strength evaluation are presented for contractions in both the concentric and the eccentric mode, plantar flexion and dorsiflexion, two angular velocities and three different positions of the subject. The heel-raise test for endurance, maximum calf circumference and tendon width were also evaluated. The re-rupture rate was 20.8% in the non-surgically-treated group and 1.7% in the surgically-treated group. No significant differences were found between the treatment groups in terms of the isokinetic strength measurements and the endurance test among the patients who did not sustain a re-rupture. If a re-rupture is avoided, both surgical and non-surgical treatment for ATR produce good functional outcome; however, the muscle function was not restored after two years in either group.
Möller
M
M
Department of Orthopaedics, Sahlgrenska University Hospital/Ostra, SE-416 85 Göteborg, Sweden.
Lind
K
K
Movin
T
T
Karlsson
J
J
D000125:Achilles Tendon / Q000293:injuries* / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010807:Physical Endurance / Q000502:physiology; D011446:Prospective Studies; D012008:Recurrence; D012421:Rupture; D013708:Tendon Injuries / Q000534:rehabilitation / Q000601:surgery / Q000628:therapy*; D019415:Torque; D016896:Treatment Outcome