Randomised controlled trials of immediate weight-bearing mobilisation for rupture of the tendo Achillis.
We performed two independent, randomised, controlled trials in order to assess the potential benefits of immediate weight-bearing mobilisation after rupture of the tendo Achillis. The first trial, on operatively-treated patients showed an improved functional outcome for patients mobilised fully weight-bearing after surgical repair. Two cases of re-rupture in the treatment group suggested that careful patient selection is required as patients need to follow a structured rehabilitation regimen. The second trial, on conservatively-treated patients, provided no evidence of a functional benefit from immediate weight-bearing mobilisation. However, the practical advantages of immediate weight-bearing did not predispose the patients to a higher complication rate. In particular, there was no evidence of tendon lengthening or a higher re-rupture rate. We would advocate immediate weight-bearing mobilisation for the rehabilitation of all patients with rupture of the tendo Achillis.
Costa
M L
ML
School of Medicine, The University of East Anglia, Norwich NR4 7TJ, Norfolk, UK. mattcosta@hotmail.com
MacMillan
K
K
Halliday
D
D
Chester
R
R
Shepstone
L
L
Robinson
A H N
AH
Donell
S T
ST
D000125:Achilles Tendon / Q000293:injuries*; D000328:Adult; D000368:Aged; D000465:Algorithms; D004434:Early Ambulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D012421:Rupture / Q000534:rehabilitation / Q000601:surgery / Q000628:therapy; D016037:Single-Blind Method; D013177:Sports; D013708:Tendon Injuries / Q000534:rehabilitation* / Q000601:surgery / Q000628:therapy; D016138:Walking; D016474:Weight-Bearing / Q000502:physiology*