title: Randomized controlled trial of accelerated rehabilitation versus standard protocol following surgical repair of ruptured Achilles tendon.
abstract: BACKGROUND
  There is no consensus regarding the optimal management of the acutely ruptured Achilles tendon (TA). Functional bracing alone achieves outcomes similar to those of surgical repair. Surgical repair combined with immediate mobilization may improve the clinical outcome further. The purpose of our study was to determine if an accelerated rehabilitation programme following surgical repair of the ruptured TA could improve clinical outcome, relative to the standard protocol.
  
  
  METHODS
  Patients with an acutely ruptured TA were randomly allocated to undergo an accelerated programme (AP) or standard programme (SP), following surgery. Outcome was assessed at 12 months post-surgery using the Achilles tendon Total Rupture Score (ATRS), the heel-raise height and the time taken to return to running.
  
  
  RESULTS
  Fifty-one patients completed the study, 25 in the AP group and 26 in the SP group. At 12 months post-surgery, the ATRS results were similar in the two treatment groups (87.46 in AP with standard error (SE) of 0.735 versus 87.12 in SP with SE of 0.75) while the AP group had less lengthening of the TA (0.385 cm, SE 0.166 versus 1.00 cm, SE 0.169) and a more rapid return to running (17.231 weeks, SE 0.401 versus 21.08 weeks, SE 0.409), than the SP group.
  
  
  CONCLUSIONS
  The accelerated rehabilitation programme resulted in less tendon lengthening, more rapid return to running, but similar ATRS relative to the standard rehabilitation. Immobilization following TA repair may prolong recovery.
authors.affiliation: Porter Sports Orthopaedics, Canberra, Australian Capital Territory, Australia.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Porter
authors.forename: Bruce
authors.initials: B
authors.lastname: Shadbolt
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D004434:Early Ambulation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000534:rehabilitation*; D009989:Orthotic Devices; D020127:Recovery of Function; D012421:Rupture / Q000601:surgery; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Achilles tendon; mobilization; rehabilitation; surgical repair