TY - JOUR
T1 - Effect of Early Versus Late Weightbearing in Conservatively Treated Acute Achilles Tendon Rupture
T2 - A Meta-Analysis
AU - El-Akkawi, Ali Imad
AU - Joanroy, Rajzan
AU - Barfod, Kristoffer Weisskirchner
AU - Kallemose, Thomas
AU - Kristensen, Søren Skydt
AU - Viberg, Bjarke
N1 - Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
PY - 2018/3
Y1 - 2018/3
N2 - Achilles tendon ruptures can be either surgically or conservatively treated with either early functional mobilization or cast immobilization. The purpose of the present study was to conduct a meta-analysis comparing the effect of early versus late weightbearing in conservatively treated adult patients, including only randomized controlled trials (RCTs). The primary endpoint was rerupture, and the secondary endpoints were strength, quality of life during treatment, range of motion, deep venous thrombosis, return to sports, and return to work. The search for studies was conducted using PubMed, EMBASE, and the Cochrane Central Register of Controlled trials. A search was performed, and 2 reviewers independently screened the studies by title, abstract, and, finally, by reading the full text. Four studies met the inclusion criteria. The reference lists of the included studies were scanned and 1 additional RCT study was included. The critical appraisal skills program checklist was applied for study appraisal. A statistician performed the data management and analysis. No statistically significant differences were found between the 2 treatment groups concerning rerupture (p = .796), return to sports (p = .455), or return to work (p = .888). One RCT found 1 case of deep venous thrombosis in the late weightbearing group. One RCT reported significant improvement in quality of life and one reported a significantly improved range of dorsiflexion in the early weightbearing group. No statistically significant difference was found between early and late weightbearing with conservative treatment regarding the rerupture rate. The results of the other outcomes were limited by the low number of studies included in the present meta-analysis. Larger randomized studies are needed to investigate these outcomes. From the results in the present study, we would recommend early weightbearing when an Achilles tendon rupture is treated conservatively.
AB - Achilles tendon ruptures can be either surgically or conservatively treated with either early functional mobilization or cast immobilization. The purpose of the present study was to conduct a meta-analysis comparing the effect of early versus late weightbearing in conservatively treated adult patients, including only randomized controlled trials (RCTs). The primary endpoint was rerupture, and the secondary endpoints were strength, quality of life during treatment, range of motion, deep venous thrombosis, return to sports, and return to work. The search for studies was conducted using PubMed, EMBASE, and the Cochrane Central Register of Controlled trials. A search was performed, and 2 reviewers independently screened the studies by title, abstract, and, finally, by reading the full text. Four studies met the inclusion criteria. The reference lists of the included studies were scanned and 1 additional RCT study was included. The critical appraisal skills program checklist was applied for study appraisal. A statistician performed the data management and analysis. No statistically significant differences were found between the 2 treatment groups concerning rerupture (p = .796), return to sports (p = .455), or return to work (p = .888). One RCT found 1 case of deep venous thrombosis in the late weightbearing group. One RCT reported significant improvement in quality of life and one reported a significantly improved range of dorsiflexion in the early weightbearing group. No statistically significant difference was found between early and late weightbearing with conservative treatment regarding the rerupture rate. The results of the other outcomes were limited by the low number of studies included in the present meta-analysis. Larger randomized studies are needed to investigate these outcomes. From the results in the present study, we would recommend early weightbearing when an Achilles tendon rupture is treated conservatively.
KW - Achilles Tendon/injuries
KW - Acute Disease
KW - Adult
KW - Conservative Treatment/methods
KW - Denmark
KW - Female
KW - Humans
KW - Injury Severity Score
KW - Male
KW - Prognosis
KW - Randomized Controlled Trials as Topic
KW - Return to Sport
KW - Return to Work
KW - Rupture/therapy
KW - Tendon Injuries/diagnosis
KW - Time Factors
KW - Treatment Outcome
KW - Weight-Bearing
U2 - 10.1053/j.jfas.2017.06.006
DO - 10.1053/j.jfas.2017.06.006
M3 - Review
C2 - 28974345
SN - 1067-2516
VL - 57
SP - 346
EP - 352
JO - Journal of Foot & Ankle Surgery
JF - Journal of Foot & Ankle Surgery
IS - 2
ER -