Effect of Early Versus Late Weightbearing in Conservatively Treated Acute Achilles Tendon Rupture: A Meta-Analysis.

Autor: El-Akkawi AI; Junior Doctor, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark. Electronic address: aliakkawi@hotmail.com., Joanroy R; Junior Doctor, Fellowship in Orthopedic Surgery, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark., Barfod KW; Doctor, Fellowship in Orthopedic Surgery, Clinical Orthopedic Research Hvidovre, Department of Orthopedics, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark., Kallemose T; Scientific Statistician, Clinical Research Centre, Clinical Orthopedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark., Kristensen SS; Senior Doctor and Chief Physician, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark., Viberg B; Doctor, Fellowship in Orthopedic Surgery, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark; Doctor, Fellowship in Orthopedic Surgery, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Jazyk: angličtina
Zdroj: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons [J Foot Ankle Surg] 2018 Mar - Apr; Vol. 57 (2), pp. 346-352. Date of Electronic Publication: 2017 Sep 30.
DOI: 10.1053/j.jfas.2017.06.006
Abstrakt: 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.
(Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: