Duration of immobilisation after Achilles tendon rupture repair by open surgery: a retrospective cohort study
| Autor: | Shan Gao, Ji Xing Fan, Chen Jiao, Fang Zhou, Teng Jiao Zhu, Yang Lv, Xiangyu Xu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Heel Time Factors lcsh:Diseases of the musculoskeletal system Open surgery Immobilisation duration Achilles Tendon Weight-Bearing 03 medical and health sciences Immobilization Young Adult 0302 clinical medicine lcsh:Orthopedic surgery Tendon Injuries Medicine Humans Orthopedics and Sports Medicine Orthopedic Procedures Postoperative Period Early rehabilitation Range of Motion Articular Retrospective Studies Rupture Achilles tendon rupture 030222 orthopedics Achilles tendon business.industry Retrospective cohort study 030229 sport sciences Recovery of Function Middle Aged Surgery lcsh:RD701-811 medicine.anatomical_structure Treatment Outcome Orthopedic surgery Female Ankle medicine.symptom lcsh:RC925-935 business Range of motion Cohort study Follow-Up Studies Research Article |
| Zdroj: | Journal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-10 (2021) Journal of Orthopaedic Surgery and Research |
| Popis: | Background The best treatment for acute Achilles tendon ruptures remains controversial. No cohort studies have compared different immobilisation durations after open surgery. This retrospective cohort study aimed to determine the optimal duration of immobilisation after this surgery. Methods A total of 266 patients with acute Achilles tendon rupture were divided into 4 groups (A, B, C, and D) according to immobilisation duration of 0, 2, 4, and 6 weeks, respectively. All patients underwent the same suture technique with a similar rehabilitation protocol and were examined clinically at 2, 4, 6, 8, 10, 12, 14, 16, 24, and 48 weeks, with a final follow-up at a mean of 22.3 months postoperatively. The primary outcome was the time of return to light sports activity (LSA). Secondary outcomes included range of motion (ROM) and single-legged heel rise height (SHRH). Data on operation time, complications, visual analogue pain scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, and Achilles tendon Total Rupture score (ATRS) were also collected. Demographic baseline data were analysed using one-way analysis of variance; outcome parameters were analysed using Kruskal-Wallis H test, and complications were analysed using Fisher’s exact test. Statistical significance was considered at P ≤ 0.05. Results VAS scores decreased significantly, reaching 0 in all groups after 12 weeks. The AOFAS and ATRS scores were significantly different between the groups from weeks 2 to 12 (P<0.001) and weeks 2 to 16 (P<0.001), respectively. All the mean scores showed better results in group B than in the other groups. In terms of recovery time of ROM, SHRH, and LSA, groups A and B were significantly faster than groups C and D (P<0.001). There were 13 (13/266, 4.9%) complications: 5 superficial infections, 3 deep venous thrombosis, and 5 trauma-related re-ruptures. On the last follow-up, all complications had recovered. There were no significant differences in complications between the groups. Conclusions Immobilisation for 2 weeks after this open surgery is the best choice for early rehabilitation and weight-bearing while minimising pain and other complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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