HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) All Versions of this Article: 35/1/59    most recent 0363546506293255v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kangas, J. Articles by Leppilahti, J. Search for Related Content PubMed PubMed Citation Articles by Kangas, J. Articles by Leppilahti, J. Related Collections Achilles tendon Operative

Achilles Tendon Elongation After Rupture Repair

A Randomized Comparison of 2 Postoperative Regimens

Jarmo Kangas, MD^*,, Ari Pajala, MD^*, Pasi Ohtonen, MD^*, and Juhana Leppilahti, MD, PhD^*,

From the ^* Department of Surgery, Oulu University Hospital, Oulu, Finland, the Department of Surgery, North Carelian Central Hospital, Joensuu, Finland, and the Department of Anesthesiology, Oulu University Hospital, Oulu, Finland

Address correspondence to Juhana Leppilahti, MD, PhD, Department of Surgery, Oulu University Hospital, Box 21, 90029 OYS, Finland (e-mail: juhana.leppilahti{at}ppshp.fi).

Background: A few prospective controlled trials comparing early functional rehabilitation after Achilles tendon repair and non-operative immobilization have been reported.

Hypotheses: There is no difference in Achilles tendon elongation between early motion and immobilization after Achilles tendon repair. Tendon elongation does not correlate with the clinical outcome.

Study Design: Randomized clinical trial; Level of evidence, 2.

Methods: Fifty patients with acute Achilles tendon rupture were randomized postoperatively to receive either early movement of the ankle between neutral and plantar flexion in a brace for 6 weeks or immobilization in tension using a below-knee cast with the ankle in a neutral position for 6 weeks. Full weightbearing was allowed after 3 weeks in both groups. Standardized radiographs to measure previously placed radiographic markers were taken on the first day postoperatively and at 1, 3, 6, 12, 24 weeks postoperatively, with the final radiograph a mean of 60 (SD, 6.4) weeks postoperatively. The outcome was assessed at the 3-month and final checkups by the clinical scoring method described by Leppilahti et al and included subjective factors and objective factors.

Results: Tendon elongation occurred in both groups but was somewhat less in the early motion group (median 2 mm in the early motion group vs median 5 mm in the cast group a mean of 60 weeks postoperatively, P = .054). The elongation curves first rose and then slowly fell in both groups. The patients who had less elongation achieved a better clinical outcome ( = –.42, P = .017). Tendon elongation did not correlate significantly with age, body mass index, or isokinetic peak torques.

Conclusion: Achilles tendon elongation was somewhat less in the early motion group and correlated with the clinical outcome scores. We recommend early functional postoperative treatment after Achilles rupture repair.

Key Words: Achilles tendon rupture • postoperative regimen • early motion • cast immobilization

This article has been cited by other articles:

				A. Amendola Elongation of the Achilles Tendon After Rupture Repair Occurred Slightly Less with Postoperative Early Motion Than with Postoperative Immobilization J. Bone Joint Surg. Am., August 1, 2007; 89(8): 1873 - 1873. [Full Text] [PDF]

				K. Knobloch, K. G. Silbernagel, R. Thomee, B. I. Eriksson, and J. Karlsson Letter to the Editor * Authors' Response Am. J. Sports Med., July 1, 2007; 35(7): 1208 - 1209. [Full Text] [PDF]