Table 1 Literature review on post operation rehabilitation protocol and functional outcome in Achilles tendon rupture
From: Jigless knotless internal brace technique for acute Achilles tendon rupture: a case series study
Study | Year | Study type | Surgical method | Rehabilitation protocol | Functional outcome | Complication |
|---|---|---|---|---|---|---|
Valkering KP et al. [27] | 2016 | Randomized control FWB [mobilized full weight bearing group] (n = 27) compared with IMM [immobilized non-weight-bearing group] (n = 29) | Longitudinal open incision; end to end repair with Kessler sutures | FWB: 0–2nd week: FWB with adjustable orthosis and crutch; 15–30° range of motion in plantar flexion 3rd–6th weeks: 5–45°range of motion in plantar flexion IMM: 0–2nd week: non-weight-bearing with crutch; ankle immobilized in 30°of equinus position. 3rd–6th weeks: FWB with crutch and wearing the heel added orthosis. | Improved early ankle range of motion (6 months); no difference in following 1 year | One patient in IMM group had traumatic rerupture. |
Olsson N et al. [14] | 2013 | Randomized control | Surgical group (longitudinal wound incision, end to end repair with a modified Kessler technique) (n = 43) compared with non-surgical group (n = 45) | Surgical group: 0–2nd week: ankle immobilized in a pneumatic walker brace with heel pads producing a plantarflexion approximately 20°. FWB with crutch was allowed. 3rd week~: Early active range of motion and strength training. Non-surgical group: 0–2nd week: The same as the surgical group. 3rd–8th weeks: Immobilized in the brace for 8 weeks. | Surgical group was significantly superior in the drop counter movement jump and hopping in following 1 year. No significant differences between the groups in symptoms, physical activity level, or quality of life. | Six superficial infections in the surgical group. |
Sarman H et al. [24] | 2016 | Retrospective analysis. | Semi-invasive internal splinting (SIIS group, n = 24) compared with open end to end repair with Krackow sutures (open group, n = 21) | Ankle immobilized in 30° plantar flexion with dorsal splint after operation. No further rehabilitation protocol was available in this article. | No significant differences between the groups in functional outcome in 1 year following. | One sural nerve injury in SIIS group (recovered 6 months later). Two deep wound infection in open surgery; one underwent debridement, and another one required additional soft tissue coverage. |
Bevoni R et al. [8] | 2014 | Case series | Longitudinal open incision; triple-bundle technique (n = 66) | 0–2nd week: non-weight-bearing with walking boot. 3rd week: partial weight bearing with boot locked in neutral position 4th–5th weeks: partial weight bearing with boot unlocked in in 20–30°of plantar flexion. 6th week: partial weight bearing without boot 8th week: full weight bearing | The mean American Orthopaedic Foot and Ankle Society scale score (AOFAS) at 36 months was 93.9 ± 5.9 | One patient had a significant amount of scar adhesion. |
McWilliam JR et al. [25] | 2016 | Case series | Internal brace (IB) with percutaneous Achilles repair system (PARS; Arthrex Inc., Naples, FL) (n = 34) | 0–1st week: Crutch-aided FWB with walking boot with heel wedge; 1/4 wedge removed every two weeks. 2nd–3rd weeks: FWB with boot only, active dorsiflexion of the ankle is allowed without passive dorsiflexion. 4th–5th weeks: Passive dorsiflexion is allowed to neutral. 6th–7th weeks: Remove boot 8th week: Passive dorsiflexion beyond neutral. | The Achilles tendon total rupture score was 94 ± 14 in following range: 24–36 months | Nil |
Yin L et al. [10] | 2017 | Case series | Panda rope bridge technique (n = 11) | 0–1st week: Active range of motion without weight-bearing. 2nd–6th weeks: FWB walking without crutches while wearing a 30-mm-height heel, which decreased 5 mm once a week. 7th–8th weeks: muscle strengthening exercises. 9th week: advised to take part in athletic exercises gradually | The mean AOFAS score at 12 months was 100. | Nil |
Current study | 2019 | Case series | Jigless knotless internal brace technique (n = 10) | 0–1st week: FWB with crutches and wearing shoes with an added heel wedge (3 cm); non-weight-bearing range of motion exercise at least 1 h a day. 2nd week: walking without ambulatory aids was allowed. 3rd–5th weeks: reducing the added heel wedge height by 1 cm per week. 5th–6th weeks: heel-raising exercise 7th week: exercise as tolerable | The mean AOFAS score at 12 months was 100. | Nil |