Abstract
Acute Achilles tendon ruptures can be treated with surgical and nonsurgical treatment.
However, the optimal intervention for acute Achilles tendon rupture remains controversial.
The aim of the present study was to compare the clinical outcomes of surgical treatment
versus conservative management for acute Achilles tendon rupture. Eight randomized
controlled studies involving 762 patients were included in the meta-analysis. In general,
re-rupture occurred in 14 of 381 surgically treated patients (3.7%) and 37 of 377
nonsurgically treated patients (9.8%). Pooled results showed that the total re-rupture
rate was significantly lower in surgical group than that in the nonsurgical group
(risk ratio 0.38, 95% confidence interval 0.21 to 0.68; p = .001). No significant differences were found between the 2 treatment groups in
the incidence of deep venous thrombosis, the number who returned to sport, ankle range
of motion (dorsiflexion, plantarflexion), Achilles tendon total rupture score, or
physical activity scale. Surgical treatment can effectively reduce the re-rupture
rate and might be a better choice for the treatment of acute Achilles tendon rupture.
Multicenter, double-blind randomized controlled trials with stratification and long-term
follow-up are needed to obtain a higher level of evidence and to guide clinical practice,
especially in the comparison and selection of different treatments.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
S. D. and Z. S. contributed equally to the present study and are co-first authors.
Identification
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© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
