The Influence of Early Weight-Bearing Compared with Non-Weight-Bearing After Surgical Repair of the Achilles Tendon

Suchak, Amar A.; Bostick, Geoff P.; Beaupré, Lauren A.; Durand, D'Arcy C.; Jomha, Nadr M.
September 2008
Journal of Bone & Joint Surgery, American Volume;Sep2008, Vol. 90-A Issue 9, p1876
Academic Journal
Background: The optimal rehabilitation protocol after surgical repair of an Achilles tendon rupture has not been well defined. The objective of this randomized study was to compare the effect of early weight-bearing with that of non-weight-bearing on early postoperative recovery following repair of an acutely ruptured Achilles tendon. Methods: Between October 2003 and May 2006, 110 patients with a surgically repaired Achilles tendon rupture were enrolled from one of two major trauma-care tertiary hospitals. All patients were non-weight-bearing for the first two weeks postoperatively. At the two-week postoperative visit, patients were randomized to either weight-bearing or non-weight-bearing for an additional four weeks. Compliance was measured with a pressure sensor in the fixed-hinge ankle-foot orthosis given to each patient. Follow-up assessments were performed at six weeks, three months, and six months postoperatively. The primary outcome was health-related quality of life assessed with use of the RAND 36-Item Health Survey (RAND-36). Secondary outcomes were activity level, calf strength, ankle range of motion, return to sports and work, and complications. Results: Ninety-eight patients (89%) completed the six-month follow-up. At six weeks, the weight-bearing group had significantly better scores than the non-weight-bearing group in the RAND-36 domains of physical functioning, social functioning, role-emotional, and vitality scores (p < 0.05). Patients in the weight-bearing group also reported fewer limitations of daily activities at six weeks postoperatively (p < 0.001). At six months, no significant differences between the groups were seen in any outcome, although both groups had poor endurance of the calf musculature. No rerupture occurred in either group. Conclusions: Early weight-bearing after surgical repair of an acute Achilles tendon rupture improves health-related quality of life in the early postoperative period and has no detrimental effect on recovery.


Related Articles

  • Augmented Compared with Nonaugmented Surgical Repair of a Fresh Total Achilles Tendon Rupture: A Prospective Randomized Study. Pajala, Ari; Kangas, Jarmo; Siira, Pertti; Ohtonen, Pasi; Leppilahti, Juhana // Journal of Bone & Joint Surgery, American Volume;May2009, Vol. 91-A Issue 5, p1092 

    Background: Augmented and nonaugmented techniques have been used for the operative repair of a fresh complete Achilles tendon rupture. Augmented techniques have been favored for their stronger pullout strengths but have been avoided because of the risk of wound complications. If proven to be...

  • Beckham to miss World Cup after injury. Wilson, Stephen // Adirondack Daily Enterprise;3/16/2010, Vol. 117 Issue 64, p10 

    The article reports on the surgery undergone by 34-year-old midfielder David Beckham for torn left Achilles' tendon, after he was injured while playing for Italian club AC Milan, which will make him miss the World Cup that begins in June 11, 2010 in South Africa.

  • Nerve-related characteristics of ventral paratendinous tissue in chronic Achilles tendinosis. Andersson, Gustav; Danielson, Patrik; Alfredson, Håkan; Forsgren, Sture; Alfredson, Håkan // Knee Surgery, Sports Traumatology, Arthroscopy;Oct2007, Vol. 15 Issue 10, p1272 

    Ultrasound and Doppler examination has shown high blood flow-neovascularisation inside and outside the ventral Achilles tendon in chronic painful tendinosis, but not in pain-free normal Achilles tendons. In patients with Achilles tendinosis, injections with the sclerosing substance polidocanol,...

  • Cochrane in CORR: Surgical Interventions for Treating Acute Achilles Tendon Ruptures (Review). Mundi, Raman; Madden, Kim; Bhandari, Mohit // Clinical Orthopaedics & Related Research;Jun2014, Vol. 472 Issue 6, p1703 

    The article discusses review of surgical interventions for treating acute achilles tendon ruptures. Topics discussed include performing randomized and quasi-randomized trials for comparing surgical and non-surgical treatment of achilles tendon rupture and use of Medline database for gathering...

  • Degradation and Remodeling of Small Intestinal Submucosa in Canine Achilles Tendon Repair. Gilbert, Thomas W.; Ann M. Stewart-Akers; Simmons-Byrd, Abby; Badylak, Stephen F. // Journal of Bone & Joint Surgery, American Volume;Mar2007, Vol. 89-A Issue 3, p621 

    Background: Extracellular matrix derived from porcine small intestinal submucosa is used for the repair of musculo-tendinous tissues. Preclinical evaluation and clinical use have suggested that small intestinal submucosa extracellular matrix degrades rapidly after implantation and can be...

  • What's New in Orthopaedic Research. Rodeo, Scott A.; Delos, Demetris; Weber, Alex; Xiaodong Ju; Cunningham, Matthew E.; Fortier, Lisa; Maher, Suzanne // Journal of Bone & Joint Surgery, American Volume;10/20/2010, Vol. 92-A Issue 14, p2491 

    The article presents several studies relating to orthopaedic medicine in the U.S. It includes the influence of the mechanical environment on tendon and ligament structure and function and the effects of mechanical stimulation on Achilles tendon healing. Also mentioned is the interface tissue...

  • INTERMEDIATE TO LONG-TERM RESULTS OF A TREATMENT PROTOCOL FOR CALCANEAL FRACTURE MALUNIONS. Clare, Michael P.; Lee III, William E.; Sanders, Roy W. // Journal of Bone & Joint Surgery, American Volume;May2005, Vol. 87-A Issue 5, p963 

    Background: Nonoperative management of displaced intra-articular calcaneal fractures may result in malunion affecting the function of both the ankle and the subtalar joint. The purpose of this study was to report the intermediate to long-term results of a treatment protocol for calcaneal...

  • Successful treatment of a fracture of a huge Achilles tendon ossification with autologous hamstring tendon graft and gastrocnemius fascia flap: a case report. Ishikura, Hisatoshi; Fukui, Naoshi; Takamure, Hiroshi; Ohashi, Satoru; Iwasawa, Mitsuyasu; Takagi, Kentaro; Horita, Ayako; Saito, Ikuo; Mori, Toshihito // BMC Musculoskeletal Disorders;11/24/2015, Vol. 16, p1 

    Background: Fracture of an ossified Achilles tendon is a rare entity, and no standard treatment has been established. This is the first report to describe the use of a hamstring tendon graft and gastrocnemius fascia flap for Achilles tendon reconstruction.Case Presentation:...

  • Augmented Compared with Nonaugmented Surgical Repair After Total Achilles Rupture: Results of a Prospective Randomized Trial with Thirteen or More Years of Follow-up. Heikkinen, Juuso; Lantto, Iikka; Flinkkilä, Tapio; Ohtonen, Pasi; Pajala, Ari; Siira, Pertti; Leppilahti, Juhana // Journal of Bone & Joint Surgery, American Volume;1/20/2016, Vol. 98 Issue 2, p85 

    Background: This prospective randomized trial with a mean fourteen-year follow-up compared simple end-to-end repair with fascial flap-augmented repair for acute Achilles tendon ruptures.Methods: From 1998 to 2001, sixty patients with acute Achilles tendon rupture were...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics