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A Treatment Protocol for Achilles Tendinopathy with Extracorporeal Shockwave Therapy
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WITHDRAWN: Interventions for treating acute Achilles tendon ruptures
Riaz J K Khan1, Daniel P Fick, Angus Keogh
1Trauma and Orthopaedics, University of Western Australia, 1/14-16 Hamersley Street, Cottesloe, Perth, Western Australia, Australia, 6011. rjkkhan@gmail.com
The Cochrane Database of Systematic Reviews
|January 23, 2009
Summary
Surgical repair of acute Achilles tendon ruptures reduces rerupture risk but increases other complications. Percutaneous surgery may lower infection rates, and functional braces improve recovery compared to casts.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Musculoskeletal Injuries
Background:
- Management of acute Achilles tendon ruptures lacks consensus.
- Treatment options include operative (open, percutaneous) and non-operative (cast, functional brace) methods.
- Post-operative immobilization varies from rigid casts to functional braces.
Purpose of the Study:
- To systematically review evidence from randomized controlled trials (RCTs).
- To evaluate the effectiveness of different interventions for acute Achilles tendon ruptures.
Main Methods:
- Searched multiple databases and contacted trialists for relevant RCTs.
- Included 14 trials with 891 patients comparing various treatment regimens.
- Assessed trial quality using a ten-item scale.
Main Results:
- Open surgery reduced rerupture risk versus non-operative treatment but increased complications (infection, etc.).
- Percutaneous repair showed shorter operation times and lower infection risk than open repair.
- Functional braces led to shorter hospital stays, quicker return to work/sport, and fewer complications than casts.
Conclusions:
- Open operative treatment decreases rerupture risk but elevates other complications.
- Percutaneous surgery may mitigate wound infection risks.
- Functional bracing post-operatively appears beneficial for recovery and complication rates.
