Early weight-bearing after Achilles tendon repair improved quality of life and activity .
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by one or more authors of the
original publication.
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OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(3):51 J Bone Joint Surg Am. 2008 Sep;90(9):1876-83Exclusive Author Interview
Dr. Beaupre on Early Weight-Bearing after Surgical Repair of the Achilles Tendon.
110 patients (ages of 17-70 years) after undergoing a surgical repair for Achilles tendon rupture were kept non-weight-bearing for the first two weeks after surgery. Subsequently, they were randomized to be kept either weight-bearing or non-weight-bearing for an additional four weeks. Early weight-bearing at 2 weeks following surgical repair of an acute Achilles tendon rupture improved the health-related quality of life in the early postoperative period with no consequential detrimental effect on the overall recovery process.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sì = 1
Incerto = 0,5
Non rilevante = 0
No = 0
La valutazione dei criteri di segnalazione valuta la trasparenza con cui gli autori riportano le caratteristiche metodologiche e sperimentali dello studio all'interno della pubblicazione. La valutazione è suddivisa in cinque categorie che vengono presentate di seguito.
3/4
Randomization
3/4
Outcome Measurements
4/4
Inclusion / Exclusion
4/4
Therapy Description
4/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
L'Indice di Fragilità è uno strumento che aiuta l'interpretazione dei risultati significativi, fornendo una misura della forza di un risultato. L'Indice di Fragilità rappresenta il numero di eventi consecutivi che devono essere aggiunti a un risultato dicotomico per rendere il risultato non più significativo. Un numero piccolo rappresenta un risultato più debole, mentre un numero grande rappresenta un risultato più forte.
Perché questo studio era necessario ora?
Achilles tendon rupture is a common condition, often managed with open surgical repair. The importance of post-operative rehabilitation can't be over emphasized. The study was conducted, as the the optimal rehabilitation protocol post surgical repair of an Achilles tendon rupture was not well outlined.
Qual era la domanda di ricerca principale?
Does the early weight-bearing translates into quicker postoperative recovery following repair of an acutely ruptured Achilles tendon in comparison to non-weight bearing?
- At 6 weeks, the weight-bearing group had significantly better scores in RAND-36 domains of physical functioning, social functioning, role-emotional and vitality scores, than the non-weight-bearing group (p<0.05). Also, the weight-bearing group reported fewer limitations of daily activities (p < 0.001).
- 89% (98/109) patients completed the 6-month follow-up
- At 6 months, no significant differences between the groups were seen in any of the outcome measures, although both groups had poor endurance of the calf musculature.
- No re-rupture reportedly occurred in either group at 6 month follow up.
Che cosa devo ricordare di più?
Early weight-bearing at 2 weeks following surgical repair of an acute Achilles tendon rupture improved the health-related quality of life in the early postoperative period with no consequential detrimental effect on the overall recovery process.
Come influenzerà l'assistenza ai miei pazienti?
In the light of this study's findings, this protocol of early weight bearing should be recommended for adoption, as the new standard of care for carefully selected group of patients. Further research with larger sample sizes is needed.
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