Early Functional Rehabilitation for Acute Achilles Tendon Ruptures: An Update Meta-Analysis of Randomized Controlled Trials
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2020;8(4):15 J Foot Ankle Surg.2019;58(5):938-945.What this means for my practice?
Overall, it is unclear if early mobilization has any benefit compared to standard care. There may be a slightly faster return to work with early mobilization, though the difference is small. There is likely no danger associated with early mobilization, but there may also be no significant benefit. Thus, it may be best to decide the mobilization protocol based on patient and surgeon preference.
Study Summary
Achilles tendon ruptures can be treated both operatively and non-operatively. With either technique, patients can be either be immobilized initially, or allowed some weight-bearing and range of motion, otherwise known as "Early" or "Functional" rehabilitation. While early mobilization may have benefits in terms of return to activity and function, it is unclear whether it is also associated with adverse events. In this study, the authors assessed 14 randomized controlled trials which compared these protocols. Overall, on a wide range of outcomes including adverse events, function, and return to work and sport, the only significant difference was a slightly faster return to work time with the early mobilization group.
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