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Right arrow Achilles tendon
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The American Journal of Sports Medicine 26:789-793 (1998)
© 1998 American Orthopaedic Society for Sports Medicine

Early Full Weightbearing and Functional Treatment After Surgical Repair of Acute Achilles Tendon Rupture

Matthias Speck, MD*,{dagger} and Kay Klaue, MD{ddagger}

* Department of Orthopaedic Surgery, University of Berne, Inselspital, Berne
{ddagger} Ospedale Regionale San Giovanni, Bellinzona, Switzerland

{dagger} Address correspondence and reprint requests to Matthias Speck, MD, Department of Orthopaedic Surgery II, SRH-Klinikum Karlsbad-Langensteinbach (associated to the University of Heidelberg), Guttmannstrasse 1, D-76307 Karlsbad, Germany

We prospectively evaluated the clinical outcomes of 20 patients (mean age, 42.8 years) with early full weightbearing and functional treatment after surgical repair of acute Achilles tendon rupture according to a prospective intra- and postoperative protocol. All patients underwent open repair using a Kessler-type suture and simple apposition sutures. The postoperative regimen included a plantigrade splint for 24 hours and 6 weeks of early full weightbearing in a removable walker. All patients were evaluated with clinical and ultrasound examination and according to a new scoring system at 3, 6, and 12 months after repair. After 3 months, the score averaged 73 of 100 points; after 6 months, 86; and after 1 year, 94. All patients reached the same level of sports activities as preoperatively and demonstrated no significant difference in ankle mobility and isokinetic strength. There were no reruptures. One patient had a deep venous thrombosis 3 weeks after the operation after having prematurely stopped thromboprophylaxis. We believe that early careful ankle mobilization and full weightbearing in a removable walker after primary Achilles tendon repair does not increase the risk of rerupture. An accelerated rehabilitation program improves early foot function with excellent recovery of plantar flexion strength and amplitude.




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