Comparison of Tendon Lengthening with Traditional vs. Accelerated Rehab Following Achilles Tendon Repair: A Randomized Controlled Trial

Abstract

Purpose/Introduction: Repair of Achilles tendon ruptures has shown successful outcomes. Little is known about the amount of tendon or repair site lengthening after repair and if lengthening is affected by rehab protocols. The purpose of our study was to compare lengthening of the Achilles tendon after surgical repair, comparing traditional and accelerated rehab protocols. Methods: Fourteen patients undergoing primary repair of Achilles tendon ruptures were assessed for participation. We performed a prospective randomized controlled trial in accordance with the CONSORT (Consolidated Standards of Reporting Trials) statement. Study arms included operative repair of Achilles tendon rupture with either accelerated (graduated weight bearing at 2weeks) or traditional rehab (weight bearing at 6 weeks). During repair, two tantalum beads with holes were sutured to the tendon at the repair site. Beads were evaluated via CT immediately post-operatively and at 12 weeks. X-rays were obtained at time 0 and at 2, 6, and 12weeks. The primary outcome of the study was the difference in tendon lengthening between the study arms. Randomization by a computerized algorithm. Observer was blinded and patient was not blinded to the intervention. Results: All 14 patients included for analysis. All patients showed statistically significant lengthening at two week follow-up. There was a trend toward lengthening at 6weeks in accelerated group (9.9mm, range 2.6 -13.9mm) compared to traditional group (4.1mm, range 1.5 -9.0mm), although not statistically significant; p =.07. Final amount of lengthening at 12weeks was not different between the accelerated group (14.4mm, range 11.7 -17.0mm) and traditional group (13.4mm, range 10.7 -17.0mm); p =.38. Conclusion: This studya[Euro sign][TM]s findings suggest that patients undergoing operative repair of Achilles ruptures have significant lengthening after surgery. Although there was a trend toward lengthening at 6weeks in the accelerated group, there was no difference in tendon lengthening at final follow-up between the groups. Disclosure(s): No interests to disclose.