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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 1, 69-77.
doi: 10.1302/0301-620X.88B1.16549  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Randomised controlled trials of immediate weight-bearing mobilisation for rupture of the tendo Achillis

M. L. Costa, PhD, FRCS Orth, Honorary Lecturer in Orthopaedics1; K. MacMillan, MCSP, Senior Physiotherapist2; D. Halliday, MCSP, Senior Physiotherapist2; R. Chester, MSc, Lecturer in Physiotherapy3; L. Shepstone, PhD, Reader in Medical Statistics4; A. H. N. Robinson, FRCS Orth, Consultant Orthopaedic Surgeon5; and S. T. Donell, MD, FRCS Orth, Honorary Reader in Orthopaedics4

1 School of Medicine
3 Department of Physiotherapy
3 School of Allied Health Professionals
4 School of Medicine, University of East Anglia, Norwich NR4 7TJ, Norfolk, UK.
5 Addenbrooke’s Hospital, Hills Road, Cambridge CB2 3QQ, Cambridgeshire, UK.

Correspondence should be sent to Mr M. L. Costa; e-mail: mattcosta{at}hotmail.com

We performed two independent, randomised, controlled trials in order to assess the potential benefits of immediate weight-bearing mobilisation after rupture of the tendo Achillis. The first trial, on operatively-treated patients showed an improved functional outcome for patients mobilised fully weight-bearing after surgical repair. Two cases of re-rupture in the treatment group suggested that careful patient selection is required as patients need to follow a structured rehabilitation regimen. The second trial, on conservatively-treated patients, provided no evidence of a functional benefit from immediate weight-bearing mobilisation. However, the practical advantages of immediate weight-bearing did not predispose the patients to a higher complication rate. In particular, there was no evidence of tendon lengthening or a higher re-rupture rate. We would advocate immediate weight-bearing mobilisation for the rehabilitation of all patients with rupture of the tendo Achillis.




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The early history of tendo Achillis and its rupture
J Bone Joint Surg Br, April 1, 2007; 89-B(4): 545 - 547.
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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General