Description
Matt Welch presents a comprehensive overview of Achilles tendon ruptures, focusing on whether surgical intervention is necessary. He navigates through the current debate in medical literature, highlighting the variances in treatment approaches and outcomes. Welch explains his personal treatment regimen, emphasizing the importance of gap size between tendon ends in determining management strategies. For gaps less than 10mm (or 5mm in elite athletes), he prefers non-operative treatment with a vacoped boot; for larger gaps, he opts for surgical repair. He discusses the evolving evidence surrounding operative vs. non-operative strategies, sharing findings from recent meta-analyses that show varying re-rupture rates. Welch articulates the need for tailored patient selection based on individual circumstances such as activity level and age while advocating for early rehabilitation and functional treatments. His conclusion recommends a thoughtful approach towards patient treatment, asserting that both minimally invasive surgery and optimized non-operative care can achieve satisfactory outcomes.
DOI: 10.1302/3114-240879