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- Talk
- 21/09/2021
- UK
Functional Outcome of Early Weight Bearing on Conservatively Managed Complete Achilles Tendon Rupture
Description
This presentation, led by Rajib Naskar, discusses a study conducted at East Kent Hospital University Foundation Trust, which investigates the effects of early weight bearing on the functional outcomes of conservatively managed complete Achilles tendon ruptures. The study took place between 2019 and 2020, focusing on a demographic primarily composed of middle-aged men aged 40 to 50 years, with an annual incidence of 21 per 100,000 individuals.
Rajib highlights the ongoing debate regarding the treatment options for Achilles tendon ruptures, traditionally favoring surgical intervention due to lower rates of re-rupture and quicker recovery. However, the evidence has shifted towards conservative management, particularly using modern bracing techniques that facilitate early weight bearing and improve patient satisfaction.
The study involved a cohort of 41 patients who were treated with a specific conservative protocol using a new functional orthosis. Follow-up assessments after one year included the Achilles Tendon Rupture Score (ATRS), heel raise measurements, and other functional tests. The results showed promising outcomes, with a mean ATRS score of 82.1%, a re-rupture rate of only 2%, and 66% of patients returning to their pre-injury activity levels.
There were significant correlations noted between calf muscle girth and functional scores, while no notable relationships were found between the heel raise height or repetitions. Rajib further explains the benefits of the new orthosis over traditional methods, emphasizing that it maintains an optimal angle for recovery, thus reducing complications typically associated with plaster casts.
The discussion includes insights from various studies reaffirming the superiority of functional braces, highlighting the innovative approaches in treating Achilles tendon injuries conservatively. Additionally, Rajib addresses questions from the audience regarding implications of ultrasound scans on management decisions, the relationship between rupture location and recovery, and potential long-term effects on tendon strength post-conservative treatment.
Overall, Rajib concludes that most complete Achilles tendon ruptures can be successfully managed through conservative methods, reserving surgical options for specific cases, particularly elite athletes.