Achilles Tendon Rupture: Rehab as Good As Surgery
In the long run, patients who rupture their Achilles tendon fare equally well following nonsurgical treatment as they do with surgery, a new Canadian research review shows.
The catch: Nonsurgical patients can only expect to see results on par with surgery patients if they simultaneously engage in so-called functional rehabilitation, a bracing process that offers patients the opportunity to quickly engage in range-of-motion exercises to promote tendon healing.
And even so, nonsurgical patients will experience a slower speed of recovery than surgery patients.
If you rupture your Achilles you need to consider nonoperative treatment, because it’s safer than surgical treatment. What this means is that if you have nonoperative treatment with functional rehabilitation you will have an outcome just as good as surgery and you almost eliminate the absolute risk for surgical complications.
The Achilles tendon — located at the back of the leg, between the heel and calf — is the most commonly ruptured tendon, the study team pointed out.
Nonsurgical treatment options typically involve the use of a cast, a cast-boot or a splint, sometimes accompanied by physical therapy or functional rehabilitation bracing. Such bracing is a relatively recent innovation that enables patients to begin monitored range-of-motion exercising very shortly after the initial injury.
Nevertheless, in the United States, surgery has been the more favored treatment route, in large measure due to the widespread belief that the risk of re-rupturing is lower following surgery than it is following nonsurgical interventions.
That said, while nonsurgical intervention is considered extremely low risk, roughly 10 percent of surgical patients end up developing serious complications, such as deep infection, skin death, tendon death, and a draining sinus. About 15 percent will also develop relatively minor skin complications.
When functional rehabilitation was included in either treatment mix, the investigators found no appreciable difference in the risk for tendon re-rupturing when comparing surgical and nonsurgical patients. Similarly, both sets of patients fared equally well in terms of range of motion, calf circumference and overall function when functional rehabilitation was in play.
However, when functional rehabilitation was not part of the overall treatment package, surgery patients did face a lower risk — nearly 9 percent lower — for re-rupture compared to nonsurgical patients.
When looking at the four studies that assessed the time it took for patients to return to work following treatment launch, the team found that surgery patients did see a faster recovery, being able to return to work about 19 days sooner than nonsurgical patients.
As far as cost comparisons between surgical and nonsurgical treatment, Barber said costs vary so much from hospital to hospital that it’s impossible to say which would be more for any given patient.
More information about Achilles tendon injury, visit the health information site at the UW
via Blogger http://chiropractic-lane.blogspot.com/2013/09/achilles-tendon-rupture-rehab-as-good.html
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