WANG Zhonghe 1,2 , KONG Lingtong 1 , CAO Wenhao 1 , TANG Junjun 1 , QI Hongzhe 1 , DOU Meijing 1 , LIU Haoyu 1 , CHEN Chen 1 , CHEN Hua 1,2,3
  • 1. Senior Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, 100142, P. R. China;
  • 2. Graduate School, Ningxia Medical University, Yinchuan Ningxia, 750004, P. R. China;
  • 3. Orthopedic Department Unit 1, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, P. R. China;
CHEN Hua, Email: chenhua0270@126.com
Acute Achilles tendon rupture; dynamic rehabilitation; static rehabilitation; minimally invasive surgery; prospective trial
10.7507/1002-1892.202408024
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Objective  To explore the difference in effectiveness between a dynamic rehabilitation protocol and a traditional static rehabilitation protocol after the treatment of acute Achilles tendon rupture with channel assisted minimally invasive repair (CAMIR) technique through a prospective comparative trial, aiming to provide a reference for clinically selecting a feasible treatment regimen. Methods  Patients with acute Achilles tendon rupture admitted between June 2021 and June 2022 were included in the study, with 60 patients meeting the selection criteria. They were randomly divided into a dynamic rehabilitation group (n=30) and a static rehabilitation group (n=30) using a computer-generated random number method. There was no significant difference in baseline data such as gender, age, body mass index, smoking history, injured side, cause of injury, and disease duration between the two groups (P>0.05). After Achilles tendon anastomosis by using CAMIR technique, the dynamic rehabilitation group implemented early partial weight-bearing training with the assistance of an Achilles heel boot and controlled ankle joint exercises for 6 weeks, while the static rehabilitation group maintained a non-weight-bearing status during this period. Complications in both groups were recorded. At 3 and 6 months after operation, the Achilles tendon total rupture score (ATRS) was used to evaluate the degree of functional limitation of the Achilles tendon in the affected limb, and the 12-Item Short Form Health Survey (SF-12 scale) was used to assess the patients’ quality of life, including physical component summary (PCS) and mental component summary (MCS) scores. Results  No sural nerve injury occurred during operation in both groups. All patients were followed up 12-18 months (mean, 14 months). The dynamic rehabilitation group had significantly higher ATRS scores at 3 and 6 months after operation compared to the static rehabilitation group (P<0.05). At 3 months after operation, the dynamic rehabilitation group had significantly lower PCS, MCS, and SF-12 total scores compared to the static rehabilitation group (P<0.05). At 6 months, all quality of life scores in the two groups were similar (P>0.05). Two cases (6.6%) in the dynamic rehabilitation group and 5 cases (16.7%) in the static rehabilitation group developed complications, with no significant difference in incidence of complications (P>0.05). Conclusion  For acute Achilles tendon rupture, the dynamic rehabilitation protocol after Achilles tendon anastomosis by using CAMIR technique can improve early functional recovery and maintains comparable safety and effectiveness compared to static rehabilitation.

Citation： WANG Zhonghe, KONG Lingtong, CAO Wenhao, TANG Junjun, QI Hongzhe, DOU Meijing, LIU Haoyu, CHEN Chen, CHEN Hua. A comparative study of dynamic versus static rehabilitation protocols after acute Achilles tendon rupture repair with channel assisted minimally invasive repair technique. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(12): 1492-1498. doi: 10.7507/1002-1892.202408024 Copy

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