To explore the effect of fast functional rehabilitation combined with percutaneous minimally invasive suture treatment for acute closed Achilles tendon rupture (ACATR) through 2-year follow-up study.We collected 32 patients with acute closed Achilles tendon rupture operated in our hospital, they were divided into early accelerated functional rehabilitation group(EAFR) and traditional rehabilitation group(TR). AOFAS Ankle Hindfoot Scale (AOFAS), Achilles tendon Total Rupture Score (ATRs) and the Muscle Strength recovery Rate (MSR) were used as follow-up evaluation. No incision-related complications or Achilles tendon rupture re-occurrence in both two groups. ATRS scores and AOFAS scores of the EAFR group were higher than those of the TR group in the 6th and 12th month after surgery, respectively (P<0.05), while no statistical significance in the 24th month when compared the two groups (P>0.05). In the EAFR group, the scores attained in the 12th month were higher when compared with those attained in the 6th month (P<0.05), lower when compared with those assessed in the 24th month (P<0.05). In the TR group, the scores attained in the 24th month were higher than those assessed in the 12th month (P<0.05), no statistical significance between the 6th month and the 12th month after surgery (P>0.05). The rate of muscle strength recovery was higher in the EAFR group in the 12th month after sugery (P<0.05), no statistical significance between the two groups in the 24th month (P>0.05). Percutaneous minimally invasive suture combined with early accelerated functional rehabilitation in treating the ACATR can accelerate the Achilles tendon function recovery without increasing the incidence of complications.

Jin Chen, Ding Jie, Zhang Lu, Song Yun. A Two-year Follow-up Study of Accelerated Functional Rehabilitation Combined with Percutaneous Minimally Invasive Suture in the Treatment of Acute Closed Achilles Tendon Rupture. Academic Journal of Medicine & Health Sciences (2023) Vol. 4, Issue 4: 7-13. https://doi.org/10.25236/AJMHS.2023.040402.

[1] Ochen Y, Beks R B, Van Heijl M, et al. Operative treatment versus nonoperative treatment of Achilles tendon ruptures: systematic review and meta-analysis [J]. BMJ, 2019, 364(1):1-13.

[2] Mattila Ville M, Huttunen Tuomas T, Haapasalo Heidi, et al. Declining incidence of surgery for Achilles tendon rupture follows publication of major RCTs: evidence-influenced change evident using the Finnish registry study [J]. British Journal of Sports Medicine, 2015, 49(16):1084-1086. 

[3] Egger A C, Berkowitz M J. Achilles tendon injuries [J]. Current Reviews in Musculoskeletal Medicine, 2017, 10(1):72-80.

[4] Reda Y, Farouk A, Abdelmonem I, et al. Surgical versus non-surgical treatment for acute Achilles' tendon rupture. A systematic review of literature and meta-analysis [J]. Foot and Ankle Surgery, 2020, 26(3):280-288.

[5] Nicola Maffulli, Giuseppe M Peretti. Treatment decisions for acute Achilles tendon ruptures [J]. The Lancet, 2020, 395(10222):441-448.

[6] Wilkins R, Bisson LJ. Operative versus nonoperative management of acute Achilles tendon ruptures: a quantitative systematic review of randomized controlled trials [J]. The American journal of sports medicine, 2012, 40(9): 2154-2160.

[7] Soroceanu A, Sidhwa F, Aarabi S, et al. Surgical versus nonsurgical treatment of acute Achilles tendon rupture: a meta-analysis of randomized trials [J]. The Journal of bone and joint surgery. American volume, 2012, 94(23): 2136-2143.

[8] Maffulli G, Buono AD, Richards P, et al. Conservative, minimally invasive and open surgical repair for management of acute ruptures of the Achilles tendon: a clinical and functional retrospective study [J]. Muscles, ligaments and tendons journal, 2017, 7(1): 46-52.

[9] Braunstein Mareen, Baumbach Sebastian F, Boecker Wolfgang, et al. Development of an accelerated functional rehabilitation protocol following minimal invasive Achilles tendon repair[J]. Knee Surgery Sports Traumatology Arthroscopy, 2018, 26(3):846-853.

[10] Calder JD, Freeman R, Domeij-Arverud E, et al. Meta-analysis and suggested guidelines for prevention of venous thromboembolism (VTE) in foot and ankle surgery[J]. Knee Surgery, Sports Traumatology, Arthroscopy, 2016, 24(4):1409-1420.

[11] Barfod KW, Bencke J, Lauridsen HB, et al. Nonoperative, dynamic treatment of acute achilles tendon rupture: influence of early weightbearing on biomechanical properties of the plantar flexor muscle-tendon complex-a blinded, randomized, controlled trial [J]. The Journal of foot and ankle surgery, 2015, 54(2):220-226.

[12] Wang XN, Zhu YB, Huang X, et al.A new minimal incision suture technique for acute close rupture of Achilles tendon[J].Chinese Journal of Orthopaedic Trauma,2016,18(3):187-191.

[13] Ma GWC, Griffith TG. Percutaneous repair of acute closed ruptured Achilles tendon: a new technique [J]. Clinical Orthopaedics and Related Research,1977, 128(10):247-255.

[14] Ecker TM, Bremer AK, Krause FG, et al. Prospective use of a standardized nonoperative early weightbearing protocol for Achilles tendon rupture: 17 years of experience[J]. Am J Sports Med, 2016, 44(4): 1004-1010.

[15] Wu Yaohong, Lin Linghan, Li Ha, et al. Is surgical intervention more effective than non-surgical treatment for acute Achilles tendon rupture? A systematic review of overlapping meta-analyses [J]. International Journal of Surgery, 2016, 36(12):305-311. 

[16] Ma YF, Zhang J, Jiang N, et al. Research progress concerning acute closed Achilles tendon rupture [J].Chinese Journal of Orthopaedic Trauma, 2021,23(4):323-327.

[17] Stehno-Bittel L, Reddy G K, Gum S, et al. Biochemistry and biomechanics of healing tendon: Part I. Effects of rigid plaster casts and functional casts[J]. Medicine science in Sports & Exercise, 1998, 30(6):788-793.

[18] Xiao J, Xu X, Zhou JB. Advance in Dynamic Functional Rehabilitation after Non-operative Treatment of Acute Achilles Tendon Rupture(review)[J].Chinese Journal of Rehabilitation Theory and Practice, 2019,25(10):1162-1167.

[19] Domiziano Tarantino, Stefano Palermi, Felice Sirico, et al. Achilles Tendon Rupture: Mechanisms of Injury, Principles of Rehabilitation and Return to Play[J].Journal of Functional Morphology and Kinesiology, 2020,95(5):1-15.

[20] Fang JL, Zhan JF, Li J, et al. Advances in the treatment of acute closed Achilles tendon rupture [J]. Chinese Journal of Orthopaedics, 2018, 38(1):53-58.

[21] Wang YZ, Hao JH, Wang JH. Effect of different fixation methods on functional recovery after repair of acute achilles tendon rupture [J].Chinese Journal of Rehabilitation Medicine, 2022, 37(1): 101-105.

[22] Wang YZ, Ying C, Wen SZ, et al. Experimental study on the effect of sustained distraction stress on the expression of type HI collagen and plateletderived growth factor after acute injury of achilles tendon [J].Chinese Journal of Experimental Surgery, 2018,35(07):1367