Clinical Practice Guideline for Achilles Tendon Rupture Issued

AAOS issues evidence-based recommendations for diagnosis and treatment

MONDAY, Nov. 29 (HealthDay News) -- A summary of a clinical practice guideline for the diagnosis and treatment of acute Achilles tendon rupture is available in the Oct. 20 issue of the Journal of Bone & Joint Surgery, though the authors recommend reviewing the full guideline and evidence report.

Christopher P. Chiodo, M.D., of the Brigham & Women's Foot & Ankle Center at Faulkner Hospital in Jamaica Plain, Mass., and colleagues used a systematic, evidence-based process to create the guideline for the American Academy of Orthopaedic Surgeons. They note that treatments and procedures available to each patient are dependent on mutual communication among the patient, the physician, and other health care providers.

Among their recommendations are that a detailed history and physical exam should be carried out and that the latter should incorporate at least two of the following: a clinical Thompson test, decreased ankle plantar flexion strength, presence of a palpable gap, and increased passive ankle dorsiflexion. The group was unable to reach a consensus on the routine use of imaging to confirm a diagnosis of acute Achilles tendon rupture.

"We are confident that those who read the full guideline and evidence report will also see that the recommendations were developed using systematic evidence-based processes designed to combat bias, enhance transparency, and promote reproducibility. This summary of recommendations is not intended to stand alone. Treatment decisions should be made in light of all circumstances presented by the patient," the authors write.

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