Standard Treatments Comparable for Achilles' Tendon Rupture

Patient-reported outcomes not better for open repair or minimally invasive surgery compared with noninvasive treatment

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THURSDAY, April 14, 2022 (HealthDay News) -- Patient-reported outcomes at 12 months are similar for open-repair, minimally invasive surgery, or nonoperative treatment of Achilles' tendon rupture, according to a study published in the April 14 issue of the New England Journal of Medicine.

Ståle B. Myhrvold, M.D., from the University of Oslo in Norway, and colleagues conducted a multicenter, randomized trial comparing nonoperative treatment, open repair, and minimally invasive surgery for 526 adults with acute Achilles' tendon rupture who presented to four trial centers.

The researchers found that the mean changes in the Achilles' tendon Total Rupture Score were –17.0, –16.0, and 14.7 points in the nonoperative, open-repair, and minimally invasive surgery groups. No evidence of differences between the groups was seen in pairwise comparisons. The three groups had similar changes from baseline in physical performance and patient-reported physical function. The nonoperative group had a higher number of tendon reruptures than the open-repair or minimally invasive surgery groups (6.2, 0.6, and 0.6 percent, respectively). Nerve injuries occurred in 5.2, 2.8, and 0.6 percent of patients in the minimally invasive surgery, open-repair, and nonoperative groups (nine, five, and one injuries, respectively).

"The present trial provides compelling evidence that none of the standard treatments of acute Achilles' tendon rupture is clearly superior when used for unselected patients," write the authors of an accompanying editorial.

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