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. 2022 Jul 29;12(8):1824.
doi: 10.3390/diagnostics12081824.

Fast Functional Rehabilitation Protocol versus Plaster Cast Immobilization Protocol after Achilles Tendon Tenorrhaphy: Is It Different? Clinical, Ultrasonographic, and Elastographic Comparison

Mario Mosconi  1   2 , Gianluigi Pasta  1 , Salvatore Annunziata  1   2 , Viviana Guerrieri  1   2 , Matteo Ghiara  1 , Simone Perelli  3   4 , Camilla Torriani  1 , Federico Alberto Grassi  1   2 , Eugenio Jannelli  1   5
Affiliations

Fast Functional Rehabilitation Protocol versus Plaster Cast Immobilization Protocol after Achilles Tendon Tenorrhaphy: Is It Different? Clinical, Ultrasonographic, and Elastographic Comparison

Mario Mosconi et al. Diagnostics (Basel). .

Abstract

Background: the incidence of Achilles tendon (AT) rupture is rising; however, there is no clear consensus regarding the optimal treatment. The aim of this retrospective study was to compare instrumental and patient-reported outcome scores after fast functional rehabilitation (group A) versus plaster cast immobilization (group B) programs in patients who underwent AT tenorrhaphy.

Methods: 33 patients, with similar clinical and demographic features, underwent open AT tenorrhaphy between January and July 2018. Of these, 15 patients were treated with fast functional rehabilitation program (group A), and 18 patients were treated with plaster cast immobilization protocol (group B). Sural triceps hypotrophy and functional scores (American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score, and Achilles tendon Total Rupture Score (ATRS)) were recorded at a 12-month follow-up. Ultrasonography (US) and elastosonography (ES) were used to compare the characteristics of the tendons after surgery.

Results: At 12 months, no significant differences in any of the patient-reported outcomes or the instrumental measurement tests were seen between the two groups.

Conclusions: fast functional rehabilitation after AT surgical repair is safe, effective, and may be the first choice of treatment, especially in young, collaborative, and active patients.

Keywords: Achilles tendon; early rehabilitation; elastosonography; rupture; surgical repair; ultrasonography.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Longitudinal scan image of complete Achilles tendon rupture; gap in the tendon (*) and the ends of the torn tendon (below the arrows). The muscular belly of the flexor hallucis longus muscle (FHL) is clearly visible below the lesion. (B) Image of longitudinal scan, complete rupture of the Achilles tendon. Note the greater retraction than in case A, with a larger gap in the tendon, torn tendon ends (below the arrows), and herniated (hyperechoic) fat in the lesion space (***).
Figure 2
Figure 2
Transverse (A) and longitudinal (B) ultrasonographic images of the Achilles tendon after tenorrhaphy surgery following complete rupture. The loss of the fibrillar structure, the inhomogeneity, and the surgical material in the context of the tendon are "normal" aspects after surgical repair.
Figure 3
Figure 3
Longitudinal elastography image of Achilles tendon after surgery.
See this image and copyright information in PMC

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