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Achilles tendon rupture
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Non-Surgical Option for Those Who Tear Their Achilles Tendon

Achilles tendon tears, the bane of many middle-aged "weekend warriors," may heal as effectively with a supportive splint and exercises as with surgery, according to Dr. Alexandra Kirkley, associate professor of surgery at the University of Western Ontario, London, Ontario, Canada.

Although surgery is the method typically used for these common sports injuries, the nonsurgical method may be as effective, with fewer risks.

Rupture of the Achilles tendon is a surprisingly common injury, occurring most often in middle-aged people who are trying to stay fit and participate in recreational activities. Some of the sports where people are at risk include basketball, tennis and squash, as well as any other sports that involve jumping and starts and stops.

In this small trial the researchers compared treatment outcomes in 24 people who had torn their Achilles tendon. Among these people, 12 were treated with a splint, and with rehabilitation exercises that emphasized motion and resistance. The other 12 were treated with conventional Achilles repair surgery.

The basic scientific rationale for the splint with exercises is that, if you have a healing tendon and apply motion and resistance, the tendon heals much more completely. The splint protects the tendon, but it allows for motion and load-bearing exercises.

The investigators assessed the outcomes with a questionnaire and with evaluations that included range of motion, walking, and hopping on one foot. According to these measurements, the two groups were very similar at the end of the study.

It's exciting to see that you can get the same result without having to subject someone to the risk of surgery. It looks like motion and stress are important to recovery. Although surgical repair is the conventional method for treating Achilles tendon tears, some patients may have health risks that make surgery unwise, such as diabetics and smokers. Other patients may be reluctant to undergo surgery.

This study shows that it's safe to treat people for an Achilles tendon rupture without surgery. "For the patient who wants to avoid surgery, or for the patient who has risk factors, there is a nonsurgical option that will give them an excellent result."

28th Annual Meeting Of The American Orthopedic Society For Sports Medicine July 3, 2002 New York, New York

  • Nonoperative treatment of Achilles tendon rupture, American Family Physician,  May 15, 2004  by Karl E. Miller. There are two main treatment options for acute rupture of the Achilles tendon: operative repair and nonoperative care. The nonoperative option has been shown to produce good results with reasonable complication rates. Operative treatment may provide a stronger repair with a faster rehabilitation and, in the long term, better Achilles tendon strength with less risk for rerupture. However, surgical treatment also carries with it operative morbidity.

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