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Surgery May Not Be Needed for Ruptured Achilles Tendon
Date:12/29/2012

isk of re-rupturing is lower following surgery than it is following nonsurgical interventions.

That said, while nonsurgical intervention is considered extremely low risk, roughly 10 percent of surgical patients end up developing serious complications, such as deep infection, skin death, tendon death, and a draining sinus. About 15 percent will also develop relatively minor skin complications.

The authors reviewed the findings of 10 Achilles tendon studies conducted between 2005 and 2011. In sum, the studies included 418 patients who underwent surgery and 408 patients, mostly male, who underwent nonsurgical treatment. Some patients had additionally undergone functional rehabilitation, while others had not.

When functional rehabilitation was included in either treatment mix, the investigators found no appreciable difference in the risk for tendon re-rupturing when comparing surgical and nonsurgical patients. Similarly, both sets of patients fared equally well in terms of range of motion, calf circumference and overall function when functional rehabilitation was in play.

However, when functional rehabilitation was not part of the overall treatment package, surgery patients did face a lower risk -- nearly 9 percent lower -- for re-rupture compared to nonsurgical patients.

When looking at the four studies that assessed the time it took for patients to return to work following treatment launch, the team found that surgery patients did see a faster recovery, being able to return to work about 19 days sooner than nonsurgical patients.

Glazebrook and colleagues concluded that at institutions where functional rehabilitation is available, the option to go the nonsurgical route should be given consideration, given the inherently lower risk for complications. But they added that when functional rehabilitation is not an option, surgery should be the go-to approach.

For his part, Dr. James Barber, an orthopedic surgeon with the Coffee Re
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