[Effect of early versus late rehabilitation in patients with Achilles tendon tenorrhaphy].

BACKGROUND

Achilles tendon tear is a prevalent condition in our setting. There is no consensus in the literature regarding the ideal treatment modality or the right immobilization period before starting physiatrics. The harmful effect of prolonged immobilization is widely known, so the functional results of early versus late physical therapy are compared in patients subjected to surgery for Achilles tendon tear.

MATERIAL AND METHODS

Ambispective, longitudinal, comparative study in patients over 16 years of age with Achilles tendon rupture treated surgically and referred to rehabilitation; they followed the management protocol established at the service. Retrospective record review was performed for discharged patients and patients admitted after the study initiation date were followed-up prospectively. The evaluation continued by means of a phone interview; results were recorded according to the Achilles Tendon Rupture Score.

RESULTS

A total of 115 patients were included; they were classified into two groups according to the time elapsed between the surgery and the onset of physical therapy, as follows: 31 patients in group A, with onset between postoperative days 0 and 21; and 84 patients in group B, with onset after postoperative day 21. Two infectious complications were reported and no re-ruptures. Functional results were 6.52 for group A and 8.18 for group B.

CONCLUSIONS

The duration of rehabilitation was similar in all patients, regardless of the protocol. The time elapsed between surgery and discharge was shortest in patients who underwent early physical therapy. The functional score is independent from the onset of physical therapy. Surgery followed by early mobilization is a safe practice that does not increase complications and shortens the total time the patients need to resume their daily activities.