Barfod Kristoffer Weisskirchner, Hansen Maria Swennergren, Holmich Per, Troelsen Anders, Kristensen Morten Tange
Department of Orthopedic Surgery, Clinical Orthopedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, Hvidovre, 2650, Denmark.
Physical Medicine and Rehabilitation Research - Copenhagen (PMR-C), Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, Hvidovre, 2650, Denmark.
Trials. 2016 Nov 29;17(1):564. doi: 10.1186/s13063-016-1697-2.
Early controlled ankle motion is widely used in the non-operative treatment of acute Achilles tendon rupture, though its safety and efficacy have never been investigated in a randomized setup. The objectives of this study are to investigate if early controlled motion of the ankle affects functional and patient-reported outcomes.
METHODS/DESIGN: The study is performed as a blinded, randomized, controlled trial with patients allocated in a 1:1 ratio to one of two parallel groups. Patients aged from 18 to 70 years are eligible for inclusion. The intervention group performs early controlled motion of the ankle in weeks 3-8 after rupture. The control group is immobilized. In total, 130 patients will be included from one big orthopedic center over a period of 2½ years. The primary outcome is the patient-reported Achilles tendon Total Rupture Score evaluated at 12 months post-injury. Secondary outcome measures are the heel-rise work test, Achilles tendon elongation, and the rate of re-rupture. The primary analysis will be conducted as intention-to-treat analyses.
This trial is the first to investigate the safety and efficacy of early controlled motion in the treatment of acute Achilles tendon rupture in a randomized setup. The study uses the patient-reported outcome measure, the Achilles tendon Total Rupture Score, as the primary endpoint, as it is believed to be the best surrogate measure for the tendon's actual capability to function in everyday life.
ClinicalTrials.gov: NCT02015364 . Registered on 13 December 2013.
早期控制踝关节活动广泛应用于急性跟腱断裂的非手术治疗,但其安全性和有效性从未在随机试验中得到研究。本研究的目的是探讨早期控制踝关节活动是否会影响功能及患者报告的结局。
方法/设计:本研究为双盲、随机、对照试验,患者按1:1比例分配至两个平行组之一。年龄在18至70岁之间的患者符合纳入标准。干预组在断裂后第3至8周进行早期控制踝关节活动。对照组进行固定。在2年半的时间里,将从一个大型骨科中心纳入130例患者。主要结局是伤后12个月时患者报告的跟腱完全断裂评分。次要结局指标包括提踵功测试、跟腱延长情况及再断裂率。主要分析将采用意向性分析。
本试验是首个在随机试验中研究早期控制踝关节活动治疗急性跟腱断裂安全性和有效性的试验。本研究采用患者报告的结局指标——跟腱完全断裂评分作为主要终点,因为它被认为是肌腱在日常生活中实际功能的最佳替代指标。
ClinicalTrials.gov:NCT02015364。于2013年12月13日注册。