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They have lower patient satisfaction scores
4%
112/2603
They are less likely to return to sport
115/2603
Their ultimate strength is decreased
14%
353/2603
They have a higher risk for rerupture
75%
1943/2603
They have a higher risk of skin problems
3%
70/2603
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This is a classic tested topic for which the answer has been a higher risk of rerupture in the traditional conservative method as compared to operative management or the newer progressive rehab protocols, including early controlled motion. Weber et al retrospectively compared the results of nonoperative and operative management of Achilles tendon ruptures. They found that patient satisfaction, return to sports, and ultimate strength was the same for both groups. The complication rate was similar except for reruptures, with more occurring in the nonoperative treated group versus the operatively treated group. Khan et al conducted a meta-analysis of randomized controlled trials and they found that open operative treatment of acute Achilles tendon ruptures significantly reduces the risk of rerupture compared with nonoperative treatment, but operative treatment is associated with a significantly higher risk of other complications. A more recent randomized study by Willits et al showed no statistical difference in rerupture rates, which has created new controversy on this subject. The Willits et al nonoperative protocol included early ROM and weightbearing compared to earlier protocols which included prolonged immobilization and limited weightbearing.
2.0
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