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Researchers recommend early walking in brace for Achilles tendon rupture

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A new study comparing two different methods of treating rupture of the Achilles tendon has found that early walking in a brace provides similar outcomes to plaster casting with no increase in the risk of complications.

The findings represent a “breakthrough” for sportsmen and women in the treatment of Achilles tendon rupture, the researchers say.

Rupture of the Achilles tendon affects more than 11,000 people each year from both the sporting and non-sporting populations of the UK. Some patients are treated with surgery, while those who have non-operative treatment are given either a plaster cast to immobilise the foot and ankle or functional bracing that allows weight-bearing. Before this study there was little evidence to show which was more effective.

The UKSTAR trial included 540 patients from 39 UK hospitals, with participants randomly assigned to treatment with plaster cast or functional brace. The objective was to compare function and pain, quality of life, complications including re-rupture, and resource use in patients having non-operative treatment. The study found no difference between the patient-reported Achilles Tendon Rupture Score (ATRS) at nine months, or in the rate of re-rupture of the tendon.

Funding for the study came from the National Institute for Health Research (NIHR) and it involved universities and hospitals across the UK including the University of Oxford and University of Warwick.

“This research is particularly important for sportsmen and women of all levels and abilities,” said Matthew Costa, Professor of Orthopaedic Trauma Surgery at the University of Oxford’s Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS).

“Achilles tendon rupture keeps people away from sport for many months. For some, it stops them ever returning to their favourite recreational activities, and for professional athletes it can be a career-ending injury. Immediate mobilisation in a brace is a safe alternative to plaster casting after an Achilles rupture and patients report better early outcomes, probably because the brace allows them to walk earlier than the cast.”

The results from the trial have been published in The Lancet.