Early full weightbearing and functional treatment after surgical repair ofacute Achilles tendon rupture

We prospectively evaluated the clinical outcomes of 20 patients (mean age, 42.8 years) with early full weightbearing and functional treatment after su rgical repair of acute Achilles tendon rupture according to a prospective i ntra- and postoperative protocol. Ail patients underwent open repair using a Kessler-type suture and simple apposition sutures. The postoperative regi men included a plantigrade splint for 24 hours and 6 weeks of early full we ightbearing in a removable walker. All patients were evaluated with clinica l and ultrasound examination and according to a new scoring system at 3, 6, and 12 months after repair. After 3 months, the score averaged 73 of 100 p oints; after 6 months, 86; and after 1 year, 94. All patients reached the s ame level of sports activities as preoperatively and demonstrated no signif icant difference in ankle mobility and isokinetic strength. There were no r eruptures. One patient had a deep venous thrombosis 3 weeks after the opera tion after having prematurely stopped thromboprophylaxis. We believe that e arly careful ankle mobilization and full weightbearing in a removable walke r after primary Achilles tendon repair does not increase the risk of rerupt ure. An accelerated rehabilitation program improves early foot function wit h excellent recovery of plantar flexion strength and amplitude.