Is nonoperative treatment effective for acute Achilles tendon rupture?
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Q: Is nonoperative treatment effective for acute Achilles tendon rupture? Evidence-based answer: YES. Nonoperative and open surgical interventions provide equal long-term functional outcomes of the affected Achilles tendon and ankle (strength of recommendation [SOR], A; based on 2 meta-analyses and a separate randomized controlled trial [RCT]). Although nonoperative management is associated with increased risk of re-rupture, it confers lower risk for complications including wound infection and nerve injury (SOR, A; based on meta-analysis and separate RCT). Select individuals—high-performing athletes or those who otherwise require near-baseline strength and function of their Achilles tendon—would likely benefit from surgical intervention (SOR, A; based on meta-analysis and consensus recommendations). Patients with comorbid conditions that would put them at greater risk for postoperative complications should be advised to consider nonoperative treatment of acute Achilles tendon rupture (SOR, C; based on consensus opinion).
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