Prospective Use of a Standardized Nonoperative Early Weightbearing Protocol for Achilles Tendon Rupture 17 Years of Experience

Background:Acute traumatic rupture of the Achilles tendon can be treated operatively or nonoperatively. Throughout the literature, there is no consensus regarding the optimal treatment protocol.Purpose:To report on 17 years of experience with treating this injury with a standardized nonoperative treatment protocol.Study Design:Case Series; Level of evidence, 4.Methods:The treatment protocol was based on a combination of an equinus cast and rehabilitation boot, which promoted immediate full weightbearing and early functional rehabilitation. A total of 171 patients were consecutively treated and prospectively followed from 1996 to 2013. Assessed were subjective parameters such as pain, loss of strength, return to previous activity level, meteosensitivity, and general satisfaction with the treatment outcome. Clinical assessment included testing of plantar flexion strength and endurance, calf circumference, and tendon length. Subjective and clinical parameters were then used to calculate a modified Thermann s...