Early Functional Treatment Versus Cast Immobilization in Tension After Achilles Rupture Repair Results of a Prospective Randomized Trial With 10 or More Years of Follow-up

Background:There are no long-term prospective controlled trials comparing postoperative regimens after Achilles tendon rupture repair.Purpose:To compare ≥10-year outcomes of 2 postoperative regimens after Achilles tendon rupture repair: early weightbearing with early mobilization versus early weightbearing with early immobilization in tension.Study Design:Randomized controlled trial; Level of evidence, 1.Methods:A total of 50 patients with acute Achilles tendon ruptures were randomized postoperatively to receive either early movement of the ankle between neutral and plantar flexion in a brace for 6 weeks (group 1) or Achilles tendon immobilization in tension using a below-knee cast with the ankle in a neutral position for 6 weeks (group 2). Patients were assessed at 3, 6, and 14 months and 11 years postoperatively.Results:There were 37 patients (74%) evaluated at a mean (±SD) of 11.0 ± 0.9 years. The mean Leppilahti score was 92.9 ± 5.6 in group 1 and 93.6 ± 7.2 in group 2 (P = .68). The mean isokinetic p...