• Wenli Dai, Xi Leng, Jian Wang, Xiaoqing Hu, and Yingfang Ao.
• Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, People's Republic of China.
• J Sci Med Sport. 2021 Jun 1; 24 (6): 536-543.

ObjectivesTo compare re-rupture rate, functional and quality-of-life outcomes, return to sports and work, complications, and resource use in patients treated non-surgically with different rehabilitation regimens for Achilles tendon rupture.DesignSystematic review and meta-analysis.MethodsWe performed a systematic literature search in PubMed, Embase, Scopus and the Cochrane Library through May 2020 to identify randomized controlled trials (RCTs) that included patients treated non-surgically for Achilles tendon rupture. All analyses were stratified according to rehabilitation protocols.ResultsEight RCTs with a total of 978 patients were included. There was no significant difference about re-rupture rate (P=0.38), return to sports (P=0.85) and work (P=0.33), functional outcome (P=0.34), quality of life (P=0.50), and complication rate (P=0.29) between early weight bearing with functional ankle motion and traditional ankle immobilisation with non-weight bearing. Similarly, no significant difference in re-rupture rate (P=0.88), return to sports (P=0.45) and work (P=0.20), functional outcome (P=0.26), and complication rate (P=0.49) was seen between ankle immobilisation with non-weight bearing and early weight bearing without functional ankle motion.ConclusionsTraditional ankle immobilisation with non-weight bearing was not found to be superior to early weight bearing with or without functional ankle motion for patients treated non-surgically for Achilles tendon rupture. Clinicians may consider early weight bearing in functional brace as a safe and cost-effective alternative to non-weight bearing with plaster casting.Copyright © 2020 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

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