• Jiasharete Jielile, Ayinazi Badalihan, Bayixiati Qianman, Tuerde Satewalede, Jianati Wuerliebieke, Mailamuguli Kelamu, and Ayidaer Jialihasi.
• Department of Orthopaedics Centre, First Teaching Hospital of Xinjiang Medical University, Sports Medicine Research Centre of Orthopaedics Research Institute, and Kazakh Traditional Medical Association of Xinjiang, No. 137 Liyushan South Road, Urumqi, 830054, Xinjiang Uygur Autonomous Region, China.
• Knee Surg Sports Traumatol Arthrosc. 2016 Jul 1; 24 (7): 2148-55.

PurposeTreatment of neglected Achilles tendon rupture is very challenging. This randomized study aimed to compare the clinical outcome of early post-operative rehabilitation (EPR) with post-operative cast immobilization (PCI).MethodsFifty-seven patients with neglected Achilles tendon rupture were randomized to receive EPR (n = 26) or PCI (n = 31) management following surgery. Clinical outcome was monitored by follow-up at weeks 8, 12, 18 and 26 and year 2. The significance of intergroup differences from the Leppilahti scoring system (LSS), ultrasonography, multislice spiral computerized tomography (MSCT) and electromyography was assessed.ResultsUltrasonography and MSCT revealed no occurrence of tendon elongation or adhesion. Four patients could perform sustained single-leg heel-raise exercise for 60 s at post-operative day 40. The PCI group also showed increased post-operative LSS score, but recovery was slower. Post-operative complications, such as ankle joint ankylosis and osteoporosis, only occurred in the PCI group.ConclusionsCompared with cast immobilization, early post-operative rehabilitation results in better clinical outcome and faster overall tendon regeneration of neglected Achilles tendon rupture.Level Of EvidenceII.

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