Treatment Outcome at 1 Year Did Not Differ Between Use of Cast or Walker in the First 3 Weeks after an Acute Achilles Tendon Rupture. A Registry Study of 1304 Patients from the Danish Achilles Tendon Database

Background: The best choice of orthosis in the treatment of acute Achilles tendon rupture is still under debate.Objective: To investigate if choice of orthosis in the first 3 weeks of treatment affected patient reported outcome (Achilles tendon Total Rupture Score (ATRS)), tendon elongation (Achilles Tendon Resting Angle (ATRA) and Heel Rise Height (HRH)) and re-rupture.Methods: Registry study in the Danish Achilles tendon Database. Patients treated with cast and patients treated with walker in the first 3 weeks of treatment were compared using a linear mixed-effects model adjusted for potential confounders. Results: 1304 patients were included in the study. No clinically relevant difference was found: Adjusted mean difference (using walker the whole period as reference)(95% CI) ATRS after 1 year = 0.1(-3.0; 4.1), ATRS after 6 months = 2.0(-4.5; 5.8), ATRS after 2 years = 3.0(-0.7; 7.0), HRH difference = 0.6(-6.6; 8.2), ATRA difference = 0.03 degrees(-1.5; 1.6), re-rupture(odds ratio) = 0.812(0.4; 1.61).Conclusion: Patients treated with cast the first 3 weeks after acute Achilles tendon rupture did not have better treatment outcome than patients treated with walker.(c) 2022 The Author(s). Published by Elsevier Ltd on behalf of European Foot and Ankle Society. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).