Effect of Early Versus Late Weightbearing in Conservatively Treated Acute Achilles Tendon Rupture: A Meta-Analysis

Ali Imad El-Akkawi, Rajzan Joanroy, Kristoffer Weisskirchner Barfod, Thomas Kallemose, Søren Skydt Kristensen, Bjarke Viberg

Research output: Contribution to journalJournal articleResearchpeer-review


Achilles tendon ruptures can be either surgically or conservatively treated with either early functional mobilization or cast immobilization. The purpose of the present study was to conduct a meta-analysis comparing the effect of early versus late weightbearing in conservatively treated adult patients, including only randomized controlled trials (RCTs). The primary endpoint was rerupture, and the secondary endpoints were strength, quality of life during treatment, range of motion, deep venous thrombosis, return to sports, and return to work. The search for studies was conducted using PubMed, EMBASE, and the Cochrane Central Register of Controlled trials. A search was performed, and 2 reviewers independently screened the studies by title, abstract, and, finally, by reading the full text. Four studies met the inclusion criteria. The reference lists of the included studies were scanned and 1 additional RCT study was included. The critical appraisal skills program checklist was applied for study appraisal. A statistician performed the data management and analysis. No statistically significant differences were found between the 2 treatment groups concerning rerupture (p = .796), return to sports (p = .455), or return to work (p = .888). One RCT found 1 case of deep venous thrombosis in the late weightbearing group. One RCT reported significant improvement in quality of life and one reported a significantly improved range of dorsiflexion in the early weightbearing group. No statistically significant difference was found between early and late weightbearing with conservative treatment regarding the rerupture rate. The results of the other outcomes were limited by the low number of studies included in the present meta-analysis. Larger randomized studies are needed to investigate these outcomes. From the results in the present study, we would recommend early weightbearing when an Achilles tendon rupture is treated conservatively.

Original languageEnglish
JournalThe Journal of Foot & Ankle Surgery
Issue number2
Pages (from-to)346-352
Publication statusPublished - 5. Oct 2017


  • Journal Article
  • Review
  • rehabilitation
  • weightbearing
  • conservative treatment
  • meta-analysis
  • systematic review
  • Achilles Tendon/injuries
  • Prognosis
  • Humans
  • Male
  • Tendon Injuries/diagnosis
  • Return to Work
  • Injury Severity Score
  • Time Factors
  • Adult
  • Female
  • Acute Disease
  • Treatment Outcome
  • Rupture/therapy
  • Randomized Controlled Trials as Topic
  • Conservative Treatment/methods
  • Return to Sport
  • Denmark
  • Weight-Bearing

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