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Foot & Ankle Specialist
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Recovery of Calf Muscle Strength Following Acute Achilles Tendon Rupture Treatment

A Comparison Between Minimally Invasive Surgery and Conservative Treatment

Roderik Metz, MD, PhD

Department of Surgery, Diakonessenhuis Utrecht, Utrecht, the Netherlands, metz_r{at}hotmail.com

Geert J. M. G. van der Heijden, MD, PhD

Julius Center for Health Sciences and Primary Care, Utrecht, the Netherlands

Egbert-Jan M. M. Verleisdonk, MD, PhD

Department of Surgery, Diakonessenhuis Utrecht, Utrecht, the Netherlands

Rob Tamminga

Medicort, Centre for Sportfysiotherapie, Utrecht, the Netherlands

Christiaan van der Werken, MD, PhD

Department of Surgerym University Medical Center Utrecht, Utrecht, the Netherlands

The aim of this study was to measure the effect of treatment of acute Achilles tendon ruptures on calf muscle strength recovery. Eighty-three patients with acute Achilles tendon rupture were randomly allocated to either minimally invasive surgery with functional after-treatment or conservative treatment by functional bracing. Calf muscle strength using isokinetic testing was evaluated at 3 months and after 6 or more months posttreatment. To exclusively investigate the effect of treatment on outcome, the authors excluded patients with major complications from the analysis. In 31 of 39 patients in the surgical treatment group and 25 of 34 patients in the conservative treatment group, isokinetic strength tests were performed. In the analysis of differences in mean peak torque, no statistically significant differences were found between surgery and conservative treatment, except for plantar flexion strength at 90 degrees per second at the second measurement, favoring conservative treatment. After 8 to 10 months follow- up, loss of plantar flexion strength was still present in the injured leg in both treatment groups. In conclusion, isokinetic muscle strength testing did not detect a statistically significant difference between minimally invasive surgical treatment with functional after-treatment and conservative treatment by functional bracing of acute Achilles tendon ruptures.

Key Words: isokinetic • Achilles tendon • rupture • recovery

This version was published on October 1, 2009

Foot & Ankle Specialist, Vol. 2, No. 5, 219-226 (2009)
DOI: 10.1177/1938640009348338
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