The short-term clinical effects of accelerated rehabilitation following open surgery for acute Achilles tendon rupture based on ultrasonography monitoring: a retrospective cohort study.

Background: Individualized rehabilitation after acute Achilles tendon rupture (AATR) repair is important. The aim of this study was to evaluate and compare the short-term clinical effects of different rehabilitation processes following open surgery for AATR based on ultrasonography (US) monitoring.

Methods: This retrospective cohort study included 80 patients (mean age, 32.0 ± 4.4 years) who underwent open surgery for AATR repair between March 2022 and May 2023. The patients were categorised into two groups (ultrasound-guided rehabilitation group, UR, and conventional rehabilitation group, CR) according to whether postoperative rehabilitation relied on US monitoring. All patients received the same suture technique and immobilisation duration; they were clinically examined at 2, 4, 6, 8, 10, 12, 14, and 16 weeks postoperatively, with a final follow-up at a mean of 18.8 months. The primary outcome was the recovery time for the one-leg heel-rise height (OHRH). Secondary outcomes included the time required to return to range of motion(ROM) and light exercise (LE), the clinical function scores, and complications. Data regarding the surgical duration, the visual analogue scale (VAS) score for pain, the Achilles tendon Total Rupture Score (ATRS), and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale score were also collected.

Results: The recovery times for OHRH (11.6 ± 2.1 vs. 12.1 ± 1.4) and LE (17.2 ± 1.7 vs. 18.3 ± 2.2) were significantly shorter in group UR than in group CR (P < 0.05). The VAS scores decreased over time, reaching 0 in both groups by 10 weeks. ATRS and the AOFAS Ankle-Hindfoot scale score increased across both groups over time, showing significant between-group differences from 4 to 14 weeks(36.2 ± 9.7 vs. 28.4 ± 5.7; 61.0 ± 12.3 vs. 52.2 ± 6.8; 76.1 ± 9.7 vs. 69.7 ± 5.1; 87.2 ± 8.4 vs. 82.1 ± 4.6; 93.8 ± 5.8 vs. 91.6 ± 4.0; 96.7 ± 2.8 vs. 96.1 ± 2.0; P < 0.05) and 4 to 8 weeks (67.6 ± 7.9 vs. 60.1 ± 4.8; 77.8 ± 11.7 vs. 68.9 ± 7.4; 94.9 ± 9.8 vs. 92.9 ± 7.9; P < 0.05). The mean scores were better in group UR than in group CR. Three re-ruptures (3.8%) were observed, and all complications were resolved at the last follow-up, with no significant between-group differences.

Conclusions: Rehabilitation under ultrasonography monitoring may be a promising strategy to optimize early functional recovery after AATR repair for young people with high demands for sports.