Abstract
Background
Conservative treatment of acute AT ruptures with functional rehabilitation has demonstrated superior results with equal reported re-rupture rates but without the added complications of surgical treatment.
There is no consensus on the duration and method of treatment using functional rehabilitation regimes.
The purpose of this paper is to define our treatment regime, the Leicester Achilles Management Protocol (LAMP), supported with patient reported outcomes and objective measures of assessment.
Methods
All patients with an acute achilles tendon rupture were treated with the same non-operative LAMP functional rehabilitation regime in a VACOped boot for 8 weeks. 12 months post rupture ATRS scores and objective measures of calf muscle girth and heel raise height were obtained and analysed. Venous thromboembolic rates and rates of re-rupture were recorded.
Results
442 patients were treated with this regime between February 2011 and December 2015. The incidence of a thromboembolic event was 5.9% and a re-rupture rate of 2%.
The ATRS score at 12 months was available in 200 patients. Objective measures were available in 50 patients. The average age was 50 years (range 21–82). The average ATRS score was 75.3 (SD 22, 95% CI 72.2 – 78.4) at an average follow up of 25 months post injury. Men had better ATRS than women (P< 0.05). The calf muscle girth and heel raise height were significantly different from the uninjured side. However, these did not correlate with the ATRS (P>0.05)
Conclusions
The LAMP is a simple effective regime which is very easy to adopt and involves a VACOped boot for 8 weeks. Compared to other studies, the overall time in the boot is less with similar patient reported outcomes.
Implications
Simple non-operative functional rehabilitation regime that can be applied to ALL patients with acute achilles tendon ruptures.
