Document Type
Article
Publication Date
5-2-2023
Abstract
OBJECTIVE: To compare the rerupture rate after conservative treatment, open repair, and minimally invasive surgery management of acute Achilles tendon ruptures.
DESIGN: Systematic review and network meta-analysis.
DATA SOURCES: We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials from inception to August 2022.
METHODS: Randomised controlled trials involving different treatments for Achilles tendon rupture were included. The primary outcome was rerupture. Bayesian network meta-analysis with random effects was used to assess pooled relative risks (RRs) and 95% confidence intervals. We evaluated the heterogeneity and publication bias.
RESULTS: Thirteen trials with 1465 patients were included. In direct comparison, there was no difference between open repair and minimally invasive surgery for rerupture rate (RR, 0.72, 95% CI 0.10-4.4; I2 = 0%; Table 2). Compared to the conservative treatment, the RR was 0.27 (95% CI 0.10-0.62, I2 = 0%) for open repair and 0.14 (95% CI 0.01-0.88, I2 = 0%) for minimally invasive surgery. The network meta-analysis had obtained the similar results as the direct comparison.
CONCLUSION: Both open repair and minimally invasive surgery were associated with a significant reduction in rerupture rate compared with conservative management, but no difference in rerupture rate was found comparing open repair and minimally invasive surgery.
Recommended Citation
Deng, Haidong; Cheng, Xin; Yang, Yi; Fang, Fang; He, Jialing; Tian, Yixin; Li, Tiangui; Xiao, Yangchun; Feng, Yuning; Wang, Peng; Chong, Weelic; Hai, Yang; and Zhang, Yu, "Rerupture Outcome of Conservative Versus Open Repair Versus Minimally Invasive Repair of Acute Achilles Tendon Ruptures: A Systematic Review and Meta-Analysis" (2023). Department of Medicine Faculty Papers. Paper 412.
https://jdc.jefferson.edu/medfp/412
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Analysis of heterogeneity for rerupture rate.docx (20 kB)
Forest plot of re-rupture rate in network meta-analysis of achilles tendon ruptures.tif (90 kB)
Brooks–Gelman–Rubin plots.tif (195 kB)
Node-splitting analysis of inconsistency for the wound infection.tif (163 kB)
Node-splitting analysis of inconsistency for the deep vein thrombosis.tif (208 kB)
Node-splitting analysis of inconsistency for the sural nerve injury.tif (154 kB)
Risk of bias summary.tif (1028 kB)
Risk of bias graph.tif (204 kB)
PRISMA NMA checklist of items to include when reporting a systematic review involving a network meta-analysis.docx (161 kB)
PRISMA 2020 checklist.docx (32 kB)
PubMed ID
37130120
Language
English
Comments
This article is the author's final published version in PLoS One, Volume 18, Issue 5, May 2023, Article number e0285046.
The published version is available at https://doi.org/10.1371/journal.pone.0285046.
Copyright © 2023 Deng et al
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.