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.
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.
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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)
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