THE EFFECTIVENESS OF SURGICAL VERSUS CONSERVATIVE TREATMENT FOR ACUTE ACHILLES TENDON RUPTURE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Purpose: To compare the outcomes of surgical versus conservative treatment for acute Achilles tendon rupture (ATR).
Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) and cohort studies comparing surgical and conservative treatment for ATR was conducted. The primary outcomes were re-rupture rates, complications, and functional outcomes. Data were extracted from selected studies and analyzed using RevMan 5.4 software.
Results: A total of 15 studies (10 RCTs and 5 cohort studies) involving 2,457 patients were included. Surgical treatment significantly reduced the risk of re-rupture (RR 0.44, 95% CI 0.25-0.76, p=0.003) compared to conservative treatment. However, surgical treatment was associated with a higher complication rate (RR 1.89, 95% CI 1.28-2.79, p=0.001). No significant difference was found in functional outcomes measured by the Achilles Tendon Total Rupture Score (ATRS) between the two groups.
Conclusion: Surgical treatment for ATR reduces the risk of re-rupture but increases the risk of complications. Both treatment methods result in comparable functional outcomes. Further high-quality RCTs are required to refine treatment guidelines.