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Clinical outcomes of heel-elevating insole application in the late phase of functional rehabilitation after Achilles tendon rupture
Arthrosc Orthop Sports Med 2020;7:30-34
Published online November 1, 2020;  https://doi.org/10.14517/aosm20012
© 2020 Korean Arthroscopy Society and Korean Orthopedic Society for Sports Medicine.

Jungtae Ahn, Bi O Jeong

Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea
Correspondence to: Bi O Jeong, https://orcid.org/0000-0002-9881-2319
Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, 23 Kyunghee-daero, Dongdaemun-gu, Seoul 02447, Korea. Tel: +82-2-958-9488, Fax: +82-2-964-3865, E-mail: biojeong@khmc.or.kr
Received October 5, 2020; Revised October 20, 2020; Accepted October 27, 2020.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: The optimal treatment for Achilles tendon rupture has long been debated and is still subject to considerable controversy. Tendon elongation occurs during the first 6 months of recovery; during which, re-rupture or elongation of an Achilles tendon that is not fully healed can occur. The current study reports the clinical results of the application of heel-elevating insoles to both feet to prevent tendon elongation in the late phase of the rehabilitation process.
Methods: This study included 14 patients with acute or chronic Achilles tendon rupture who showed tendon elongation in the rehabilitation phase. The mean follow-up duration was 12.9 months, and the mean age of the patients was 45.7 years. Out of 14 cases, 11 had acute rupture and 3 had chronic rupture. Heel-elevating insoles were applied in the 6th month of rehabilitation. The clinical outcomes, including various patient-reported outcome measures, were evaluated.
Results: All patients could perform a single heel raise at the last follow-up. The side-to-side difference in maximal calf circumference was 1.8 ± 1.2 cm. Of 4 cases in which tendon elongation was present in the initial rehabilitation phase in which a brace was worn, 2 (2/14, 14.3%) had persistent elongation at the last follow-up. No wound complications or infections were observed after the surgery. The mean Achilles tendon Total Rupture Score, Foot Function Index, Foot and Ankle Outcome Score, American Orthopaedic Foot and Ankle Society ankle-hindfoot score, and Visual Analogue Scale for pain were 88.7 ± 6.9, 1.6% ± 1.8%, 94.4 ± 4.0, 96.6 ± 4.9, and 0.5 ± 0.5, respectively.
Conclusion: Good clinical results were demonstrated in patients who showed tendon elongation during the rehabilitation phase after Achilles tendon rupture. Heel-elevating insoles were applied in the late phase of the rehabilitation process, and may aid rehabilitation after Achilles tendon rupture.
Keywords : Ankle; Achilles tendon; Rehabilitation; Heel-elevating insole
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November 2020, 7 (2)