Surgical versus functional conservative treatment of acute Achilles tendon rupture

Leodanis Hernández Cabrera, Leodanishernandezcabrera1@gmail.com, Eirina Pernas Cano, Eirinapernas@gmail.com, Gabriela González Pernas, Gabriela20252002@outlook.es, Mariam Alejandra González González and Marian040206@gmail.com

SAP Podiatry, 2026

Abstract: Introduction: Acute Achilles tendon rupture is a common injury whose incidence continues to rise, yet the choice between surgical repair and functional conservative treatment remains unresolved. Methods: Scopus, PubMed, OpenAlex and Crossref were searched for randomized and comparative studies published from 2018 to 2026 that compared surgical repair with conservative treatment of acute Achilles tendon rupture in adults. Results: A total of 973 records were identified and 572 were screened, leaving 12 studies (four randomized trials and eight comparative cohorts) with samples ranging from 18 to 17,996 participants. Re-rupture was consistently lower after surgery (0.6% to 3%) than after conservative treatment (up to 11% to 13%) in most studies, whereas functional scores (ATRS and PROMIS) were comparable between strategies. Surgical treatment carried more wound and sural nerve complications. Conclusions: Surgical repair reduces the risk of re-rupture but does not improve functional recovery and adds surgical complications, so functional conservative treatment is a valid alternative and the choice should be individualized.

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:cwf:podart:pod2026271

DOI: 10.62486/pod2026271

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