Acupuncture-Integrated Chinese-Western Medicine Accelerated Rehabilitation Protocol Following Acute Achilles Tendon Repair: A Prospective Cohort Study.

OBJECTIVE

Postoperative pain and swelling often impede early rehabilitation after Achilles tendon repair. This study aimed to evaluate the clinical efficacy of an acupuncture-integrated Chinese-Western medicine accelerated rehabilitation protocol following acute Achilles tendon rupture repair.

METHODS

We prospectively analyzed 193 patients with acute Achilles tendon rupture treated between May 2022 and November 2023. Participants were stratified into three postoperative rehabilitation groups: accelerated rehabilitation (AR, n = 69), traditional rehabilitation (TR, n = 61), and sham acupuncture (SA, n = 63). All patients underwent identical surgical procedures, with postoperative complications documented. Pain was assessed using the Visual Analog Scale (VAS) at postoperative days 1 and 4, and weeks 1, 2, and 4. Limb swelling was quantified by measuring calf and midfoot circumference differences between affected and unaffected limbs. Functional outcomes were evaluated at 12 weeks using objective measures (one-leg heel-rise height [OHRH] and time [OHRT]) and validated scales (Achilles tendon Total Rupture Score [ATRS], AOFAS ankle-hindfoot score, and Holden Walking Ability Classification [HWAC]). Functional outcomes were evaluated at 12 weeks. Statistical analyses were performed using one-way ANOVA, Kruskal-Wallis H test, χ 2 test, or Fisher's exact test as appropriate, with Bonferroni correction for multiple comparisons.

RESULTS

Compared with the TR group and the SA group, the AR group had lower VAS scores on the 4th day (p < 0.001) and 1 week (p < 0.001) postoperatively, and more obvious reduction of limb swelling on the 4th day (p < 0.001) and 1 week (p < 0.001) postoperatively. At 12 weeks postoperatively, the AR group showed higher OHRH (p < 0.001) and longer OHRT (p < 0.001). There was no statistically significant difference in ATRS scores, AOFAS ankle-hindfoot scores, and HWAC among the three groups at 12 weeks postoperatively.

CONCLUSION

The early adoption of the acupuncture-integrated accelerated rehabilitation strategy after acute Achilles tendon rupture repair can effectively reduce pain and accelerate the resolution of swelling within 1 week after surgery, which facilitates early functional mobilization for patients.

TRIAL REGISTRATION: NCT05957614 (https://www.

CLINICALTRIALS: gov/, registered 15 July 2023).