Foot (Edinburgh, Scotland) · 2026
A systematic review of orthotic devices for conservative management of achilles tendon rupture in adults.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Zamani Rohid, Cooper Regan, Haq Ibrahim Inzarul, Ananthaligam Sweatha, Grela Michal, Dasari Kishore
Аннотация
BACKGROUND: The conservative management of Achilles tendon rupture (ATR) commonly utilises various orthotic devices to facilitate healing alongside functional rehabilitation protocols. However, comparative evidence regarding functional outcomes, complication rates, re-rupture rates and return to pre-injury status between individual orthoses remains limited. The aim of this systematic review was to assess which orthotic device yielded the best results for these categories.
METHODS: We performed a systematic review of 14 studies including 2011 patients treated non-operatively for ATR with five orthotic device categories: VACOped®, Ossur Boot/Fixed Angle Walking Wedge (FAWW), Mixed, Foam Walker/Aircast, and Other. Outcomes included demographic data and patient reported outcome measures. Specifically, Achilles Tendon Total Rupture Score (ATRS) at < 6 and > 12 months, complication and re-rupture rates, and time to return to pre-injury function.
RESULTS: Mean patient age ranged from 40.7 to 49.8 years. ATRS was the only patient-reported functional outcome reported with sufficient consistency for grouped comparison. Complications, re-rupture, and return to pre-injury status were analysed on an outcome-specific descriptive basis. ATRS scores showed no statistically significant differences between boot types at both < 6 and > 12 months follow-up. Complication rates varied significantly (p < 0.0001), with Mixed (31.2%) and Ossur/FAWW (19.5%) groups exhibiting the highest rates, while VACOped® (5.75%) and Foam Walker (4.4%) had the lowest. Re-rupture rates ranged from 3.05% (VACOped®) to 12.5% (Other) without significant intergroup differences. Return to pre-injury function times varied widely (13.8-40 weeks), with no statistically significant differences.
CONCLUSION: Orthotic device selection influences complication risk but not long-term functional outcomes in non-operative ATR treatment. VACOped® and Foam Walker/Aircast were associated with more favourable descriptive outcome profiles; however, findings should be interpreted cautiously given the heterogeneity of included studies and the absence of formal meta-analytic effect estimation. Further prospective, standardised research is required to confirm these findings and inform evidence-based orthotic selection in Achilles tendon rehabilitation.
METHODS: We performed a systematic review of 14 studies including 2011 patients treated non-operatively for ATR with five orthotic device categories: VACOped®, Ossur Boot/Fixed Angle Walking Wedge (FAWW), Mixed, Foam Walker/Aircast, and Other. Outcomes included demographic data and patient reported outcome measures. Specifically, Achilles Tendon Total Rupture Score (ATRS) at < 6 and > 12 months, complication and re-rupture rates, and time to return to pre-injury function.
RESULTS: Mean patient age ranged from 40.7 to 49.8 years. ATRS was the only patient-reported functional outcome reported with sufficient consistency for grouped comparison. Complications, re-rupture, and return to pre-injury status were analysed on an outcome-specific descriptive basis. ATRS scores showed no statistically significant differences between boot types at both < 6 and > 12 months follow-up. Complication rates varied significantly (p < 0.0001), with Mixed (31.2%) and Ossur/FAWW (19.5%) groups exhibiting the highest rates, while VACOped® (5.75%) and Foam Walker (4.4%) had the lowest. Re-rupture rates ranged from 3.05% (VACOped®) to 12.5% (Other) without significant intergroup differences. Return to pre-injury function times varied widely (13.8-40 weeks), with no statistically significant differences.
CONCLUSION: Orthotic device selection influences complication risk but not long-term functional outcomes in non-operative ATR treatment. VACOped® and Foam Walker/Aircast were associated with more favourable descriptive outcome profiles; however, findings should be interpreted cautiously given the heterogeneity of included studies and the absence of formal meta-analytic effect estimation. Further prospective, standardised research is required to confirm these findings and inform evidence-based orthotic selection in Achilles tendon rehabilitation.