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16982 Deep vein thrombosis after acute achilles tendon rupture: a randomized controlled trial comparing early controlled motion of the ankle with no motion
Sports Orthopedic Research Center – Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Copenhagen, Denmark
Deep vein thrombosis (DVT) following acute Achilles tendon rupture (ATR) is common (up to 34%) and potentially dangerous. Immobilization is thought to be an important factor in the pathogenesis. It has never been investigated if early controlled ankle motion (ECM) can reduce the incidence of DVT.
Purpose/Aim of the study
To investigate if ECM could reduce the incidence of DVT compared to IM in the treatment of acute Achilles tendon rupture.
Materials and methods
The study was performed as a randomized controlled trial with patients allocated in a 1:1 ratio to one of two parallel groups. Patients aged 18 to 70 years were eligible for inclusion. Treatment was non-operative. The ECM group performed movements of the ankle 5 times a day from week 3 to 8 after rupture. The control group was IM for 8 weeks. Follow up was performed with Color Doppler ultrasound for above and below knee DVT at 2 and 8 weeks by two experienced radiologists. DVT was a secondary outcome, why a secondary power calculation was performed before analyzing the data: 124 patients were required to have a 60% chance of detecting, as significant at the 5% level, a decrease in DVT from 34% in the IM group to 17% in the ECM group.
189 patients were assessed for eligibility from February 2014 to December 2016. 130 were randomized, 69 in the ECM group and 61 in the IM group. All patients participated in the follow up. In total 60 (46%) patients were diagnosed with DVT; 31/69 (45%) in the ECM group and 29/61 (48%) in the IM group (p=0.77).
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