PDF(Pubmed)
Abstract：
BACKGROUND: Chronic Achilles tendon ruptures (CATR) often require surgical intervention to restore function. Despite numerous treatment modalities available, the optimal management strategy remains controversial given the limited high-quality evidence available. This article aims to provide evidence-based guidelines for the surgical management of CATR through a comprehensive systematic review of the available data. The consensus reached by synthesizing the findings will assist clinicians in making informed decisions and improving patient outcomes.
METHODS: A group of 9 foot surgeons in three continents was consulted to gather their expertise on guidelines regarding the surgical management of CATR. Following the proposal of 9 clinical topics, a thorough and comprehensive search of relevant literature published since 1980 was conducted for each topic using electronic databases, including PubMed, MEDLINE, and Cochrane Library, to identify relevant studies published until 1 October 2023. All authors collaborated in drafting, discussing, and finalizing the recommendations and statements. The recommendations were then categorized into two grades: grade a (strong) and grade b (weak), following the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) concept. Additionally, feedback from 21 external specialists, who were independent from the authors, was taken into account to further refine and finalize the clinical guidelines.
RESULTS: Nine statements and guidelines were completed regarding surgical indications, surgical strategies, and postoperative rehabilitation protocol.
CONCLUSIONS: Based on the findings of the systematic review, this guideline provides recommendations for the surgical management of CATR. We are confident that this guideline will serve as a valuable resource for physicians when making decisions regarding the surgical treatment of patients with CATR.
METHODS: A group of 9 foot surgeons in three continents was consulted to gather their expertise on guidelines regarding the surgical management of CATR. Following the proposal of 9 clinical topics, a thorough and comprehensive search of relevant literature published since 1980 was conducted for each topic using electronic databases, including PubMed, MEDLINE, and Cochrane Library, to identify relevant studies published until 1 October 2023. All authors collaborated in drafting, discussing, and finalizing the recommendations and statements. The recommendations were then categorized into two grades: grade a (strong) and grade b (weak), following the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) concept. Additionally, feedback from 21 external specialists, who were independent from the authors, was taken into account to further refine and finalize the clinical guidelines.
RESULTS: Nine statements and guidelines were completed regarding surgical indications, surgical strategies, and postoperative rehabilitation protocol.
CONCLUSIONS: Based on the findings of the systematic review, this guideline provides recommendations for the surgical management of CATR. We are confident that this guideline will serve as a valuable resource for physicians when making decisions regarding the surgical treatment of patients with CATR.
摘要：
背景：慢性跟腱断裂（CATR）通常需要手术干预以恢复功能。尽管有多种治疗方式，鉴于现有的高质量证据有限,最优管理策略仍存在争议.本文旨在通过对现有数据的全面系统回顾，为CATR的手术管理提供循证指南。通过综合研究结果达成的共识将有助于临床医生做出明智的决定并改善患者的预后。
方法：咨询了来自三大洲的9名足外科医生，以收集他们关于CATR外科治疗指南的专业知识。根据9个临床课题的建议，使用电子数据库对1980年以来发表的相关文献进行了全面全面的搜索，包括PubMed,MEDLINE,和Cochrane图书馆,确定直到2023年10月1日发表的相关研究。所有作者都合作起草，讨论,并最终确定建议和声明。然后将建议分为两个等级：a级（强）和b级（弱），按照等级(建议评估的等级，发展,和评估)概念。此外,来自21名外部专家的反馈，独立于作者，考虑到进一步完善和最终确定临床指南。
结果：完成了9项关于手术适应症的声明和指南，手术策略，和术后康复方案。
结论：根据系统综述的结果，本指南为CATR的外科治疗提供了建议.我们相信，该指南将为医生做出有关CATR患者手术治疗的决定提供宝贵的资源。
方法：咨询了来自三大洲的9名足外科医生，以收集他们关于CATR外科治疗指南的专业知识。根据9个临床课题的建议，使用电子数据库对1980年以来发表的相关文献进行了全面全面的搜索，包括PubMed,MEDLINE,和Cochrane图书馆,确定直到2023年10月1日发表的相关研究。所有作者都合作起草，讨论,并最终确定建议和声明。然后将建议分为两个等级：a级（强）和b级（弱），按照等级(建议评估的等级，发展,和评估)概念。此外,来自21名外部专家的反馈，独立于作者，考虑到进一步完善和最终确定临床指南。
结果：完成了9项关于手术适应症的声明和指南，手术策略，和术后康复方案。
结论：根据系统综述的结果，本指南为CATR的外科治疗提供了建议.我们相信，该指南将为医生做出有关CATR患者手术治疗的决定提供宝贵的资源。
