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Achilles tendon tears may not need surgery

A recent publication in the BMJ indicates that surgery and immobilisation have similar outcomes on Achilles tendon tears. The review examined 29 studies with a total of 15,862 patients. The authors report that risk of re-rupture following surgery was 2.3%, whereas risk of re-rupture following immobilisation with specialised boot or cast was only slightly higher at 3.9%. Additionally, the risk of adverse events was higher following surgery (around 4.9% compared to 1.6% in conservative approaches) and included infection, nerve injury, deep vein thrombosis, and pulmonary embolism.

However, there are some further nuances. Some of the studies reviewed were from as long ago as the 1960s, several different surgical approaches were included, and the severity of the Achilles tears was not recorded.

The full paper is available online at