The Effect Of Continuous Passive Motion After Repair Of Achilles Tendon Ruptures
Kadir Ertem*, Nurzat Elmalı*, Muharrem İnan*, Ahmet Harma*, İrfan Ayan*, Mustafa Karakaplan*.
Aims: Traditional treatment of surgically repaired achilles tendons includes complete immobilization of the joint in rigid casts for 8 to 10 weeks. It is well-known that immobilization has a detrimental effect on tendon healing. The aim of this study was to determine the beneficial effect of limited immobilization and early passive motion on both macroscopical and histological recovery following repair of disected Achilles tendons in rabbits. Material and Methods: In 20 adult rabbits after their achilles tendons were surgically transected, we repaired them with modified Kessler technique. The second 10 rabbits were also held in cast immobilization, but in the postoperative second day their bi-valve casts were removed, and the rabbits were led to the Continuous Passive Motion device for 4 hours each day for 6 weeks. All the animals were kept in cast immoblization in cage. All rabbits were sacrified at the end of 6 weeks and their healed tendon tissue were examined according to macroscopical and histological aspects.
Results:On macroscopical evaluation, adhesions in the operation area, periarticular atrophy, and the ROM of the ankle joint were better in CPM group than the immobilized group. On histological evaluation, we found 70% regular collagen bundle alignment in CPM group, compared to 20% in immobilized group. The results on hyalinization and inflamatory infiltration were not significantly different in either group.
Conclusion:On the basis of the results of this investigation, following achilles tendon repair the utilization of continous controlled passive motion has benifical effects on tendon healing.
Key words: Achilles Tendon, Rupture, Repair, immobilization, Continous Passive Motion