Letter to the Editor

Abstract

Thank you for your letter regarding our recent publication “Results of Accelerated Postoperative Rehabilitation Using Novel ‘Suture Frame’ Repair of Achilles Tendon Rupture” (1Talbot J.C. Williams G.T. Bismil Q. Shaw D.L. Schilders E. Results of accelerated postoperative rehabilitation using novel suture frame repair of Achilles tendon rupture.J Foot Ankle Surg. 2012; 51: 147-151Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar).The timing of this study is crucial to the valid and well presented points you raise. The patients were operated on between April 1999 and July 2004, at which time the biomechanical analyses of suture techniques you quote were not published. We have not formally assessed our suture frame biomechanically but report no cases of re-rupture. We agree with the American Academy of Orthopaedic Surgeons recommendation that accelerated rehabilitation is essential following surgical repair of a ruptured Achilles tendon; however, at the time of the study, accelerated rehabilitation was not commonplace, although it is currently gaining popularity in the UK.In response to the question of clinical scoring, these patients were followed up prior to the publication of the validated Achilles Tendon Total Rupture Score. The American Orthopaedic Foot and Ankle Society and Leppilahti scores, in combination with the Cybex testing, were therefore deemed the most appropriate way of objectively scoring patient outcomes. We agree that the newer validated system may be more appropriate currently.There was a delay from this study being performed and the publication of the work. We remain happy with our postoperative rehabilitation regimen, but we will look further into the possibility of whether a more “aggressive accelerated protocol” can be performed safely.Once again thank you for interest in our work. Thank you for your letter regarding our recent publication “Results of Accelerated Postoperative Rehabilitation Using Novel ‘Suture Frame’ Repair of Achilles Tendon Rupture” (1Talbot J.C. Williams G.T. Bismil Q. Shaw D.L. Schilders E. Results of accelerated postoperative rehabilitation using novel suture frame repair of Achilles tendon rupture.J Foot Ankle Surg. 2012; 51: 147-151Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar). The timing of this study is crucial to the valid and well presented points you raise. The patients were operated on between April 1999 and July 2004, at which time the biomechanical analyses of suture techniques you quote were not published. We have not formally assessed our suture frame biomechanically but report no cases of re-rupture. We agree with the American Academy of Orthopaedic Surgeons recommendation that accelerated rehabilitation is essential following surgical repair of a ruptured Achilles tendon; however, at the time of the study, accelerated rehabilitation was not commonplace, although it is currently gaining popularity in the UK. In response to the question of clinical scoring, these patients were followed up prior to the publication of the validated Achilles Tendon Total Rupture Score. The American Orthopaedic Foot and Ankle Society and Leppilahti scores, in combination with the Cybex testing, were therefore deemed the most appropriate way of objectively scoring patient outcomes. We agree that the newer validated system may be more appropriate currently. There was a delay from this study being performed and the publication of the work. We remain happy with our postoperative rehabilitation regimen, but we will look further into the possibility of whether a more “aggressive accelerated protocol” can be performed safely. Once again thank you for interest in our work.