Evidence map›Paper›PMID 41243574›Full record

SynthesisAnnals of medicine2025

Operative versus nonoperative management of acute Achilles tendon rupture: a systematic review and meta-analysis of clinical outcomes from randomized controlled trials.

Shenghao Xu, Jianlin Xiao, Yang Li, Enbo Liu, Yanguo Qin, Xianyue Shen

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in Annals of medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Shenghao XuDepartment of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.ORCID 0000-0003-3281-7747
Jianlin XiaoDepartment of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.ORCID 0000-0001-7175-2726
Yang LiDepartment of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.
Enbo LiuDepartment of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.
Yanguo QinDepartment of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China.
Xianyue ShenDepartment of Orthopedics, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.ORCID 0000-0002-3623-201X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe objective of this study was to compare the differences in re-rupture rates, complications, and functional assessments of Achilles tendon ruptures (ATRs) treated operatively or nonoperatively to guide clinical treatment choices.

methodsA literature search was performed in the PubMed, Cochrane Library, and Embase databases up to March 1, 2025, for randomized controlled trials (RCTs) involving patients with ATR receiving operative and nonoperative therapies. Primary outcomes included re-rupture rates, complications, and functional assessment. Meta-analysis of the extracted data was carried out using Review Manager 5.3 and Stata 17.0.

resultsA total of 14 RCTs were included in the meta-analysis, comprising 1,628 participants. The meta-analysis results revealed a considerably lower re-rupture rate in both the minimally invasive (MI) group (risk ratio [RR], 0.28; 95% confidence interval [CI]: 0.11 to 0.74) and the open group (RR, 0.30; 95% CI: 0.19 to 0.50). For complications, subgroup analysis showed no significant difference between the MI and nonoperative groups (RR, 2.40; 95% CI: 0.52 to 10.98), whereas the open group had a higher complication rate (RR, 3.03; 95% CI: 1.75 to 5.26) than nonoperative groups. There was no significant difference in the functional assessment between operative and nonoperative groups. Regarding return to work, the MI group returned to work earlier compared to the nonoperative group.

conclusionOpen operative treatment significantly reduces the rate of re-rupture compared to nonoperative treatment but is accompanied by a higher risk of complications. MI treatment offers both of these advantages, along with superiority in return to work.

Indexed as

Achilles TendonConservative TreatmentTendon InjuriesHumansMinimally Invasive Surgical ProceduresRandomized Controlled Trials as TopicRecurrenceRuptureTreatment OutcomeAchilles tendon ruptureComplicationMeta-analysisNonoperativeOperativeRe-rupture

Identifiers

PMID41243574
PMCPMC12624965

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.