Evidence map›Paper›PMID 41281104›Full record

ReviewCureus2025

Optimizing Venous Thromboembolism Prophylaxis in Achilles Tendon Rupture: A Systematic Review of Current Evidence and Protocol Recommendations.

Mohamed Hashem, Mohamed Elbeshbeshy, Mohamed Khalafallah, Yousif A Othman, Ahmed Al-Saqili, Ahmed A Ghobashy

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Mohamed HashemOrthopaedics, Frimley Health NHS Foundation Trust, London, GBR.
Mohamed ElbeshbeshyTrauma and Orthopaedics, Wirral University Teaching Hospital, Wirral, GBR.
Mohamed KhalafallahMedicine, Faculty of Medicine, Alexandria University, Alexandria, EGY.
Yousif A OthmanTrauma and Orthopaedics, Faculty of Medicine, Fayoum University, Fayoum, EGY.
Ahmed Al-SaqiliTrauma and Orthopaedics, Faculty of Medicine, Alexandria University, Alexandria, EGY.
Ahmed A GhobashyTrauma and Orthopaedics, Faculty of Medicine, Alexandria University, Alexandria, EGY.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The Achilles tendon plays a vital role in maintaining normal gait and locomotion. The incidence of Achilles tendon rupture (ATR) has been increasing, mainly due to the rising popularity of recreational sports. This review assesses anticoagulation efficacy in preventing venous thromboembolism (VTEs) during ATR treatment and aims to establish an evidence-based prophylaxis protocol. Initially, a comprehensive search across PubMed, Scopus, Web of Science (WoS), and the Cochrane Library databases, and the citation analysis identified studies on VTE prophylaxis in patients with acute or chronic ATR. We summarized results qualitatively, focusing on VTE prevention, complications, and clinical outcomes while considering study quality, bias, and confounders in our analysis. Eight studies, involving 1199 patients with ATR, were analyzed for the efficacy of various VTE prophylaxis strategies. Risk stratification using validated tools, such as the Thrombosis Risk Prediction Following Cast Immobilization (TRiP(cast)) score, was consistently advocated. High-risk patients benefited substantially from pharmacological prophylaxis, typically low molecular weight heparin (LMWH) or rivaroxaban, for a minimum duration of 28 days. In contrast, patients assessed as low-risk effectively managed VTE risks through early mobilization, with supplementary mechanical prophylaxis when indicated. The importance of individualized monitoring for VTE symptoms, bleeding complications, and patient adherence was also highlighted, particularly addressing obesity, prior VTE episodes, pregnancy, and the type of surgical intervention. The findings from this review advocate for an individualized approach to VTE prophylaxis in Achilles tendon rupture patients. Employing structured risk assessments using validated tools, e.g., TRiP(cast) score, ensures targeted and effective prophylactic interventions, significantly reducing complications. Pharmacological prophylaxis (LMWH or rivaroxaban) is indicated in high-risk patients; however, its benefit in low-risk patients remains uncertain and inconsistently demonstrated across studies. In these patients, early mobilization, patient education, and mechanical prophylaxis may offer a safe alternative. Further high-quality, long-term studies are needed to optimize prophylaxis duration and refine patient-specific protocols, especially in low-risk patients, ultimately improving patient outcomes and safety in clinical practice.

Indexed as

achilles tendon injuryachilles tendon rupturesdeep vein thrombosis (dvt)venous thromboembolism (vte)vte prophylaxis

Identifiers

PMID41281104
PMCPMC12638070

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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.