Letter to the Editor: Re-rupture is not the only failure: tendon elongation and the 6-week nonoperative protocol for Achilles tendon rupture

Authors

  • Filippo Spiezia Department of Health Sciences, University of Basilicata, Potenza, Italy; Department of Orthopaedic and Trauma Surgery, Ospedale San Carlo, Potenza, Italy https://orcid.org/0000-0002-3710-7982
  • Francesco Oliva Department of Sports Traumatology, Università Telematica San Raffaele, Rome, Italy
  • Nicola Maffulli Department of Trauma and Orthopaedic Surgery, Faculty of Medicine and Psychology, University La Sapienza, Rome, Italy; Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, UK; School of Pharmacy and Bioengineering, Keele University School of Medicine, Stoke on Trent, UK https://orcid.org/0000-0002-5327-3702

DOI:

https://doi.org/10.2340/17453674.2026.46973

Keywords:

Achilles minimally invasive surgery, Achilles Tendon, Achilles tendon rupture, Conservative management, Foot and ankle

Downloads

Download data is not yet available.

References

Happonen V, Koivisto A, Härkönen A, Kröger H. Nonoperative treatment of Achilles tendon rupture with 6- versus 8-week protocol: a single-center cohort study from Finland. Acta Orthop 2026; 97: 722-6. doi: 10.2340/17453674.2026.46872.

Eliasson P, Agergaard A S, Couppé C, Svensson R, Hoeffner R, Warming S, et al. The ruptured Achilles tendon elongates for 6 months after surgical repair regardless of early or late weightbearing in combination with ankle mobilization: a randomized clinical trial. Am J Sports Med 2018; 46(10): 2492-502. doi: 10.1177/0363546518781826.

Heikkinen J, Lantto I, Piilonen J, Flinkkilä T, Ohtonen P, Siira P, et al. Tendon length, calf muscle atrophy, and strength deficit after acute Achilles tendon rupture: long-term follow-up of patients in a previous study. J Bone Joint Surg Am 2017; 99(18): 1509-15. doi: 10.2106/JBJS.16.01491.

Carmont M R, Grävare Silbernagel K, Brorsson A, Olsson N, Maffulli N, Karlsson J. The Achilles tendon resting angle as an indirect measure of Achilles tendon length following rupture, repair, and rehabilitation. Asia Pac J Sports Med Arthrosc Rehabil Technol 2015; 2(2): 49-55. doi: 10.1016/j.asmart.2014.12.002.

Maffulli N, Gougoulias N, Maffulli G D, Oliva F, Migliorini F. Slowed-down rehabilitation following percutaneous repair of Achilles tendon rupture. Foot Ankle Int 2022; 43(2): 244-52. doi: 10.1177/10711007211038594.

Maffulli N, Spiezia F, Migliorini F, Maffulli G, Oliva F. Walking on the Achilles tendons. Br Med Bull 2026; 157(1): ldag009. doi: 10.1093/bmb/ldag009.

Maffulli N, Migliorini F, Oliva F, Maffulli G, Spiezia F. Percutaneous repair of acute Achilles tendon tears with minimally invasive augmentation with the tendon of flexor hallucis longus: a 5 years outcome study. Br Med Bull 2026; 159(1): ldag018. doi: 10.1093/bmb/ldag018.

Feng S M, Maffulli N, Oliva F, Paul C, Fehske K, Plaass C, et al. Evidence-based clinical practice guidelines on the surgical management of acute Achilles tendon rupture. Br Med Bull 2026; 157(1): ldaf026. doi: 10.1093/bmb/ldaf026.

Downloads

Additional Files

Published

2026-10-19

How to Cite

Spiezia, F., Oliva, F., & Maffulli, N. (2026). Letter to the Editor: Re-rupture is not the only failure: tendon elongation and the 6-week nonoperative protocol for Achilles tendon rupture. Acta Orthopaedica, 97, 740–741. https://doi.org/10.2340/17453674.2026.46973

Issue

Vol. 97 (2026): Acta Orthopaedica

Section

Publications

Categories

License

Copyright (c) 2026 Filippo Spiezia, Francesco Oliva, Nicola Maffulli

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Acta Orthopaedica (Scandinavica) content is available freely online as from volume 1, 1930. The journal owner owns the copyright for all material published until volume 80, 2009. As of June 2009, the journal has however been published fully Open Access, meaning the authors retain copyright to their work. As of June 2009, articles have been published under CC-BY-NC or CC-BY licenses, unless otherwise specified.
 
Crossref
Scopus
Google Scholar
Europe PMC

PlumX (by Elsevier) is an altmetrics platform that tracks and visualizes the online attention, usage, captures, citations, and social media engagement.