About this trial
Acute Achilles tendon rupture (ATR) is an injury that is commonly associated with complications, such as blood clotting, muscle loss and tendon lengthening, all of which affect the long-term outcome and return to sports. These complication are related to the treatment of ATR with lower leg immobilization in a boot.
The investigators aim to demonstrate that an intervention with calf neuromuscular electrical stimulation (C-NMES) during leg immobilization after ATR can 1) reduce blood clots, 2) lower the degree of muscle loss, 3) decrease tendon lengthening and 4) improve long-term outcome.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Diagnosed with acute unilateral Achilles tendon rupture
Included within 10 days after injury.
Disqualifiers
Inability to give consent to participate,
ongoing treatment with anticoagulants,
known allergy to contrast agents,
planned follow-up at another hospital,
Trial design
Parallel
Treatments tested in this trial
Neuromuscular Electrical Stimulation
DevicePatients will be instructed to apply the wearable NMES-therapy continuously, both day and night at least 10h/daily.
Treatment groups
Trial outcomes
Primary outcomes
Incidence of Venous thromboembolic events (VTE)
VTE, is defined as symptomatic/ asymptomatic DVT assessed at the end of immobilization, i.e. 8 weeks, by compression duplex ultrasound (CDU) screening, or symptomatic pulmonary embolism detected by computer tomography. Assessors of CDU will be skilled ultrasonographists, masked to the treatment allocation. The CDU-examination will document absence/presence of thrombus in the calf, popliteal and femoral veins separately
Secondary outcomes
Patient function
Functional evaluation of healing will be performed by the validated heel-rise test at one-year post-injury.
Callus production
Callus production will be assessed at eight weeks using microdialysis followed by quantification of procollagens for tendon healing.
Treatment adherence
Treatment adherence to allocated treatment, NMES, will be registered by the patient and by the device.
Adverse events
Adverse events that will be registered are 1) Any damage to the skin of the legs including infection. 2) Any reasons for prematurely stopping the NMES. 3) Any fall associated with significant injury occurring within 6 weeks of enrollment. The frequency of the adverse events of each group will be presented.
Locations
Sponsors and contacts
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Karolinska University Hospital
Lead sponsor
Danderyd Hospital
Collaborator
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