This 2009 AAOS clinical practice guideline systematically reviews literature from 1966–2009 to answer how acute Achilles tendon ruptures should be diagnosed and treated. It evaluates 16 clinical questions spanning diagnosis, surgical vs. nonsurgical management, surgical technique selection, and postoperative rehabilitation protocols.
When managing acute Achilles rupture, default to early protected weight bearing with a dorsiflexion-limiting device by 2 weeks postop — this is the most evidence-supported recommendation and accelerates recovery without sacrificing long-term outcomes.
When counseling higher-risk patients (diabetes, obesity, peripheral vascular disease, age >65, tobacco use), the guideline favors leaning toward nonsurgical management given consensus-level concern for wound healing complications with surgery.
This 2009 AAOS clinical practice guideline systematically reviews literature from 1966–2009 to answer how acute Achilles tendon ruptures should be diagnosed and treated. It evaluates 16 clinical questions spanning diagnosis, surgical vs. nonsurgical management, surgical technique selection, and postoperative rehabilitation protocols.
When managing acute Achilles rupture, default to early protected weight bearing with a dorsiflexion-limiting device by 2 weeks postop — this is the most evidence-supported recommendation and accelerates recovery without sacrificing long-term outcomes.
When counseling higher-risk patients (diabetes, obesity, peripheral vascular disease, age >65, tobacco use), the guideline favors leaning toward nonsurgical management given consensus-level concern for wound healing complications with surgery.