{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:00:54Z","timestamp":1792429254521,"version":"4.5.0"},"reference-count":15,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ActaO"],"abstract":"<jats:p>Background and purpose:\u00a0Although nonoperative treatment of Achilles tendon rupture (ATR) has become increasingly common, the optimal duration of immobilization and early functional rehabilitation remains uncertain. We aimed to compare outcomes of 8-week and 6-week nonoperative treatment protocols for ATR, with particular focus on re-rupture rates and treatment failure requiring surgery.Methods:\u00a0This register study included all university hospital-treated ATRs in the Northern Savo region, Finland, between 2014 and 2023. Patients were identified using ICD-10 and NOMESCO procedure codes. We compared outcomes between an 8-week nonoperative treatment protocol used in 2014\u20132018 and a 6-week protocol used in 2019\u20132023. Outcomes included patient demographics, treatment distribution, indications for surgery, and complications.Results:\u00a0Among 479 ATRs, 429\/479 (90%) were treated nonoperatively. Operative treatment was mainly done in athletes. Operative treatment was performed in 32\/251 (13%) patients in the 8-week protocol group and in 18\/228 (7.9%) patients in the 6-week protocol group. Re-rupture rates were similar between the 8-week and 6-week protocols (7\/251 [2.8%] vs 4\/228 [1.8%] absolute risk difference \u22121.0 percentage point, 95% confidence interval \u22123.7 to 1.6). Operative treatment was mainly indicated for athletes, chronic ruptures, and re-ruptures, with a postoperative complication rate of 14%.Conclusion:\u00a0Outcomes regarding re-rupture and treatment failure following the 6-week nonoperative protocol were comparable to those observed with the 8-week protocol However, larger comparative studies in more diverse populations are needed to confirm the generalizability of these findings.<\/jats:p>","DOI":"10.2340\/17453674.2026.46872","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:40:29Z","timestamp":1790754029000},"source":"Crossref","is-referenced-by-count":2,"title":["Nonoperative treatment of Achilles tendon rupture with 6- versus 8-week protocol: a single-center cohort study from Finland"],"prefix":"10.2340","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7039-4071","authenticated-orcid":false,"given":"Ville","family":"Happonen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anu","family":"Koivisto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anssi","family":"H\u00e4rk\u00f6nen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heikki","family":"Kr\u00f6ger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"169709","doi-asserted-by":"crossref","unstructured":"Leino O, Keskinen H, Laaksonen I, M\u00e4kel\u00e4 K, L\u00f6yttyniemi E, Ekman E. Incidence and treatment trends of Achilles tendon ruptures in Finland: a nationwide study. Orthop J Sports Med 2022; 10(11): 23259671221131536. doi: 10.1177\/23259671221131536.","DOI":"10.1177\/23259671221131536"},{"key":"169710","doi-asserted-by":"crossref","unstructured":"Ho G, Tantigate D, Kirschenbaum J, Greisberg J K, Vosseller J T. Increasing age in Achilles rupture patients over time. Injury 2017; 48(7): 1701-9. doi: 10.1016\/j.injury.2017.04.007.","DOI":"10.1016\/j.injury.2017.04.007"},{"key":"169711","doi-asserted-by":"crossref","unstructured":"Gianakos A L, Hartman H, Kerkhoffs G M M J, Calder J, Kennedy J G. Sex differences in biomechanical properties of the Achilles tendon may predispose men to higher risk of injury: a systematic review. J ISAKOS 2024; 9(2): 184-91. doi: 10.1016\/j.jisako.2023.11.001.","DOI":"10.1016\/j.jisako.2023.11.001"},{"key":"169712","doi-asserted-by":"crossref","unstructured":"Ganestam A, Kallemose T, Troelsen A, Barfod K W. Increasing incidence of acute Achilles tendon rupture and a noticeable decline in surgical treatment from 1994 to 2013: a nationwide registry study of 33,160 patients. Knee Surg Sports Traumatol Arthrosc 2016; 24(12): 3730-7. doi: 10.1007\/s00167-015-3544-5.","DOI":"10.1007\/s00167-015-3544-5"},{"key":"169713","doi-asserted-by":"crossref","unstructured":"Svedman S, Marcano A, Ackermann P W, Fell\u00e4nder-Tsai L, Berg H E. Acute Achilles tendon ruptures between 2002\u20132021: sustained increased incidence, surgical decline and prolonged delay to surgery\u2014a nationwide study of 53 688 ruptures in Sweden. BMJ Open Sport Exerc Med 2024; 10(3): e001960. doi: 10.1136\/bmjsem-2024-001960.","DOI":"10.1136\/bmjsem-2024-001960"},{"key":"169714","doi-asserted-by":"crossref","unstructured":"Huttunen TT, Kannus P, Rolf C, Fell\u00e4nder-Tsai L, Mattila V M. Acute Achilles tendon ruptures: incidence of injury and surgery in Sweden between 2001 and 2012. Am J Sports Med 2014; 42(10): 2419-23. doi: 10.1177\/0363546514540599.","DOI":"10.1177\/0363546514540599"},{"key":"169715","doi-asserted-by":"crossref","unstructured":"Mattila V M, Huttunen T T, Haapasalo H, Sillanp\u00e4\u00e4 P, Malmivaara A, Pihlajam\u00e4ki H. Declining incidence of surgery for Achilles tendon rupture follows publication of major RCTs: evidence-influenced change evident using the Finnish registry study. Br J Sports Med 2015; 49(16): 1084-6. doi: 10.1136\/bjsports-2013-092756.","DOI":"10.1136\/bjsports-2013-092756"},{"key":"169716","doi-asserted-by":"crossref","unstructured":"Reda Y, Farouk A, Abdelmonem I, El Shazly O A. Surgical versus non-surgical treatment for acute Achilles\u2019 tendon rupture: a systematic review of literature and meta-analysis. Foot Ankle Surg 2020; 26(3): 280-8. doi: 10.1016\/j.fas.2019.03.010.","DOI":"10.1016\/j.fas.2019.03.010"},{"key":"169717","doi-asserted-by":"crossref","unstructured":"Myhrvold S B, Brouwer E F, Andresen T K M, Rydevik K, Amundsen M, Gr\u00fcn W, et al. Nonoperative or surgical treatment of acute Achilles\u2019 tendon rupture. N Engl J Med 2022; 386(15): 1409-20. doi: 10.1056\/NEJMoa2108447.","DOI":"10.1056\/NEJMoa2108447"},{"key":"169718","doi-asserted-by":"crossref","unstructured":"Fan L, Hu Y, Zhou L, Fu W. Surgical vs. nonoperative treatment for acute Achilles\u2019 tendon rupture: a meta-analysis of randomized controlled trials. Front Surg 2024; 11: 1483584. doi: 10.3389\/fsurg.2024.1483584.","DOI":"10.3389\/fsurg.2024.1483584"},{"key":"169719","doi-asserted-by":"crossref","unstructured":"Ghaddaf A A, Alomari M S, Alsharef J F, Alakkas E, Alshehri M S. Early versus late weightbearing in conservative management of acute Achilles tendon rupture: a systematic review and meta-analysis of randomized controlled trials. Injury 2022; 53(4): 1543-51. doi: 10.1016\/j.injury.2022.01.028.","DOI":"10.1016\/j.injury.2022.01.028"},{"key":"169720","doi-asserted-by":"crossref","unstructured":"Naskar R, Oliver L, Velazquez-Ruta P, Dhinsa B, Southgate C. Functional outcome of early weight bearing for acute Achilles tendon rupture treated conservatively in a weight-bearing orthosis. Foot Ankle Surg 2022; 28(5): 595-602. doi: 10.1016\/j.fas.2021.06.008.","DOI":"10.1016\/j.fas.2021.06.008"},{"key":"169721","doi-asserted-by":"crossref","unstructured":"Hutchison A M, Topliss C, Beard D, Evans R M, Williams P. The treatment of a rupture of the Achilles tendon using a dedicated management programme. Bone Joint J 2015; 97-B(4): 510\u20135. doi: 10.1302\/0301-620X.97B4.35314","DOI":"10.1302\/0301-620X.97B4.35314"},{"key":"169722","doi-asserted-by":"crossref","unstructured":"Aujla R, Kumar A, Bhatia M. Non-surgical treatment of Achilles rupture: Does duration in functional weight bearing orthosis matter? Foot Ankle Surg 2016; 22(4): 254\u20138. doi: 10.1016\/j.fas.2015.11.003","DOI":"10.1016\/j.fas.2015.11.003"},{"key":"169723","doi-asserted-by":"crossref","unstructured":"Ochen Y, Beks R B, van Heijl M, Hietbrink F, Leenen L P H, van der Velde D, et al. Operative treatment versus nonoperative treatment of Achilles tendon ruptures: systematic review and meta-analysis. BMJ 2019; 364:k5120. doi: 10.1136\/bmj.k5120.","DOI":"10.1136\/bmj.k5120"}],"container-title":["Acta Orthopaedica"],"original-title":[],"link":[{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/46872\/55633","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/46872\/55654","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/46872\/55655","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/46872\/55633","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:40:38Z","timestamp":1790754038000},"score":1,"resource":{"primary":{"URL":"https:\/\/actaorthop.org\/actao\/article\/view\/46872"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":15,"URL":"https:\/\/doi.org\/10.2340\/17453674.2026.46872","relation":{},"ISSN":["1745-3682","1745-3674"],"issn-type":[{"value":"1745-3682","type":"electronic"},{"value":"1745-3674","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,30]]}}}