Retrospective Study from a Single Center in Poland of Postoperative Outcomes of Muscle Strength in Patients After Surgical Suturing of the Achilles Tendon Using a Kessler’s Suture and 28 Weeks of Supervised Postoperative Physiotherapy

BACKGROUND: A retrospective study from a single center in Poland was aimed to evaluate the effect of 47 supervised physiotherapy (SVPh) visits on relative peak torque (RPT) and relative isometric torque (RIT) of foot plantar flexion muscles (FPFM) and foot dorsiflexion muscles (FDFM) with a frequency of 1.7 visits per week conducted for 28 weeks after surgical suturing of the Achilles tendon using a Kessler’s suture (ATSSKS). We hypothesized a higher number, frequency, and intensity of supervised physiotherapy visits (HNFISVPhVs) would correlate with and significantly improve RIT and RPT for FPFM. MATERIAL/METHODS: Group A included 20 patients (x=47 visits) after ATSSKS with one SVPh protocol who were divided into subgroups: with HNFISVPhVs (x=72) and with a lower number, frequency, and intensity of SVPh visits (LNFISVPhVs, x=33). Twenty participants without Achilles tendon rupture were included in group B (control). Both groups (≥7 Tegner activity scale) underwent RIT, RPT, and Limb Symmetry Index (LSI) measurements using Biodex Medical System 3. RESULTS: FPFM RIT were significantly lower in operated limbs in group A than for non-operated limbs in group B (P≤0.001). HNFISVPhVs correlated with higher FPFM RIT and LSI in operated limbs (from r=0.444, P=0.05 to r=0.585, P=0.007). HNFISVPhVs obtained higher LSI of FPFM RPT of 180°/s (P=0.022) and 30°/s (P=0.049) than LNFISVPhVs. CONCLUSIONS: SVPh with 47 visits after ATSSKS for 28 weeks was insufficient to obtain equal values of RIT for FPFM and FDFM, but HNFISVPhVs correlated with higher RIT values and considerably improved RIT and RPT for FPFM compared with LNFISVPhVs.