Abstract
Background: Achilles Tendon Rupture (ATR) is a common musculoskeletal injury with an increasing incidence in the United States. Early functional rehabilitation is a key component of improving patient outcomes, and restoration of range of motion is a common threshold for progression to strengthening. Neutral ankle dorsiflexion represents an important early milestone in ATR recovery. This study aimed to assess which patient factors were associated with achieving this early rehabilitation milestone. Methods: A retrospective review was performed on 70 patients who sustained ATR and were treated at an academic center. Demographics, baseline characteristics, and common ATR risk factors were collected. The primary outcome was whether patients achieved neutral ankle dorsiflexion at the six-week follow-up visit. Univariate analysis was conducted to assess associations between risk factors, and multivariate analysis was subsequently performed for variables of interest. Results: There were 70 patients, with a mean age of 41.87 years ± 13.8 years; 56 were male (80%) and 14 were female (20%). In univariate logistic regression, only operative management demonstrated a statistically significant association with achieving the six-week clinical milestone of neutral dorsiflexion (Odds Ratio [OR]: 5.48, 95% Confidence Interval [CI]: 1.51 – 22.01, P < 0.01). This association persisted after controlling for age, sex, and hypertensive status (OR: 5.48, 95% CI: 1.66 – 19.9, P < 0.01). Conclusion: Operative treatment of acute ATR was independently associated with earlier recovery of ankle dorsiflexion. Achievement of early dorsiflexion was largely independent of most baseline patient characteristics. For patients who prioritize early rehabilitation progression, operative management may offer a meaningful short-term advantage.
Recommended Citation
Elliott, W. Chad; Alvin Ouseph; Alexander Abraham; and Jerry Speight Grimes. "Analysis of Patient Factors That Predict Early Restoration of Neutral Dorsiflexion After Achilles Tendon Rupture." Western Journal of Orthopaedics 15, 1 (2026). https://digitalrepository.unm.edu/wjo/vol15/iss1/10