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Table 1 Treatment overview. CARTA Copenhagen Achilles Rupture Treatment Algorithm, CALM Copenhagen Achilles Length Measure, ATRA Achilles Tendon Resting Angle

From: Individualized treatment for acute Achilles tendon rupture based on the Copenhagen Achilles Rupture Treatment Algorithm (CARTA): a study protocol for a multicenter randomized controlled trial

VisitTime pointPlaceScheduled intervention
1Day 0Emergency Department
Diagnosis of Achilles tendon rupture. The injured leg will be placed in a split plaster cast with the ankle in maximal plantar flexion achieved by placing the patient in prone position on the examination bed.
20-4 daysOutpatient clinic
Surgeon or physiotherapist
Inclusion, informed consent, randomization and decision of treatment based on CARTA.
  1) For the patients allocated individualized treatment the finding of ultrasonographic evaluation decides further treatment of non-operative and operative regime.
  2) Patients allocated non-operative treatment will be treated with a circular below-the-knee cast
  3) Patients allocated operative treatment will be scheduled and prepared for surgery.
30-14 daysOperating theatre
Operation of the patients appointed for operative treatment performed or supervised by trained orthopedic surgeon specialized in Foot- and Ankle, Traumatology or Sports Traumatology.
Counting of weeks starts at “day of randomization” if non-operative treatment or at “day of surgery” if operative treatment.
43 weeksOutpatient clinic
Nurse Physiotherapist
Removal of cast and any sutures. Injured leg placed in functional brace with 20 degrees plantar flexion of the ankle. Instructions of limited, protected movements over the ankle and successive removal of two wedges at 2 weeks interval.
59 weeksOutpatient clinic
Functional brace is removed, and the tendon is examined. Instructions by physiotherapist of rehabilitation from 9 weeks and onwards.
66 monthsOutpatient clinic
Follow-up evaluation with Heel-Rise Work Test, CALM and ATRA.
712 monthsOutpatient clinic
Follow-up evaluation with Heel-Rise Work Test, CALM and ATRA.