Ruptured Achilles tendon 2 weeks or 8 weeks in a cast

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Goodfellow Gems

Ruptured Achilles tendon 2 weeks or 8 weeks in a cast

There is a new way of treating full ruptures of Achilles tendon. A trial in 2020 found that 2 weeks in a cast followed by 6 weeks in a graduated moon boot was as good as 8 weeks in a cast when evaluated 9 months later.1 

The results found that re-rupture was 6% in the cast and 5% in the moon boot. The moon boot option was cheaper.  There is an Auckland protocol that starts weight bearing at 6 weeks with removal of the boot at night and full weight-bearing by 8 weeks.2


  1. Plaster cast versus functional brace for non-surgical treatment of Achilles tendon rupture (UKSTAR): a multicentre randomised controlled trial and economic evaluation. Lancet (2020). View here
  2. Achilles Tendon Rupture. Axis Sports Medicine View here

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.

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