Minimally Invasive Achilles Tendon Repair Using the Achillon Repair System

2006 ◽  
Vol 5 (3) ◽  
pp. 171-174 ◽  
Author(s):  
Andrew J. Elliott ◽  
John G. Kennedy ◽  
Martin O'Malley
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Tendon Repair ◽  
Repair System ◽  
Achilles Tendon Repair

scholarly journals Biomechanical Comparison of Panda Rope Bridge Technique and Other Minimally Invasive Achilles Tendon Repair Techniques In Vitro

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110084
Author(s):  
Ting Wang ◽  
Yuan Mu ◽  
Yulei Diao ◽  
Wenke Liu ◽  
Yahong Wu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Biomechanical Properties ◽  
Repair System ◽  
Postoperative Rehabilitation ◽  
Achilles Tendon Repair ◽  
Repair Techniques

Background: Although nonoperative management of acute Achilles tendon rupture (ATR) is a reasonable option, surgical repair has attracted attention for young and active patients. More reliable Achilles tendon repair techniques are needed to enhance recovery after ATR in this population. Purpose/Hypothesis: To biomechanically analyze the panda rope bridge technique (PRBT) and compare it with other minimally invasive repair techniques over a simulated, progressive rehabilitation program. It was hypothesized that PRBT would result in better biomechanical properties and enhanced recovery after ATR. Study Design: Controlled laboratory study. Methods: An Achilles tendon rupture was created 4 cm from the distal tendon insertion site in 40 bovine lower extremities, and specimens were then randomly allocated to 5 Achilles tendon repair techniques: (1) Achillon, (2) modified Achillon, (3) Percutaneous Achilles Repair System (PARS), (4) modified PARS, and (5) PRBT. Each group was subjected to a cyclic loading protocol that was representative of progressive postoperative rehabilitation for ATR (250 cycles at 1 Hz for each loading stage: 20-100 N, 20-200 N, 20-300 N, and 20-400 N). Results: The PRBT technique demonstrated significantly less elongation (1.62 ± 0.25 mm) than the 4 other repair techniques after the first loading stage of 20 to 100 N ( P < .05). All specimens in the 4 other groups developed a large gap (elongation ≥5 mm) at the 20- to 200-N loading stage. When overall biomechanical performance was examined, the PRBT group exhibited higher strength (20-400 N) and more mean loading cycles (984 ± 10) compared with the 4 other groups ( P < .05). Conclusion: In this bovine model, PRBT biomechanically outperformed the other minimally invasive Achilles tendon repair techniques that were tested and could therefore meet the requirements of accelerated rehabilitation. Clinical Relevance: The reduced tendency for premature rerupture and the overall improved biomechanical properties of PRBT suggest that ATR patients treated with PRBT may more readily complete early and aggressive postoperative rehabilitation protocols. In addition, they may have a lower risk of early irreversible suture failure.

scholarly journals Transverse versus longitudinal incision for minimally invasive Achilles tendon repair

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0016
Author(s):  
Daniel Bohl ◽  
Eric Barnard ◽  
Kamran Movassaghi ◽  
Kamran Hamid ◽  
Adam Schiff
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Suture Material ◽  
Tendon Repair ◽  
Wound Complications ◽  
Transverse Incision ◽  
Longitudinal Incision ◽  
Achilles Tendon Repair ◽  
Deep Suture ◽  
No Tourniquet

Category: Sports Introduction/Purpose: The rate of wound complications following traditional open Achilles tendon repair is reported at 7-8%. In an effort to reduce the rate of wound complications, orthopaedic surgeons have adopted novel minimally invasive techniques. The purpose of this study is to characterize the rate of wound and other early complications following a minimally invasive Achilles tendon repair, to identify any factors associated with increased risk. Methods: The postoperative courses of 55 patients who underwent minimally invasive Achilles tendon repair by two surgeons at separate academic medical centers were retrospectively reviewed. Repair technique was similar in all cases, making use of the same commercially available suture-guidance jig, silicone-impregnated deep suture material, and locking stitch technique. However, 31 procedures used a longitudinal incision and a tourniquet (one surgeon’s preference), while 24 procedures used a transverse incision and no tourniquet (the second surgeon’s preference). Of the 24 procedures using transverse incisions, 2 had to be converted to L-shaped incisions to achieve better access to the tendon. The rates of early complications within 3 months after surgery were characterized and compared between patients with differing procedural characteristics. Results: Of the 55 patients included in the study, 2 (3.6%) developed wound complications. Both wound complications appeared to be reactions to the deep suture material (see Table 1 for details). There was no statistical difference in the rate of wound complications between patients in the longitudinal incision/tourniquet group and patients in the transverse incision/no tourniquet group (6.5% versus 0.0%; p=0.499). Three patients (5.5%) developed sural neuropraxia, which manifested as mild-to-moderate subjective numbness with sensation remaining intact to light touch. There were no cases of re-rupture. At 3-month follow-up, all 55 patients had intact Thompson tests and well-healed wounds. Conclusion: The rate of wound complications following minimally invasive Achilles repair is low at 3.6%. The present study could not demonstrate a difference in risk for wound complications between patients treated with a longitudinal incision and tourniquet and patients treated with a transverse incision and no tourniquet. The wound complications we observed were primarily attributable to inflammatory reactions to the silicone-impregnated deep suture material. Patients should be counseled that although risk for wound complications may be lower with minimally invasive techniques, such techniques do risk sural neuropraxia and deep suture reaction. Further prospective analysis is warranted.

The use of ultrasonography during minimally invasive Achilles tendon repair to avoid sural nerve injury

2019 ◽  
Vol 46 (4) ◽  
pp. 513-514 ◽  
Author(s):  
Joverienne Chavez ◽  
Soichi Hattori ◽  
Yuki Kato ◽  
Shuzo Takazawa ◽  
Shin Yamada ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Nerve Injury ◽  
Sural Nerve ◽  
Tendon Repair ◽  
Achilles Tendon Repair

Percutaneous and Minimally Invasive Techniques of Achilles Tendon Repair

2007 ◽  
Vol 458 ◽  
pp. 188-193 ◽  
Author(s):  
Francesco Ceccarelli ◽  
Lisa Berti ◽  
Laura Giuriati ◽  
Matteo Romagnoli ◽  
Sandro Giannini
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Tendon Repair ◽  
Minimally Invasive Techniques ◽  
Achilles Tendon Repair ◽  
Invasive Techniques

scholarly journals A simple suture-guiding device for minimally invasive Achilles tendon repair

2017 ◽  
Vol 25 (3) ◽  
pp. 230949901773948
Author(s):  
Sinan Obut ◽  
Alper Gultekin ◽  
Meric Unal ◽  
Ulaş Serarslan ◽  
Ümit Tuhanioğlu
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Tendon Repair ◽  
Achilles Tendon Repair

Open minimally invasive Achilles tendon repair with early rehabilitation: Functional results of 25 consecutive patients

Injury ◽  
2009 ◽  
Vol 40 (6) ◽  
pp. 669-672 ◽  
Author(s):  
Ufuk Ozkaya ◽  
Atilla Sancar Parmaksizoglu ◽  
Yavuz Kabukcuoglu ◽  
Sami Sokucu ◽  
Seckin Basilgan
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Tendon Repair ◽  
Functional Results ◽  
Early Rehabilitation ◽  
Achilles Tendon Repair

scholarly journals Clinical Outcomes and Complications With Open vs Minimally Invasive Achilles Tendon Repair

2021 ◽  
Vol 6 (4) ◽  
pp. 247301142110600
Author(s):  
Kristin C. Caolo ◽  
Stephanie K. Eble ◽  
Carson Rider ◽  
Andrew J. Elliott ◽  
Constantine A. Demetracopoulos ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Nerve Injury ◽  
Sural Nerve ◽  
Tendon Repair ◽  
Suture Repair ◽  
Complication Rates ◽  
Achilles Tendon Repair ◽  
Patient Reported ◽  
Acute Rupture

Background: There is no current consensus on whether to use an open or minimally invasive (MIS) approach for Achilles tendon repair after acute rupture. We hypothesized that patients in both open and MIS groups would have improved patient-reported outcome scores using the PROMIS system postoperatively, but that there would be minimal differences in these scores and complication rates between operative techniques. Methods: A total of 185 patients who underwent surgery for an acute, unilateral Achilles tendon rupture between January 2016 and June 2019, with minimum 1-year follow-up were included in the cohort studied. The minimally invasive group was defined by use of a commercially available minimally invasive device through a smaller surgical incision (n=118). The open repair group did not use the device, and suture repair was performed through larger surgical incisions (n=67). Postoperative protocols were similar between groups. Preoperative and postoperative PROMIS scores were collected prospectively through our institution’s registry. Demographics and complications were recorded. Results: PROMIS scores overall improved in both study groups after operative repair. No significant differences in postoperative PROMIS scores were observed between the open and MIS repair groups. There were also no significant differences in complication rates between groups. Overall, 19.5% of patients in the MIS group had at least 1 postoperative complication (8.5% deep vein thrombosis [DVT], 3.3% rerupture, 1.7% sural nerve injury, 2.5% infection), compared to 16.4% in the open group (9.0% DVT, 1.5% rerupture, 1.5% sural nerve injury, 0% infection). Conclusion: Patients undergoing either minimally invasive or open Achilles tendon repair after acute rupture have similar PROMIS outcomes and complication types and incidences. Level of Evidence: Level III, retrospective cohort study.

scholarly journals Anatomic Relationship of the Sural Nerve when Performing Achilles Tendon Repair using the Percutaneous Achilles Repair System, a Cadaveric Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0035
Author(s):  
Roddy McGee ◽  
Troy S. Watson ◽  
Adam Eudy ◽  
Candice L. Brady ◽  
Cheryl Vanier ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Sural Nerve ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Wound Complications ◽  
Repair System ◽  
Achilles Tendon Repair ◽  
Open Versus ◽  
Relationship Of ◽  
Percutaneous Achilles Repair

Category: Sports; Trauma Introduction/Purpose: Minimally-invasive techniques for Achilles tendon repair are gaining popularity by orthopedic surgeons due to the reports of similar re-rupture rates with open versus percutaneous techniques with less wound complications and quicker recovery with percutaneous methods. The goal of the study was to quantify the relationship of the sural nerve to the Percutaneous Achilles Repair System (PARS) during Achilles tendon repair and identify sural nerve violations utilizing this system. Methods: The PARS was placed into ten lower extremity cadaveric specimens after simulation of an Achilles tendon rupture. After placement of the PARS jig and passage of the needles, careful dissection was performed in order to identify whether the sural nerve was violated and the distance of the sural nerve in relation to the passed needles was recorded. Results: Of the 10 cadaveric specimens, none had violation of the sural nerve during percutaneous needle passage. Zero of the 50 (0%) needles directly punctured the substance of the sural nerve, however, one needle was found to have come into close proximity separating the sural nerve and small saphenous vein but when the suture was passed and the PARS jig removed, the nerve was found remain intact with no evidence of entrapment. Conclusion: This study demonstrated the potential risk for sural nerve injury when using the PARS for Achilles tendon repair.

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