The Reinforced Ma–Griffith Method Combined with Minimally Invasive Small‐Incision Suture for Acute Achilles Tendon Rupture

Abstract Purpose: To review the clinical outcomes of treatment acute Achilles tendon rupture using oval forceps assisted with small incision.Methods: This was a retrospective study of 23 patients with acute Achilles tendon rupture treated with this technique. Distance from calcaneal insertion to rupture site and the operation time were recorded. During follow-up, all the occurrence of complications was recorded. The AOFAS score and the ROM of the repaired ankle joint were recorded at 3 and 6 months.Results: All patients were followed up for 7-15 months. There have no cases of Achilles tendon re-rupture and sural nerve injury were found. All incisions healed by first intention, except for one case of delayed suture knot irritation. The AOFAS score was 82–100 (median, 92) at 3 months and 92–100 (median, 98) at 6 months. The 3-month ROM was 28–37, and the 6-month ROM was 36–49.Conclusion: The technique of oval forceps assisted with small incision for minimally invasive treatment of acute Achilles tendon rupture is a safe, reliable, and have an extremely low complication rate. Furthermore, this technique is easy to learn, utilizes simple instruments, and is cost-effective, making this technique an attractive alternative to traditional techniques.

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Percutaneous Repair Method and Achilles Tendon Rupture Rehabilitation

10.21203/rs.3.rs-86536/v1 ◽

2020 ◽

Author(s):

Krzysztof Ficek ◽

Paweł Gwiazdoń ◽

Jolanta Rajca ◽

Grzegorz Hajduk

Keyword(s):

Side Effects ◽

Soft Tissue ◽

Minimally Invasive ◽

Achilles Tendon ◽

Range Of Motion ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Well Being ◽

Professional Activity ◽

Rehabilitation Protocol

Abstract Background: Subcutaneous, spontaneous, complete ruptures of the Achilles tendon are usually caused indirectly by trauma associated with rapid movement. When minimally invasive Achilles tendon repair is performed, an active rehabilitation protocol can be implemented that allows for fast, measurable progress, reduced tissue atrophy, and an improved range of motion, thereby reducing pain and increasing patients’ overall physical well-being. However, overestimating the effectiveness of rehabilitative interventions can lead to arbitrary advancements in rehabilitation that significantly exceed the permitted levels of daily or professional activity. This issue can lead to various side effects and slow rehabilitation. The aim of the study was to evaluate the influence of adverse effects on objective outcomes after minimally invasive Achilles tendon repair.Methods: The study included 36 individuals with complete Achilles tendon rupture who underwent the percutaneous Ma-Griffith technique. The same rehabilitation protocol was used.Results: Five side effects were identified during rehabilitation: deformation of the repair construct (DRC), irritation of the sural nerve (SNI), morning ankle stiffness (MAS), edema of the soft tissue around the tendon (OST) and suture knots. DRC and MAS were associated with a longer time being required to achieve full ankle range of motion. SNI and OST were associated with a longer time being required to meet the criteria for dynamic training. None of the side effects were related to the isokinetic strength of the ankle plantar and dorsiflexors.Conclusions: The incidence of the assessed side effects in the postoperative period is not related to the type of activity, whether it is professional or amateur. Among the identified side effects, deformation of the regenerated shape of the heel tendon and MAS cause a delay in the recovery of full ankle range of motion. Calf nerve irritation and soft tissue swelling increase the time it takes to meet the criteria for starting dynamic training.Trial registration:The study was approved by the ethics committee of the Academy of Physical Education in Katowice (no. 13/2007)

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A New Minimally Invasive Technique for Repairing Achilles Tendon Rupture:A Biomechanical Study

10.1101/642520 ◽

2019 ◽

Author(s):

Peng zhao ◽

Dawei Sun ◽

Yaru Xiong ◽

Ribo Zhuo

Keyword(s):

Minimally Invasive ◽

Achilles Tendon ◽

Research Group ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Biomechanical Study ◽

New Technique ◽

Invasive Technique ◽

Invasive Treatment ◽

Cyclical Loading

AbstractIntroductionThe incidence of Achilles tendon rupture shows a gradually increasing trend, which is mainly managed by minimally invasive treatment due to its advantages, such as low wound infection rate. At present, the firmness of the commonly applied minimally invasive suture method for Achilles tendon remains controversial. Our research group has developed a novel suture method for Achilles tendon, which has achieved favorable clinical outcomes. Therefore, this experiment aimed to explore the optimal approach to repair Achilles tendon rupture through comparing the biomechanical strength of the commonly used Achilles tendon suture methods currently.Materials and methods6 fresh frozen human cadaveric Achilles tendon specimens were sutured by three kinds of technique, and were tested through the cyclical loading after repair.ResultsResults of cyclical loading showed that, the repair using the new technique was stronger after 10 cycles, 1000 cycles, and rupture. Moreover, the new technique had displayed superior anti-deformation strength to that of the Ma-Griffith technique.ConclusionsOur experimental results demonstrate that, the new technique proposed by our research group can attain comparable biomechanical properties to those of the Krachow technique. However, the sample size in this study is small, and further clinical trials are warranted.

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Achilles tendon repair by a minimally invasive technique using Tenolig®

Journal of the Foot & Ankle ◽

10.30795/jfootankle.2020.v14.1194 ◽

2020 ◽

Vol 14 (3) ◽

pp. 269-273

Author(s):

Vinicius Oliveira ◽

Sérgio Prata

Keyword(s):

Minimally Invasive ◽

Achilles Tendon ◽

Postoperative Infection ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Case Series ◽

Minimally Invasive Technique ◽

Invasive Technique ◽

Aofas Score ◽

Functional Scores

Objective: To assess the degree of postoperative satisfaction of patients with acute Achilles tendon rupture who underwent surgical reconstruction by a minimally invasive technique using Tenolig®. Methods: A retrospective observational study was conducted with 18 patients with acute Achilles tendon rupture diagnosed by a positive Thompson test who underwent surgery. Outcomes were assessed using the American arthopaedic Foot and Ankle Society (AOFAS) score and the Foot Function Index (FFI). Furthermore, quantitative variables were descriptively treated, and patients’ age was correlated with FII and AOFAS score using Spearman’s correlation coefficient at a significance level of 5%. Results: Patients underwent surgery from one to six days after injury and were discharged one day later. Only one patient had a superficial postoperative infection. Patients’ AOFAS scores ranged from 75 to 100 points, and FFI ranged from 0 to 20%. The patient withsuperficial postoperative infection had an AOFAS score and a FFI of 75 points and 20%, respectively. Conclusion: Percutaneous repair of complete Achilles tendon rupture with Tenolig® resulted in high functional scores and a low rate of complications. Level of Evidence IV; Therapeutic Studies; Case Series.

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Intraoperative Ultrasonography assistance for minimally invasive repair of the acute Achilles Tendon Rupture

10.21203/rs.3.rs-16380/v1 ◽

2020 ◽

Author(s):

Yongliang Yang ◽

Honglei Jia ◽

Wupeng Zhang ◽

Shihong Xu ◽

Fu Wang ◽

...

Keyword(s):

Minimally Invasive ◽

Achilles Tendon ◽

Nerve Injury ◽

Saphenous Vein ◽

Sural Nerve ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Intraoperative Ultrasonography ◽

Medial Side ◽

Significant Difference

Abstract Background: Minimally invasive repair is a better option for Achilles tendon rupture with low re-rupture and wound-related complications than conservative treatment or traditional open repair. The major problem is sural nerve injury. The purpose of this study was to evaluate the effect and advantage of the intraoperative ultrasonography assistance for minimally invasive repair of the acute Achilles tendon rupture.Methods: A retrospective study was performed on 36 cases of acute Achilles tendon rupture treated with minimally invasive repair assisted with intraoperative ultrasonography from January 2015 to December 2017. The relationship of the sural nerve and small saphenous vein was confirmed on the preoperative MRI. The course of the small saphenous vein and sural nerve were identified and marked by intraoperative ultrasonography. The ruptured Achilles tendon was repaired with minimally invasive Bunnell suture on the medial side of the SSV.Results: All patients were followed up for at least 12 months. No sural nerve injury or other complications was found intraoperatively and postoperatively. All the patients returned to work and light sporting activities at a mean of 12.78±1.40 weeks and 17.28±2.34 weeks, respectively. The Mean AOFAS scores improved from 59.17±5.31 preoperatively to 98.92±1.63 at the time of 12 months follow-up. There was statistically significant difference (P<0.001). No patient complained a negative effect on their life.Conclusions: The minimally invasive repair assisted with intraoperative ultrasonography can yield good clinical outcomes, less surgical time and less complications, especially sural nerve injury. It is an efficient, reliable and safe method for acute AT rupture.

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Comparison of Two Surgical Methods in the Treatment of Acute Achilles Tendon Rupture: a Case-control Study

10.21203/rs.3.rs-149540/v1 ◽

2021 ◽

Author(s):

Hao Yu ◽

Fangyuan Wang ◽

Jia Xie ◽

Junfeng Zhan ◽

Yunfeng Yao ◽

...

Keyword(s):

Minimally Invasive ◽

Achilles Tendon ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Treatment Method ◽

Suture Technique ◽

Demographic Characteristics ◽

Vein Thrombosis ◽

Surgical Methods ◽

Operative Recovery

Abstract Background: The Achilles tendon is the strongest tendon in the human body but also prone to injury and rupture, thereby requiring early diagnosis and treatment to prevent the development of lower limb dysfunction. Currently, the best treatment method for acute Achilles tendon rupture remains controversial. As both traditional incision repair and minimally invasive repair have limitations, we propose a new surgical method: the modified Ma-Griffith method combined with minimally invasive small incision(M-G/MISI). This study aimed to compare the efficacy of M-G/MISI and the modified suture technique (MST) for the treatment of acute Achilles tendon rupture.Methods: We conducted a retrospective review of the medical records of all patients who underwent treatment for acute Achilles tendon rupture between January 2012 and January 2020 at our hospital. A total of 67 patients were included and divided into two groups: 34 males in the M-G/MISI treatment group and 33 patients (2 females and 31 males) in the MST group. Demographic characteristics, operative details, and postoperative complications were recorded, and data were statistically analysed using SPSS 24.0 for Windows (IBM Corp. Released 2016. IBM SPSS Statistics for Windows, Version 24.0) to compare the treatment efficacy of the two surgical methods.Results: Although there was no difference in demographic characteristics between the two groups, there were significant differences in the incision length, intra-operative blood loss, post-operative Achilles tendon total rupture score, and post-operative American Orthopedic Foot and Ankle Society score. Post-operatively, there was one case of traumatic Achilles tendon rupture in the M-G/MISI group and one case each of infection and deep vein thrombosis in the modified suture group.Conclusion: After follow-up, the post-operative recovery of acute Achilles tendon rupture treated with M-G/MISI is better than that with the MST.

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Minimally Invasive Flexor Hallucis Longus Transfer in Management of Acute Achilles Tendon Rupture Associated With Tendinosis

Foot & Ankle Specialist ◽

10.1177/1938640011433829 ◽

2012 ◽

Vol 5 (2) ◽

pp. 111-114 ◽

Cited By ~ 8

Author(s):

Tun Hing Lui

Keyword(s):

Minimally Invasive ◽

Achilles Tendon ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Flexor Hallucis Longus ◽

Flexor Hallucis Longus Transfer

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Percutaneous and Minimally Invasive Surgical Technique for Achilles Tendon Repair

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00258 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0025

Author(s):

Tyler Hoskins ◽

David Goyette ◽

Jay Patel ◽

Christopher Mazzei ◽

Arianna L. Gianakos ◽

...

Keyword(s):

Surgical Technique ◽

Minimally Invasive ◽

Achilles Tendon ◽

Functional Outcome ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

P Value ◽

Invasive Approach ◽

Minimally Invasive Surgical ◽

Iatrogenic Nerve Injury

Category: Ankle; Sports; Trauma Introduction/Purpose: Achilles tendon rupture is a traumatic injury that can cause considerable morbidity and reduced function. The optimal treatment method for this injury remains controversial. Non-operative intervention puts patients at higher risk of re-rupture whereas surgical intervention has risks of infection and iatrogenic nerve injury. Recently, surgeons have established a less invasive surgical approach to repairing the achilles tendon. The ‘Percutaneous or Mini-Invasive’ technique was adopted in order to reduce infection rates and wound breakdown. However, due to the scarce amount of literature reported, the efficacy of this procedure still remains under scrutiny. The goal of this study was to examine the functional outcomes of patients treated at our facility for a ruptured achilles tendon using the percutaneous and minimally invasive surgical technique. Methods: From 2014 to 2020 eighty-one patients underwent a percutaneous or mini invasive surgery at our facility for the treatment of a ruptured achilles tendon. Functional outcome scores were assessed using the American Orthopaedic Foot & Ankle scoring system (AOFAS) and the Achilles Tendon Rupture Score (ATRS). Outcomes, complications, and any reoperations were recorded through retrospective chart review, direct patient examination, and phone calls to patients and their families. A statistical analysis was performed using Fischer’s Exact Test. Results were deemed statistically significant if the calculated p-value was less than 0.05. Results: The mean follow up for our patient cohort was 36.40 months (range, 6 to 71). The average age was 41.46 years (range, 17- 65). Mean pre-op AOFAS and ATRS were 45.60 and 47.18 respectively, compared to 90.29 and 87.97 after surgery (p-value <0.05). There were two significant complications reported post-operatively. One patient re-ruptured their Achilles tendon four months post-operatively. This patient was successfully treated with a mini invasive approach and reconstruction of the tendon. A second patient developed a superficial infection ten months post-operatively. This patient successfully underwent irrigation and debridement of the wound. Conclusion: The pre-op and post-op AOFAS and ATRS scores were deemed statistically significant. A percutaneous and mini invasive approach to repair a ruptured achilles tendon, although new, offers promising functional outcome results and remains a viable treatment option to decrease the incidence rate of post-operative infection and iatrogenic nerve injury. However, a prospective randomized controlled trial comparing the efficacy of this procedure to other surgical methods would be necessary to further evaluate and validate our findings.

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