scholarly journals Surgical Strategy for the Chronic Achilles Tendon Rupture

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Yangjing Lin ◽  
Liu Yang ◽  
Li Yin ◽  
Xiaojun Duan
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Functional Results ◽  
Resonance Imaging ◽  
Surgical Options ◽  
Magnetic Resonance Imaging Mri ◽  
American Orthopaedic

Background. Chronic Achilles tendon rupture is usually misdiagnosed and treated improperly. This study aims to better understand the treatment of chronic Achilles tendon rupture.Methods. Patients who were not able to perform a single-limb heel rise were chosen. Pre- and postoperative magnetic resonance imaging (MRI) were conducted. By evaluating the presence or absence of Achilles tendon stumps and the gap length of rupture, V-Y advancement, gastrocnemius fascial turndown flap, or flexor halluces longus tendon transfer were selected for tendon repair. The function of ankle and foot was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores and Achilles Tendon Total Rupture Score (ATRS).Results. Twenty-nine patients were followed up. One patient had superficial incision infection, which was healed after debridement and oral antibiotics. Three months postoperatively, MRI showed some signs of inflammation, which disappeared at one or two years postoperatively. All patients were able to perform a single-limb heel rise. Mean AOFAS scores and ATRS scores were increased at the latest follow-up.Conclusion. Surgical options can be determined by evaluating the presence of the Achilles tendon stumps and the gap length, which can avoid using the nearby tendon and yield satisfactory functional results.

Percutaneous versus Open Repair of the Ruptured Achilles Tendon

2005 ◽  
Vol 33 (9) ◽  
pp. 1369-1379 ◽  
Author(s):  
Andrej Čretnik ◽  
Miloš Kosanović ◽  
Vladimir Smrkolj
Keyword(s):  
Achilles Tendon ◽  
Local Anesthesia ◽  
Tendon Rupture ◽  
Open Repair ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Functional Results ◽  
Level Of Evidence ◽  
Significant Difference ◽  
American Orthopaedic

Background Controversy regarding the optimal treatment of the fresh total Achilles tendon rupture remains. Purpose To compare the results of percutaneous and open Achilles tendon repair. Study Design Cohort study; Level of evidence, 2. Methods The results of 132 consecutive patients with acute complete Achilles tendon rupture who were operated on exclusively with modified percutaneous repair under local anesthesia from 1991 to 1997 and followed up for at least 2 years were compared to the results of 105 consecutive patients who were operated on exclusively with open repair under general or spinal anesthesia in the same period. Results There were significantly fewer major complications in the group of percutaneous repairs in comparison with the group of open repairs (4.5% vs 12.4%; P = .03), particularly necrosis (0% vs 5.6%; P = .019), and a lower total number of complications (9.7% vs 21%; P = .013). There were slightly more reruptures (3.7% vs 2.8%; P = .680) and sural nerve disturbances (4.5% vs 2.8%; P = .487) in the group of percutaneous repairs, with no statistically significant difference. Functional assessment using the American Orthopaedic Foot and Ankle Society scale and the Holz score showed no statistically significant difference. Conclusion The results of the study support the choice of (modified) percutaneous suturing under local anesthesia as the method that brings comparable functional results to open repair, with a significantly lower rate of complications.

scholarly journals Ankle Hindfoot Scale vs Comprehensive SRMC Scoring System in Acute Achilles Tendon Rupture

2015 ◽  
Vol 2 (2) ◽  
pp. 77-79 ◽  
Author(s):  
Jambu Nageswaran ◽  
Samuel Chittaranjan Bedford ◽  
Ganesan Ganesan Ram
Keyword(s):  
Achilles Tendon ◽  
Scoring System ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Asia Pacific ◽  
Foot And Ankle ◽  
Medical College ◽  
American Orthopaedic

ABSTRACT The existing scoring system like American Orthopaedic Foot and Ankle Society (AOFAS)-ankle hindfoot scale, Leppilahti et al scoring system, Achilles tendon total rupture score, foot and ankle outcome score, the physical activity scale (PAS) questionnaire and Tegner activity score were not designed to evaluate all the parameters following surgical treatment of Achilles tendon rupture. Hence, we developed a comprehensive score called the comprehensive Sri Ramachandra Medical College (SRMC) scoring system. We compared the results of 60 patients who were surgically treated for acute Achilles tendon rupture using our comprehensive SRMC scoring system with the most commonly used AOFAS-ankle hindfoot scale. Results We found that there was 6.7% poor results using our scoring system, whereas no poor results using AOFAS scoring system mainly because our scoring system also assesses quality of life, patient satisfaction and tendon strength. Similarly, there was 10% fair results in our scoring system compared to 3.3% in AOFAS scale indicating that our scoring system is more sensitive. Comprehensive SRMC scoring system was found to be reliable statistically as per alpha method (α = 0.7787) and was statistically significant at p < 0.001. Conclusion Comprehensive SRMC scoring system was found to be superior to AOFAS scale specifically for analyzing Achilles tendon repair. Poor results are likely to be picked up by our scoring system which has been shown in our results. How to cite this article Nageswaran J, Ram GG, Bedford SC. Ankle Hindfoot Scale vs Comprehensive Srmc Scoring System in Acute Achilles Tendon Rupture. J Foot Ankle Surg (Asia- Pacific) 2015;2(2):77-79.

scholarly journals Supine Surgical Achilles Tendon Repair

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Katherine Sage ◽  
Gregory Guyton
Keyword(s):  
Achilles Tendon ◽  
Supine Position ◽  
Complication Rate ◽  
Sural Nerve ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Wound Complications ◽  
Achilles Tendon Repair

Category: Ankle, Hindfoot, Trauma Introduction/Purpose: Open Achilles tendon repair is typically performed in the prone position for easy visibility of the tendon, but serious complications may be associated with general anesthesia in this position. Open Achilles tendon repair with supine position has been described and potentially avoids these issues, but it is not known whether this position is safe. We reviewed the complication rate of supine open Achilles tendon repair in a retrospective series of patients, looking specifically at wound healing, infection, re-rupture, and sural nerve injury. Methods: CPT codes for Achilles tendon rupture were used to search the records of one surgeon for the years 2010-2014. The charts were then reviewed. Patients were included if they had an Achilles tendon rupture that was surgically treated with primary repair in the supine position within 15 days of injury. Patients were excluded if further reconstruction or tendon transfer was performed. A paramedian incision was utilized 1 cm medial to the Achilles sheath. Results: A total of 37 patients met the inclusion criteria. Of these 37 patients, 31 were men and 6 were women. The average age was 40.0 years (range, 20 to 66 years). Average length of follow-up was 159 days (range 25 to 1589 days). The average BMI was 28 (range 24-36). There were no major complications, including no infections or wound complications. No reruptures and no sural nerve injuries were observed. Conclusion: In 37 patients with early follow-up, supine open Achilles tendon repair had a complication rate equivalent to reported historical data for the prone procedure.

scholarly journals Operative Outcome of Side-Locking Loop Suture Technique Accompanied by Autologous Semitendinosus Tendon Grafting for Chronic Rupture of Achilles Tendon

2021 ◽  
Vol 6 (2) ◽  
pp. 247301142110035
Author(s):  
Keisuke Tsukada ◽  
Youichi Yasui ◽  
Maya Kubo ◽  
Shinya Miki ◽  
Kentaro Matsui ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Scale Score ◽  
Tendon Rupture ◽  
Plantar Flexion ◽  
Achilles Tendon Rupture ◽  
Case Series ◽  
Semitendinosus Tendon ◽  
Level Of Evidence ◽  
Operative Outcomes

Background: The purpose of this retrospective study was to clarify the operative outcomes of the side-locking loop suture (SLLS) technique accompanied by autologous semitendinosus tendon grafting for chronic Achilles tendon rupture. Methods: A chart review was conducted of consecutive patients treated with the SLLS technique at our department from 2012 to 2017. Postoperatively, a below-knee splint was applied for 2 weeks in 20 degrees of plantar flexion and then active range of motion exercise was started. Partial weightbearing exercise was allowed at 4 weeks according to patient tolerance, and full weightbearing without crutches was allowed at 8 weeks. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale score and the Achilles tendon rupture score (ATRS) were used to evaluate clinical outcomes preoperatively and at the final follow-up. Results: Ten patients (6 men, 4 women) were included in the analysis. Mean AOFAS ankle-hindfoot scale score increased significantly from 64.2 ± 5.6 points preoperatively to 95.0 ± 5.3 points at the final follow-up ( P < .001). The mean ATRS also increased significantly from 29.8 ± 4.4 points to 86.2 ± 7.7 points, respectively ( P < .001). Mean time between surgery and ability to perform 20 continuous double-leg heel raises of the operated foot was 13.5 ± 3.4 (range 10-18) weeks. One patient complained of postoperative hypoesthesia in the foot, which had spontaneously resolved by 3 months after surgery. Conclusion: The SLLS technique accompanied by autologous semitendinosus tendon grafting provided successful operative outcomes for patients with chronic Achilles tendon rupture regardless of the size of the defect, and thus long-term orthotic use was not needed after surgery. Level of Evidence: Level IV, retrospective case series.

Partial achilles tendon rupture presenting with giant hematoma; MRI findings of 4 year follow up

The Foot ◽  
2011 ◽  
Vol 21 (4) ◽  
pp. 204-206
Author(s):  
Aysegul Sarsilmaz ◽  
Makbule Varer ◽  
Gulten Coskun ◽  
Melda Apaydın ◽  
Orhan Oyar
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Mri Findings

scholarly journals Management of Missed Traumatic Achilles Tendon Rupture in a Pediatric Patient: A Case Report

2021 ◽  
Vol 9 (4) ◽  
pp. 465-470
Author(s):  
Saad Andaloussi
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Skin Wound ◽  
Plantaris Tendon ◽  
First Case ◽  
Tendon Ruptures ◽  
Post Traumatic

BACKGROUND: Missed traumatic Achilles tendon ruptures in children are rarely reported in the literature. Various techniques have been described to reconstruct delayed Achilles tendon ruptures for adults, but the long-term consequences in the growing child are unknown. CLINICAL CASE: The article presents a clinical observation of a 8-year-old girl with missed rupture of the Achilles tendon operated 7 weeks after the trauma by end-to-end Kessler-type sutures augmented with the plantaris tendon. At 2-year follow-up, the patient was completely asymptomatic. DISCUSSION: A review of the literature shows that this is the third neglected pediatric case of post-traumatic Achilles tendon rupture. The first case concerns a 10-year-old boy treated successfully six weeks after the traumat by open surgical repair using the Bunnell sutures technique. The second patient was a 7-year-old girl, she was operated 8 weeks after the trauma with a termino-terminal tenorrhaphy using the Bunnell technique augmented with the plantaris tendon. CONCLUSIONS: Using the plantaris tendon to reinforce the Achilles tendon repair offers satisfactory results with minimal morbidity. Prognosis depends on the extent of tendon defect which determines the long-term functional outcome. Any skin wound that sits on the back of the leg requires a systematic and careful physical examination to check the integrity of the Achilles tendon.

scholarly journals Minimally invasive repair of ruptured Achilles tendon

2015 ◽  
Vol 62 (1) ◽  
pp. 85-88
Author(s):  
Nikola Bulatovic ◽  
Miroslav Kezunovic ◽  
Zarko Dasic ◽  
Nikola Fatic
Keyword(s):  
Surgical Technique ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Functional Results ◽  
Recreational Athletes ◽  
Acute Injuries ◽  
Clinical Center ◽  
Immobility Time ◽  
Heel Bone

INTRODUCTION: Achilles tendon rupture usually occurs in recreational athletes of middle age 30-50godina and typical place of the rupture of 3-5 cm above the insertion of the heel bone. Most common in recreational athletes. OBJECTIVE: To view the surgical technique suture the tendon with a guide ?Achillon? the functional outcome of acute injuries. MATERIAL AND METHODS: retrospective analysis included a total of 20 patients treated at the Clinic of Orthopedics and Traumatology, Clinical Center of Montenegro in Podgorica in the 2009-14. They were monitored for 12 months. Diagnosis is based on history, clinical examination Thompson?s Simmond O?Brien test, ECHO and NMR. RESULTS: The average age was 38.8 ?2.79 years 21-52 years. Right in 14 respondents 70%, the left side in 6 30%. There were no complications as: infection, thrombosis, rerupture and embolism. Functional results tables we have shown through specific scores. CONCLUSION: It can be concluded that this procedure provides a simple and quick surgical technique, a small percentage of complications, shorter immobility time and good functional results.

scholarly journals The ultrasonographic dynamic heel-rise test of the Achilles tendon

2021 ◽  
Vol 21 (86) ◽  
pp. e260-e266
Author(s):  
Beata Ciszkowska-Łysoń ◽  
◽  
Urszula Zdanowicz ◽  
Robert Śmigielski ◽  
◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Dynamic Assessment ◽  
Healing Process ◽  
Achilles Tendon Rupture ◽  
Recovery Process ◽  
Biomechanical Properties ◽  
Resonance Imaging ◽  
Ultrasound Monitoring ◽  
And Function

The treatment of Achilles tendon rupture attempts to restore the primary anatomical structure and principal biomechanical properties of the damaged tendon. Postoperative clinical assessment of the healing progression and function monitoring may be difficult and require experience. Diagnostic imaging (ultrasonography and magnetic resonance imaging) helps monitor the healing process. In the following paper, we propose a heel-rise test – a dynamic assessment of the Achilles tendon performed under direct observation and ultrasound monitoring to establish the tension of the Achilles tendon. The test allows for a simple assessment of tendon function and may be safely repeated at any postoperative stage. It may be performed by a physician, radiologist and physiotherapist to monitor the recovery process following Achilles tendon damage.

Strength Measurement After Achilles Tendon Repair

2018 ◽  
Vol 12 (5) ◽  
pp. 471-479 ◽  
Author(s):  
Henrik C. Bäcker ◽  
Adrian J. Yenchak ◽  
David P. Trofa ◽  
J. Turner Vosseller
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Functional Performance ◽  
Outcome Measurement ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Performance Outcomes ◽  
Strength Measurement ◽  
Optimal Method ◽  
Strength Assessment

The goal of treatment after Achilles tendon rupture (ATR) is to restore appropriate tension to the tendon, so that normal baseline strength and functional soft-tissue length can be achieved. The assessment of plantarflexion strength has shown widespread variability. The purpose of this study is to document variations in strength assessment after the treatment of ATR in the literature. A comprehensive literature review was performed. In total, 2758 articles were found on Achilles tendon rupture and Achilles tendon strength measurement. The full text of articles including strength as a functional outcome measurement in the abstract were assessed. All objective strength measurements performed were reviewed and recorded for comparison. One-hundred articles were included in our study. In 78 articles, a dynamometer was used to measure strength, whereas in 22 articles, an endurance test (n=14) or formal gait assessment (n=8) was applied. When a dynamometer was used, there was wide variability in the various methods used including the incorporation of both isokinetic (n = 65) and isometric (n = 29) exercises utilizing varying degrees of knee flexion and patient testing position. Furthermore, the number of measurements at certain angular velocities varied. This study illustrates that no general consensus exists regarding an optimal method for measuring strength after ATR. The variability creates difficulty and challenges medical professionals’ ability to formulate consistent conclusions when determining functional performance outcomes. A more uniform way of measuring strength after ATR may allow for better comparisons between studies in the literature, potentially leading to a better understanding of strength. Levels of Evidence: Therapeutic, Level II

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