Division Tenorrhaphy: A Novel Technique for Chronic or Failed Nonoperatively Treated Achilles Tendon Rupture

2017 ◽  
Vol 10 (3) ◽  
pp. 242-245
Author(s):  
Jesse Doty ◽  
Yoshihiro Katsuura ◽  
Nicholas Richardson
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
High Strength ◽  
Nonoperative Treatment ◽  
Poor Quality ◽  
Myotendinous Junction ◽  
Foot And Ankle ◽  
Open Technique ◽  
American Orthopaedic

Here we describe a modified open technique for the repair of a ruptured Achilles tendon using multiple looped sutures with the creation of interdigitating tendon stumps maximizing surface area for suture application as well as allowing for significant tissue overlay. This technique produces a high strength repair that is useful in cases of extensive degeneration or poor-quality tissue. Degenerative tissue may be encountered with chronic ruptures or failed nonoperative treatment, as well as those ruptures that occur at the proximal myotendinous junction. We present 2 cases in which the technique was utilized: one of a failed nonoperatively treated rupture and another of a chronic rupture. The technique was found to be successful for both patients with improvement in visual analogue scale, Achilles tendon total rupture score, American Orthopaedic Foot and Ankle Score, and Foot and Ankle Disability Index. Levels of Evidence: Level IV

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.

Surgical Treatment of the Neglected Achilles Tendon Rupture with Hyalonect

2014 ◽  
Vol 104 (5) ◽  
pp. 434-443 ◽  
Author(s):  
Cem Zeki Esenyel ◽  
Cagri Tekin ◽  
Murat Çakar ◽  
Kursat Bayraktar ◽  
Selcuk Saygili ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Major Complication ◽  
Benzyl Ester ◽  
Foot And Ankle ◽  
Fascial Flap ◽  
Neglected Achilles Tendon Rupture ◽  
The Mean ◽  
American Orthopaedic

BackgroundThe purpose of this study was to report the management and outcomes of ten patients with chronic Achilles tendon rupture treated with a turndown gastrocnemius-soleus fascial flap wrapped with a surgical mesh (Hyalonect).MethodsTen men with neglected Achilles tendon rupture were treated with a centrally based turndown gastrocnemius fascial flap wrapped with Hyalonect. Hyalonect is a knitted mesh composed of HYAFF, a benzyl ester of hyaluronic acid. The Achilles tendon ruptures were diagnosed more than 1 month after injury. The mean patient age was 41 years. All of the patients had weakness of active plantarflexion. The mean preoperative American Orthopaedic Foot and Ankle Society score was 64.8.ResultsThe functional outcome was excellent. The mean American Orthopaedic Foot and Ankle Society score was 97.8 at the latest follow-up. There were significant differences between the preoperative and postoperative scores. Ankle range of motion was similar in both ankles. Neither rerupture nor major complication, particularly of wound healing, was observed.ConclusionsFor patients with chronic Achilles tendon rupture with a rupture gap of at least 5 cm, surgical repair using a single turndown fascial flap covered with Hyalonect achieved excellent outcomes.

scholarly journals The Influence of Diabetes on Acute Achilles Tendon Rupture Repair

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0028
Author(s):  
Jonathan Kaplan ◽  
Jeffery Hillam ◽  
Amiethab Aiyer ◽  
Niall Smyth
Keyword(s):  
Diabetes Mellitus ◽  
Postoperative Complications ◽  
Achilles Tendon ◽  
Power Analysis ◽  
Tendon Rupture ◽  
Surgical Repair ◽  
Achilles Tendon Rupture ◽  
The United States ◽  
Foot And Ankle ◽  
Tendon Ruptures

Category: Sports Introduction/Purpose: Diabetes Mellitus (DM) is an epidemic affecting millions of individuals in the United States. Multiple studies have demonstrated an increase in complications in foot and ankle surgery in patients with DM, including wound healing complications, surgical site infections (SSI), or surgical failure. The goal of this study was to retrospectively review outcomes data from the National Surgical Quality Improvement Program (NSQIP) to determine the impact of DM on operative treatment of achilles tendon ruptures. Methods: Using the NSQIP from 2006-2015, patients were identified using common procedure terminology (CPT) for Achilles tendon ruptures. Diabetic and non-diabetic cohorts were evaluated to compare demographics, comorbidities, perioperative details and 30-day outcomes. Statistical evaluation included a power analysis for the primary outcome measure of wound disruption as well as univariate analysis was performed using chi-squared or Fisher’s exact and Wilcoxon signed-rank tests. Results: A total of 2,014 patients were identified having sustained an Achilles tendon rupture. There were 1,981 patients without DM and 33 patients with DM. There were no significant differences in postoperative complications, including SSI, medical complications, and 30-day outcomes between patients with DM and non-DM patients undergoing surgical repair of acute Achilles tendon ruptures. The power analysis for wound disruption showed a P=0.9 with an alpha of 0.05, sample size of n=2014, and Pearson correlation coefficient of r=0.0721 Conclusion: While DM has been shown to have an increase in complications in various foot and ankle procedures, this study demonstrates that there is no significant difference in postoperative complications and 30-day outcomes between patients with DM and non-DM patients undergoing surgical repair of acute Achilles tendon ruptures using the NSQIP database from 2006-2015. Based on this data, patients with diabetes mellitus can be considered adequate surgical candidates for acute Achilles tendon rupture repair.

Surgical repair of acute Achilles tendon rupture using a “mini-open” technique

2002 ◽  
Vol 7 (3) ◽  
pp. 611-619 ◽  
Author(s):  
Pascal F Rippstein ◽  
Maximilien Jung ◽  
Mathieu Assal
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Surgical Repair ◽  
Achilles Tendon Rupture ◽  
Open Technique ◽  
Mini Open

Risk Factors for Failed Nonoperative Treatment and Rerupture in Acute Achilles Tendon Rupture

2018 ◽  
Vol 39 (6) ◽  
pp. 694-703 ◽  
Author(s):  
Aleksi Reito ◽  
Hanna-Liina Logren ◽  
Katri Ahonen ◽  
Heikki Nurmi ◽  
Juha Paloneva
Keyword(s):  
Risk Factors ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Case Series ◽  
Nonoperative Treatment ◽  
Activity Level ◽  
Factors Associated ◽  
Increased Risk ◽  
Male Patients

Background: Nonoperative treatment is feasible in most patients with acute Achilles tendon rupture. Risk factors associated with failed nonoperative treatment are poorly understood. We investigated risk factors associated with rerupture after nonoperative treatment and otherwise failed nonoperative treatment of Achilles tendon rupture. Methods: All patients diagnosed with acute Achilles tendon rupture between January 2009 and June 2016 and who underwent 8 weeks of nonoperative treatment with functional rehabilitation were included in the study. Patients with rerupture or otherwise failed nonoperative treatment were identified retrospectively. Time to rerupture and association of age, sex, time from injury, diabetes, and visits to the physiotherapist for cases of reruptures and otherwise failed nonoperative treatment were investigated. A total of 210 patients were included in the study. Results: Fifteen patients sustained a rerupture. Rerupture incidence was 7.1%. Incidence of late reruptures, those occurring after return to daily activities at 12 weeks, was 1.9%. Six patients had otherwise failed nonoperative treatment. Median time to rerupture was 23 days (6 to 61) after the end of the treatment. The incidence of all-cause failure was 10.0%. Male gender was associated with reruptures ( P = .013) and failed nonoperative treatment for any reason ( P = .029). Conclusion: It is important to highlight the increased risk of rerupture in male patients during the first month after the end of the nonoperative treatment. Age alone, even in male patients, was a poor indication for operative treatment since it did not predict early failure. Further studies will hopefully clarify the influence of activity level on the risk of rerupture. Level of Evidence: Level IV, retrospective case series.

scholarly journals Bearing Weight at the Same Day in Conservatively Treated Acute Achilles Tendon Rupture Patients

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0020
Author(s):  
Murat Korkmaz ◽  
Sadiye Yolcu ◽  
Özlem Balbaloğlu ◽  
Zekeriya Öztemur ◽  
Fatih Karaarslan
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Treatment Protocol ◽  
Early Mobilization ◽  
Treated Group ◽  
Plaster Cast ◽  
Wound Complications ◽  
American Orthopaedic

Objectives: Achilles tendon rupture (ATR) often occurs in 40- to 50-year-old men.. At treating there has been considerable research interest in attempting to identify the optimal treatment strategy, surgical or non-surgical, combined with functional early mobilisation or plaster cast immobilisation. Our aimed to compare the outcomes of bearing weight at the same day in conservatively treated and surgically treated groups of ATR patients. Methods: Thirty-two conservatively treated ATR patients and twenty nine surgically treated ATR patients were included to our study. Patients were over 18 years old who had been followed for 12 months by our clinic. All patients underwent knee supporting cast at four week and both group was asked for walking with bearing weight (%30-40) at same day. Results: In all groups 2nd and 12th months’ AOFAS (American Orthopaedic Foot and Ankle Society) scorings of the patients had significant differences (p<0.001). Return to work time results were significantly different and shorter in conservatively treated group (p= 0.035). This study founded a relatively high complication percentage of (6 patients) 20.6% in the surgically treated group. On the contrary the wound complications non-surgical group has not been be observed. Conclusion: In conclusion, this study adds to evidence that a well conducted non-surgical treatment protocol (early mobilization treatment regimen) gives a good clinical outcome and complication rate is not higher than after surgical treatment.

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