scholarly journals Return to Play After Mini-Open Repair of Achilles Tendon Ruptures in the NFL Athlete

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Stephen Greenfield ◽  
Robert Anderson
Keyword(s):  
Achilles Tendon ◽  
Performance Metrics ◽  
Open Repair ◽  
Return To Sport ◽  
Return To Play ◽  
Post Injury ◽  
Significant Difference ◽  
Tendon Ruptures ◽  
The Impact ◽  
Mini Open

Category: Sports Introduction/Purpose: Non-insertional Achilles tendon ruptures are a devastating injury in the National Football League (NFL) athlete. Depending on timing, these often are season ending injuries. There are mixed reports in the literature regarding impact of Achilles injuries in elite athletes. Additionally, there have been advancements in techniques including a mini-open repair that has proven successful. The purpose of this study was to critically analyze a large, single surgeon series of non-insertional Achilles ruptures in NFL athletes treated with a mini-open technique. Our primary focus was to determine return to play and evaluate possible contributing factors that affect this. Additionally, we sought to compare pre and post injury performance for those who successfully returned to the NFL. Methods: NFL athletes treated for non-insertional Achilles ruptures since 2012 were included. Demographic and performance data were obtained from the NFL.com player database and included position, age, years in the league, return to sport and relevant performance metrics listed below. Pre injury frequency of play (games played per total games in season) for athletes were recorded. The impact of injury on performance after return to sport was assessed by comparing data from two years prior and two years post injury, normalized to a “per game” basis. For defensive players, specific metrics included tackles, pass deflection, interceptions and sacks. For offensive players, rushing and receiving statistics for running backs and wide receivers/tight ends were recorded, respectively. Average yards per run/catch, attempts per game, number of 20+ yard plays and touchdowns were recorded. Data was analyzed with Welch’s method 2-Sample t test in Minitab. Results: Thirty-five ruptures were identified in predominantly defensive players (25/35). Ruptures occurred, on average, at age 27.7 years with 4.1 years of NFL experience. There was no significant difference in offensive (70%) and defensive (76%) player’s ability to return to the NFL (p=1.0). The frequency of play in the two seasons prior to injury differed significantly for players who did not return (21%) compared to those who did (95%) (p=.0013). Due to limited skill-position offensive players, further sub- analysis was limited. Defensive players who returned demonstrated significant differences in performance pre-injury compared to players who failed to return. In the two years following injury, returning defensive players performed at near baseline compared to pre injury statistics (figure 1). Conclusion: Achilles injuries occurred predominately in defensive players. Typically occurring past the average NFL career length, it represents a mid to late career injury. The comeback rate of 74% is excellent and is higher than previously reported. Those who failed to return were utilized less frequently pre-injury and had poorer performance statistics (defensive), indicating less talented players were impacted to a greater extent. Lastly, given limited or no differences found in productivity for those who returned, we conclude that while an Achilles injury is most often season ending, most skilled players are able to return with little impact on performance.

Retrospective Analysis of Mini-Open Repair Versus Open Repair for Acute Achilles Tendon Ruptures

2012 ◽  
Vol 6 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Erin E. Klein ◽  
Lowell Weil ◽  
Jeffrey R. Baker ◽  
Lowell Scott Weil ◽  
Wenjay Sung ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Open Repair ◽  
Surgical Intervention ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Level Of Evidence ◽  
Tendon Ruptures ◽  
Return To Activity ◽  
Mini Open

Purpose: Debate exists over optimal treatment for acute Achilles tendon ruptures. Recent literature suggests the mini-open technique may provide the reliability of the open repair with the decreased complication rate of non-operative treatment. This retrospective review compares acute tendon ruptures treated with one of two techniques: open repair (TO) or mini-open repair (MOA). Methods & Results: Records were reviewed and 34 patients were found to meet the inclusion criteria for open or mini-open repair of an acute Achilles tendon rupture with follow up of at least 12 months. TO (n=16) and MOA (n=18) had no statistically significant differences in age at time of injury [TO: 41 + 2.5 years (range 20 – 68); MOA: 46 + 2.5 years (range 33 – 73)] or time between injury and surgical repair [TO: 15 + 2 days (range 2 – 30); MOA: 15 + 2 days (range 2 – 30)]. Post-operative VISA-A scores were 82 + 10 (range 42 – 98) and 92 + 5 (range 66 – 100) for TO and MOA, respectively. Significant differences were found in the time between surgical intervention and beginning of rehabilitation [TO: Post op day 37 + 5 (range 21 – 46); MOA: Post op day 19 + 2 (range 7 – 32)] and the time between surgical intervention and full return to activity [TO: Post op month 7 + 1 (range 4 – 11); MOA: Post op month 5 + 0.6 (range 4 – 11)]. Conclusion: These results suggest that the mini-open repair provides acceptable surgical outcomes while optimizing patient function after Achilles tendon repair. Level of Evidence: Therapeutic, Level III: Retrospective Comparative

Outcomes and Complications of Open Versus Minimally Invasive Repair of Acute Achilles Tendon Ruptures: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2021 ◽  
pp. 036354652110536
Author(s):  
Ahmed Khalil Attia ◽  
Karim Mahmoud ◽  
Pieter d’Hooghe ◽  
Jason Bariteau ◽  
Sameh A. Labib ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Functional Outcomes ◽  
Sural Nerve ◽  
Open Repair ◽  
Meta Analysis ◽  
Deep Infection ◽  
Surgical Time ◽  
Significant Difference ◽  
Tendon Ruptures ◽  
The Mean

Background: An acute Achilles tendon rupture is one of the most common sports injuries, affecting 18 per 100,000 persons, and its operative repair has been evolving and increasing in frequency since the mid-1900s. Traditionally, open surgical repair has provided improved functional outcomes, reduced rerupture rates, and a quicker recovery and return to activities at the expense of increased wound complications such as infections and skin necrosis compared with nonoperative management. In 1977, Ma and Griffith introduced the percutaneous approach, and over the following decades, multiple improved techniques, and modifications thereof, have been described with comparable outcomes with open repair. Purpose: The current study aimed to provide updated level 1 evidence comparing open repair with minimally invasive surgery (MIS) through a comprehensive search of the literature published in English, Arabic, Spanish, Portuguese, and German while avoiding limitations of previous studies such as heterogeneous study designs and a small number of included trials. Study Design: Meta-analysis; Level of evidence, 1. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, 2 independent team members searched several databases to identify randomized controlled trials (RCTs) comparing open repair and MIS of Achilles tendon ruptures. The primary outcomes were (1) functional outcomes, (2) reruptures, (3) sural nerve injuries, and (4) infections (deep/superficial), whereas the secondary outcomes were (1) skin complications, (2) adhesions, (3) other complications, (4) ankle range of motion, and (5) surgical time. Results: There were 10 RCTs that qualified for the meta–analysis with a total of 522 patients. Overall, 260 (49.8%) patients underwent open repair, while 262 (50.2%) underwent MIS. The mean postoperative AOFAS score was 94.8 and 95.7 for open repair and MIS, respectively, with a nonsignificant difference (mean difference [MD], –0.73 [95% CI, –1.70 to 0.25]; P = .14; I2 = 0%). The pooled mean total complication rate was 15.5% (0%-36.4%) for open repair and 10.4% (0%-45.5%) for MIS, with a nonsignificant statistical difference (odds ratio [OR], 1.50 [95% CI, 0.87-2.57]; P = .14; I2 = 40%). The mean rerupture rate was 2.5% (0%-6.8%) for open repair versus 1.5% (0%-4.6%) for MIS, with a nonsignificant statistical difference (OR, 1.56 [95% CI, 0.42-5.70]; P = .50; I2 = 0%). No cases of sural nerve injuries were reported in the open repair group. The mean sural nerve injury rate was 3.4% (0%-7.3%) in the MIS group, which was statistically significant (OR, 0.16 [95% CI, 0.03-0.46]; P = .02; I2 = 0%). The mean overall superficial infection rate was 6.0% (0%-18.2%) and 0.4% (0%-4.5%) for open repair and MIS, respectively, with a statistically significant difference (OR, 5.70 [95% CI, 1.80-18.02]; P < .001; I2 = 0%). The mean overall deep infection rate reported in the open repair group was 1.4% (0%-5.0%), while no deep infection was reported in the MIS group, with no statistically significant difference (OR, 3.14 [95% CI, 0.48-20.54]; P = .23; I2 = 0%). There were no significant differences between the open repair and MIS groups in the skin necrosis and dehiscence rate, adhesion rate, or keloid scar rate. The mean surgical time was 51.0 and 29.7 minutes for open repair and MIS, respectively, with a statistically significant difference (MD, 21.13 [95% CI, 15.50-26.75]; P < .001; I2 = 15%). Conclusion: Open Achilles tendon repair was associated with a longer surgical time, higher risk of superficial infections, and higher risk of ankle stiffness, while MIS was associated with a greater risk of temporary sural nerve palsy. The rerupture rate and functional outcomes were mostly equivalent. We found MIS to be a safe and reliable technique. However, high–quality standardized RCTs are still needed before recommending MIS as the gold standard for managing Achilles tendon ruptures.

scholarly journals Professional Athletes’ Return to Play and Performance after Achilles Tendon Ruptures

2017 ◽  
Vol 2 (2) ◽  
pp. 2473011416S0000
Author(s):  
Johnathan Miller ◽  
Denzel Woode ◽  
Eugene Jang ◽  
David Trofa ◽  
Justin Greisberg ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Surgical Repair ◽  
Achilles Tendon Rupture ◽  
Return To Play ◽  
Inclusion Criteria ◽  
Post Injury ◽  
Tendon Ruptures ◽  
Performance Statistics ◽  
And Performance

Category: Sports Introduction/Purpose: The majority of Achilles tendon ruptures are sports-related. A significant decrease in return to play, playing time, and performance has been shown in National Basketball Association (NBA) players who sustained a complete Achilles tendon rupture requiring surgical repair. However, no study to date has examined and compared the impact on performance and return to play across multiple professional sports. Methods: Publicly available records yielded a list of NBA, National Football League (NFL), Major League Baseball (MLB), and National Hockey League (NHL) athletes who suffered Achilles tendon ruptures requiring surgical repair from 1989-2013. Demographic information and performance-related statistics were recorded from public sports statistics websites. The primary outcome of this study was the proportion of games played post- vs. pre-injury. Secondary markers of longevity were minutes played for NBA, games started for NFL, and innings played in field for MLB. Inclusion criteria included individuals in the NBA, NFL, MLB, and NHL with professional experience for at least 2 years before and after sustaining a primary Achilles tendon rupture requiring surgical repair. A matched control was selected for all returning players by identifying athletes with similar playing position, number of seasons played, and career performance statistics. The study was powered to detect a 15% difference in games played between ruptures and controls. Results: Of 100 athletes initially screened for the study, 43 met the inclusion criteria. Others were excluded for not completing at least 2 seasons pre- (n=16) or post-injury (n=32), or having a confounding injury (n=9). Athletes on average played 75.4% (p < 0.001) and 81.9% (p=0.002) of the games played the season prior to injury at 1 and 2 years post-injury, respectively. Other markers of longevity were also significantly decreased in athletes at 1 and 2 years post-injury (p < 0.001). Athletes also performed worse, with post-injury performances equivalent to 74.8% of pre-injury performance at 1 year (p=0.001) and 77.7% at 2 years (p < 0.001). Compared to controls, athletes with Achilles injuries played fewer games (p < 0.001) and had decreased longevity (p=0.025), and performance statistics (p < 0.001) at 1 year, but not 2 years after injury. Conclusion: An Achilles rupture is a devastating injury with many athletes unable to return to play. Further, athletes who managed to play for 2 years after injury play significantly fewer games, and experience significant decreases in secondary measures of longevity and performance metrics. Compared to controls, however, only the 1-year post-injury longevity and performance statistics were significantly worse. This implies a bimodal distribution of successful return to play: a significant portion of athletes undergoing repair never return to their prior level of competition, but those that do can often perform at a level commensurate with non-injured controls after 2 years.

scholarly journals Management of acute Achilles tendon ruptures

2018 ◽  
Vol 7 (10) ◽  
pp. 561-569 ◽  
Author(s):  
X. Yang ◽  
H. Meng ◽  
Q. Quan ◽  
J. Peng ◽  
S. Lu ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Open Repair ◽  
Weight Bearing ◽  
Achilles Tendon Rupture ◽  
Complication Rates ◽  
Functional Rehabilitation ◽  
Percutaneous Repair ◽  
Tendon Ruptures ◽  
Mini Open

ObjectivesThe incidence of acute Achilles tendon rupture appears to be increasing. The aim of this study was to summarize various therapies for acute Achilles tendon rupture and discuss their relative merits.MethodsA PubMed search about the management of acute Achilles tendon rupture was performed. The search was open for original manuscripts and review papers limited to publication from January 2006 to July 2017. A total of 489 papers were identified initially and finally 323 articles were suitable for this review.ResultsThe treatments of acute Achilles tendon rupture include operative and nonoperative treatments. Operative treatments mainly consist of open repair, percutaneous repair, mini-open repair, and augmentative repair. Traditional open repair has lower re-rupture rates with higher risks of complications. Percutaneous repair and mini-open repair show similar re-rupture rates but lower overall complication rates when compared with open repair. Percutaneous repair requires vigilance against nerve damage. Functional rehabilitation combining protected weight-bearing and early controlled motion can effectively reduce re-rupture rates with satisfactory outcomes. Biological adjuncts help accelerating tendon healing by adhering rupture ends or releasing highly complex pools of signalling factors.ConclusionThe optimum treatment for complete rupture remains controversial. Both mini-open repair and functional protocols are attractive alternatives, while biotherapy is a potential future development. Cite this article: X. Yang, H. Meng, Q. Quan, J. Peng, S. Lu, A. Wang. Management of acute Achilles tendon ruptures: A review. Bone Joint Res 2018;7:561–569. DOI: 10.1302/2046-3758.710.BJR-2018-0004.R2.

scholarly journals Return to Play and Performance After Achilles Tendon Rupture in Women’s National Basketball Association Players

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0020
Author(s):  
Vincent Federico ◽  
Samy Gabriel ◽  
Christopher W. Reb
Keyword(s):  
Achilles Tendon ◽  
Effect Size ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
National Basketball Association ◽  
Return To Play ◽  
Post Injury ◽  
Tendon Ruptures ◽  
Performance Statistics ◽  
And Performance

Category: Sports; Trauma Introduction/Purpose: For the professional athlete, an Achilles tendon rupture is a devastating and potentially career ending injury. Basketball players with Achilles tendon injuries have among the lowest reported return to play rates for orthopaedic injuries. Among National Basketball Association (NBA) players, Achilles rupture has been shown to result in difficulty with returning to competition and significantly decreased productivity exhibiting a large effect size (0.95). Comparable data regarding Women’s National Basketball Association (WNBA) players is lacking. This study evaluated the impact of Achilles tendon rupture on return to play and post-injury performance among WNBA players in order to test the null hypothesis of equal negative impact as observed in the NBA. Methods: This was an IRB exempt retrospective matched cohort study. Public records indicated 12 WNBA players incurred Achilles tendon ruptures between the 2006 and 2018 seasons. Demographic data and performance statistics were collected for pre and post-injury seasons. A control cohort was matched for age, height, weight, years of experience in WNBA, position, and pre-injury player efficiency rating (PER). Individual pre versus post injury and injury cohort versus control cohort performance statistics were compared using paired and independent samples t-tests, respectively. Injury effect size on performance was calculated. The primary outcome was difference in PER. Secondary outcomes included differences in itemized performance statistics. A priori sample size based on effect size of 0.95 indicated that 12 players per cohort were needed for 80% power to detect a difference in PER at alpha of 0.05. Results: 7 (58%) players returned to WNBA play by mean 9.5 months. There was no significant difference in pre injury PER from seasons matched for years of WNBA experience between cohorts (13.7 vs 11.9; P = 0.6). Mean PER significantly decreased in the first year (13.66 vs 9.00; P = .04; Cohen’s d = .99) and approached a significance difference in the second year (14.56 vs 9.95; P = 05; Cohen’s d = 1.02) in the injured cohort only. Minutes per game (MPG) significantly decreased only year 1 post-injury (25.84 vs 19.54; P = .04; Cohen’s d = 6.56). Points per game (PPG), field goals attempted per game (FGA), and free throws attempted per game (FTA) significantly decreased in both years post-injury (all p < 0.05). Conclusion:: WNBA players incurred Achilles tendon ruptures at a rate of 2% annually. This was associated with a moderate rate of return to play and significantly reduced production (PER, MPG, PPG, FGA, and FTA) in the first year. The second season following injury found players returning closer to pre-injury performance, with persistent significant reduction in PPG, FGA, and FTA. Effect sizes were uniformly large. These data were consistent with NBA results, supporting the null hypothesis. Providers may use this data to counsel high and elite level female basketball players on return to play and performance expectations following Achilles tendon ruptures.

scholarly journals Epidemiology and Outcomes of Achilles Tendon Ruptures in the National Football League

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Selene Parekh ◽  
Jay Shah
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
National Football League ◽  
Achilles Tendon Rupture ◽  
Return To Play ◽  
Football Players ◽  
Professional Football ◽  
Post Injury ◽  
Tendon Ruptures ◽  
Player Performance

Category: Ankle, Sports Introduction/Purpose: While much less common than ankle sprains and other sports injuries, Achilles tendon ruptures have represented unexpected and potentially career-altering injuries for professional football athletes in the National Football League (NFL). Over the past decade, the technique for surgical repair of the ruptured Achilles tendon has evolved. Mini-open and percutaneous techniques have become more common, allowing for the minimization of wound complications and expediting the rehabilitation of athletes. Therefore, the objectives of this study were to update the epidemiology of Achilles tendon ruptures in the NFL, and to analyze how recovery and post-injury performance of professional football players with this injury have progressed in the last two decades. Methods: Several online sources including NFL news and injury reports, player registries, and player statistic databases were cross-referenced to conduct a retrospective identification of all NFL players sustaining complete Achilles tendon ruptures during the 2010-2015 NFL seasons. Yearly player performance statistics were also obtained and recorded for both offensive and defensive players. A power rating formula and “approximate value” algorithm, commonly used to evaluate player production, were borrowed to calculate yearly Offensive and Defensive performance metrics for each injured player. These calculated measurements were used to quantify both offensive and defensive player performance up to 3 seasons before and after their respective Achilles tendon rupture injuries, allowing for each player to serve as his own control. Results: 78 Achilles tendon ruptures were identified in professional football players during the 2010-2015 NFL seasons. 58% of these injuries occurred during the preseason. Of those that suffered an Achilles tendon rupture, 26% did not ever return to play in the NFL. Players who did return to play in the NFL took an average of 9 months to recover after the date of injury. Across all positions, there was a net decrease in power ratings by 22% and a net decrease in approximate value by 23% over 3 years following player return after Achilles tendon rupture. Across all positions, running backs saw the biggest decrease in production with a 78% decrease over 3 years post-injury in both power ratings and approximate value. Conclusion: While the incidence of Achilles tendon ruptures in NFL players, especially in the preseason, has increased substantially, more players are returning to play after injury and with better post-injury performance as compared to the previous two decades. These injuries should still be considered potentially career-altering as 26% of players never return to play after Achilles tendon ruptures and there is still a net decrease in power-ratings by 22% for those who do return. However, these numbers optimistically suggest that advancements in treatment protocol and rehabilitation are resulting in faster recovery and improved performance after Achilles tendon ruptures in NFL players.

scholarly journals Return to Play after Open Repair for Achilles Rupture in Recreational Athletes

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0032
Author(s):  
Hong S. Lee ◽  
Kiwon Young ◽  
Tae-Hoon Park ◽  
Hong Seop Lee
Keyword(s):  
Achilles Tendon ◽  
Sport Participation ◽  
Open Repair ◽  
Return To Sport ◽  
Return To Play ◽  
Return To Sports ◽  
Personal Reason ◽  
Recreational Athletes ◽  
General Weakness ◽  
The Mean

Category: Sports Introduction/Purpose: The management of Achilles tendon ruptures in recreational athletes can be challenging. This study assessed the average time to return to sport after open repair for Achilles rupture in recreational athletes. Methods: Twenty one recreational athletes with prodromal tendinous problems sustained an acute tear of the AT and surgical repair with Krachow method from June 2013 to April 2017. Their average age was 39.7 years, and the average follow-up time was 53.2 months. Each patient was evaluated for postoperative ATRS (Achilles Tendon Total Rupture Score), complication and time to return to sports. Results: The mean postoperative ATRS was 85.1. The mean length of time to return to sports was 8 months. Eighteen patients of 21 athletes returned to full sport participation. Eleven athletes returned to the original sports. Seven athletes changed their sports due to fear of re-rupture (four athletes), discomfort during running or jumping (one athlete), general weakness (one athlete), dissuade of family (one athlete). Three athletes didn’t return to sport participation due to thickening of Achilles tendon (two athletes) and personal reason (one athlete). Conclusion: The return to play was 85 % at 8 months postoperatively. The results provide reference data for sports physician in evaluation surgical results and informing athletes about expectations after surgery in terms of timing of return to sports in recreational athletes.

Mini-open Repair for Acute Achilles Tendon Rupture: Ring Forceps vs the Achillon Device

2021 ◽  
pp. 036354652110444
Author(s):  
Chul Hyun Park ◽  
Hongfei Yan ◽  
Jeongjin Park ◽  
Min Cheol Chang
Keyword(s):  
Postoperative Complications ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Open Repair ◽  
Plantar Flexion ◽  
Achilles Tendon Rupture ◽  
Operation Time ◽  
Maximum Height ◽  
Significant Difference ◽  
Mini Open

Background: Repair of acute Achilles tendon rupture using the Achillon device is a representative mini-open repair technique; however, the limitations of this technique include the need for special instruments and decreased repair strength. A modified mini-open repair using ring forceps might overcome these limitations. Purpose: To compare the Achillon device with ring forceps in mini-open repairs of acute Achilles tendon rupture. Study Design: Cohort study; Level of evidence, 3. Methods: Fifty patients (41 men and 9 women) with acute Achilles tendon rupture on 1 foot were consecutively treated using mini-open repair techniques. The first 20 patients were treated using the Achillon device (Achillon group), and the subsequent 30 were treated using a ring forceps (forceps group). Clinical, functional, and isokinetic results and postoperative complications were compared between the groups at the last follow-up. Clinical evaluations were performed using the AOFAS (American Orthopaedic Foot and Ankle Society) score, Achilles Tendon Total Rupture Score, length of incision, and operation time. Functional evaluations included active range of motion of the ankle joint, maximum calf circumference, hopping test, and single-limb heel rise (SLHR). Isokinetic evaluations were performed using the isokinetic test for ankle plantar flexion. Results: The AOFAS score ( P = .669), Achilles Tendon Total Rupture Score ( P = .753), and length of incision ( P = .305) were not significantly different between the groups (mean ± SD, 90.1 ± 8.7, 88.3 ± 9.9, and 2.7 ± 0.3 cm in the Achillon group vs 92.2 ± 9.4, 89.9 ± 10.9, and 2.5 ± 0.4 cm in the forceps group, respectively). Operation times in the Achillon group were significantly shorter than those in the forceps group (41.4 ± 9.6 vs 62.8 ± 14.1 minutes, P < .001). The maximum height of the SLHR ( P = .042) and the number of SLHRs ( P = .043) in the forceps group (79.7% ± 7.4% and 72.9% ± 10.2%) were significantly greater than those in the Achillon group (75.3% ± 7.1% and 66.7% ± 11.0%). No significant differences were detected between the groups in mean peak torques for plantar flexion at angular speeds of 30 deg/s ( P = .185) and 120 deg/s ( P = .271). There was no significant difference in the occurrence of postoperative complications between the groups ( P = .093). Conclusion: The ring forceps technique is comparable to the Achillon technique with respect to clinical, functional, and isokinetic results and postoperative complications. Given that no special instrument is required, the ring forceps technique could be a better option for acute Achilles tendon rupture repair.

scholarly journals Open Repair of Acute Achilles Tendon Ruptures: Is the Incidence of Clinically Significant Wound Complications Overestimated?

2017 ◽  
Vol 2 (2) ◽  
pp. 247301141769983 ◽  
Author(s):  
Meghan E. Bishop ◽  
Carly D. Comer ◽  
Justin M. Kane ◽  
Mitchell G. Maltenfort ◽  
Steven M. Raikin
Keyword(s):  
Achilles Tendon ◽  
Open Repair ◽  
Local Treatment ◽  
Retrospective Chart Review ◽  
Additional Treatment ◽  
Operative Intervention ◽  
Wound Complications ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Tendon Ruptures

Background: Conflicting evidence exists regarding the optimal management of acute Achilles tendon ruptures. Operative repair is thought to afford patients a lower risk of rerupture, albeit at a higher overall risk of wound complications. Methods: A retrospective chart review of 369 consecutive patients undergoing open repair of acute Achilles tendon ruptures performed by a single foot and ankle fellowship-trained orthopedic surgeon was undertaken. Healing was classified as no complications, complications without prolonging treatment, complications requiring prolonged local treatment, and complications requiring operative intervention. A statistical analysis comparing the rates of complications in this cohort to that reported in the literature was conducted. Results: There were a total of 33 (8.94%) wound complications. Compared to the rates reported in the literature, no significant difference was detected ( P = .3943; CI 6.24-12.33). However, when the complications not requiring additional treatment or prolonged care were excluded, only 9 wound complications (2.44%) were identified—a significantly lower complication rate than that reported in the literature ( P < .0001; CI 1.12-4.58). There were only 2 (0.54%) major complications requiring operative intervention, also a significantly lower rate than in the literature ( P < .0001; CI 0.067-1.94). Conclusion: In the past, wound-healing complications have been cited as a concern when treating patients operatively. We found that when solely looking at healing complications prolonging the patients’ overall recovery, a significantly lower rate of complications existed compared to that reported in the literature. Level of Evidence: Level IV.

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