scholarly journals Minimally Invasive Knotless-Bridge Suture Technique for Acute Achilles Tendon Rupture

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0038
Author(s):  
Zhongmin Shi ◽  
Xiaokang Wang
Keyword(s):  
Minimally Invasive ◽  
Return To Work ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Suture Technique ◽  
Calf Circumference ◽  
Aofas Score ◽  
Superficial Infection

Category: Hindfoot Introduction/Purpose: To investigate the clinical effect of minimally invasive knotless-bridge suture technique combined with PRP augamentation for acute achilles tendon rupture. Methods: Totally 23 cases of acute achilles tendon rupture were treated from August 2016 to December 2016 including 21 cases of males and 2 cases of females with an average age of 42.1 years-old (from 29-51 years). Mini-invasive knotless-bridge suture technique was performed in all cases until the soft tissue condition improved. Ankle range of motion, calf circumference difference between two lower extrenities, number of repetions for single heel-rise in one minute, American Orthopaedic Foot & Ankle Society (AOFAS) score, The Achilles Tendon Total Rupture Score(ATRS) and time to return to work were investigated at last follow-up, as well as complications during follow-up. Results: 23 cases were followed for an average of 28 months . At last follow-up, the average ankle ROM was 60.3±2.2°, calf circumference difference between two lower extrenities was 92.7±1.8%, number of repetions for single heel-rise in one minute was 25±2, AOFAS score was 91.5±2.2, ATRS score was 92.6±2.4, time to return to work ranged from 6 to 9 weeks, averaging 7 weeks.Wound was sutured in one stage and united in one stage.No skin necrosis, superficial infection, sural nerve injury occurred.No achilles tendon re-rupture was seen during follow-up. Conclusion: Minimally invasive knotless-bridge suture technique combined with PRP augamentation for acute achilles tendon rupture is operated easily and lesser-trama, enabling patients to return to work earlier and proved to be an effective treatment.

scholarly journals Achilles tendon repair by a minimally invasive technique using Tenolig®

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.

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

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.

scholarly journals Results of tenorrhaphy with early rehabilitation for acute tear of Achilles tendon

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901880248 ◽  
Author(s):  
Chang Hyun Ryu ◽  
Ho Seong Lee ◽  
Sang Gyo Seo ◽  
Ho Yeon Kim
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Surgical Repair ◽  
Plantar Flexion ◽  
Achilles Tendon Rupture ◽  
Early Rehabilitation ◽  
Calf Circumference ◽  
Major Complications ◽  
The Mean

Background: For the treatment of acute Achilles tendon rupture, early rehabilitation after surgical repair is believed to be a useful method. The purpose of this study was to evaluate the outcome of open tenorrhaphy followed by early rehabilitation. Methods: A total of 112 patients who underwent open repair and early rehabilitation for acute Achilles tendon rupture from January 2003 to March 2015 were retrospectively reviewed. These 112 patients (80 men, 32 women) had an average age of 43.1 years (22–62 years), and the mean follow-up period was 91.8 months (12–171 months). A short leg cast was applied postoperatively for an average of 16.5 days (12–20 days). The mean duration of bracing was 6.9 weeks (6–8 weeks). Each patient was assessed based on range of motion, single heel raising test, calf circumference compared to the contralateral limb, ability to return to previous activity, the Arner–Lindholm scale, and the American orthopaedic foot and ankle society (AOFAS) hind foot scale. Isokinetic plantar flexion power was also checked. Results: All patients were fully satisfied (AOFAS ≥ 90) with the treatment results, and 96 patients were able to return to their previous athletic activities. As assessed by the Arner–Lindholm scale, 103 cases were rated as excellent and the other 9 cases were rated as good. At the 1-year follow-up period, single heel raise and hopping was possible in every patient. Compared to the contralateral side, 10 subjects (8.9%) had minor limitation of dorsiflexion motion, and an average of 1.6 cm calf circumference difference without functional disabilities. There were no major complications such as re-rupture, nerve injury, or infection. Conclusion: For acute Achilles tendon ruptures, open surgical repair with optimal length restoration, followed by earlier rehabilitation results in good functional outcomes and a successful return to pre-injury levels of physical activity without major complications. Level of evidence: Level IV.

scholarly journals Degenerative tendoachilles tear repaired and augumented by peroneous brevis tendon by dynamic loop technique one year follow up

2020 ◽  
Vol 6 (4) ◽  
pp. 788
Author(s):  
K. Vijaya Bhaskar Reddy ◽  
Narsimha Lavudi
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Age Groups ◽  
Clinical Results ◽  
Suture Technique ◽  
Common Symptom ◽  
Peroneus Brevis ◽  
One Year

<p class="abstract"><strong>Background:</strong> Repair of degenerative rupture of tendoachilles is a challenge for orthopaedician. We used peroneus brevis tendon in our patients to augment the repair of degenerated tendoachilles tears by creating a dynamic loop.</p><p class="abstract"><strong>Methods:</strong> In our study, we evaluated 31 patients with Achilles tendon rupture treated by reconstruction using peroneus brevis tendon transfer by dynamic loop suture technique. The patients were from all age groups excluding those lesser than 35 years. The average follow-up being 6 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> In total 31 patient’s majority of patients belong to 41-50 years (15 cases 48.4%). Male patients being 24 (77.4%) constituted the majority, right sided injury was noted in 23 (74.2%) of the patients. Most common symptom of Achilles tendon rupture is pain. The mechanism of injury in most of the patients by stumbling in the fields in 19 (61.3%). Results of testing the patient’s ability to heel raise for 60 seconds 20 patients were able to sustain, while 8 patients were able to stand on toe with heel raised but could not sustain it. 3 patients could not do raise the heel. 5 patients complained of sensory hypoesthesia at 12 months follow-up. By Rupp scoring, 77% patients had excellent or good results and 10% had fair or poor results.</p><p class="abstract"><strong>Conclusions:</strong> Results of reconstruction of Achilles tendon ruptures using peroneus brevis tendon show a strong and stable repair that allows early weightbearing ambulation with favourable clinical results in most patients.</p>

scholarly journals Outcomes of Limited Open Achilles Repair Using Modified Ring Foreceps

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Jessica Telleria ◽  
Jeremy Smith ◽  
Lauren Ready ◽  
Eric Bluman
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Functional Outcomes ◽  
Achilles Tendon Rupture ◽  
Attractive Alternative ◽  
Functional Level ◽  
Superficial Infection ◽  
Absorbable Sutures ◽  
Clinical Records

Category: Sports Introduction/Purpose: Acute Achilles tendon ruptures have a 2.4-4.7% rate of infection and wound healing complications when treated operatively. The incidence doubles in those with risk factors such as diabetes, smoking or steroid use. To diminish complications minimally invasive approaches have received increasing interest. Meta-analyses have demonstrated equivalent rerupture rates, significantly lower risk of superficial infection, and higher patient satisfaction rates with minimally invasive repairs compared with traditional open Achilles repair techniques. We have previously published a novel technique for limited open Achilles repair using modified ring forceps. The objective of the present study is to review the clinical outcomes of this technique, and to analyze functional results using validated outcomes measures. Methods: Between 2009 and 2016, the clinical records of 29 consecutive patients (average age 45 years [range, 21-76 years], 24 males [83%]) who underwent limited-open repair of an acute Achilles tendon rupture with modified ring forceps were retrospectively reviewed. Through a 2.5-3 cm midline incision a pair of ring forceps bent 30 degrees were used to grasp the tendon stumps deep to paratenon. Three #2 non-absorbable sutures were placed in the proximal and distal segments and delivered out of the wound. The tendon ends were reapproximated and the sutures tied down to secure the tendon. At a minimum of 6 months follow-up the 10-cm Visual Analog Scale (VAS), the Foot and Ankle Ability Measure (FAAM), and the Victorian Institute of Sports Assessment – Achilles (VISA-A) were assessed. Results: At final follow-up (average 43.5 months[range, 5.7-90.1]) 28 of 29 patients reported no pain in their Achilles with an average Achilles VAS of 0.8 out of 100(SD±4.5). The average post-operative VISA-A score was 87.9 out of 100(SD±13.2). The average FAAM Activities of Daily Living and Sports subscales were 96.4%(SD±5.5) and 85.1%(SD±21.3), respectively. Post- operatively patients reported their overall functional level was 94.2% of their pre-injury level when performing ADLs, and 80.1% when participating in sports. Seventeen of 29 patients(58.6%) rated their current functional level as “normal,” nine(31.0%) as “nearly normal,” three(10.3%) as “abnormal,” and none as “severely abnormal.” There was one case of superficial wound infection that resolved with oral antibiotics and local wound care; there were no cases of deep infection, sural neuritis or rerupture. Conclusion: These results demonstrate that limited-open Achilles repair with modified ring forceps provides an economical repair with excellent pain relief and good functional outcomes at mid-term follow-up. Additionally, this is one of the first studies to report validated Achilles specific outcomes(VISA-A) in the setting of acute repair. The wide age range, and subsequent variability in elective sport involvement, may have differentially lowered the sports-related functional outcomes in this study. The complication rate was extremely low making it an attractive alternative to traditional open techniques. Furthermore, this technique is easy to learn and cost-effective without the requirement of commercially available single-use kits.

scholarly journals Clinical Outcomes in Patients With Minimally Invasive Surgical Approach Combined With Plantar Tendon Transfer Repairing Neglected Achilles Tendon Rupture Compared to the Conventional Approach of V-Y Tendon Plasty: A Retrospective Study With Two Years Follow-Up

2021 ◽  
Author(s):  
Feiyu Cai ◽  
Kai Liu ◽  
Yanshi Liu ◽  
Biao Luo ◽  
Pengfei Li ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Neglected Achilles Tendon Rupture ◽  
Group A ◽  
Group B

Abstract Background Unlike acute Achilles tendon rupture (AATR), neglected Achilles tendon rupture (NATR) requires usually tendon grafting procedures for repair tendon defects caused by removing scar tissue. The conventional open surgery of V-Y tendon plasty and minimally invasive technique with plantar tendon transfer had been described, but the long-term efficacy between the two techniques still needs further certification. Methods Between February 1, 2008, and July 31, 2018. All of 46 patients with neglected Achilles tendon rupture, 25 patients in group A (21 males and 4 females; age, 34.28 ± 6.97 years) underwent the conventional operation of V-Y tendon plasty, and 21 patients in group B (14 males and 7 females; age, 35.29 ± 7.42 years) were treated by the minimally invasive technique. Two years follow-up was performed for the functional recovery with examinations of the Achilles tendon rupture score (ATRS), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hind-Foot Scale Score, dorsiflexion, calf circumference, and heel raise test. Results Patient characteristics between the two groups were similar. The functional score of ATRS and AOFAS in Group B was higher than patients in group A at postoperative months 3, 6, and 12, while there is no difference at month 24. In group A, there were three patients exposed to soft tissue infections (two superficial infections and one deep infection) and one case with tendon exposure. In group B, a patient with tendon re-rupture was observed. There was no difference in dorsiflexion and calf circumference at follow-up two years and the much better recovery in heel raise test group B than A. Conclusions Two different techniques produced a significant functional improvement, and return to sports. However, this study demonstrated that the minimally invasive technique was recommended for patients with a tendon defect less than 6 cm and who have an urgent demand to return to the sports.

scholarly journals PO 18150 - Comparison between the open and minimally invasive repair techniques in acute Achilles tendon injuries

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. S32
Author(s):  
João Paulo Primo de Araujo ◽  
Marcus Vinicius Mota Garcia Moreno ◽  
Janice De Souza Guimarães ◽  
Marilton Jorge Torres Gomes ◽  
Túlio Eduardo Marçal Vieira ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Functional Outcomes ◽  
Tendon Rupture ◽  
Open Repair ◽  
Achilles Tendon Rupture ◽  
Invasive Technique ◽  
Repair Technique ◽  
Repair Techniques

Objective: Our study compares the functional outcomes of patients who underwent open repair of the Achilles tendon with those of patients treated with the minimally invasive technique using the percutaneous Achilles repair system (PARS) over a 1-year minimum follow-up period and presents the complication rates for the 2 techniques. Methods: Between 2011 and 2016, 31 patients were reviewed; of these, 20 were included in the study (10 PARS X 10 open repair technique). Patients with chronic Achilles tendon rupture, insertional or bilateral, and patients with a history of surgery or previous ankle pathology that could mask functional outcomes were excluded from the study. The open repair technique was performed via a posteromedial incision to the ankle to repair the tendon and was combined with myotendinous transfer of the flexor hallucis longus tendon, which was fixed with a Biotenodesis screw. The minimally invasive technique was performed using the PARS of the company Arthrex through a small transverse incision at the site of the Achilles tendon rupture. Functional outcomes and complications were collected after at least 1 year of follow-up. Results: Both groups had similar American Orthopedic Foot and Ankle Society (AOFAS) scores (PARS: 95.3±5.1, open: 96.5±5.1; p=0.604), demonstrating similar functional outcomes. The PARS group had a higher number of complications than the open repair group (PARS: 20% x open: 10%), but the difference was not significant (p=0.383). Conclusion: For the treatment of acute Achilles tendon injuries, the PARS and open repair techniques had similar functional outcomes after 1 year of follow-up.

scholarly journals Achillon versus modified minimally invasive repair treatment in acute Achilles tendon rupture

2020 ◽  
Vol 28 (1) ◽  
pp. 230949902090835
Author(s):  
Jun-Yi Liu ◽  
Wei-Feng Duan ◽  
Sheng Shen ◽  
Ye Ye ◽  
Yong-Qiang Sun ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Complication Rate ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Operation Time ◽  
Accelerated Rehabilitation ◽  
Significant Difference ◽  
Specialized Equipment

Purpose: To date, the best treatment of acute Achilles tendon rupture (AATR) is still inconclusive. Achillon seems to be a promising approach with satisfactory function and low complication rate. We hypothesize a modified minimally invasive repair (MMIR), which provides direct visualization of proximal tendon stump without specialized equipment that could provide comparable results. This trial is aimed to evaluate the functional and surgical outcomes of MMIR comparing with Achillon. Methods: From February 2013 to February 2017, 114 patients with AATR were enrolled in this trial, underwent an alternative operation (Achillon or MMIR), and accelerated rehabilitation protocol. Forty-four patients took the Achillon and the other 70 patients took the MMIR at their subjective choice. One hundred eleven full follow-up data were obtained including Achilles tendon total rupture score (ATRS), time back to work, rerupture rate, overall complication rate, and operation time. Results: There was no significant difference between groups in demographic characters. There was no statistical difference between both groups regarding to time return to work and ATRS at 3rd, 6th, 12th, and 24th month, respectively. Five reruptures and two Achilles tendons tethering to skins were found in the Achillon group, and two reruptures and one sural nerve injury in the MMIR group. No wound infection and dehiscence occurred. Overall complication rate in the Achillon group is higher (16.3% vs. 4.4%, p = 0.044). The operation time of Achillon is less than MMIR (34.84 vs. 39.71, p < 0.001). Conclusion: Both techniques combining with accelerated rehabilitation showed to be reliable and effective. MMIR is safer and more economical, and Achillon is faster.

scholarly journals Modified Bunnell suture versus bundle-to-bundle suture for acute Achilles tendon rupture: A prospective comparative study of patients aged <45 years

2020 ◽  
Author(s):  
xiaomeng wang ◽  
Huixin Liu ◽  
dengke li ◽  
zixuan luo ◽  
Yansen Li ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Open Repair ◽  
Achilles Tendon Rupture ◽  
Test Group ◽  
Suture Technique ◽  
Percutaneous Repair ◽  
Group A ◽  
Group B

Abstract Background: This study was performed to compare the operative outcome between percutaneous repair (modified Bunnell suture) and open repair (bundle-to-bundle suture) for treatment of acute Achilles tendon rupture.Methods: Seventy-two consecutive patients who underwent surgical treatment of Achilles tendon rupture were evaluated. Thirty-six patients were treated by the bundle-to-bundle suture technique (Group A), and 36 patients were treated by the modified Bunnell suture technique (Group B). Functional examination included measurement of the calf muscle circumference and performance of the single-leg heel-rise test. The length and diameter of the Achilles tendon were compared between the injured and uninjured sides using magnetic resonance imaging. The number of single-leg heel rises (height of >5 cm) performed within 15 s was compared between the injured and uninjured sides. The ankle joint range of motion was also recorded. The Achilles tendon total rupture score (ATRS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale score, and visual analog scale (VAS) pain score were used to evaluate the clinical outcome after a minimum 12-month postoperative follow-up period.Results: In total, 61 patients were followed up. The mean follow-up time was not significantly different between Group A (23.73 ± 2.81 months) and Group B (22.61 ± 3.96 months). However, there were significant differences in the heel-rise test (Group A, 1.74 ± 0.96; Group B, 2.37 ± 1.42) and length of the Achilles tendon (Group A, 11.98 ± 1.64 cm; Group B, 11.11 ± 1.74 cm). The calf circumference of the injured side was significantly larger in Group A than B (p = 0.043). The cross-sectional diameter of the Achilles tendon after open repair was significantly different from that after percutaneous repair. There were no significant differences in the ATRS, AOFAS score, or VAS score at the final follow-up between the two groups. One patient in Group A had delayed wound healing, which resolved in about 40 days.Conclusions: Both suture methods described in this report can provide good clinical results. The bundle-to-bundle suture technique is more effective for restoration of the Achilles tendon length and muscle function. This method is safe, effective, and worthy of promotion.

scholarly journals Outcome of surgical management of ruptured Achilles tendon

2018 ◽  
Vol 5 (2) ◽  
pp. 18-22
Author(s):  
Balakrishnan M Acharya ◽  
Pramod Devkota ◽  
Amrit Shrestha ◽  
Abhishek Kumar Thakur ◽  
Toya Raj Bhatta ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Surgical Management ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
First Year ◽  
Foot And Ankle ◽  
Aofas Score ◽  
The Mean ◽  
Second Year

Introductions: The incidence of Achilles tendon rupture has been increasing worldwide. The optimal management of this problem is controversial but the surgical intervention is being applied widely. Methods: We retrospectively analyzed patients who had Achilles tendon (AT) rupture treated surgically at Patan Academy of Health Sciences from January 2010 to December 2015. Functional outcome assessment of ankle was done by using American Orthopedic foot and Ankle Society Score (AOFAS). Results: Total 71 patients (male 45, female 26) had surgery for AT, 38 right and 33 left side. The mean age of the patient was 36.14 years (range 18-67 years). The mean AOFAS score was 83.32 (range 75-93) after first year follow up and 90.36 (range 80-99) after second year, difference was statistically significant (p<0.05). Conclusions: The study showed high AOFAS score for surgical management of ruptured Achilles tendon.

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