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 Long Term Clinical–Functional and Ultrasound Outcomes in Recreational Athletes after Achilles Tendon Rupture: Ma and Griffith Versus Tenolig

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1073
Author(s):  
Carlo Biz ◽  
Mariachiara Cerchiaro ◽  
Elisa Belluzzi ◽  
Nicola Luigi Bragazzi ◽  
Giacomo De Guttry ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Return To Sport ◽  
Functional Results ◽  
Return To Sports ◽  
Recreational Athletes ◽  
Sport Activities ◽  
Long Term Follow Up

Background and Objectives: The purpose of this retrospective study was to compare the long-term clinical–functional and ultrasound outcomes of recreational athletes treated with two percutaneous techniques: Ma and Griffith (M&G) and the Tenolig technique (TT). Materials and Methods: recreational athletes, between 18 and 50 years of age, affected by acute Achilles tendon rupture (AATR), treated by M&G or Tenolig techniques were recruited. Clinical–functional outcomes were evaluated using Achilles Tendon Rupture Score (ATRS), AOFAS Ankle–Hindfoot score, VAS (for pain and satisfaction) questionnaires, and ultrasound analysis (focal thickening, hypoechoic areas, presence of calcifications, tendinitis and alteration of normal fibrillar architecture). Results: 90 patients were included: 50 treated by M&G, 40 by TT. In all, 90% of patients resumed sports activities, with pre-injury levels in 56% of cases after M&G and in 60% after TT. In the M&G group, the averages of the questionnaires were ATRS 90.70 points, AOFAS 91.03, VAS satisfaction 7.08, and VAS pain 1.58. In the TT group: ATRS 90.38 points, AOFAS 90.28, VAS satisfaction 7.76, and VAS pain 1.34. The TT group showed a significantly higher satisfaction and return to sport activities within a shorter time. In the M&G group, ultrasound check showed a significantly greater incidence of thickening and an alteration of fibrillar architecture in the treated tendon. Three infections were reported, including one deep after M&G, two superficial in the TT group, and two re-ruptures in the Tenolig group following a further trauma. Conclusions: At long-term follow-up, M&G and TT are both valid techniques for the treatment of AATRs in recreational athletes, achieving comparable clinical–functional results. However, TT seems to have a higher patient satisfaction rate, a faster return to sports and physical activities, and fewer ultrasound signs of tendinitis. Finally, the cost of the device makes this technique more expensive.

scholarly journals Percutaneous and Minimally Invasive Surgical Technique for Achilles Tendon Repair

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.

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.

Chronic Achilles tendon rupture: a novel modification of surgical technique described by El Shewy

2021 ◽  
Author(s):  
Rajitha Gunaratne ◽  
Yu Chuan Chong ◽  
Yi Heng ◽  
Jayhee Hahn ◽  
Jeremy Lek ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture

scholarly journals Lijecenje akutne rupture Ahilove tetive neoperativno vs. operativno

2013 ◽  
Vol 60 (3) ◽  
pp. 57-60 ◽  
Author(s):  
Nikola Bulatovic ◽  
Velisa Aligrudic ◽  
Zarko Dasic ◽  
Dzihad Pepic ◽  
Aleksandar Juskovic
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon Rupture ◽  
Functional Results ◽  
Control Group ◽  
Cast Immobilization ◽  
Complete Rupture ◽  
Clinical Center ◽  
Rehabilitation Period ◽  
Heel Bone ◽  
Male Patients

INTRODUCTION: It affects most frequently middle aged recreational male sportsmen (30-50 years old), previously followed by prodromal symptoms (5-33%). Rupture spot is 3 to 5 cm above heel bone vertex (90-95%). Retrospective study. WORKING OBJECTIVE: Comparison of functional results and complications of cast immobilization non-operative treatment and open suture surgical treatment. MATERIAL AND METHODS: Overall 46 patients included who were treated at the Clinic for Orthopedics and Traumatology within the Clinical Center of Montenegro in Podgorica between 2004 and 2012. Patients were divided into two groups: I group consisted of 21 patients (45.65%) who were treated by cast immobilization and the II (control) group consisted of 25 patients (54.35%) who were treated by open surgical technique. Division by gender: 44 male patients (95.65%) and 2 female patients (4.35%). WORKING RESULTS: The average age of patients was 38.8+2.79 (21-60 years of age); for the patients treated operationally 37.1+3.98 years of age, for the patients treated non-operationally 40.2+2.39; 28 right side patients (60.86%), 18 left side patients (39.14%); Surface infection detected on 1 patient (2.17%) 2 patients with partial rupture, while 3 patients had complete rupture during early rehabilitation period after immobilization was taken off. Complete rupture detected on 3 patients (6.25%) has been recovered surgically. Thromboembolism noticed on 3 patients (6.52%) while 2 patients (4.34%) were affected by pulmonary embolism. Tendon elongation present on 3 patients (Magnetic Resonance (MR) Diagnostics) and on 1 patient reoperation was performed 3 months after the primary surgical intervention. CONCLUSION: This study didn?t show significant statistical difference between two ways of treatment, but early immobilization is recommended because of better results. In case of Achilles tendon rupture, the advantage should be given to the surgical treatment, especially if younger population is treated.

Total rupture of achilles tendon induces inflammatory response and glial activation on the mice spinal cord 

2020 ◽  
Author(s):  
Diego De Paula ◽  
Martha França ◽  
Luana Leão ◽  
Analú Maciel ◽  
Thalita Moura ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Inflammatory Response ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Glial Activation ◽  
Control Group ◽  
Over Expression ◽  
Recreational Athletes ◽  
Lumbar Segment

Abstract Rupture of Achilles tendon is a common accident affecting professional and recreational athletes. Acute and chronic pains are symptoms commonly observed in ruptured patients. Despite that, no studies have described whether Achilles tendon rupture is able to promote disorders in CNS. Based in these finds, the current study aimed to evaluate nociceptive alterations and inflammatory response in L5 lumbar segment of Balb/c mice spinal cord after Achilles tendon rupture. We demonstrated increased algesic response in the paw of ruptured group on the 7th and 14th days post tenotomy when compared with control group. This phenomenon was accompanied by over expression of COX-2 and NOS-2 as well as hyperactivation of astrocytes and microglia in nociceptive areas of L5 spinal cord as evidenced by intense GFAP and IBA-1 immunostaining, respectively. Biochemical studies also demonstrated increased levels of nitrite in the L5 spinal cord of tenotomized animals when compared with control group. Thus, we have demonstrate for the first time that total rupture of the Achilles tendon induces inflammatory response, nitrergic and glial activation in the CNS at L5 spinal cord region.

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.

scholarly journals Chronic Achilles Tendon Rupture

2017 ◽  
Vol 11 (1) ◽  
pp. 660-669 ◽  
Author(s):  
Nicola Maffulli ◽  
Alessio Giai Via ◽  
Francesco Oliva
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Primary Repair ◽  
Achilles Tendon Rupture ◽  
Functional Results ◽  
Wound Complications ◽  
Reconstruction Technique ◽  
Acute Injuries ◽  
Tendon Ruptures ◽  
Complications Rate

Background:The Achilles tendon, the largest and strongest tendon in the human body, is nevertheless one of the tendons which most commonly undergoes a complete subcutaneous tear. Achilles tendon ruptures are especially common in middle aged men who occasionally participate in sport. Even though Achilles tendon ruptures are frequent, up to 25% of acute injuries are misdiagnosed, and present as chronic injuries.Methods:This is a review article about diagnosis and management of chronic Achilles tendon ruptures. Minimally invasive Achilles tendon reconstruction is discussed.Results:The optimal surgical procedure is still debated, however, less invasive peroneus brevis reconstruction technique and free hamstring autograft provide good functional results.Conclusion:The management of chronic ruptures is more demanding than acute tears, because of the retraction of the tendon ends, and the gap makes primary repair impossible. Wound complications and infections are frequent after open procedures. Minimally invasive treatments provide good functional results and lower complications rate.

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