scholarly journals Comparing Absorbable and Nonabsorbable Suture Materials for Repair of Achilles Tendon Rupture: A Magnetic Resonance Imaging-Based Study

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1085
Author(s):  
Jaeho Cho ◽  
Hyun-Joo Kim ◽  
Jeong Seok Lee ◽  
Jahyung Kim ◽  
Sung Hun Won ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Sectional Area ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Cross Sectional ◽  
Significant Difference ◽  
Group A ◽  
Group B

We aimed to compare magnetic resonance imaging (MRI) findings and corresponding clinical outcomes of repaired Achilles tendons using absorbable and nonabsorbable sutures. Patients who underwent Achilles tendon repair were divided into 2 groups, with 11 in the absorbable group (group A) and 11 in the nonabsorbable group (group B). For all patients, MRI findings taken 6 months postoperatively were evaluated for morphological changes in the tendon. Concurrently, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot score and incidence of postoperative complications were evaluated. Regarding MRI findings, the extent to which the cross-sectional area of the repaired tendon was thicker than that of the preoperative tendon was significantly greater in group B than in group A (p = 0.0012). Notably, more stitches remained within the tendon in group B than in group A (p = 0.0063). No other MRI findings showed a significant difference between the two groups. No significant difference was observed in the AOFAS score, and there was one re-rupture each in both groups. Because nonabsorbable suture material in the treatment of Achilles tendon rupture yielded a thicker postoperative MRI cross-sectional area, enhanced rehabilitation is recommended in order to prevent scar formation.

scholarly journals Percutaneous repair versus open repair for acute Achilles tendon rupture

2019 ◽  
Author(s):  
xiaomeng wang ◽  
Huixin Liu ◽  
dengke li ◽  
zixuan luo ◽  
Yansen Li ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Open Repair ◽  
Achilles Tendon Rupture ◽  
Visual Analogue Scale Pain ◽  
Consecutive Series ◽  
Cross Sectional ◽  
Group A ◽  
Group B

Abstract Backgroup: To compare the operative outcome between modified Kessler suture method and Bundle-Bundle suture for the treatment of acute rupture of Achilles tendon. Methods: A consecutive series of 72 patients who underwent operation of Achilles tendon rupture were evaluated. Thirty patients were treated by the bundle-bundle suture method (group A) and 31 patients by modified Kessler suture (group B). Functional examination included measurement of calf muscle circumference, and a single-leg heel-rise test. The diameter of the Achilles tendon of the trouble side was recorded compared with the contralateral limb through the MRI (magnetic resonance imaging). The number of single-leg heel-rise was recorded within 15s (height>5cm) compared with the uninjured side. The ankle joint range of motion is recorded. The evaluation form ATRS(Achilles Tendon Total Rupture Score), AOFAS(American Orthopedic Foot And ankle Society) Ankle-Hindfoot scale scores and VAS( visual analogue scale) pain score were used to evaluate the clinical outcome after a minimum follow-up period of 12 months postoperatively. Results: 61 patients at 1 year following surgery. There was no difference in mean follow-up time between the two groups (group A: 23.73±2.81 months; group B: 22.61±3.96 months). There were significant differences between the groups in heel-rise test 1.74±0.96 in group A, 2.37±1.42 in group B. Compared with the group B, the calf circumference of the injured side was bigger in group A (p=0.043). The cross-sectional diameters of the Achilles tendon after open repair was significantly different from that after percutaneus repair. There were no significant differences in ATRS, AOFAS and VAS at the final follow-up between the two groups. One patients of group A experienced delayed wound healing, which resolved in about 40 days. Conclusions : Two suture methods can provide good clinical results. Bundle-Bundle suture is more effective in solving the shortcomings of traditional methods. It is a safe and effective method, and is worthy of promotion.

Effect of Electroacupuncture Stimulation on Long-Term Recovery following Achilles Tendon Rupture in a Rat Model

2018 ◽  
Vol 36 (5) ◽  
pp. 327-332
Author(s):  
Miwa Imaeda ◽  
Tatsuya Hojo ◽  
Hiroshi Kitakoji ◽  
Kazuto Tanaka ◽  
Megumi Itoi ◽  
...  
Keyword(s):  
Mechanical Strength ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Breaking Strength ◽  
Achilles Tendon Rupture ◽  
Cross Sectional Area ◽  
Control Group ◽  
Sectional Area ◽  
Cross Sectional

Aims In this study we examined the effect of electroacupuncture (EA) stimulation on the mechanical strength of the rat Achilles tendon after long-term recovery. Methods Using 20 rats, an Achilles tendon rupture model was created in an invasive manner. The rats were assigned to one of three groups, that received EA treatment (EA group), minimal acupuncture (MA group) or remained untreated (Control group). In the EA group, EA stimulation (5 ms, 50 Hz, 20 µA, 20 min) was applied to the rupture region over a period of 90 days (five times/week). In the MA group, needles were inserted into the same positions as in the EA group but no electrical current was applied. After 90 days the tendon was measured to calculate the cross-sectional area of the rupture region. Then, the mechanical strength of the tendon was measured by tensile testing. Results No significant differences were observed between the three groups in cross-sectional area of the injured tendon. For maximum breaking strength, the EA group showed a significantly higher threshold compared with the Control group (P<0.05) but not the MA group (P=0.24). No significant difference was seen between the MA group and the Control group (P=0.96). Conclusion Given the EA group showed a significant increase in maximum breaking strength, it is likely that EA stimulation increases the mechanical strength of a repaired tendon after long-term recovery, and EA stimulation could be useful for preventing re-rupture.

Quantitative Magnetic Resonance Imaging Analysis of the Common Site of Acute Achilles Tendon Rupture: 5 to 8 cm Above the Distal End of the Calcaneal Insertion

2019 ◽  
Vol 47 (10) ◽  
pp. 2374-2379 ◽  
Author(s):  
Young Hwan Park ◽  
Jung Wook Lim ◽  
Gi Won Choi ◽  
Hak Jun Kim
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Interobserver Reliability ◽  
Achilles Tendon Rupture ◽  
Patient Characteristics ◽  
Resonance Imaging ◽  
Significant Difference ◽  
Rupture Site

Background: Previous studies have not quantitatively analyzed the site of acute Achilles tendon rupture. Purpose: To investigate the site of acute Achilles tendon rupture via magnetic resonance imaging (MRI). Study Design: Cross-sectional study; Level of evidence, 4. Methods: The medical records and MRIs of 195 patients with acute Achilles tendon rupture were retrospectively reviewed. The rupture site was measured as the distance from the most distal fibers of the Achilles tendon at the calcaneal insertion to the proximal end of the distal stump. The relationship between the site of rupture and patient characteristics was analyzed, and the intra- and interobserver reliability of the measurements was assessed using intraclass correlation coefficients. Results: The rupture site had a mean distance of 6.4 cm (SD, 1.5) and the 10th to 90th percentile range was 5.0 to 8.4 cm. There was no significant difference in location of the rupture according to patient characteristics and the time of imaging. The intra- and interobserver reliability of measurements was excellent. Conclusion: Most acute Achilles tendon ruptures visible on MRI occurred 5 to 8 cm above the distal end of the calcaneal insertion, which is more proximal than the previously reported 2 to 6 cm location.

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 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 Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Yangjing Lin ◽  
Jin Cao ◽  
Changgui Zhang ◽  
Liu Yang ◽  
Xiaojun Duan
Keyword(s):  
Achilles Tendon ◽  
Recurrence Rate ◽  
Operative Time ◽  
Achilles Tendon Rupture ◽  
Tendon Lengthening ◽  
Group A ◽  
Achilles Tendon Lengthening ◽  
The Mean ◽  
Group B

Background. Both percutaneous Achilles tendon lengthening by triple hemisection and the traditional open Z-lengthening are effective methods for Achilles tendon contracture. This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon, as compared with the traditional open Z-lengthening. Methods. Retrospective analysis of the Achilles tendon contracture cases in our hospital between January 2010 and September 2016 was conducted. Twenty-five cases received percutaneous Achilles tendon lengthening (group A), and 30 patients who underwent open Z-lengthening during the same period were in the control group (group B). Operative time and hospital stay were statistically analyzed. Incision complication, equinus recurrence rate and Achilles tendon rupture morbidity were recorded. The function was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) score. All cases in group A received Magnetic Resonance Imaging (MRI) of ankle preoperatively and in the follow-ups. Results. The mean follow-up period was 42.04 months in group A and 61.7 months in group B. The entire operative time and the mean hospitalization days were lower in group A than in group B. No incision and infection complication occurred in group A. The infection rate in group B was 3.3%. Equinus recurrence rate was 4% in group A and the equinus recurrence rate in group B was 21.4%. In group A, the mean AOFAS score increased from 64 ± 10.16 points preoperatively to 96.08 ± 3.17 at final follow-up, while the score in group B increased from 63.48 ± 6.2 points to 85.4 ± 10.3. MRI showed continuity of the Achilles tendon and homogeneous signal in group A. Conclusion. Modified surgery can significantly reduce the risk of Achilles tendon rupture, provide better balance in soft tissue strength between ankle dorsiflexion and ankle plantarflexion, helping to avoid recurrence of the deformity.

The Percutaneous Surgical Approach for Repairing Acute Achilles Tendon Rupture

2010 ◽  
Vol 100 (4) ◽  
pp. 270-275 ◽  
Author(s):  
Shay Tenenbaum ◽  
Niv Dreiangel ◽  
Ayal Segal ◽  
Amir Herman ◽  
Amnon Israeli ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Demographic Data ◽  
Achilles Tendon Rupture ◽  
Treatment Modalities ◽  
Main Concern ◽  
Complication Rates ◽  
Percutaneous Surgery ◽  
Significant Difference ◽  
The Mean

Background: Treatment modalities for acute Achilles tendon rupture can be divided into operative and nonoperative. The main concern with nonoperative treatment is the high incidence of repeated ruptures; operative treatment is associated with risk of infection, sural nerve injury, and wound-healing sequelae. We assessed our experience with a percutaneous operative approach for treating acute Achilles tendon rupture. Methods: The outcomes of percutaneous surgery in 29 patients (25 men; age range, 24–58 years) who underwent percutaneous surgery for Achilles tendon rupture between 1997 and 2004 were retrospectively evaluated. Their demographic data, subjective and objective evaluation findings, and isokinetic evaluation results were retrieved, and they were assessed with the modified Boyden score and the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale. Results: All 29 patients demonstrated good functional outcome, with no- to mild-limitations in recreational activities and high patient satisfaction. Mean follow-up was 31.8 months. Changes in ankle range of motion in the operated leg were minimal. Strength and power testing revealed a significant difference at 90°/sec for plantarflexion power between the injured and healthy legs but no difference at 30° and 240°/sec or in dorsiflexion. The mean modified Boyden score was 74.3, and the mean Ankle-Hindfoot Scale score was 94.5. Conclusions: Percutaneous surgery for Achilles tendon rupture is easily executed and has excellent functional results and low complication rates. It is an appealing alternative to either nonoperative or open surgery treatments. (J Am Podiatr Med Assoc 100(4): 270–275, 2010)

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 Patients with Achilles Tendon Rupture Have a Degenerated Contralateral Achilles Tendon: An Elastography Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Qianru Li ◽  
Qi Zhang ◽  
Yehua Cai ◽  
Yinghui Hua
Keyword(s):  
Achilles Tendon ◽  
Axial Strain ◽  
Achilles Tendon Rupture ◽  
Cross Sectional Area ◽  
Control Group ◽  
Computer Assisted ◽  
Study Group ◽  
Sectional Area ◽  
Cross Sectional ◽  
The Mean

Purpose. To evaluate differences of Achilles tendon (AT) hardness and morphology between asymptomatic tendons in patients with acute AT ruptures on the contralateral side and asymptomatic tendons in healthy people by using computer-assisted quantification on axial-strain sonoelastography (ASE). Methods. The study consisted of 33 asymptomatic tendons in 33 patients (study group) and 34 tendons in 19 healthy volunteers (control group). All the tendons were examined by both ASE and conventional ultrasound. Computer-assisted quantification on ASE was applied to extract hardness variables, including the mean (Hmean), 20th percentile (H20), median (H50) and skewness (Hsk) of the hardness within tendon, and the ratio of the mean hardness within tendon to that outside tendon (Hratio) and three morphological variables: the thickness (THK), cross-sectional area, and eccentricity (ECC) of tendons. Results. The Hmean, Hsk, H20, H50, and Hratio in the proximal third of the tendon body in study group were significantly smaller than those in control group (Hmean: 0.43±0.09 vs 0.50±0.07, p=0.001; Hsk: -0.53±0.51 vs -1.09±0.51, p<0.001; H20: 0.31±0.10 vs 0.40±0.10, p=0.001; H50: 0.45±0.10 vs 0.53±0.08, p<0.001; Hratio: 1.01±0.25 vs 1.20±0.23, p=0.003). The THK and cross-sectional area of tendons in the study group were larger than those in the control group (p<0.05). Conclusions. As a quantitative objective method, the computer-assisted ASE reveals that the asymptomatic ATs contralateral to acute rupture are softer than those of healthy control group at the proximal third and the asymptomatic tendons in people with rupture history are thicker, larger, and rounder than those of normal volunteers especially at the middle and distal thirds of AT body.

scholarly journals Intraoperative Ultrasonography assistance for minimally invasive repair of the acute Achilles Tendon Rupture

2020 ◽  
Author(s):  
Yongliang Yang ◽  
Honglei Jia ◽  
Wupeng Zhang ◽  
Shihong Xu ◽  
Fu Wang ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Nerve Injury ◽  
Saphenous Vein ◽  
Sural Nerve ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Intraoperative Ultrasonography ◽  
Medial Side ◽  
Significant Difference

Abstract Background: Minimally invasive repair is a better option for Achilles tendon rupture with low re-rupture and wound-related complications than conservative treatment or traditional open repair. The major problem is sural nerve injury. The purpose of this study was to evaluate the effect and advantage of the intraoperative ultrasonography assistance for minimally invasive repair of the acute Achilles tendon rupture.Methods: A retrospective study was performed on 36 cases of acute Achilles tendon rupture treated with minimally invasive repair assisted with intraoperative ultrasonography from January 2015 to December 2017. The relationship of the sural nerve and small saphenous vein was confirmed on the preoperative MRI. The course of the small saphenous vein and sural nerve were identified and marked by intraoperative ultrasonography. The ruptured Achilles tendon was repaired with minimally invasive Bunnell suture on the medial side of the SSV.Results: All patients were followed up for at least 12 months. No sural nerve injury or other complications was found intraoperatively and postoperatively. All the patients returned to work and light sporting activities at a mean of 12.78±1.40 weeks and 17.28±2.34 weeks, respectively. The Mean AOFAS scores improved from 59.17±5.31 preoperatively to 98.92±1.63 at the time of 12 months follow-up. There was statistically significant difference (P<0.001). No patient complained a negative effect on their life.Conclusions: The minimally invasive repair assisted with intraoperative ultrasonography can yield good clinical outcomes, less surgical time and less complications, especially sural nerve injury. It is an efficient, reliable and safe method for acute AT rupture.

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