A Comparative Study of Surgical Treatment Result in the Ruptured Achilles Tendon: Minimal Incision Percutaneous Repair and Open Repair

2017 ◽  
Vol 52 (3) ◽  
pp. 249 ◽  
Author(s):  
Jung-Han Kim ◽  
Heui-Chul Gwak ◽  
Chang-Rack Lee ◽  
Jeon-Gyo Kim ◽  
Jun-Woo Jeong
Keyword(s):  
Surgical Treatment ◽  
Comparative Study ◽  
Achilles Tendon ◽  
Open Repair ◽  
Treatment Result ◽  
Percutaneous Repair ◽  
Minimal Incision

Comparison of Functional Ability Following Percutaneous and Open Surgical Repairs of Acutely Ruptured Achilles Tendons

1993 ◽  
Vol 2 (2) ◽  
pp. 115-127 ◽  
Author(s):  
Gregory J. Steele ◽  
Rod A. Harter ◽  
Arthur J. Ting
Keyword(s):  
Achilles Tendon ◽  
Open Repair ◽  
Plantar Flexion ◽  
Secondary Purpose ◽  
Percutaneous Repair ◽  
Study Results ◽  
Male Patients ◽  
Flexion Strength ◽  
Repair Group ◽  
Repair Techniques

The purpose of our study was to evaluate the functional outcomes of two methods of surgical treatment of acute closed raptures of the Achilles tendon, specifically, the primary open repair and the percutaneous repair techniques, utilizing (a) isokinetic plantar flexion strength, (b) midcalf girth, (c) ankle joint proprioception, and (d) ankle range of motion values. As a secondary purpose, the frequency of reruptures and postsurgical complications were compared between techniques. Twenty male patients (mean age, 43.8 ± 9.4 years) who sustained complete, closed ruptures of the Achilles tendon participated in this study. Results of pairedttests revealed significant differences between postsurgical and contralateral normal limbs for 6 of 12 variables. Results of the ANOVAs revealed no significant differences between the open repair group and percutaneous repair group for any of the evaluative parameters. The significant deficits in postoperative isokinetic plantar flexion strength and midcalf girth measurements, irrespective of surgical technique, suggest an incompleteness of rehabilitation or, more likely, the physiological inability to regain these characteristics postoperatively.

scholarly journals TREATMENT OPTIONS FOR NEGLECTED ACHILLES TENDON RUPTURED: WETHER SPONTANEOUS HEALING IS POSSIBLE?

2018 ◽  
Vol 24 (2) ◽  
pp. 59-69
Author(s):  
A. P. Sereda
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Treatment Outcomes ◽  
Plantar Flexion ◽  
Treatment Options ◽  
Tendon Healing ◽  
Spontaneous Healing ◽  
Minimal Incision ◽  
Better Than

The paper considers cases of spontaneous healing of achilles tendon with elongation. In such condition the tendon defect is not palpable, active plantar flexion is preserved and patients are complaining for strength diminution.Purpose— to study features of spontaneous achilles tendon healing with elongation and to analyze the shortening tenoplasty option as a procedure primarily aimed at restoration of strength for gastrocnemius-soleus complex.Material and Methods.The paper presents features and outcomes of surgical treatment of 25 patients who underwent a shortening tenoplasty of various types: crimping (3 patients), Z-type (2 patients), oblique (1 patient) and transverse (19 patients).Results.No re-ruptures or other serious complications were observed in the patients of the present study. Treatment outcomes were evaluated by j. leppilahti scale in 304,7±8,9 days after the procedure. postoperative leppilahti scores were statistically significantly better than prior to surgery — 82,4±5,6 and 62,2±7,7, respectively, (p<0,0001). Conclusion. Shortening tenoplasty can be indicated in cases of spontaneous achilles tendon healing with elongation. at relatively early stages of the injury with rather elastic scars the crimping tenoplasty can be applied.  At later stages a resection shortening tenoplasty is recommended through a minimal incision with transverse resection of tendon and removal of scar block. 

The Effectiveness of Open Repair Versus Percutaneous Repair for an Acute Achilles Tendon Rupture

2016 ◽  
Vol 25 (4) ◽  
pp. 404-410 ◽  
Author(s):  
Heidi Krueger ◽  
Shannon David
Keyword(s):  
Achilles Tendon ◽  
Open Repair ◽  
Supporting Evidence ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Bottom Line ◽  
Physically Active ◽  
Men And Women ◽  
Percutaneous Repair ◽  
Tendon Ruptures

Clinical Scenario:There are 2 approaches available for surgical repair of the Achilles tendon: open or percutaneous. However, there is controversy over which repair is superior.Focused Clinical Question:Which type of surgery is better in providing the best overall patient outcome, open or percutaneous repair, in physically active men and women with acute Achilles tendon ruptures?Summary of Search, “Best Evidence” Appraised, and Key Findings:The literature was searched for studies of level 3 evidence or higher that investigated the effectiveness of open repair versus percutaneous repair on acute Achilles tendon ruptures in physically active men and women. The literature search resulted in 3 studies for possible inclusion. All 3 good-quality studies were included.Clinical Bottom Line:There is supporting evidence to indicate that percutaneous repair is the best option for Achilles tendon surgery when it comes to the physically active population. Percutaneous repair has faster surgery times, less risk of complications, and faster recovery times over having an open repair, although it is acknowledged that every patient has a different situation and best individual option may vary patient to patient.

scholarly journals Intraoperative Ultrasound Guided Percutaneous Repair of Ruptured Achilles Tendon: A Comparative Study with Open Repair

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0024
Author(s):  
Chan Kang ◽  
Gi Soo Lee ◽  
Jeong-kil Lee ◽  
Ki Jun Ahn ◽  
Sung Jin Hwang ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Clinical Outcomes ◽  
Open Repair ◽  
Intraoperative Ultrasound ◽  
Ultrasound Guided ◽  
Superficial Infection ◽  
Starting Time ◽  
Percutaneous Repair ◽  
Group A ◽  
Group B

Category: Ankle, Trauma Introduction/Purpose: To compare and analyze the clinical outcomes between ultrasound guided percutaneous repair(USPR) and open repair in ruptured Achilles tendon. Methods: We retrospectively analyzed the outcomes between 12 patients with USPR (group A) and 18 patients with open repair (group B), from January 2015 to February 2018. The postoperative clinical evaluations were done by Arner-Lindholm scale, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, Achilles tendon Total Rupture score (ATRS), visual analogue scale (VAS) for overall satisfaction and cosmetic satisfaction of scar, and starting time of single heel raise. And we evaluated complications. Results: There was no statistical difference between two groups in Arner-Lindholm scale, AOFAS score, ATRS, starting time of single heel raise (all p>.05). There was statistically higher overall patient’s satisfaction and cosmetic satisfaction in group A than group B (all p<.05). There were 2 cases of Achilles tendon elongation in group A, and 1 case of re-rupture with deep infection and 1 case of superficial infection in group B. Conclusion: The USPR showed not only good clinical outcomes but also high satisfaction and low rate of complications like sural nerve injury. Thus, it is thought that USPR can be considered as an effective surgical treatment options for Achilles tendon ruptures.

scholarly journals Comparison of mini-open repair system and percutaneous repair for acute Achilles tendon rupture

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yong Li ◽  
Qiang Jiang ◽  
Hua Chen ◽  
Hongkui Xin ◽  
Qing He ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Open Repair ◽  
Achilles Tendon Rupture ◽  
Control Group ◽  
Repair System ◽  
Percutaneous Repair ◽  
Repair Group ◽  
Mini Open

Abstract Background To reduce incision complications, minimally invasive operative approaches for treatment with acute Achilles tendon rupture have been developed, such as Mini-open repair and percutaneous repair. Which technique is the better surgical option? In the present study, we compared the two surgical procedures— modified Mini-open repair versus percutaneous repair—in the treatment of acute Achilles tendon rupture. Methods From January 2016 to November 2018, 68 matched patients with acute Achilles tendon rupture were divided into treatment group (Mini-open with modified Ma-Griffith technique) and control group (the Ma–Griffith technique). The patients were then treated with different surgical techniques and followed up for no less than 24 months, and the functional outcome scores and complications were retrospectively evaluated. Results The mean follow-up time in Mini-open repair group was 29.0±2.9 months, and that in control group was 27.9±2.9 months (P=0.147). The Mini-open repair group showed reliably higher American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score and Achilles tendon Total Rupture Score (ATRS) than the control group in functional assessment (95.0±3.8 vs. 92.3±5.3, P=0.000; 93.8±3.8 vs. 90.9±4.5,P=0.000). There was no cases of sural nerve injury in Mini-open repair group, whereas the percutaneous repair group had 5 cases of the same (P=0.027). No significant differences were found in the calf circumference (32.3±3.9 vs. 31.8±3.6) (P=0.564), range of motion of the ankle (51.3±4.8 vs. 50.5±4.2, P=0.362), or wound complications (34/0 vs. 34/0) (P=1.000) between the two groups at the end of the follow-up time. However, the percutaneous repair group had a shorter average operating time (23.1±5.2 min) than that of the Mini-open repair group (27.7±4.3 min) (P=0.000). Conclusions Acute Achilles tendon ruptures may be treated successfully with a new Mini-open repair system or percutaneous repair technique. However, the Mini-open repair system may represent a superior surgical option, since it offers advantages in terms of direct visual control of the repair, AOFAS Ankle-Hindfoot Score, Achilles tendon Total Rupture Score and risk of sural nerve palsy. Study design Case-control studies, Level of evidence, 3.

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 A comparative study of innovative percutaneous repair and open repair for acute Achilles tendon rupture: Innovative usage of intraoperative ultrasonography

2020 ◽  
Vol 28 (1) ◽  
pp. 230949902091027
Author(s):  
Jeong-Kil Lee ◽  
Chan Kang ◽  
Deuk-Soo Hwang ◽  
Dong-Hun Kang ◽  
Gi-Soo Lee ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Clinical Outcomes ◽  
Nerve Injury ◽  
Sural Nerve ◽  
Tendon Rupture ◽  
Open Repair ◽  
Achilles Tendon Rupture ◽  
Operative Outcomes ◽  
Athletic Ability ◽  
Percutaneous Repair

Purpose: There is no definitive consensus on the optimal treatment of Achilles tendon rupture. We comparatively analyzed the clinical outcomes of two types of repair surgeries in treating Achilles tendon rupture. Methods: This retrospective study included 12 patients of Achilles tendon rupture (group A) treated with ultrasound-guided percutaneous repair and 18 patients (group B) treated with open repair. Clinical evaluation was performed using the Arner–Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) ankle–hindfoot score, Achilles Tendon Total Rupture score (ATRS), visual analog scale, time to single heel raise, bilateral calf circumferences, recovery of athletic ability, and other complications. Results: While the Arner–Lindholm scale, AOFAS ankle–hindfoot score, ATRS, time point when single heel raise was possible, differences in bilateral calf circumference, and recovery of athletic ability compared to pre-rupture level were not significantly different between the two groups (p = 0.999, 0.235, 0.357, 0.645, 0.497, and 0.881, respectively), overall and aesthetic satisfaction levels were higher in the group treated with percutaneous repair under ultrasonography guidance (p = 0.035 and 0.001, respectively). Overall, there were no cases involving sural nerve injury in either group. Conclusion: Innovative percutaneous repair provides not only similar clinical outcomes but also greater overall and aesthetic satisfaction levels of operative outcomes and minimal complications (i.e. sural nerve injury) compared to open repair surgeries. Therefore, percutaneous repair may be a useful technique in the treatment of Achilles tendon rupture.

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