Percutaneous versus open repair of acute Achilles tendon ruptures
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Controversy exists regarding the optimal treatment for acute Achilles tendon ruptures. Conservative and surgical treatments have been reported with variable results and complications rates. The purpose of this study is to compare the postoperative clinical and functional results of percutaneous versus open repair of acute Achilles tendon ruptures.
Materials and methods
We present 34 patients with acute Achilles tendon ruptures treated with open and percutaneous surgical repair. There were 15 patients who had open surgical repair and 19 patients who had percutaneous repair. The mean follow-up was 22 months (range 10–24 months) for the open repair group and 20 months (range 9–24 months) for the percutaneous repair group; no patient was lost to follow-up. Postoperative rehabilitation was the same for both groups. Wound healing, complications, ankle range of motion, and patients’ return to work, activity level, weight-bearing, and subjective assessment of their treatment were recorded.
No significant difference was observed with respect to any of the examined variables between the open and percutaneous repair groups. Tendon healing was observed in all patients of both groups by 7–9 weeks. The mean time of patients’ return to work was 7 weeks for the open repair group and 9 weeks for the percutaneous repair group. All patients were capable of full weight bearing by the 8th postoperative week time; the time to return to previous activities including non-contact sports was 5 months for both groups. All patients expressed satisfaction and graded their treatment as good. As expected, cosmetic appearance was significantly better in the percutaneous repair group. One patient who had open repair experienced skin incision pain and dysesthesia and graded his operation as fair. No patient experienced other complications such as re-rupture, infection, sural neuroma, or Achilles tendinitis within the period of this study.
The present study showed similarly successful clinical and functional results after both open and percutaneous repair of acute Achilles tendon ruptures are similar. Cosmetic appearance is superior in the group of patients who had a percutaneous treatment.
KeywordsAchilles tendon rupture Percutaneous repair Open repair
- 3.Azar FM (2008) Rupture of muscles and tendons. Achilles tendon injuries. In: Canale ST, Beaty JH (eds) Campbell’s operative orthopaedics, vol 3, 11th edn. Mosby Elsevier, China, pp 2748–2753Google Scholar
- 8.Jiang N, Wang B, Chen A, Dong F, Yu B (2012) Operative versus nonoperative treatment for acute Achilles tendon rupture: a meta-analysis based on current evidence. Int Orthop 36(4):765–773 Google Scholar
- 9.Wilkins R, Bisson LJ (2012) Operative versus nonoperative management of acute Achilles tendon ruptures: a quantitative systematic review of randomized controlled trials. Am J Sports Med 40(9):2154–2160Google Scholar
- 10.Chiodo CP, Glazebrook M, Bluman EM, Cohen BE, Femino JE, Giza E, Watters WC 3rd, Goldberg MJ, Keith M, Haralson RH III, Turkelson CM, Wies JL, Raymond L, Anderson S, Boyer K, Sluka P (2010) Diagnosis and treatment of acute Achilles tendon rupture. J Am Acad Orthop Surg 18(8):503–510PubMedGoogle Scholar
- 11.Olsson N, Nilsson-Helander K, Karlsson J, Eriksson BI, Thomee R, Faxen E, Silbernagel KG (2011) Major functional deficits persist 2 years after acute Achilles tendon rupture. Knee Surg Sports Traumatol Arthrosc 19(8):1385–1393Google Scholar
- 12.Horstmann T, Lukas C, Merk J, Brauner T, Mundermann A (2012) Deficits 10-years after Achilles tendon repair. Int J Sports Med 33(6):474–479Google Scholar
- 15.McMahon SE, Smith TO, Hing CB. A meta-analysis of randomised controlled trials comparing conventional to minimally invasive approaches for repair of an Achilles tendon rupture. Foot Ankle Surg 17(4):211–217Google Scholar
- 22.Talbot JC, Williams GT, Bismil Q, Shaw DL, Schilders E (2012) Results of accelerated postoperative rehabilitation using novel “suture frame” repair of Achilles tendon rupture. J Foot Ankle Surg 51(2):147–151Google Scholar
- 26.Carmont MR, Heaver C, Pradhan A, Mei-Dan O, Gravare Silbernagel K (2013) Surgical repair of the ruptured Achilles tendon: the cost-effectiveness of open versus percutaneous repair. Knee Surg Sports Traumatol Arthrosc 21(6):1361–1368Google Scholar
- 27.Kolodziej L, Bohatyrewicz A, Kromuszczynska J, Jezierski J, Biedron M (2013) Efficacy and complications of open and minimally invasive surgery in acute Achilles tendon rupture: a prospective randomised clinical study—preliminary report. Int Orthop 37(4):625–629Google Scholar
- 28.Guillo S, Del Buono A, Dias M, Denaro V, Maffulli N (2013) Percutaneous repair of acute ruptures of the tendo Achillis. Surgeon 11(1):14–19Google Scholar
- 33.Rosso C, Vavken P, Polzer C, Buckland DM, Studler U, Weisskopf L, Lottenbach M, Muller AM, Valderrabano V (2013) Long-term outcomes of muscle volume and Achilles tendon length after Achilles tendon ruptures. Knee Surg Sports Traumatol Arthrosc 21(6):1369–1377Google Scholar
- 38.Guillo S, Del Buono A, Dias M, Denaro V, Maffulli N (2013) Percutaneous repair of acute ruptures of the tendo Achillis. Surgeon 11(1):14–19Google Scholar