Abstract
The surgical benefit of minimally invasive tendo Achilles repair (n = 25) with early weight-bearing mobilisation after rupture of the tendo Achilles was compared with operative treatment using an open technique (n = 34) with full weight-bearing after 8 weeks of surgical repair. The minimally invasive technique provided no evidence of wound problems and a functional benefit from early weight-bearing mobilisation. However, we noted that increased post-operative morbidity in terms of wound infection (n = 7) leading to delayed wound healing and wound pain requiring opiate-based analgesia post-operatively in the open repair group may have an additional impact on the patients and health care providers. This study showed that the mini-invasive open surgical repair of the Achilles tendon with the Achillon™ instrument and early weight-bearing mobilisation in an orthosis for the accelerated rehabilitation may offer cost-effectiveness and less financial burden on the health care provider in terms of associated nursing and physiotherapy costs.
Résumé
Le bénéfice chirurgical de la réparation du tendon d'Achille par voie mini-invasive (n = 25), permettant un appui avec mobilisation précoce est comparé au traitement de la rupture par voie sanglante conventionnelle (n = 34) avec un appui différé à 8 semaines après la réparation chirurgicale. Il est important de noter l'augmentation de la morbidité avec infection profonde (n = 7), défaut de cicatrisation et douleur nécessitant, notamment des traitements analgésiques à base d'opiacés. Cependant cette technique par voie mini-invasive ne semble pas, à l'évidence, entraîner plus de problèmes mais, au contraire est bénéfique du fait de la mobilisation et de l'appui précoces. Ce travail montre que la réparation par voie mini-invasive du tendon d'Achille avec la technique Achillon™ et un appui précoce en orthèse permettent une récupération rapide et surtout un rapport coût bénéfice intéressant.
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Acknowledgement
We thank Dr. Obonna Ekoecha for collecting initial data, Mrs. Helen Bradley and Mrs. Louise Nurchin for continuing wound care to the patients. We also thank our patients for giving consent to publish the clinical pictures. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
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Bhattacharyya, M., Gerber, B. Mini-invasive surgical repair of the Achilles tendon—does it reduce post-operative morbidity?. International Orthopaedics (SICO 33, 151–156 (2009). https://doi.org/10.1007/s00264-008-0564-5
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DOI: https://doi.org/10.1007/s00264-008-0564-5