Achillon Mini-Open Achilles Tendon Repair: Early Outcomes and Return to Duty Results in U.S. Military Service Members

Abstract

The purpose of this article is to report short-term outcomes and return to duty rates in a cohort of active duty U.S. military personnel who underwent repair of acute Achilles tendon ruptures using the Achillon mini-open technique. Between October 2009 and March 2012, 15 consecutive patients underwent mini-open repair of acute Achilles tendon ruptures using the Achillon device by a single surgeon. Minor and major complications were recorded, and American Orthopaedic Foot and Ankle Society (AOFAS) and pain visual analog scores were recorded at regular follow-up intervals. At mean latest follow-up of 16.7 months postoperatively, all 15 patients had returned to full active duty status without major complications. Specifically, no patient experienced major wound complication, infection, or rerupture. Mean AOFAS score in 9 of 15 patients was 94.1; mean pain visual analog score in 12 of 15 patients was 1.4. The Achillon mini-open technique can be used for treatment of acute Achilles tendon ruptures in appropriately selected high-demand patient populations with the expectation of minimal adverse outcomes.

Functional rehabilitation criteria required for a safe return to active duty in military personnel following a musculoskeletal injury: a scoping review

“…5,[8][9][10][11]13,15,17,19,32,33 Though the associated return-to-duty rates span a large range, many are approximately 80% and above for soldiers returning to full duties at an average time of 3-6 months. [9][10][11]13,18,21,22,24,25,27,28,30 In many cases, these interventions were used in conjunction with traditional military medical care that was largely focused on medication prescription 6,16,17 or surgery. 5,[8][9][10][11]13,26 Doukas et al 12 used a combined rehabilitation therapy approach involving a minimum of three hours of therapy a day from physiotherapy, occupational therapy, speech language pathology, social work or psychology, and medical treatment in a rehabilitation unit; however, the authors did not mention return-to-duty rates or the specifics of each intervention.…”

Low Risk for Local and Systemic Complications After Primary Repair of 1626 Achilles Tendon Ruptures

“…8,9 In fact, some patients, particularly high demand cohorts, may benefit from earlier return to work or athletic activities with surgical management. [4][5][6]15,16 This study sought to better characterize known complications following primary Achilles tendon repair using a large national surgical database in order to identify patients who are at higher risk for early complications and perhaps delineate candidates more ideally suited for nonoperative management.…”

“…First, the overall validity of the data is dependent on accurate recording at the participating institutions. 13 As with any database, a certain margin of error is [15][16][17][18][19] Finally, this data set only evaluates patients managed surgically. One might argue that patients treated nonoperatively with unfavorable comorbidity burdens would likely have increased risk of complications had they been managed surgically.…”

Minimally Invasive Achilles Tendon Repair

“…In the recent years, limited open or minimally invasive techniques were developed that allow control over the tendon ends, minimizing soft tissue dissection. An Achilles tendon suture-guiding system has been widely used mainly in the United States (Achillon ® , Integra LifeSciences Corporation, Plainsboro, NJ) [20] with satisfactory outcomes, a low rate of sural nerve damage, and a low rerupture rate [21,22]. Another limited open approach system, called PARS (percutaneous Achilles repair system [PARS]; Arthrex, Inc., Naples, FL), has been developed, and good functional results have been reported [14].…”