Comparison of open repair and modified percutaneous repair techniques for the treatment of acute achilles tendon ruptures

Abstract

Background: This study compared acute Achilles tendon repairs' functional and clinical outcomes with two different surgical techniques; modified percutaneous and open repair. Material and Method: This retrospective study analyzed 57 patients with an acute Achilles tendon rupture (AATR) who underwent modified percutaneous and open repair. 46 patients who met the eligibility criteria were enrolled and divided into two groups based on the surgical technique. 23 patients from Group 1 were treated using modified percutaneous repair under local anesthesia, and 23 patients from Group 2 were treated with an open repair under regional anesthesia. Postoperatively, patients were evaluated using American Orthopedic Foot and Ankle Society (AOFAS) Hindfoot Questionnaire score at final follow-up. The other outcomes included return to work, return to sports activities, capacity to complete single heel rise, leg circumference, estimated limb symmetry indices, Achilles tendon resting angle (ATRA), complications, and timing of index surgery. Results: At the time of surgery, the mean age of the patients was 35.9 7.5 years (range, 25-47 years). The average follow-up was 34.8±6.5 months (24-52 months). The mean age, gender, body mass index (BMI), rupture level, duration from injury to surgery, and mean follow-up time were similar in both groups. At a minimum 2-year follow-up, good pain relief was achieved for all patients. The AOFAS scores were 93.4±4.1 (88-100) in Group 1 and 92.2±5.2 (82-100) in Group 2. There was no statistically significant difference between groups concerning the Achilles tendon resting angle (ATRA), calf circumference, single-leg heel rise, return to work, and return to sports activities. However, the percutaneous repair procedure had a shorter surgical time than the open repair technique (p<0.05). Conclusion:Modified percutaneous and open repair techniques provide similar clinical and functional outcomes, but the percutaneous repair technique showed faster surgical time than open procedures. Furthermore, the percutaneous technique may be more practical than the open technique, which may be performed under local anesthesia.