Complications of Supine Surgical Achilles Tendon Repair

Marcel, John; Sage, Katherine; Guyton, Gregory P.

doi:10.1177/1071100718755474

Cited by 6 publications

(7 citation statements)

References 30 publications

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“…The overall incidence of complications was demonstrated to be lower among the supine mini-open approach group in comparison to the prone extensile approach group, with rates of 7.7% and 9.3%, respectively. A study by Marcel et al (2018) showed comparable results and, similar to our study, demonstrated zero incidences of re-rupture or sural neuritis at median follow-up of 116 days [ 17 ]. However, this study did not compare the outcomes and cost-effectiveness to individuals undergoing surgery with the prone approach.…”

Section: Discussionsupporting

confidence: 90%

“…These complexities are even greater in obese patients, who already present with challenging airways and increased risk of postoperative infections and wound complications [13,14]. Since 2008, there have been several technique reports and case series of repairing acute Achilles tendon ruptures in the supine position [15][16][17]. While the authors have noted the ease of positioning and generally good outcomes, previous studies have generally utilized a larger incision more comparable to the traditional prone approach [15].…”

Section: Introductionmentioning

confidence: 99%

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Safety and Efficacy of Achilles Repair Using the Mini-Open Approach in Supine Versus Prone Position: A Retrospective Study

McKissack¹,

McLynn²,

Pitts³

et al. 2021

Cureus

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Surgical repair of the Achilles tendon is a common procedure in cases of acute rupture. Open Achilles tendon surgery with a traditional extensile approach is most often performed in the prone position, but this can lead to numerous complications. The mini-open approach for repair in the supine position may avoid the risks of the prone position. The purpose of this study is to compare perioperative outcomes and differences in cost between patients undergoing acute Achilles rupture repair with mini-open approach, incision of approximately 3 cm, in the supine position versus traditional approach in the prone position. MethodsPatients who underwent surgical repair of acute Achilles rupture at a single institution were retrospectively identified using Current Procedural Terminology (CPT) code 27650. Complication rates and the total cost charged to the insurance companies of both the supine and prone groups were calculated. ResultsA total of 80 patients were included for analysis, 26 supine and 54 prone. The difference in average total time in the operating room was statistically significant. The prone position took approximately 15% more time (118.7 minutes) compared to the supine position (100 minutes) (p = 0.001). While not statistically significant, the total cost for the supine group ($19,889) was less than the for the prone group ($21,722) (p = 0.153) Average postoperative pain score, infection rate, dehiscence rate, sepsis rate, and deep vein thrombosis (DVT) rate were also similar between the two groups. No patient in either group experienced rerupture of the Achilles tendon within the first year of primary repair. ConclusionThe mini-open approach in the supine position may be advantageous in the repair of acute Achilles rupture in that it reduces total time in the operating room and total cost while maintaining positive patient outcomes. Prospective clinical studies are warranted to validate these assessments.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Achilles Repair Using the Mini-Open Approach in Supine Versus Prone Position: A Retrospective Study

McKissack¹,

McLynn²,

Pitts³

et al. 2021

Cureus

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“…In theory, the ideal procedure involves low cost, short hospital stay, limited tissue damage from the surgery, and the possibility of the patient quickly resuming their daily activities, with functional results close to normal. However, the best form of treatment for Achilles tendon injuries is still controversial (8)(9)(10) , ranging from conservative treatment to open repair and extending with newer techniques with minimally invasive surgical treatment possibilities (6,7,(11)(12)(13) . The latter, despite showing excellent results (6,7,(11)(12)(13) , were mostly presented using specific instruments that have not yet been provided by the public health system.…”

Section: Introductionmentioning

confidence: 99%

“…However, the best form of treatment for Achilles tendon injuries is still controversial (8)(9)(10) , ranging from conservative treatment to open repair and extending with newer techniques with minimally invasive surgical treatment possibilities (6,7,(11)(12)(13) . The latter, despite showing excellent results (6,7,(11)(12)(13) , were mostly presented using specific instruments that have not yet been provided by the public health system.…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive repair of acute Achilles tendon injury

2020

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Objective: Describe a minimally invasive surgical technique for acute repair of Achilles tendon injuries, and evaluate outcomes. Methods: Nine subjects with primary Achilles tendon injury who underwent the minimally invasive repair technique between July and October 2018 were assessed. All subjects were followed up, and the SF-36 quality of life questionnaire was applied after the first postoperative year to evaluate treatment outcomes. Results: The participants had average scores greater than 90 points in the SF-36 questionnaire, with widespread treatment adherence. Only one subject had an infectious complication in the postoperative period. Conclusion: The technique described for acute Achilles tendon repair is simple, uses basic materials, is a low-cost method and, in this series, produced good clinical outcomes measured by the SF-36 Questionnaire. Level of Evidence IV; Therapeutic Study; Case Series.

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“…9,10 Reported complication rates are comparable or better than prone open techniques, with no infections, sural nerve injuries or re-ruptures in one series of 45 patients. 11 Both surgical and total operating room times have been reported to be lower with open supine techniques when compared with either open or percutaneous prone techniques. 12…”

mentioning

confidence: 99%

Limited Open Achilles Tendon Repair in Supine Position With Modified Ring Forceps: A Technique Tip

O’Donnell

Velasco

Whitehouse

et al. 2019

Foot & Ankle Specialist

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We present a modification to prior Achilles tendon repair techniques that utilizes readily available noncommercial instrumentation, mini-open incisions, and supine positioning, thus maximizing surgical efficiencies and reducing complications. In our experience, this is a safe and effective technique that minimizes anesthetic requirements and operating room time. Levels of Evidence: Level V, expert opinion

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Complications of Supine Surgical Achilles Tendon Repair

Abstract: Level IV, case series.

Cited by 6 publications

References 30 publications

Safety and Efficacy of Achilles Repair Using the Mini-Open Approach in Supine Versus Prone Position: A Retrospective Study

Safety and Efficacy of Achilles Repair Using the Mini-Open Approach in Supine Versus Prone Position: A Retrospective Study

Minimally invasive repair of acute Achilles tendon injury

Limited Open Achilles Tendon Repair in Supine Position With Modified Ring Forceps: A Technique Tip

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