Insertional Achilles Tendon Repair with Bioabsorbable Anchors and Suture

Abstract

Sixty patients were systematically reviewed from the authors prior studies specifically for outcomes using bioabsorbable suture anchors who underwent repair of their Achilles insertion, with minimum two years post-index procedure. Fifty-five were chronic cases with and without calcific tendinosis and 5 were acute avulsions. Average age of the cohort was 51.5 ± 12.7 years. There were 38 males and 22 females. Thirty patients had their right limb operated on: 30 their left. Average return to activity was 6.9 ± 1.7 months. Average post-op VISA-A score was 94.4 ± 12.8, post-op RM score 1.3 ± 0.6, and calf atrophy 0.7 ± 1.0 cm calculated at the last post-op appointment. The ability to single leg heel raise was achieved in 45 patients: equal to the other limb 27. 95% of patients were able to return to full activity including sports. Two were Olympians. Complications were as follows: one DVT, one infection, three hypertrophic scars due to superficial suture and one subcutaneous suture reaction from a braided absorbable product. There were no re-ruptures, no suture granulomas/reactions from the Orthoc-ord™ suture and no suture anchor failures. The repair typically involved one anchor superiorly at the Achilles insertion with a suture anchor and 2 partially absorbable suture with needles. Two additional anchors are placed inferiorly that were knotless. A total of 180 Healix™ Advance BR anchors were used, 62 were 5.5 mm Healix™ Advance BR with Orthocord and needles, 104 Healix™ Advance Knotless BR 5.5 mm, and 14 Healix™ Advance Knotless BR 4.75 mm. Using this repair technique for Achilles insertion repair has good outcome with low complication rate.

Flexor Tendon Repair with Fast-Absorbable Sutures: A Rupture Incidence-Focused Analysis of a Case Series and a Review

“…Muscle weakness after prolonged limited activity and patient's caution in performing hand motion may prevent overload of the repair site. This may also be supported by the continuing successful use of absorbable sutures in Achilles tendon repairs (53), including absorbable bone anchors (54). Notably, most ruptures occur because of patient's noncompliance (48).…”