Mini open versus open repair techniques in Achilles tendon rupture: clinical and isokinetic evaluation

Munegato, Daniele; Gridavilla, Giulia; Guerrasio, S; Turati, Marco; Cazzaniga, Carlo; Zanchi, Nicolò; Zatti, Giovanni; Bigoni, Marco

doi:10.32098/mltj.03.2017.20

Cited by 7 publications

(12 citation statements)

References 20 publications

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“…Research has also been conducted to compare open and percutaneous approaches to operative management with the theory behind the percutaneous approach being that less damage to the paratenon decreases the disruption to the blood supply to the TA and thus may help with repair. Percutaneous techniques offer the advantage of decreased infection rates but overall there is no significant difference again in terms of re-rupture, satisfaction or return to sport [19] , [20] …”

Section: Discussionmentioning

confidence: 99%

Achilles' tendon rupture dancing the ‘Jerusalema’ – A case series

Roopnarinesingh

Kenyon

Turley

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance The weekend warrior has long been prey to musculoskeletal injuries as a result of intermittent, high intensity activity. The Achilles tendon is known to be particularly vulnerable in this population cohort but during the COVID-19 lockdowns in Ireland and all over the world there has been a certain level of detraining and deconditioning among all age groups and populations. Throughout the worldwide restrictions, viral internet challenges and dances have encapsulated the spirit of a global community with the ‘Jerusalema’ dance being no exception. The rise of this particular viral sensation was at the detriment of the Achilles tendons of three middle aged gentlemen on who we base our case series. Presentation of cases Over the space of ten days three cases of Achilles tendon rupture repair presented to the emergency department in Midlands Regional Hospital Tullamore (MRHT) with the mechanism of tendon rupture being through the ‘Jerusalema’ dance. These patients were surgically managed in line with local institution practice and postoperative outcomes were good with no complications noted. Follow up is ongoing. Clinical discussion This retrospective case series is based on the impact of the ‘Jerusalema Dance’ on presentations of Achilles tendon rupture to the Emergency Department in a single regional hospital from January to March 2021. We used these cases in conjunction with a review of current literature to highlight the benefit of an integrated Achilles Tendon rehabilitation programme in this at-risk patient cohort. Conclusion This paper highlights the dangers inherent when well intentioned, but physically deconditioned individuals endeavour to perform a physical exercise which is deceptively demanding. Going forward, viral challenges such as the ‘Jerusalema’ may contribute to new and interesting mechanisms of injuries in our ‘weekend warrior’ cohort. In addition to this, given the global deconditioning seen due to the COVID 19 pandemic and subsequent lockdowns we may see a higher rate of Achilles tendon injuries in the near future across a multitude of patient cohorts. Level one evidence suggests that conservative treatment is just as effective as surgical treatments in the majority of patients with an Achilles tendon rupture, as long as a protocol of rehabilitation with early weightbearing is performed. Our accelerated rehabilitation programme in MRHT is in line with others however internal audit and new literature in the future may enable us to refine it further.

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Section: Discussionmentioning

confidence: 99%

Achilles' tendon rupture dancing the ‘Jerusalema’ – A case series

Roopnarinesingh

Kenyon

Turley

et al. 2021

International Journal of Surgery Case Reports

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“…The target populations were individuals who regularly engage in sports activities. In the past, when it comes to returning to sports, there is a wide range of topics, from interviewing patients, using sports participation scores, to objective sports performance indicators (17)(18)(19)(20). However, much of the research is vague, "returning to preoperative sports levels (21,22)".…”

Section: Subjectsmentioning

confidence: 99%

Factors Associated to Return to Sport after Surgical Repair of Achilles Tendon Ruptures. A Clinical and Functional Retrospective Study

Tanaka¹,

Imaya²,

Katsuki³

et al. 2021

Muscle Ligaments and Tendons J

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Background. The factors that influence a successful return sport following Achilles tendon rupture repair have not been identified. Furthermore, the extent of heel-rise height index (HRHI) and Achilles tendon resting angle (ATRA) as indicators of Achilles tendon function recovery are unclear. Methods. We included 94 subjects who underwent a first unilateral Achilles tendon repair between 2017 and 2019, and returned to sports 9 months after surgery. Preoperative activity was set at 100 points, and subjects were classified into two groups with ≥ 80 points and < 80 points. Multiple logistic regression analysis was performed. The cutoff value of the extracted factors was also calculated. Dependent variables were patient background, extent of heel-rise height index (HRHI), and Achilles tendon resting angle (ATRA) for the unaffected side. Results. HRHI was only extracted as an influencing factor (odds ratio, 1.104)., with a cutoff value of 89.5%. The ATRA required for this HRHI was 72.4% as the cutoff value calculated. Conclusions. After Achilles tendon repair, the HRHI required for good sports activity. The HRHI was about 90%, ATRA required was 70% or more. It is necessary to prevent Achilles tendon elongation after surgery.

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“…The optimal treatment choice for an Achilles tendon rupture is controversial [1,2]. The currently used methods of treatment include nonsurgical (conservative) treatment and surgical treatment, and the surgical methods are considered either traditional (open method with or without anastomosis strengthening) or closed (percutaneous suturing method) [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…The broadly accepted view is that the open method is superior to conservative treatment because it is associated with a lower risk of secondary rupture (rerupture) of the Achilles tendon, but it is associated with a higher risk of local complications (even 20-fold higher) [4,6]. However, authors have reported inconsistent results regarding the complications associated with "open" surgery.…”

Section: Introductionmentioning

confidence: 99%

“…However, authors have reported inconsistent results regarding the complications associated with "open" surgery. Some have reported a high overall complication rate, while others have observed a lower rate, including a low incidence of tendon rupture [6,7]. Moreover, nonsurgical treatment is associated with a higher risk of subsequent heel tendon rupture and weakening of the lower leg muscles [8].…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous Repair Method and Achilles Tendon Rupture Rehabilitation

Ficek

Gwiazdoń²,

Rajca³

et al. 2020

Preprint

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Background: Subcutaneous, spontaneous, complete ruptures of the Achilles tendon are usually caused indirectly by trauma associated with rapid movement. When minimally invasive Achilles tendon repair is performed, an active rehabilitation protocol can be implemented that allows for fast, measurable progress, reduced tissue atrophy, and an improved range of motion, thereby reducing pain and increasing patients’ overall physical well-being. However, overestimating the effectiveness of rehabilitative interventions can lead to arbitrary advancements in rehabilitation that significantly exceed the permitted levels of daily or professional activity. This issue can lead to various side effects and slow rehabilitation. The aim of the study was to evaluate the influence of adverse effects on objective outcomes after minimally invasive Achilles tendon repair.Methods: The study included 36 individuals with complete Achilles tendon rupture who underwent the percutaneous Ma-Griffith technique. The same rehabilitation protocol was used.Results: Five side effects were identified during rehabilitation: deformation of the repair construct (DRC), irritation of the sural nerve (SNI), morning ankle stiffness (MAS), edema of the soft tissue around the tendon (OST) and suture knots. DRC and MAS were associated with a longer time being required to achieve full ankle range of motion. SNI and OST were associated with a longer time being required to meet the criteria for dynamic training. None of the side effects were related to the isokinetic strength of the ankle plantar and dorsiflexors.Conclusions: The incidence of the assessed side effects in the postoperative period is not related to the type of activity, whether it is professional or amateur. Among the identified side effects, deformation of the regenerated shape of the heel tendon and MAS cause a delay in the recovery of full ankle range of motion. Calf nerve irritation and soft tissue swelling increase the time it takes to meet the criteria for starting dynamic training.Trial registration:The study was approved by the ethics committee of the Academy of Physical Education in Katowice (no. 13/2007)

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Mini open versus open repair techniques in Achilles tendon rupture: clinical and isokinetic evaluation

Cited by 7 publications

References 20 publications

Achilles' tendon rupture dancing the ‘Jerusalema’ – A case series

Achilles' tendon rupture dancing the ‘Jerusalema’ – A case series

Factors Associated to Return to Sport after Surgical Repair of Achilles Tendon Ruptures. A Clinical and Functional Retrospective Study

Percutaneous Repair Method and Achilles Tendon Rupture Rehabilitation

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