Minimally Invasive Achilles Tendon Repair

Özsoy, Metin; Cengiz, Bertan; Özsoy, Arzu; Aksekili, Mehmet Atıf Erol; Yücel, Mehmet; Fakioglu, Onur; Dincel, Veysel Ercan; Aydoğan, Nevres Hürriyet

doi:10.1177/1071100713505754

Cited by 9 publications

(4 citation statements)

References 29 publications

(44 reference statements)

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“…Moreover, most operations are under direct vision, so the incidence of sural nerve injury is low. Of the 23 patients in the present series, there were no cases of sural nerve injury, which is supported by previous studies [ 29 , 30 , 40 ].…”

Section: Discussionsupporting

confidence: 91%

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A new less invasive surgical technique in the management of acute Achilles tendon rupture through limited-open procedure combined with a single-anchor and “circuit” suture technique

Zhang¹,

Liu²,

Zhang³

et al. 2018

J Orthop Surg Res

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BackgroundTraditional incision repair and minimally invasive repair for acute Achilles tendon repair have limitations. This study aimed to present our series of 23 patients with acute Achilles tendon rupture that was repaired using two small incisions to assist the anchor repair of the tear and a new “circuit” suture technique.MethodsThis was a retrospective study of 23 patients with acute Achilles tendon rupture treated with the new technique at Changhai Hospital between January 2015 and December 2016 and followed up for 14–33 months. Clinical outcome was assessed using the AOFAS, Leppilahti, and Arner-Lindholm scores. Complications, range of motion (ROM), and time to return to work and light sport activity were assessed.ResultsThe AOFAS score was 85–96 at 3 months and 92–100 at 12 months. The 3-month ROM was 27°–37°, and the 12-month ROM was 36°–48°. The Leppilahti score was 85–95 at 3 months and 90–100 at 12 months. The recovery time of the patients was 10–18 weeks. The postoperative recovery time to exercise was 16–24 weeks. There was only one case of deep venous thrombosis. According to the Arner-Lindholm assessment criteria, patient outcomes were rated as excellent in 20 (87.0%) cases, good in three (13.0%) cases, and poor in 0 cases. The excellent-to-good rate was 100%.ConclusionThe limited-open procedure combined with a single-anchor and “circuit” suture technique could be used to repair torn Achilles sites, with a low occurrence of complications. This new and minimally invasive technique could be an alternative in the management of acute Achilles tendon rupture.

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Section: Discussionsupporting

confidence: 91%

“…In addition, the force of the anchor is used to enhance the biomechanical strength after the repair of the torn ends, reducing the chance of Achilles tendon re-rupture. This method shares some similarities with previously published methods [ 27 , 29 , 30 ], but the suture technique used here was different.…”

Section: Discussionmentioning

confidence: 81%

A new less invasive surgical technique in the management of acute Achilles tendon rupture through limited-open procedure combined with a single-anchor and “circuit” suture technique

Zhang¹,

Liu²,

Zhang³

et al. 2018

J Orthop Surg Res

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“…The major problem with a percutaneous, minimally invasive technique is sural nerve involvement [ 7 – 9 ]. Some techniques have described measures taken to avoid the risk of nerve injury, such as a modified Achillon technique with the help of an arthroscopic probe [ 10 ], endoscopy-assisted percutaneous repair [ 11 ], an internal splinting technique [ 12 ], and the Mayo needle technique [ 13 – 15 ]. We hypothesized that a channel-assisted minimally invasive repair (CAMIR) that we designed could minimize the possibility of sural nerve injury.…”

Section: Introductionmentioning

confidence: 99%

Channel-assisted minimally invasive repair of acute Achilles tendon rupture

Chen

Zhang

et al. 2015

J Orthop Surg Res

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BackgroundPercutaneous (minimally invasive) suturing is a promising option for Achilles tendon (AT) repair with low rerupture and infection rates. Sural nerve lesions are the major problem to avoid with the technique. A new device was therefore designed for suturing the AT, resulting in channel-assisted minimally invasive repair (CAMIR). The purpose of this study was to compare the clinical and functional outcomes of CAMIR with traditional open techniques.MethodEighty two patients with AT rupture were included: 41 for CAMIR, 41 for open repair. All patients followed a standardized rehabilitation protocol. Follow-ups were at 12 and 24 months after surgery. Functional evaluation was based on the clinical American Orthopaedic Foot & Ankle Society score associated with neurologic deficit (sural nerve), calf circumference, range of motion (ROM), and isometric testing.ResultsThere was no difference between groups regarding plantar flexor strength, ankle ROM, or calf circumference. CAMIR significantly decreased the operative time compared to open repair (17 vs. 56 min, P < 0.0001). Mean scar length was greater in the open repair group (10 vs. 2 cm, P < 0.0001). There were no wound complications in the CAMIR group but four in the open repair group (P < 0.0001). No deep vein thrombosis, rerupture, or sural nerve injury occurred.ConclusionCAMIR and open repair yielded essentially identical clinical and functional outcomes. Sural nerve injuries can be minimized using CAMIR by carefully placing the suture channel with a stab incision and special trocar based on a modified Bunnell suture technique.

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“…After screening titles and publication dates, 93 articles were selected, and 42 articles were subsequently retained that met inclusion criteria. Of these 42 articles, 14 were published before 2010, and 28 were published after 2010 14–19,27–61 …”

Section: Methodsmentioning

confidence: 99%

Rerupture and wound complications following Achilles tendon repair: A systematic review

Shoap

Bäcker

Freibott

et al. 2022

Journal Orthopaedic Research

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Despite the relatively high frequency of Achilles ruptures, there is no general consensus on the optimal treatment method. A general trend toward more patients being treated nonoperatively has emerged recently with the advent of functional rehabilitation. However, much of the recent data on this subject has been highly variable. This systematic review focused on Achilles tendon rupture (ATR) treatment outcomes, with a focus on rerupture and complication rates. This systematic review specifically focused on articles regarding ATR treatment that also included rerupture and complication rates. Treatments were divided into three categories: open minimally invasive, open standard, and nonoperative. Bivariate analyses were performed to compare complication and rerupture rates among pairs of treatment options, as well as between early weight bearing versus immobilization. There was significantly higher complications for minimally invasive compared to nonoperative treatment (risk ratio [RR] = 4.4154; p < 0.05), lower complication rates for minimally invasive compared to open treatment (RR = 0.3231; p < 0.05), and higher complications for open standard compared to nonoperative treatment (RR = 5.6350; p < 0.001). There were significantly lower rerupture rates in minimally invasive compared to nonoperative treatment (RR = 0.4085; p < 0.001), a significantly lower rerupture rate in nonoperative treatment compared to open treatment (RR = 0.2282; p < 0.001), and no significant difference in rerupture rates when comparing minimally invasive to open standard treatment. We found that operative treatment is associated with fewer reruptures and more complications than a nonoperative approach. Minimally invasive surgery appears to be associated with a lower rate of complications than open operative treatment.

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Minimally Invasive Achilles Tendon Repair

Abstract: Level IV, retrospective case series.

Cited by 9 publications

References 29 publications

A new less invasive surgical technique in the management of acute Achilles tendon rupture through limited-open procedure combined with a single-anchor and “circuit” suture technique

A new less invasive surgical technique in the management of acute Achilles tendon rupture through limited-open procedure combined with a single-anchor and “circuit” suture technique

Channel-assisted minimally invasive repair of acute Achilles tendon rupture

Rerupture and wound complications following Achilles tendon repair: A systematic review

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