Repair of Achilles Tendon Rupture Under Endoscopic Control

Fortis, A.P.; Dimas, Anastasios; Lamprakis, Andreas

doi:10.1016/j.arthro.2008.02.018

Cited by 39 publications

(9 citation statements)

References 31 publications

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“…Many researchers have reported that conservative treatment can cause complications such as increased pain, re-rupture, calf muscle weakness, and delayed return to work [18][19][20]. To repair the Achilles tendon surgically, various methods, from open repair to limited open repair or percutaneous repair, have been reported [21,22]. With standard methods of surgical treatment, patients frequently undergo limited weightbearing, which often includes immobilisation using a brace for at least 6 weeks [23].…”

Section: Introductionmentioning

confidence: 99%

Duration of immobilisation after Achilles tendon rupture repair by open surgery: a retrospective cohort study

Gao

et al. 2021

J Orthop Surg Res

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Background The best treatment for acute Achilles tendon ruptures remains controversial. No cohort studies have compared different immobilisation durations after open surgery. This retrospective cohort study aimed to determine the optimal duration of immobilisation after this surgery. Methods A total of 266 patients with acute Achilles tendon rupture were divided into 4 groups (A, B, C, and D) according to immobilisation duration of 0, 2, 4, and 6 weeks, respectively. All patients underwent the same suture technique with a similar rehabilitation protocol and were examined clinically at 2, 4, 6, 8, 10, 12, 14, 16, 24, and 48 weeks, with a final follow-up at a mean of 22.3 months postoperatively. The primary outcome was the time of return to light sports activity (LSA). Secondary outcomes included range of motion (ROM) and single-legged heel rise height (SHRH). Data on operation time, complications, visual analogue pain scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, and Achilles tendon Total Rupture score (ATRS) were also collected. Demographic baseline data were analysed using one-way analysis of variance; outcome parameters were analysed using Kruskal-Wallis H test, and complications were analysed using Fisher’s exact test. Statistical significance was considered at P ≤ 0.05. Results VAS scores decreased significantly, reaching 0 in all groups after 12 weeks. The AOFAS and ATRS scores were significantly different between the groups from weeks 2 to 12 (P<0.001) and weeks 2 to 16 (P<0.001), respectively. All the mean scores showed better results in group B than in the other groups. In terms of recovery time of ROM, SHRH, and LSA, groups A and B were significantly faster than groups C and D (P<0.001). There were 13 (13/266, 4.9%) complications: 5 superficial infections, 3 deep venous thrombosis, and 5 trauma-related re-ruptures. On the last follow-up, all complications had recovered. There were no significant differences in complications between the groups. Conclusions Immobilisation for 2 weeks after this open surgery is the best choice for early rehabilitation and weight-bearing while minimising pain and other complications.

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Section: Introductionmentioning

confidence: 99%

Duration of immobilisation after Achilles tendon rupture repair by open surgery: a retrospective cohort study

Gao

et al. 2021

J Orthop Surg Res

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“…Apart from Thermann 7 and Lui 8 carrying out an additional superolateral endoscopic tract at the myotendinous junction, no other studies concerning sutures under endoscopic control visualized the sural nerve 6, 9. Let us emphasize that lesions of the sural nerve are primarily due to percutaneous sutures, and choosing a third superolateral arthroscopic tract did not show any significant difference concerning its iatrogenic lesion rate 10 .…”

Section: Discussionmentioning

confidence: 98%

Acute Achilles Tendon Rupture: Ultrasonography and Endoscopy-Assisted Percutaneous Repair

Severyns

Andriamananaivo

Rollet

et al. 2019

Arthroscopy Techniques

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To date, there is no consensus concerning the treatment of acute Achilles tendon ruptures. Although surgical treatment decreases the risk of a recurrent rupture, it is not without complications. In particular, percutaneous sutures may cause a lesion of the sural nerve. The purpose of this Technical Note is to describe a reliable and reproducible surgical procedure for treating these lesions. The first operative phase consists of an ultrasound detection that makes it possible to identify the tendon extremities and the sural nerve, which is necessary to secure the posterolateral arthroscopic tract as well as to perform the percutaneous suture. The entry point is thus centered on the lesion and placed at a distance from any surrounding nerve risk. The second arthroscopic phase makes it possible to release the tendon lesion, control the transtendon passage of the surgical threads, and evaluate the dynamic contact of the tendon edges. At the end of the intervention, the complete disappearance from the transillumination via the rupture also makes it possible to ensure the disappearance of the tendon gap. Achilles tendon percutaneous sutures after the ultrasound detection and under arthroscopic control thus makes it possible to control the contact of the tendon edges, while at the same time decreasing the risk of a lesion of the sural nerve, with minimal scarring.

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“…Therefore, in this area, the nerve is especially vulnerable to iatrogenic injury during surgery, particularly minimally invasive surgery 41,42. Since minimally invasive percutaneous repair techniques do not provide direct observation, percutaneous repair of AT rupture under endoscopic control has been suggested to overcome this blindness 15,16,43,44…”

Section: Discussionmentioning

confidence: 99%

Achilles tendon rupture: physiotherapy and endoscopy-assisted surgical treatment of a common sports injury

Doral¹,

Bozkurt²,

Turhan³

et al. 2010

OAJSM

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Although the Achilles tendon (AT) is the strongest tendon in the human body, rupture of this tendon is one of the most common sports injuries in the athletic population. Despite numerous nonoperative and operative methods that have been described, there is no universal agreement about the optimal management strategy of acute total AT ruptures. The management of AT ruptures should aim to minimize the morbidity of the injury, optimize rapid return to full function, and prevent complications. Since endoscopy-assisted percutaneous AT repair allows direct visualization of the synovia and protects the paratenon that is important in biological healing of the AT, this technique becomes a reasonable treatment option in AT ruptures. Furthermore, Achilles tendoscopy technique may decrease the complications about the sural nerve. Also, early functional postoperative physiotherapy following surgery may improve the surgical outcomes.

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Repair of Achilles Tendon Rupture Under Endoscopic Control

Cited by 39 publications

References 31 publications

Duration of immobilisation after Achilles tendon rupture repair by open surgery: a retrospective cohort study

Duration of immobilisation after Achilles tendon rupture repair by open surgery: a retrospective cohort study

Acute Achilles Tendon Rupture: Ultrasonography and Endoscopy-Assisted Percutaneous Repair

Achilles tendon rupture: physiotherapy and endoscopy-assisted surgical treatment of a common sports injury

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