The results of 163 Achilles tendon ruptures treated by a minimally invasive surgical technique and functional aftertreatment

• Published in: Injury Vol. 38; no. 7; pp. 839 - 844
• Main Authors: Lansdaal, J.R, Goslings, J.C, Reichart, M, Govaert, G.A.M, van Scherpenzeel, K.M, Haverlag, R, Ponsen, K.J
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-07-2007; Elsevier
• Subjects: Achilles tendon; Achilles Tendon - injuries; Adult; Aged; Biological and medical sciences; Female; Humans; Injuries of the limb. Injuries of the spine; Male; Medical sciences; Middle Aged; Minimally Invasive Surgical Procedures - methods; Minimally invasive treatment; Muscle Strength; Orthopedics; Patient Satisfaction; Recovery of Function; Rupture; Rupture - surgery; Surgical technique; Tendo Achilles; Traumas. Diseases due to physical agents; Weight bearing; Achilles tendon; Tendo Achilles; Surgical technique; Weight bearing; Rupture; Minimally invasive treatment; Tendo calcaneus; Necrosis; Treatment; Surgery; Tissue rupture; Technique; Sural nerve
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2006.12.010

Summary Background There is still controversy regarding the optimal surgical technique and post-operative treatment of acute Achilles tendon ruptures. We evaluated a treatment protocol for Achilles tendon ruptures consisting of a minimally invasive Achilles tendon repair combined with early full weight bearing. Methods A consecutive group of 163 patients was prospectively followed during a 6 year period (1998–2004) in one university hospital and five teaching hospitals. Data were collected during the outpatient department visits at 1, 3, 5, and 7 weeks, 4 months and 12 months after the intervention. Outcome parameters were the incidence of re-rupture, other complications, the functional outcome and the period of sick leave concerning work and sport. Results The patient group consisted of 128 men (79%) and 35 women (21%). The mean operating time was 41 min. In 9 patients (5.5%) a major complication occurred, necessitating 5 surgical re-interventions (2 for re-ruptures, 2 for infections and 1 for tendon necrosis). Fifteen patients (9.2%) suffered from dysfunction of the sural nerve. The median time of returning to work was 28 days (range 1–368) and the median time of returning to sport was 167 days (range 31–489). The majority of patients (150; 92%) were satisfied with the results. Conclusion Minimally invasive Achilles tendon repair in combination with a functional rehabilitation program is a safe and quick procedure with a low rate of re-rupture and a high level of patient satisfaction.