Percutaneous versus Open Repair of the Ruptured Achilles Tendon: A Comparative Study

Background Controversy regarding the optimal treatment of the fresh total Achilles tendon rupture remains. Purpose To compare the results of percutaneous and open Achilles tendon repair. Study Design Cohort study; Level of evidence, 2. Methods The results of 132 consecutive patients with acute compl...

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Bibliographic Details
Published in:The American journal of sports medicine 2005-09, Vol.33 (9), p.1369-1379
Main Authors: Čretnik, Andrej, Kosanović, Miloš, Smrkolj, Vladimir
Format: Article
Language:English
Subjects:
Achilles Tendon - injuries
Achilles Tendon - surgery
Adolescent
Adult
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Ankle
Biological and medical sciences
Care and treatment
Clinical outcomes
Comparative studies
Exercise Therapy
Female
Fundamental and applied biological sciences. Psychology
General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation
Humans
Injuries
Injuries of the limb. Injuries of the spine
Legs
Local anesthesia
Male
Medical sciences
Patient Satisfaction
Postoperative Complications - epidemiology
Rupture
Sports injuries
Sports medicine
Surgery
Suture Techniques
Tendon Injuries - rehabilitation
Tendon Injuries - surgery
Tendon repair
Tendons
Traumas. Diseases due to physical agents
Treatment Outcome
Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports
Wounds and injuries
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Summary:Background Controversy regarding the optimal treatment of the fresh total Achilles tendon rupture remains. Purpose To compare the results of percutaneous and open Achilles tendon repair. Study Design Cohort study; Level of evidence, 2. Methods The results of 132 consecutive patients with acute complete Achilles tendon rupture who were operated on exclusively with modified percutaneous repair under local anesthesia from 1991 to 1997 and followed up for at least 2 years were compared to the results of 105 consecutive patients who were operated on exclusively with open repair under general or spinal anesthesia in the same period. Results There were significantly fewer major complications in the group of percutaneous repairs in comparison with the group of open repairs (4.5% vs 12.4%; P = .03), particularly necrosis (0% vs 5.6%; P = .019), and a lower total number of complications (9.7% vs 21%; P = .013). There were slightly more reruptures (3.7% vs 2.8%; P = .680) and sural nerve disturbances (4.5% vs 2.8%; P = .487) in the group of percutaneous repairs, with no statistically significant difference. Functional assessment using the American Orthopaedic Foot and Ankle Society scale and the Holz score showed no statistically significant difference. Conclusion The results of the study support the choice of (modified) percutaneous suturing under local anesthesia as the method that brings comparable functional results to open repair, with a significantly lower rate of complications.
ISSN:0363-5465
1552-3365
DOI:10.1177/0363546504271501