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No difference in operative time, outcomes, cosmesis, or return to activity and/or sport after minimally invasive versus open repair of primary Achilles ruptures: a retrospective review

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To compare clinical outcomes and the rate of return to sport among patients that have undergone minimally invasive repair versus open approach of an acute Achilles tendon rupture.

Methods

Patients who underwent surgical repair of acute Achilles tendon rupture at a single urban academic institution from 2017 to 2020 with minimum 2-year follow-up were reviewed retrospectively. Preinjury sport participation and preinjury work activity information, the Achilles tendon Total Rupture Score (ATRS), the Tegner Activity Scale, Patient-Reported Outcomes Measurement Information System for mobility and pain interference were collected.

Results

In total, 144 patients were initially included in the study. Of these, 63 patients were followed with a mean follow-up of 45.3 ± 29.2 months. The mean operative time did not significantly differ between groups (p = 0.938). Patients who underwent minimally invasive repair returned to sport at a rate of 88.9% at a mean of 10.6 ± 5.8 months, compared to return rate of open procedures of 83.7% at 9.5 ± 5.5 months. There were no significant differences in ATRS (p = 0.246), Tegner (p = 0.137) or VAS pain (p = 0.317) scores between groups. There was no difference in cosmetic satisfaction between PARS and open repair groups (88.4 vs. 76.0; p = 0.244).

Conclusion

Patients who underwent minimally invasive repair of acute Achilles tendon ruptures demonstrate no significant differences with respect to cosmesis, operative time, patient-reported outcomes and the rate and level of return to activities when compared to an open approach.

Level of evidence

III.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Saltzman CL, Tearse DS (1998) Achilles tendon injuries. J Am Acad Orthop Surg 6:316–325

    Article  CAS  PubMed  Google Scholar 

  2. Chiodo CP, Glazebrook M, Bluman EM et al (2010) Diagnosis and treatment of acute Achilles tendon rupture. J Am Acad Orthop Surg 18:503–510

    Article  PubMed  Google Scholar 

  3. Kadakia AR, Dekker RG 2nd, Ho BS (2017) Acute Achilles Tendon Ruptures: An Update on Treatment. J Am Acad Orthop Surg 25:23–31

    Article  PubMed  Google Scholar 

  4. Caolo KC, Eble SK, Rider C et al (2021) Clinical outcomes and complications with open versus minimally invasive Achilles tendon repair. Foot Ankle Orthop 6:24730114211060064

    Article  PubMed  PubMed Central  Google Scholar 

  5. Li Y, Jiang Q, Chen H, Xin H, He Q, Ruan D (2021) Comparison of mini-open repair system and percutaneous repair for acute Achilles tendon rupture. BMC Musculoskelet Disord 22:914

    Article  PubMed  PubMed Central  Google Scholar 

  6. Park CH, Na HD, Chang MC (2021) Clinical outcomes of minimally invasive repair using ring forceps for acute Achilles tendon rupture. J Foot Ankle Surg 60:237–241

    Article  PubMed  Google Scholar 

  7. Gatz M, Driessen A, Eschweiler J, Tingart M, Migliorini F (2021) Open versus minimally-invasive surgery for Achilles tendon rupture: a meta-analysis study. Arch Orthop Trauma Surg 141:383–401

    Article  PubMed  Google Scholar 

  8. Yammine K, Assi C (2017) Efficacy of repair techniques of the Achilles tendon: a meta-analysis of human cadaveric biomechanical studies. Foot (Edinb) 30:13–20

    Article  PubMed  Google Scholar 

  9. Idarraga AJ, Bohl DD, Barnard E, Movassaghi K, Hamid KS, Schiff AP (2022) adverse events following minimally invasive Achilles tendon repair. Foot Ankle Spec 15:236–243

    Article  PubMed  Google Scholar 

  10. Wu Y, Mu Y, Yin L, Wang Z, Liu W, Wan H (2019) Complications in the management of acute Achilles tendon rupture: a systematic review and network meta-analysis of 2060 patients. Am J Sports Med 47:2251–2260

    Article  PubMed  Google Scholar 

  11. Zou Y, Li X, Wang L, Tan C, Zhu Y (2021) Endoscopically assisted, minimally invasive reconstruction for chronic Achilles tendon rupture with a double-bundle flexor Hallucis longus. Orthop J Sports Med 9:2325967120979990

    PubMed  PubMed Central  Google Scholar 

  12. Tejwani NC, Lee J, Weatherall J, Sherman O (2014) Acute achilles tendon ruptures: a comparison of minimally invasive and open approach repairs followed by early rehabilitation. Am J Orthop (Belle Mead NJ) 43:E221–E225

    PubMed  Google Scholar 

  13. Qi H, Ji X, Cui Y, Wang L, Chen H, Tang P (2019) Comparison of channel-assisted minimally invasive repair and 3 common Achilles tendon restoration techniques. Exp Ther Med 17:1426–1434

    PubMed  Google Scholar 

  14. Macaluso B, Hassan CR, Swanson DR et al (2022) Biomechanical comparison of Krackow repair and percutaneous achilles repair system for achilles tendon rupture fixation: a cadaveric and finite element analysis study. Foot Ankle Orthop 7:24730114221088504

    Article  PubMed  PubMed Central  Google Scholar 

  15. Clanton TO, Haytmanek CT, Williams BT et al (2015) A biomechanical comparison of an open repair and 3 minimally invasive percutaneous achilles tendon repair techniques during a simulated, progressive rehabilitation protocol. Am J Sports Med 43:1957–1964

    Article  PubMed  Google Scholar 

  16. Cella D, Riley W, Stone A et al (2010) The patient-reported outcomes measurement information system (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. J Clin Epidemiol 63:1179–1194

    Article  PubMed  PubMed Central  Google Scholar 

  17. Martin KD, Crouser NJ, Khan IA (2022) Minimally invasive mid-substance Achilles tendon repair using the percutaneous Achilles repair system (PARS). JBJS Essent Surg Tech 12(e21):00050

    Google Scholar 

  18. Hsu AR, Jones CP, Cohen BE, Davis WH, Ellington JK, Anderson RB (2015) Clinical outcomes and complications of percutaneous Achilles repair system versus open technique for acute Achilles tendon ruptures. Foot Ankle Int 36:1279–1286

    Article  PubMed  Google Scholar 

  19. Karabinas PK, Benetos IS, Lampropoulou-Adamidou K, Romoudis P, Mavrogenis AF, Vlamis J (2014) Percutaneous versus open repair of acute Achilles tendon ruptures. Eur J Orthop Surg Traumatol 24:607–613

    Article  PubMed  Google Scholar 

  20. Stake IK, Matheny LM, Comfort SM, Dornan GJ, Haytmanek CT, Clanton TO (2023) Outcomes following repair of achilles midsubstance tears: Percutaneous knotless repair versus open repair. Foot Ankle Int 44:499–507

    Article  PubMed  Google Scholar 

  21. Henriquez H, Munoz R, Carcuro G, Bastias C (2012) Is percutaneous repair better than open repair in acute Achilles tendon rupture? Clin Orthop Relat Res 470:998–1003

    Article  PubMed  Google Scholar 

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Funding

No funding was provided for this study.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, New York University Langone Health, 333 East 38th St, New York, NY, 10016, USA

    Ian Savage-Elliott, Zachary I. Li, Michael R. Moore, Bradley Lezak, Taylor Jazrawi, Alexander Golant & Robert J. Meislin

Authors
  1. Ian Savage-Elliott
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  2. Zachary I. Li
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  3. Michael R. Moore
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  4. Bradley Lezak
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  5. Taylor Jazrawi
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  6. Alexander Golant
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  7. Robert J. Meislin
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Corresponding author

Correspondence to Michael R. Moore.

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Conflict of interest

Robert J Meislin: Arthrex, Inc: IP royalties; Paid consultant. Mitek: Paid consultant. Smith & Nephew: Paid consultant. Alexander Golant: AAOS: Board or committee member. Arthrex, Inc: Unpaid consultant. Arthroscopy: Editorial or governing board. Arthroscopy Association of North America: Board or committee member.

Ethical approval

Protocol #19-01430.

Informed consent

The present study was retrospective and exempt by our IRB.

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Savage-Elliott, I., Li, Z.I., Moore, M.R. et al. No difference in operative time, outcomes, cosmesis, or return to activity and/or sport after minimally invasive versus open repair of primary Achilles ruptures: a retrospective review. Eur J Orthop Surg Traumatol 34, 1871–1876 (2024). https://doi.org/10.1007/s00590-024-03859-0

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  • DOI: https://doi.org/10.1007/s00590-024-03859-0

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