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Published in: BMC Surgery 1/2024

Open Access 01-12-2024 | Achilles Tendon Rupture | Research

Comparison of percutaneous and open repair of Achilles tendon rupture: results and complications from a single institution

Authors: Fabijan Čukelj jr, Dejan Blažević, Fabijan Čukelj, Srećko Sabalić, Ivan Benčić, Tomislav Ćuti, Dinko Pivalica, Bore Bakota, Dinko Vidović

Published in: BMC Surgery | Issue 1/2024

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Abstract

Background

The Achilles tendon is the strongest tendon in the human body, but it is prone to injury, especially in modern times when recreational sports are growing in popularity. As a result, Achilles tendon rupture is becoming an increasingly common medical problem in modern society. The main objective of this study was to compare the outcomes of percutaneous repair and open repair for the treatment of Achilles tendon rupture.

Methods

A retrospective study was conducted involving a total of 316 patients who had undergone surgical treatment for Achilles tendon rupture between 2013 and 2021. The data collected from the medical history of these patients included the type of surgical procedure, the mechanism of injury, the age and sex of the patients, the time spent in the hospital, and any possible complications of the surgical treatment (such as infections, reruptures, or sural nerve injuries).

Results

The study revealed that there was no significant difference between percutaneous and open surgical approaches in terms of sural nerve injury. However, there was a statistically significant advantage of the percutaneous method in terms of the number of infections, which was significantly lower than that of the open method. Additionally, the median length of hospital stay was found to be four days longer with the open approach. However, the study noted that a statistically significant advantage of the percutaneous method for rerupture could not be established due to the small number of patients with rerupture and the insufficient ratio of patients with rerupture in relation to the size of the observed population.

Conclusions

Percutaneous repair is an effective treatment option for Achilles tendon rupture and has outcomes equal to or better than those of open repair. Therefore, this approach is recommended as the preferred method of treatment due to the presence of fewer complications, provided that the indications for this technique are appropriate.
Literature
1.
go back to reference Musil V, Stingl J, Bacova T, Baca V, Kachlik D. Achilles tendon: the 305th anniversary of the French priority on the introduction of the famous anatomical eponym. Surg Radiol Anat. 2011;33:421–7.CrossRefPubMed Musil V, Stingl J, Bacova T, Baca V, Kachlik D. Achilles tendon: the 305th anniversary of the French priority on the introduction of the famous anatomical eponym. Surg Radiol Anat. 2011;33:421–7.CrossRefPubMed
2.
go back to reference Tarantino D, Palermi S, Sirico F, Corrado B. Achilles Tendon rupture: mechanisms of Injury, principles of Rehabilitation and Return to play. J Funct Morphol Kinesiol. 2020;5(4):95.CrossRefPubMedPubMedCentral Tarantino D, Palermi S, Sirico F, Corrado B. Achilles Tendon rupture: mechanisms of Injury, principles of Rehabilitation and Return to play. J Funct Morphol Kinesiol. 2020;5(4):95.CrossRefPubMedPubMedCentral
3.
go back to reference Holm C, Kjaer M, Eliasson P. Achilles tendon rupture–treatment and complications: a systematic review. Scand J Med Sci Sports. 2015;25:e1–10.CrossRefPubMed Holm C, Kjaer M, Eliasson P. Achilles tendon rupture–treatment and complications: a systematic review. Scand J Med Sci Sports. 2015;25:e1–10.CrossRefPubMed
4.
go back to reference Oliva F, Marsilio E, Asparago G, Giai Via A, Biz C, Padulo J, Spoliti M, Foti C, Oliva G, Mannarini S, Rossi AA, Ruggieri P, Maffulli N. Achilles Tendon rupture and Dysmetabolic diseases: a multicentric, epidemiologic study. J Clin Med. 2022;11(13):3698.CrossRefPubMedPubMedCentral Oliva F, Marsilio E, Asparago G, Giai Via A, Biz C, Padulo J, Spoliti M, Foti C, Oliva G, Mannarini S, Rossi AA, Ruggieri P, Maffulli N. Achilles Tendon rupture and Dysmetabolic diseases: a multicentric, epidemiologic study. J Clin Med. 2022;11(13):3698.CrossRefPubMedPubMedCentral
5.
go back to reference Maffulli N, D’Addona A, Maffulli GD, Gougoulias N, Oliva F. Delayed (14–30 days) percutaneous repair of Achilles tendon ruptures offers equally good results as compared with Acute repair. Am J Sports Med. 2020;48:1181–8.CrossRefPubMed Maffulli N, D’Addona A, Maffulli GD, Gougoulias N, Oliva F. Delayed (14–30 days) percutaneous repair of Achilles tendon ruptures offers equally good results as compared with Acute repair. Am J Sports Med. 2020;48:1181–8.CrossRefPubMed
6.
go back to reference I.S.Mu. .L.T. achilles tendon ruptures guidelines. Muscles, ligaments and Tendons. J Open AccessVolume 8, Issue 3, Pages 310–632018. I.S.Mu. .L.T. achilles tendon ruptures guidelines. Muscles, ligaments and Tendons. J Open AccessVolume 8, Issue 3, Pages 310–632018.
7.
go back to reference Cretnik A, Zlajpah L, Smrkolj V, Kosanović M. The strength of percutaneous methods of repair of the Achilles tendon: a biomechanical study. Med Sci Sports Exerc. 2000;32:16–20.CrossRefPubMed Cretnik A, Zlajpah L, Smrkolj V, Kosanović M. The strength of percutaneous methods of repair of the Achilles tendon: a biomechanical study. Med Sci Sports Exerc. 2000;32:16–20.CrossRefPubMed
8.
go back to reference Čretnik A, Kosanović M, Košir R. Long-term results with the use of modified percutaneous repair of the ruptured Achilles tendon under local anaesthesia (15-year analysis with 270 cases). J Foot Ankle Surg. 2019;58:828–36.CrossRefPubMed Čretnik A, Kosanović M, Košir R. Long-term results with the use of modified percutaneous repair of the ruptured Achilles tendon under local anaesthesia (15-year analysis with 270 cases). J Foot Ankle Surg. 2019;58:828–36.CrossRefPubMed
9.
go back to reference Chiodo CP, Glazebrook M, Bluman EM, et al. American Academy of Orthopaedic Surgeons clinical practice guideline on treatment of Achilles tendon rupture. J Bone Joint Surg Am. 2010;92:2466–8.PubMed Chiodo CP, Glazebrook M, Bluman EM, et al. American Academy of Orthopaedic Surgeons clinical practice guideline on treatment of Achilles tendon rupture. J Bone Joint Surg Am. 2010;92:2466–8.PubMed
10.
go back to reference Kou J. AAOS clinical practice guideline: acute Achilles tendon rupture. JAAOS - J Am Acad Orthop Surg. 2010;18:511–3.CrossRefPubMed Kou J. AAOS clinical practice guideline: acute Achilles tendon rupture. JAAOS - J Am Acad Orthop Surg. 2010;18:511–3.CrossRefPubMed
11.
go back to reference Jones MP, Khan RJK, Carey Smith RL. Surgical interventions for treating acute Achilles tendon rupture: key findings from a recent cochrane review. J Bone Joint Surg Am. 2012;94:e88.CrossRefPubMed Jones MP, Khan RJK, Carey Smith RL. Surgical interventions for treating acute Achilles tendon rupture: key findings from a recent cochrane review. J Bone Joint Surg Am. 2012;94:e88.CrossRefPubMed
12.
go back to reference Yang B, Liu Y, Kan S, Zhang D, Xu H, Liu F, et al. Outcomes and complications of percutaneous versus open repair of acute Achilles tendon rupture: a meta-analysis. Int J Surg Lond Engl. 2017;40:178–86.CrossRef Yang B, Liu Y, Kan S, Zhang D, Xu H, Liu F, et al. Outcomes and complications of percutaneous versus open repair of acute Achilles tendon rupture: a meta-analysis. Int J Surg Lond Engl. 2017;40:178–86.CrossRef
13.
go back to reference Rozis M, Benetos IS, Karampinas P, Polyzois V, Vlamis J, Pneumaticos SG. Outcome of percutaneous fixation of acute Achilles tendon ruptures. Foot Ankle Int. 2018;39:689–93.CrossRefPubMed Rozis M, Benetos IS, Karampinas P, Polyzois V, Vlamis J, Pneumaticos SG. Outcome of percutaneous fixation of acute Achilles tendon ruptures. Foot Ankle Int. 2018;39:689–93.CrossRefPubMed
14.
go back to reference Cukelj F, Bandalovic A, Knezevic J, Pavic A, Pivalica B, Bakota B. Treatment of ruptured Achilles tendon: operative or nonoperative procedure? Injury. 2015;46:137–42.CrossRef Cukelj F, Bandalovic A, Knezevic J, Pavic A, Pivalica B, Bakota B. Treatment of ruptured Achilles tendon: operative or nonoperative procedure? Injury. 2015;46:137–42.CrossRef
15.
go back to reference Lazaroni PSO, Baumfeld TS, Magalhães JMB, Lopes FAS, Amaral GM, Baumfeld DS. Isokinetic functional results of open and percutaneous Achilles tendon repair. Sci J Foot Ankle. 2018;12:55–60.CrossRef Lazaroni PSO, Baumfeld TS, Magalhães JMB, Lopes FAS, Amaral GM, Baumfeld DS. Isokinetic functional results of open and percutaneous Achilles tendon repair. Sci J Foot Ankle. 2018;12:55–60.CrossRef
16.
go back to reference Clanton TO, Haytmanek CT, Williams BT, Civitarese DM, Turnbull TL, Massey MB, et al. 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. 2015;43:1957–64.CrossRefPubMed Clanton TO, Haytmanek CT, Williams BT, Civitarese DM, Turnbull TL, Massey MB, et al. 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. 2015;43:1957–64.CrossRefPubMed
17.
go back to reference Karabinas PK, Benetos IS, Lampropoulou-Adamidou K, Romoudis P, Mavrogenis AF, Vlamis J. Percutaneous versus open repair of acute Achilles tendon ruptures. Eur J Orthop Surg Traumatol. 2014;24:607–13.CrossRefPubMed Karabinas PK, Benetos IS, Lampropoulou-Adamidou K, Romoudis P, Mavrogenis AF, Vlamis J. Percutaneous versus open repair of acute Achilles tendon ruptures. Eur J Orthop Surg Traumatol. 2014;24:607–13.CrossRefPubMed
18.
go back to reference Taglialavoro G, Biz C, Mastrangelo G, Aldegheri R. The repair of the Achilles tendon rupture: comparison of two percutaneous techniques. Strategies Trauma Limb Reconstr. 2011;6(3):147–54.CrossRefPubMedPubMedCentral Taglialavoro G, Biz C, Mastrangelo G, Aldegheri R. The repair of the Achilles tendon rupture: comparison of two percutaneous techniques. Strategies Trauma Limb Reconstr. 2011;6(3):147–54.CrossRefPubMedPubMedCentral
Metadata
Title
Comparison of percutaneous and open repair of Achilles tendon rupture: results and complications from a single institution
Authors
Fabijan Čukelj jr
Dejan Blažević
Fabijan Čukelj
Srećko Sabalić
Ivan Benčić
Tomislav Ćuti
Dinko Pivalica
Bore Bakota
Dinko Vidović
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2024
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-024-02333-2

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