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Published in: BMC Musculoskeletal Disorders 1/2022

Open Access 01-12-2022 | Achilles Tendon Rupture | Research

Comparison of Ma-Griffith combined with a minimally invasive small incision to a modified suture technique for the treatment of acute achilles tendon ruptures

Authors: Li Jun, Yu Hao, Zhan Junfeng, Zhang Jisen, Xu Xinzhong, Yao Yunfeng, Tian Dasheng, Xie Jia

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

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Abstract

Background

The Achilles tendon is the strongest tendon in the human body, although it is also prone to injury and rupture. Currently, the best treatment method for acute Achilles tendon rupture remains controversial. The aim of this study was to compare the efficacy of the Ma-Griffith method combined with a minimally invasive small incision (M-G/MISI) with the modified suture technique (MST).

Methods

We conducted a retrospective review of the medical records of all patients who underwent treatment for acute Achilles tendon rupture between January 2012 and January 2020 at our hospital. Demographic characteristics, operative details, and postoperative complications were recorded, and data were statistically analyzed to compare the treatment efficacy of the two operative methods.

Results

A total of 67 patients were enrolled in the study, 34 of whom underwent M-G/MISI treatment, and 33 of whom underwent MST treatment. The intraoperative blood loss in the M-G/MISI group (16.47 ± 13.23 ml) was significantly lower than that in the MST group (34.55 ± 13.01 ml), and the difference was statistically significant (P ˂0.001). The incision in the M-G/MISI group (3.79 ± 1.81 cm) was significantly shorter than that in the MST group (5.79 ± 1.00 cm), and the difference was statistically significant (P˂0.001). The Achilles tendon rupture score and the American Orthopedic Foot and Ankle Society (AOFAS) score were higher than those of the MST group at the sixth month after the operation (P˂0.001). Postoperatively, there was 1 case of traumatic Achilles tendon rupture in the M-G/MISI group and 1 case each of infection and deep vein thrombosis in the modified suture group.

Conclusions

Compared with the MST group, the M-G/MISI group had better Achilles tendon and ankle function scores at 6 months postoperatively, and less bleeding and shorter incisions. M-G/MISI is less invasive than MST.
Literature
1.
go back to reference Stecco C, Corradin M, Macchi V, Morra A, Porzionato A, Biz C, De Caro R. Plantar fascia anatomy and its relationship with Achilles tendon and paratenon. J Anat. 2013;223(6):665–76.CrossRef Stecco C, Corradin M, Macchi V, Morra A, Porzionato A, Biz C, De Caro R. Plantar fascia anatomy and its relationship with Achilles tendon and paratenon. J Anat. 2013;223(6):665–76.CrossRef
2.
go back to reference Zhao HM, Yu GR, Yang YF, Zhou JQ, Aubeeluck A. Outcomes and complications of operative versus non-operative treatment of acute Achilles tendon rupture: a meta-analysis. Chin Med J. 2011;124(23):4050–5.PubMed Zhao HM, Yu GR, Yang YF, Zhou JQ, Aubeeluck A. Outcomes and complications of operative versus non-operative treatment of acute Achilles tendon rupture: a meta-analysis. Chin Med J. 2011;124(23):4050–5.PubMed
3.
go back to reference Raikin SM, Garras DN, Krapchev PV. Achilles tendon injuries in a United States population. Foot Ankle Int. 2013;34(4):475–80.CrossRef Raikin SM, Garras DN, Krapchev PV. Achilles tendon injuries in a United States population. Foot Ankle Int. 2013;34(4):475–80.CrossRef
4.
go back to reference Houshian S, Tscherning T, Riegels-Nielsen P. The epidemiology of Achilles tendon rupture in a Danish county. Inj. 1998;29(9):651–4. Houshian S, Tscherning T, Riegels-Nielsen P. The epidemiology of Achilles tendon rupture in a Danish county. Inj. 1998;29(9):651–4.
5.
go back to reference Campbell P, Lawton JO. Spontaneous rupture of the Achilles tendon: pathology and management. Br J Hosp Med. 1993;50(6):321–5.PubMed Campbell P, Lawton JO. Spontaneous rupture of the Achilles tendon: pathology and management. Br J Hosp Med. 1993;50(6):321–5.PubMed
6.
go back to reference Reinherz R, Granoff S. Westerfield MJTJofs: Pathologic afflictions of the Achilles tendon. J Foot Surg. 1991;30(2):117–21.PubMed Reinherz R, Granoff S. Westerfield MJTJofs: Pathologic afflictions of the Achilles tendon. J Foot Surg. 1991;30(2):117–21.PubMed
7.
go back to reference Park YH, Lim JW, Choi GW, Kim HJ. Quantitative magnetic resonance imaging analysis of the common site of acute achilles tendon rupture: 5 to 8 cm above the distal end of the calcaneal insertion. Am J Sports Med. 2019;47(10):2374–9.CrossRef Park YH, Lim JW, Choi GW, Kim HJ. Quantitative magnetic resonance imaging analysis of the common site of acute achilles tendon rupture: 5 to 8 cm above the distal end of the calcaneal insertion. Am J Sports Med. 2019;47(10):2374–9.CrossRef
8.
go back to reference Kauwe M. Acute Achilles tendon rupture: clinical evaluation, conservative management, and early active rehabilitation. Clin Podiatr Med Surg. 2017;34(2):229–43.CrossRef Kauwe M. Acute Achilles tendon rupture: clinical evaluation, conservative management, and early active rehabilitation. Clin Podiatr Med Surg. 2017;34(2):229–43.CrossRef
9.
go back to reference Wu Y, Mu Y, Yin L, Wang Z, Liu W, Wan H. Complications in the management of acute Achilles tendon rupture: A systematic review and network meta-analysis of 2060 patients. Am J Sports Med. 2019;47(9):2251–60.CrossRef Wu Y, Mu Y, Yin L, Wang Z, Liu W, Wan H. Complications in the management of acute Achilles tendon rupture: A systematic review and network meta-analysis of 2060 patients. Am J Sports Med. 2019;47(9):2251–60.CrossRef
10.
go back to reference Jallageas R, Bordes J, Daviet JC, Mabit C, Coste C. Evaluation of surgical treatment for ruptured Achilles tendon in 31 athletes. Orthop Traumatol Surg Res. 2013;99(5):577–84.CrossRef Jallageas R, Bordes J, Daviet JC, Mabit C, Coste C. Evaluation of surgical treatment for ruptured Achilles tendon in 31 athletes. Orthop Traumatol Surg Res. 2013;99(5):577–84.CrossRef
11.
go back to reference Zhou K, Song L, Zhang P, Wang C, Wang W. Surgical versus non-surgical methods for acute Achilles tendon rupture: A meta-analysis of randomized controlled trials. J Foot Ankle Surg. 2018;57(6):1191–9.CrossRef Zhou K, Song L, Zhang P, Wang C, Wang W. Surgical versus non-surgical methods for acute Achilles tendon rupture: A meta-analysis of randomized controlled trials. J Foot Ankle Surg. 2018;57(6):1191–9.CrossRef
12.
go back to reference Wilkins R, Bisson LJ. Operative versus nonoperative management of acute Achilles tendon ruptures: a quantitative systematic review of randomized controlled trials. Am J Sports Med. 2012;40(9):2154–60.CrossRef Wilkins R, Bisson LJ. Operative versus nonoperative management of acute Achilles tendon ruptures: a quantitative systematic review of randomized controlled trials. Am J Sports Med. 2012;40(9):2154–60.CrossRef
13.
go back to reference Khan RJ, Fick D, Keogh A, Crawford J, Brammar T, Parker M. Treatment of acute achilles tendon ruptures A meta-analysis of randomized, controlled trials. J Bone Joint Surg Am. 2005;volume 87(10):2202–10. Khan RJ, Fick D, Keogh A, Crawford J, Brammar T, Parker M. Treatment of acute achilles tendon ruptures A meta-analysis of randomized, controlled trials. J Bone Joint Surg Am. 2005;volume 87(10):2202–10.
14.
go back to reference Alcelik I, Saeed ZM, Haughton BA, Shahid R, Alcelik JC, Brogden C, Budgen A. Achillon versus open surgery in acute Achilles tendon repair. Foot Ankle Surg. 2018;24(5):427–34.CrossRef Alcelik I, Saeed ZM, Haughton BA, Shahid R, Alcelik JC, Brogden C, Budgen A. Achillon versus open surgery in acute Achilles tendon repair. Foot Ankle Surg. 2018;24(5):427–34.CrossRef
15.
go back to reference Carmont MR, Maffulli N. Modified percutaneous repair of ruptured Achilles tendon. Knee Surg Sports Traumatol Arthrosc. 2008;16(2):199–203.CrossRef Carmont MR, Maffulli N. Modified percutaneous repair of ruptured Achilles tendon. Knee Surg Sports Traumatol Arthrosc. 2008;16(2):199–203.CrossRef
16.
go back to reference Wang H, Brown S. The effects of total ankle replacement on ankle joint mechanics during walking. J Sport Health Sci. 2017;6(3):340–5.CrossRef Wang H, Brown S. The effects of total ankle replacement on ankle joint mechanics during walking. J Sport Health Sci. 2017;6(3):340–5.CrossRef
17.
go back to reference Nilsson-Helander K, Thomeé R, Silbernagel KG, Thomeé P, Faxén E, Eriksson BI, Karlsson J. The Achilles tendon total rupture score (ATRS): development and validation. Am J Sports Med. 2007;35(3):421–6.CrossRef Nilsson-Helander K, Thomeé R, Silbernagel KG, Thomeé P, Faxén E, Eriksson BI, Karlsson J. The Achilles tendon total rupture score (ATRS): development and validation. Am J Sports Med. 2007;35(3):421–6.CrossRef
18.
go back to reference Oliva F, Bernardi G, De Luna V, Farsetti P, Gasparini M, Marsilio E, Piccirilli E, Tarantino U, Rugiero C, De Carli A. I.S.Mu.L.T. Achilles tendon ruptures guidelines. Muscles, Ligaments and Tendons J. 2018;8:310–63.CrossRef Oliva F, Bernardi G, De Luna V, Farsetti P, Gasparini M, Marsilio E, Piccirilli E, Tarantino U, Rugiero C, De Carli A. I.S.Mu.L.T. Achilles tendon ruptures guidelines. Muscles, Ligaments and Tendons J. 2018;8:310–63.CrossRef
19.
go back to reference Biz C, Cerchiaro M, Belluzzi E, Bragazzi NL, DeGuttry G, Ruggieri P. Long Term Clinical-Functional and Ultrasound Outcomes in Recreational Athletes after Achilles Tendon Rupture: Ma and Griffith versus Tenolig. Medicina (Kaunas). 2021;57(10):1073.CrossRef Biz C, Cerchiaro M, Belluzzi E, Bragazzi NL, DeGuttry G, Ruggieri P. Long Term Clinical-Functional and Ultrasound Outcomes in Recreational Athletes after Achilles Tendon Rupture: Ma and Griffith versus Tenolig. Medicina (Kaunas). 2021;57(10):1073.CrossRef
21.
go back to reference Dams OC, van den Akker-Scheek I, Diercks RL, Wendt KW, Zwerver J, Reininga IHF. Surveying the management of Achilles tendon ruptures in the Netherlands: lack of consensus and need for treatment guidelines. Knee Surgery Sports Traumatol Arthrosc. 2019;27(9):2754–64.CrossRef Dams OC, van den Akker-Scheek I, Diercks RL, Wendt KW, Zwerver J, Reininga IHF. Surveying the management of Achilles tendon ruptures in the Netherlands: lack of consensus and need for treatment guidelines. Knee Surgery Sports Traumatol Arthrosc. 2019;27(9):2754–64.CrossRef
22.
go back to reference Kadakia AR, Dekker RG 2nd, Ho BS. Acute Achilles tendon ruptures: An update on treatment. J Am Acad Orthop Surg. 2017;25(1):23–31.CrossRef Kadakia AR, Dekker RG 2nd, Ho BS. Acute Achilles tendon ruptures: An update on treatment. J Am Acad Orthop Surg. 2017;25(1):23–31.CrossRef
23.
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(4):607–13.CrossRef 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(4):607–13.CrossRef
24.
go back to reference Del Buono A, Volpin A, Maffulli N. Minimally invasive versus open surgery for acute Achilles tendon rupture: a systematic review. Br Med Bull. 2014;109:45–54.CrossRef Del Buono A, Volpin A, Maffulli N. Minimally invasive versus open surgery for acute Achilles tendon rupture: a systematic review. Br Med Bull. 2014;109:45–54.CrossRef
25.
go back to reference Grassi A, Amendola A, Samuelsson K, Svantesson E, Romagnoli M, Bondi A, Mosca M, Zaffagnini S. Minimally invasive versus open repair for acute Achilles tendon rupture: Meta-analysis showing reduced complications, with similar outcomes, after minimally invasive surgery. J Bone Joint Surg Am. 2018;100(22):1969–81.CrossRef Grassi A, Amendola A, Samuelsson K, Svantesson E, Romagnoli M, Bondi A, Mosca M, Zaffagnini S. Minimally invasive versus open repair for acute Achilles tendon rupture: Meta-analysis showing reduced complications, with similar outcomes, after minimally invasive surgery. J Bone Joint Surg Am. 2018;100(22):1969–81.CrossRef
26.
go back to reference Popovic N, Lemaire R. Diagnosis and treatment of acute ruptures of the Achilles tendon current concepts review. Acta Orthop Belg. 1999;65(4):458–71.PubMed Popovic N, Lemaire R. Diagnosis and treatment of acute ruptures of the Achilles tendon current concepts review. Acta Orthop Belg. 1999;65(4):458–71.PubMed
27.
go back to reference Ma GW, Griffith TG. Percutaneous repair of acute closed ruptured achilles tendon: a new technique. Clin Orthop Relat Res. 1977;128:247–55. Ma GW, Griffith TG. Percutaneous repair of acute closed ruptured achilles tendon: a new technique. Clin Orthop Relat Res. 1977;128:247–55.
28.
go back to reference Bradley JP, Tibone JE. Percutaneous and open surgical repairs of Achilles tendon ruptures. A comparative study. Am Journal Sports Med. 1990;18(2):188–95.CrossRef Bradley JP, Tibone JE. Percutaneous and open surgical repairs of Achilles tendon ruptures. A comparative study. Am Journal Sports Med. 1990;18(2):188–95.CrossRef
29.
go back to reference Cretnik A, Kosanovic M, Smrkolj V. Percutaneous versus open repair of the ruptured Achilles tendon: a comparative study. Am J Sports Med. 2005;33(9):1369–79.CrossRef Cretnik A, Kosanovic M, Smrkolj V. Percutaneous versus open repair of the ruptured Achilles tendon: a comparative study. Am J Sports Med. 2005;33(9):1369–79.CrossRef
30.
go back to reference Fischer S, Colcuc C, Gramlich Y, Stein T, Abdulazim A, von Welck S, Hoffmann R. Prospective randomized clinical trial of open operative, minimally invasive and conservative treatments of acute Achilles tendon tear. Arch Orthop Trauma Surg. 2021;141(5):751–60.CrossRef Fischer S, Colcuc C, Gramlich Y, Stein T, Abdulazim A, von Welck S, Hoffmann R. Prospective randomized clinical trial of open operative, minimally invasive and conservative treatments of acute Achilles tendon tear. Arch Orthop Trauma Surg. 2021;141(5):751–60.CrossRef
31.
go back to reference Lo IK, Kirkley A, Nonweiler B, Kumbhare DA. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a quantitative review. Clin J Sport Med. 1997;7(3):207–11.CrossRef Lo IK, Kirkley A, Nonweiler B, Kumbhare DA. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a quantitative review. Clin J Sport Med. 1997;7(3):207–11.CrossRef
32.
go back to reference Lim J, Dalal R, Waseem M. Percutaneous vs. open repair of the ruptured Achilles tendon--a prospective randomized controlled study. Foot Ankle Int. 2001;22(7):559–68.CrossRef Lim J, Dalal R, Waseem M. Percutaneous vs. open repair of the ruptured Achilles tendon--a prospective randomized controlled study. Foot Ankle Int. 2001;22(7):559–68.CrossRef
33.
go back to reference Buchgraber A, Pässler HH. Percutaneous repair of Achilles tendon rupture. Immobilization versus functional postoperative treatment. Clinical Orthop Relat Res. 1997;341:113–22.CrossRef Buchgraber A, Pässler HH. Percutaneous repair of Achilles tendon rupture. Immobilization versus functional postoperative treatment. Clinical Orthop Relat Res. 1997;341:113–22.CrossRef
34.
go back to reference Khan RJ, Carey Smith RL. Surgical interventions for treating acute Achilles tendon ruptures. Cochrane Database Syst Rev. 2010;8(9):Cd003674. Khan RJ, Carey Smith RL. Surgical interventions for treating acute Achilles tendon ruptures. Cochrane Database Syst Rev. 2010;8(9):Cd003674.
35.
go back to reference Assal M, Jung M, Stern R, Rippstein P, Delmi M, Hoffmeyer P. Limited open repair of Achilles tendon ruptures: a technique with a new instrument and findings of a prospective multicenter study. J Bone Joint Surg Am. 2002;84(2):161–70.CrossRef Assal M, Jung M, Stern R, Rippstein P, Delmi M, Hoffmeyer P. Limited open repair of Achilles tendon ruptures: a technique with a new instrument and findings of a prospective multicenter study. J Bone Joint Surg Am. 2002;84(2):161–70.CrossRef
Metadata
Title
Comparison of Ma-Griffith combined with a minimally invasive small incision to a modified suture technique for the treatment of acute achilles tendon ruptures
Authors
Li Jun
Yu Hao
Zhan Junfeng
Zhang Jisen
Xu Xinzhong
Yao Yunfeng
Tian Dasheng
Xie Jia
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-022-05769-w

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