A comparative study with novel percutaneous repair and open repair of an acute achilles tendon rupture: novel usage of intraoperative ultrasonography
ESSKA Academy. Kang C. 11/08/19; 285207; epAFAS-04 Topic: A5 - Minimal invasive & endoscopic-assisted sutures for Achilles tendon rupture
Prof. Chan Kang
Prof. Chan Kang
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Abstract
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Background: A definitive consensus on the optimal treatment of achilles tendon rupture is yet to be established. This study aimed to comparatively analyze the clinical outcomes of ultrasound-guided percutaneous repair and open repair surgeries to treat achilles tendon rupture.
Methods: This retrospective study included 12 cases of achilles tendon rupture (Group A) treated with ultrasound-guided percutaneous repair and 18 cases (Group B) treated with open repair. Clinical evaluation was performed using the Arner-Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Achilles Tendon Total Rupture score (ATRS), visual analogue scale (VAS) regarding postoperative satisfaction scores (overall/aesthetics), time to single heel raise, difference in bilateral calf circumferences, recovery of athletic ability compared to pre-rupture level, and other complications.
Results: While the Arner-Lindholm scale, AOFAS ankle-hindfoot score, ATRS, time point when single heel raise was possible, differences in bilateral calf circumference, and recovery of athletic ability compared to pre-rupture level were no significant differences between the two groups (P=.999, .235, .357, .645, .497 and .881, respectively), overall and aesthetic satisfaction levels were higher in the group treated with percutaneous repair under ultrasonography guidance (P=.035 and .001, respectively). In Group A, there were two cases of elongation observed at the suture site. In Group B, there was one case of recurrent rupture caused by deep infection and one case of superficial infection. There were no cases involving sural nerve injury in either group.
Conclusion: Novel percutaneous repair provides not only similar clinical outcomes but also greater overall and aesthetic satisfaction levels of operative outcomes and minimal complications (i.e. sural nerve injury), compared to open repair surgeries. Therefore, percutaneous repair may be a useful technique in the treatment of achilles tendon rupture.
Level of Evidence: Level III, Retrospective Comparative Study.
Key words: Achilles tendon; Ultrasonography; Percutaneous repair; Sural nerve; Absorbable suture
Background: A definitive consensus on the optimal treatment of achilles tendon rupture is yet to be established. This study aimed to comparatively analyze the clinical outcomes of ultrasound-guided percutaneous repair and open repair surgeries to treat achilles tendon rupture.
Methods: This retrospective study included 12 cases of achilles tendon rupture (Group A) treated with ultrasound-guided percutaneous repair and 18 cases (Group B) treated with open repair. Clinical evaluation was performed using the Arner-Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Achilles Tendon Total Rupture score (ATRS), visual analogue scale (VAS) regarding postoperative satisfaction scores (overall/aesthetics), time to single heel raise, difference in bilateral calf circumferences, recovery of athletic ability compared to pre-rupture level, and other complications.
Results: While the Arner-Lindholm scale, AOFAS ankle-hindfoot score, ATRS, time point when single heel raise was possible, differences in bilateral calf circumference, and recovery of athletic ability compared to pre-rupture level were no significant differences between the two groups (P=.999, .235, .357, .645, .497 and .881, respectively), overall and aesthetic satisfaction levels were higher in the group treated with percutaneous repair under ultrasonography guidance (P=.035 and .001, respectively). In Group A, there were two cases of elongation observed at the suture site. In Group B, there was one case of recurrent rupture caused by deep infection and one case of superficial infection. There were no cases involving sural nerve injury in either group.
Conclusion: Novel percutaneous repair provides not only similar clinical outcomes but also greater overall and aesthetic satisfaction levels of operative outcomes and minimal complications (i.e. sural nerve injury), compared to open repair surgeries. Therefore, percutaneous repair may be a useful technique in the treatment of achilles tendon rupture.
Level of Evidence: Level III, Retrospective Comparative Study.
Key words: Achilles tendon; Ultrasonography; Percutaneous repair; Sural nerve; Absorbable suture
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