Journal of Foot and Ankle Surgery (Asia Pacific)

Register      Login

VOLUME 9 , ISSUE 1 ( January-March, 2022 ) > List of Articles

Original Article

Retrospective Comparative Study between Open and Modified Ultrasound-guided Percutaneous Achilles Tendon Repair

Keith Hay-Man Wan, Michael Siu-Hei Tse, Irene Oi-Lam Lo, Simon Chi-Pan Yuen, Richard Hin-Lun Lee, Kam-Kwong Wong

Keywords : Achilles tendon repair, Foot and ankle surgery, Minimal invasive, Surgical technique

Citation Information : Wan KH, Tse MS, Lo IO, Yuen SC, Lee RH, Wong K. Retrospective Comparative Study between Open and Modified Ultrasound-guided Percutaneous Achilles Tendon Repair. J Foot Ankle Surg Asia-Pacific 2022; 9 (1):7-11.

DOI: 10.5005/jp-journals-10040-1178

License: CC BY-NC 4.0

Published Online: 31-12-2021

Copyright Statement:  Copyright © 2022; The Author(s).


Introduction: To compare the outcomes between the percutaneous repair technique of the Achilles tendon rupture with the open repair technique. Materials and methods: A retrospective review of patients with complete Achilles tendon rupture managed surgically in our institution from January 2015 to June 2019. Group I consisted of patients managed with the percutaneous repair technique. Group II consisted of patients managed with the open technique. Clinical outcomes including re-rupture, wound infection, and pain control were compared. Results: Fifty-two patients were included in the study with 22 patients allocated into group I and 30 patients allocated to group II. The mean age of group I was 41.2 (range 21–78, SD 16.097). The mean follow-up time was 38.4 months (range 14–55 months, SDV 12.738). The mean age of group II was 48.8 (range 27–80, SDV 14.938). At postoperative 1 year, there was no statistical difference in the range of motion. Among the patients in group I, the mean numeral pain rating scale (NPRS) was statistically lower than that of the patients in group II. There was no wound infection, sural nerve injury, or re-rupture in group I. Two patients in group II developed postoperative wound infection. One of them had been complicated with the re-rupture of the repaired Achilles tendon. Conclusion: The percutaneous repair technique is a reasonable treatment option for ruptured Achilles tendon, with a satisfactory medium-term outcome comparable, if not better, than the traditional open repair technique.

  1. Cetti R, Christensen S, Ejsted R. Operative versus nonoperative treatment of Achilles tendon rupture. Am J Sports Med 1993;21(6):791–799. DOI: 10.1177/036354659302100606.
  2. Longo UG, Petrillo S, Maffulli N, et al. Acute achilles tendon rupture in athletes. Foot Ankle Clin 2013;18(2):319–338. DOI: 10.1016/j.fcl.2013.02.003.
  3. Willits K, Amendola A, Bryant D, et al. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg Am 2010;92(17):2767–2775. DOI: 10.2106/JBJS.I.01401.
  4. Wong J, Barrass V, Maffulli N. Quantitative review of operative and nonoperative management of achilles tendon ruptures. Am J Sports Med 2002;30(4):565–575. DOI: 10.1177/03635465020300041701.
  5. Khan RJ, Fick D, Keogh A, et al. Treatment of acute achilles tendon ruptures. A meta-analysis of randomized, controlled trials. J Bone Joint Surg Am 2005;87(10):2202–2210. DOI: 10.2106/JBJS.D.03049.
  6. Ma GW, Griffith TG. Percutaneous repair of acute closed ruptured Achilles tendon: a new technique. Clin Orthop Relat Res 1977;128(128):247–255. DOI: 10.1097/00003086-197710000-00036.
  7. Hockenbury RT, Johns JC. A biomechanical in vitro comparison of open versus percutaneous repair of tendon Achilles. Foot Ankle 1990;11(2):67–72. DOI: 10.1177/107110079001100202.
  8. Cretnik A, Zlajpah L, Smrkolj V, et al. The strength of percutaneous methods of repair of the Achilles tendon: a biomechanical study. Med Sci Sports Exerc 2000;32(1):16–20. DOI: 10.1097/00005768-200001000-00004.
  9. Cretnik A, Kosanović M, Smrkolj V. Percutaneous suturing of the ruptured Achilles tendon under local anesthesia. J Foot Ankle Surg 2004;43(2):72–81. DOI: 10.1053/j.jfas.2004.01.008.
  10. Ceccarelli F, Berti L, Giuriati L, et al. Percutaneous and minimally invasive techniques of Achilles tendon repair. Clin Orthop Relat Res 2007;458:188–193. DOI: 10.1097/BLO.0b013e3180396f07.
  11. Thompson TC. A test for rupture of the tendo Achillis. Acta Orthop Scand 1962;32(1-4):461–465. DOI: 10.3109/17453676208989608.
  12. Citak M, Knobloch K, Albrecht K, et al. Anatomy of the sural nerve in a computer-assisted model: implications for surgical minimal-invasive Achilles tendon repair. Br J Sports Med 2007;41(7):456–458. DOI: 10.1136/bjsm.2006.031328.
  13. Maffuli N. Rupture of the Achilles tendon. J Bone Joint Surg 1999;81A(7):1019–1036. DOI: 10.2106/00004623-199907000-00017.
  14. Asplund CA, Best TM. Achilles tendon disorders. BMJ 2013;346(mar12 1):f1262. DOI: 10.1136/bmj.f1262.
  15. Ahmed IM, Lagopoulos M, McConnell P, et al. Blood supply of the Achilles tendon. J Orthop Res 1998;16(5):591–596. DOI: 10.1002/jor.1100160511.
  16. Klein W, Lang DM, Saleh M. The use of the Ma-Griffith technique for percutaneous repair of fresh ruptured tendo Achillis. Chir Organi Mov 1991;76(3):223–228.
  17. Compston A. Aids to the investigation of peripheral nerve injuries. Medical Research Council: Nerve Injuries Research Committee. His Majesty's Stationery Office: 1942; p. 48.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.