Current literature shows that minimally invasive (MIS) tendo-Achilles (TA) repairs carry a lower risk of infection compared to open repairs. Our study aimed to assess whether MIS TA repair also contributed to improved patient outcomes as well as lowered infection and wound complication rates. Between January 2017 and December 2019, 19 patients underwent minimally invasive TA repairs performed by two fellowship-trained foot and ankle surgeons at a tertiary institution. A retrospective review of registry data was performed. Outcomes were measured to include AOFAS Score, RAND36 Scores as well as patient-reported satisfaction scores and visual analog scale (VAS) for pain assessment. Statistical analysis was performed using a Student\'s t-test for continuous variables and Pearson\'s Chi-squared test for categorical variables. The overall results showed that patients who underwent MIS TA repair had much faster recovery when compared to traditional open TA repairs. Of the 19 patients who underwent MIS TA repair, there were two cases of superficial wound infection compared to six in the open group (p < 0.05). The MIS TA repair arm of the study also had higher patient-reported satisfaction rates, lower VAS pain scores (p < 0.05), with better AOFAS and SF36 quality of life measures. Overall, the rate of superficial infection, wound complication and length of stay were all reduced in the MIS group with similar deep infection rates. Our study concludes that where possible, TA rupture should be repaired minimally invasively and by an experienced foot and ankle surgeon as this will yield the best outcomes for the patient.
Level of evidence: III
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