Re-ruptures and early outcomes after surgical repair of acute Achilles tendon ruptures: prospective, comparative multicenter study

Int Orthop. 2023 Jul;47(7):1855-1861. doi: 10.1007/s00264-023-05827-5. Epub 2023 May 13.

Abstract

Purpose: The primary objective of this study was to compare the re-rupture rate, clinical results, and functional outcomes six months after the surgical repair of an acute Achilles tendon rupture between three different techniques (open repair, percutaneous repair with the Tenolig®, and minimally invasive repair).

Methods: A prospective, comparative, multicenter, non-randomized study was performed and included 111 patients who had an acute ruptured Achilles tendon: 74 underwent an open repair, 22 underwent a percutaneous repair using the Tenolig® and 15 had a minimally invasive repair. At six months follow-up we analyzed the number of re-ruptures, phlebitis, infections, complex regional pain syndrome, clinical outcomes (muscle atrophy, ankle dorsal flexion), functional scores (ATRS, VISA-A, EFAS, SF-12), and return to running.

Results: There were more re-ruptures (p=0.0001) after repair with the Tenolig® (27%) than with open repairs (1.3%) and minimally invasive repairs (0%). The rate of other complications was not different. No clinical differences were found between the three groups. Only some functional scores EFAS Total (p=0.006), and VISA-A (p=0.015) were worse in the Tenolig® group. All the other results were similar between the three groups.

Conclusion: Despite heterogeneous studies in literature, the results of this comparative and prospective study between three surgical techniques of Achilles tendon repair confirmed that Tenolig® repair increased the rate of early re-rupture compared to open or minimally invasive techniques.

Keywords: Achilles tendon rupture; Tenolig®; early outcomes; minimally invasive surgery; open repair.

Publication types

  • Multicenter Study

MeSH terms

  • Achilles Tendon* / surgery
  • Acute Disease
  • Ankle Injuries* / surgery
  • Humans
  • Orthopedic Procedures* / adverse effects
  • Orthopedic Procedures* / methods
  • Prospective Studies
  • Rupture / surgery
  • Tendon Injuries* / surgery
  • Treatment Outcome