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Open versus percutaneous repair in the treatment of acute Achilles tendon rupture: a randomized prospective study.
Gigante A, Moschini A, Verdenelli A, Del Torto M, Ulisse S, de Palma L. Knee Surg Sports Traumatol Arthrosc. 2008 Feb;16(2):204-9.
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There is no agreement on the ideal type of surgical management for Achilles tendon rupture. The present randomized prospective study was performed to compare outcome data of open and percutaneous repair in the treatment of Achilles tendon rupture. Forty consecutive patients with acute rupture of Achilles tendon were recruited. Patients were randomized to receive open (group A) or percutaneous repair with Tenolig (group B). All patients followed the same rehabilitation protocol except for slight differences in the duration of immobilization. Follow-up included objective evaluation (at 4 and 12 months), subjective evaluation using the SF-12 questionnaire (at 24 months), and bilateral ultrasound scanning and isokinetic testing (at 12 months). The differences in the parameters evaluated clinically were not significant except for ankle circumference, which was significantly greater in group B. There were two minor complications in the open repair group and one case of failed repair in the percutaneous group. SF-12 questionnaire, ultrasound and isokinetic test data did not show significant differences between the groups. The present study demonstrates that the open and the percutaneous technique are both safe and effective in repairing the ruptured Achilles tendon and that both afford the same degree of restoration of clinical, ultrasound and isokinetic patterns. Medium-term results were substantially comparable. Percutaneous repair is performed on a day-surgery basis, it reduces cutaneous complications and operation times, and enables faster recovery, enhancing overall patient compliance. To us, these characteristics make it preferable to open repair in managing subcutaneous ruptures of Achilles tendon in non-professional sports practicing adults.
Acute Achilles Tendon Rupture: Minimally Invasive Surgery Versus Nonoperative Treatment With Immediate Full Weightbearing—A Randomized Controlled Trial
Roderick Metz, Egbert-Jan M. M. Verleisdonk, Geert J.-M.-G. van der Heijden, et al American Journal of Sports Medicine, First published on July 21, 2008
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Background: Surgical repair of acute Achilles tendon ruptures is considered superior to nonoperative treatment, but complications other than rerupture range up to 34%. Nonoperative treatment by functional bracing seems a promising alternative.
Hypothesis: Nonoperative treatment of acute Achilles tendon rupture with functional bracing reduces the number of complications compared with surgical treatment with a minimally invasive technique.
Study Design: Randomized controlled clinical trial; Level of evidence, 2.
Method: Using concealed random allocation, 83 patients with acute Achilles tendon rupture were assigned to nonoperative treatment by functional bracing or minimally invasive surgical treatment followed by tape bandage. Patients were allowed full weightbearing, and follow-up was 1 year.
Results: Complications risk other than rerupture by intention-to-treat basis was 9 in 42 patients (21%) for surgical treatment and 15 in 41 patients (36%) for nonoperative treatment (risk ratio, 0.59; 95% confidence interval, 0.29-1.19). Reruptures risk was 5 in 41 patients after nonoperative treatment and 3 in 42 patients for surgical treatment (risk ratio, 0.59; 95% confidence interval, 0.15-2.29). The mean time to work was 59 days (SD, 82) after surgical treatment and 108 days (SD, 115) after nonoperative treatment (difference, 49 days; 95% confidence interval, 4-94; P < .05). The difference between treatments for return to sports (risk ratio, 0.55; 95% confidence interval, 0.23-1.29), pain, and treatment satisfaction did not reach statistical significance.
Conclusion: There appears to be a clinically important difference in the risk of complications between minimally invasive surgical treatment and nonoperative treatment for acute Achilles tendon ruptures, but this was not statistically significant.
BACKGROUND: The optimal surgical management of Achilles tendon ruptures remains a topic of active debate. Recently, many authors have preferred the limited open method because it afforded sufficient visualization to ensure anatomic apposition of disrupted tendon fibers, minimized local blood supply disturbances, guaranteed free tendon movement, and produced excellent cosmesis. We report our initial experience with this technique and review the literature.
MATERIALS AND METHODS: The outcomes of 30 consecutive patients that underwent limited open repair for Achilles tendon rupture using Achillon(R) (Newdeal SA, Lyon, France) from June 2003 to May 2006 were retrospectively reviewed. There were 20 men and 10 women, of average age 38.6 years, and the average followup period was 18.5 months. Twenty of the injuries were sports-related, eight were caused by a fall, and two by a laceration. The clinical results were assessed using patient satisfaction, the ankle-hindfoot scale of the American Orthopaedic Foot and Ankle Society (AOFAS), and the occurrence of complications.
RESULTS: At last followup, sixteen patients were very satisfied, 11 were satisfied, and the remaining three were dissatisfied. Mean patient AOFAS score was 93.0 points. Surgical complications noted were re-rupture in two cases, deep infection in one, and sural nerve injury in one. All patients except the three patients with a re-rupture or infection, returned to work 2 months postoperatively and resumed light exercise at 3 months, and previous sporting activities by 6 months.
CONCLUSION: The described limited open repair technique for Achilles tendon ruptures provided excellent cosmetic results, satisfactory functional results, and a high level of patient satisfaction.
The Influence of Early Weight-Bearing Compared with Non-Weight-Bearing After Surgical Repair of the Achilles Tendon
Amar A. Suchak, Geoff P. Bostick, Lauren A. Beaupré, D'Arcy C. Durand and Nadr M. Jomha The Journal of Bone and Joint Surgery (American). 2008;90:1876-1883.
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Background: The optimal rehabilitation protocol after surgical repair of an Achilles tendon rupture has not been well defined. The objective of this randomized study was to compare the effect of early weight-bearing with that of non-weight-bearing on early postoperative recovery following repair of an acutely ruptured Achilles tendon.
Methods: Between October 2003 and May 2006, 110 patients with a surgically repaired Achilles tendon rupture were enrolled from one of two major trauma-care tertiary hospitals. All patients were non-weight-bearing for the first two weeks postoperatively. At the two-week postoperative visit, patients were randomized to either weight-bearing or non-weight-bearing for an additional four weeks. Compliance was measured with a pressure sensor in the fixed-hinge ankle-foot orthosis given to each patient. Follow-up assessments were performed at six weeks, three months, and six months postoperatively. The primary outcome was health-related quality of life assessed with use of the RAND 36-Item Health Survey (RAND-36). Secondary outcomes were activity level, calf strength, ankle range of motion, return to sports and work, and complications.
Results: Ninety-eight patients (89%) completed the six-month follow-up. At six weeks, the weight-bearing group had significantly better scores than the non-weight-bearing group in the RAND-36 domains of physical functioning, social functioning, role-emotional, and vitality scores (p < 0.05). Patients in the weight-bearing group also reported fewer limitations of daily activities at six weeks postoperatively (p < 0.001). At six months, no significant differences between the groups were seen in any outcome, although both groups had poor endurance of the calf musculature. No rerupture occurred in either group.
Conclusions: Early weight-bearing after surgical repair of an acute Achilles tendon rupture improves health-related quality of life in the early postoperative period and has no detrimental effect on recovery.
Open minimally invasive Achilles tendon repair with early rehabilitation: Functional results of 25 consecutive patients.
Ozkaya U, Parmaksizoglu AS, Kabukcuoglu Y, Sokucu S, Basilgan S. Injury. 2009 Feb 18. [Epub ahead of print]
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BACKGROUND: Various treatment techniques have been described for the treatment of acute Achilles tendon rupture. However, there is no consensus among orthopaedic surgeons regarding the surgical technique and the postoperative rehabilitation program. Mid-term functional outcome results of the patients who had undergone open minimally invasive repair of fresh Achilles tendon ruptures followed by an early rehabilitation programme were evaluated.
METHODS: Twenty-five consecutive patients who underwent open minimally invasive repair of Achiles tendon ruptures during January 2004-October 2005 were independently reviewed at an average follow-up of 34 months (range 24-45 months). The mean age of the patients was 41 (35-47). A functional rehabilitation protocol based on early range of motion exercises was used after surgery. The American Orthopaedic Foot and Ankle Society score was used to evaluate the outcomes of the patients. Ankle range of motion; thigh, calf and ankle circumferences of the injured leg and the contralateral side, return to work and sports activities time were evaluated.
RESULTS: One patient had a partial rerupture and one had superficial wound infection. The mean American Orthopaedic Foot and Ankle Society score was 93 (80-100). Patients returned to work at 3 weeks (range 1-5 weeks) and to preinjury sportive activities at 3 months (range 2-4 months). Ankle ROM and circumference measurements did not reveal a significant difference between the two sides.
CONCLUSION: These results suggest that open minimally invasive Achilles tendon repair and an early rehabilitation programme provides satisfactory results with early return to previous functional status with low complication rates.
No influence of physiotherapy on outcome after open repair of achilles tendon ruptures?
Ateschrang A, Gratzer C, Rolauffs B, Glatzle J, Weise K, Braun A. Zentralbl Chir. 2008 Dec;133(6):602-7.
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AIM: Many studies have been performed to analyse the influence of surgical techniques and the postoperative aftercare after Achilles tendon ruptures on the outcome. However, there is no study investigating the influence of physiotherapy on outcome after surgical repair and standardised early functional rehabilitation of Achilles tendon rupture, so that this was the objective of the present study.
PATIENTS AND METHODS: In this retrospective study, 104 patients with Achilles tendon ruptures, all treated by open repair followed by a standardised early rehabilitation, were evaluated by the Thermann score. The average age was 42 years. We could identify 3 patient groups. Group I (n=23) did not receive any physiotherapy. Group II (n=41) received physiotherapy for 3-6 weeks, and group III (n=40) received more than 6 weeks of physiotherapy. Physiotherapy consisted of 3 units per week. Each unit lasted for 30 min. All groups were compared statistically via variance analysis.
RESULTS: Group I scored on average 88.8 points, group II 88.6 and group III 87.0 points. There were no statistically significant differences between the three groups (p=0.50). The age of patients had also no relevant influence on the outcome (p=0.48).
CONCLUSIONS: Physiotherapy and age of the patients involved were not found to influence the outcome after open augmented repair of Achilles tendon ruptures followed by a standardised early rehabilitation. These results should be confirmed by a prospective randomised trial. Also elderly patients participating in demanding sport activities should receive a surgical repair
Chronic Achilles tendon ruptures are often challenging to repair because of muscle and tendon atrophy, retraction, and short distal stumps. We undertook a retrospective investigation of 14 patients who were treated with the Ligament Advanced Reinforcement System (LARS) ligament for the treatment of chronic, neglected rupture of the Achilles tendon. The patients pursued a course of early functional rehabilitation, and postoperative outcome scores were obtained at 3, 6, and 12 months, based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot scoring system, and the Tegner Activity score. The minimum duration of follow-up was 36 months. After a minimum of 28 months postoperative, and up to 41 months postoperative, there was no observed incidence of rerupture or recurrent pain. The mean time to return to full activity was 18.3 +/- 2.7 weeks, and >90% of the patients scored > or =80 points on the AOFAS scoring scale. Specifically, the mean AOFAS score increased from 48.64 +/- 12.67 to 85.86 +/- 6.6 after the operation, and this difference was statistically significant (P = .001). Furthermore, the Tegner activity scale score improved from 2.58 +/- 0.31 to 1.73 +/- 0.29 after the operation, and this difference was also statistically significant (P = .001). The results of this retrospective clinical study suggest that augmentation with the LARS ligament offers a satisfactory reconstructive option for the neglected Achilles tendon rupture
Press Release: In Achilles Tendon Rupture Surgery May Not Be Necessary
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The two ends of a ruptured Achilles tendon are often stitched together before the leg is put in plaster, in order to reduce the risk of the tendon rupturing again. However, a thesis from the Sahlgrenska Academy, University of Gothenburg, Sweden, now suggests that surgery may be unnecessary. Patients who do not undergo surgery have just as good a chance of recovery.
The Achilles tendon, which attaches the calf muscle to the heel, is the body's strongest tendon. The tendon may rupture on sudden tensing of the muscle, something that affects middle-aged men in particular, typically when playing badminton or tennis.
"When the Achilles tendon ruptures, it feels like a sudden, violent and intensely painful snap in the calf or tendon above the heel. It is an injury that has become increasingly common in recent years, probably because exercise is increasingly popular. But whether or not one should operate has been the subject of debate for quite some time," says orthopaedic surgeon Katarina Nilsson Helander, the author of the thesis.
When the Achilles tendon has ruptured, the foot is put in plaster with the toes pointing downwards, so that the torn ends of the tendon come into contact and join together as they heal. The torn ends of the tendon are often stitched together before the foot is put in plaster, to make sure they stay in place. In recent times, a removable orthosis has begun to replace plaster casts, making it possible for the patient to start to move the foot sooner. Other studies have shown that early motion stimulates healing.
Surgery increases the risk of infections and sores but is often carried out anyway, as studies have shown that the operation reduces the risk of the tendon rupturing again.
One hundred patients were randomly assigned to surgery with early mobilisation or to early mobilisation alone with the removable orthosis and without prior surgery. In every other respect, all the patients in the study had the same treatment. The thesis shows that there is no difference in the re-rupture rate. A year after the injury, there was no difference in the patients' own impression of symptoms and function, but irrespective of which treatment the patient received, the function tests showed that there remained a substantial difference between the healthy and the injured foot.
"I have concluded that not everybody needs to have surgery, but it is important that those who suffer an Achilles tendon rupture discuss the treatment options with their orthopaedic surgeon," says Katarina Nilsson Helander.
Thesis for the degree of Doctor of Medical Science at the Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy
Title of thesis: Acute Achilles tendon rupture; Evaluation of Treatment and Complications
Source:
Elin Lindstrom Claessen
University of Gothenburg
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Repair of Chronic Rupture of the Achilles Tendon Using 2 Intratendinous Flaps From the Proximal Gastrocnemius-Soleus Complex
Mohamed Taha El Shewy, Hassan Magdy El Barbary, Hisham Abdel-Ghani American Journal of Sports Medicine (in press)
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Background: Chronic rupture of the Achilles tendon is a surgical challenge, owing to the presence of a gap between the retracted ends, which renders direct repair almost impossible.
Purpose: In this study, 2 intratendinous distally based flaps fashioned from the proximal gastrocnemius-soleus complex are used to bridge the gap between the retracted edges of the ruptured Achilles tendon. The flaps are placed in the same line of pull of the ruptured tendon, in an effort to make the graft mimic the original biomechanics as much as possible.
Study Design: Case series; Level of evidence, 4.
Methods: Eleven patients (9 male and 2 female) with neglected ruptures of the Achilles tendon with retracted ends were included in this study. Two flaps fashioned from the proximal gastrocnemius-soleus complex were rotated over themselves, passed through the proximal stump, and then securely inserted into a previously prepared bed in the distal stump.
Results: The patients were followed up for a period of 6 to 9 years. At the final follow-up, all patients were able to return to their preinjury level of activity within a period of 6 to 9 months. The mean preoperative American Orthopedic Foot and Ankle Society score was 42.27, whereas it was 98.91 at the final follow-up, with a range of 88 (in 1 patient) to 100 points (in 10 patients). All 11 patients showed statistically significant improvement according to the Holz rating system.
Conclusion: This technique allows for a bridging of the defect present in chronic ruptures of Achilles tendons, with a minimum of complications and a good final outcome.
Chronic Achilles tendon rupture reconstruction using a modified flexor hallucis longus transfer.
Wegrzyn J, Luciani JF, Philippot R, Brunet-Guedj E, Moyen B, Besse JL. Int Orthop. 2009 Aug 21. [Epub ahead of print]
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The purpose of this study was to report the management and outcome of 11 patients presenting with chronic Achilles tendon (AT) rupture treated by a modified flexor hallucis longus (FHL) transfer. Seven patients presented with a neglected AT rupture, one with a chronic AT rupture associated with Achilles tendinosis and three with an AT re-rupture. AT defect after fibrosis debridement averaged 7.4 cm. In addition to FHL transfer, we performed an augmentation using the two remaining fibrous scar stumps of the ruptured AT. Functional assessment was performed using the AOFAS score and isokinetic evaluation was performed to assess ankle plantarflexion torque deficit. Follow-up averaged 79 months. Functional outcome was excellent with a significant improvement of the AOFAS score at latest follow-up. No re-rupture nor major complication, particularly of wound healing, was observed. All patients presented with a loss of active range of motion of the hallux interphalangeal joint without functional weakness during athletic or daily life activities. Isokinetic testing at 30 degrees/second and 120 degrees/second revealed a significant average decrease of 28 +/- 11% and 36 +/- 4.1%, respectively, in plantarflexion peak torque. Although strength deficit persisted at latest follow-up, functional improvement was significant without morbidity due to FHL harvesting. For patients with chronic AT rupture with a rupture gap of at least 5 cm, surgical repair using FHL transfer with fibrous AT stump reinforcement achieved excellent outcomes.
Introduction
Neglected rupture of Achilles tendon is an infrequent but debilitating injury. Several surgical methods of treatment have been described to repair neglected Achilles tendon rupture.
Material and methods
In our study we reviewed 20 patients (18 male and 2 female). We describe a new surgical technique using percutaneous repair of the neglected Achilles tendon ruptures. It consists of 10 micro-incisions, five lateral and five medial to the posterior aspect of the Achilles tendon, the suture is performed using an absorbable number 1 Vicryl (Ethicon, Edinburgh UK) inserted percutaneously in a figure of eight fashion.
Results
The advantages of this procedure are a short time immobilization, an early weight bearing and a return to complete ankle range of motion. The mean AOFAS score was 99.0, no re-ruptures or sural nerve damage were observed. In all the treated patients the results obtained were rated from good to excellent.
Conclusion
We would like to encourage this technique as being fast, inexpensive and very satisfactory both to the patient and to the surgeon.
Purpose
To study the feasibility of applying Krackow locking stitches in the endoscopic-assisted repair of acute Achilles tendon rupture and the possible complications encountered.
Type of study
Anatomic study.
Methods
Twelve Achilles tendons in six cadavers were cut at 6 cm from its insertion and endoscopic-assisted repair of Achilles tendon was performed. These legs were then cut open in midline to study (i) the locking stitches formed and (ii) the relation of the sural nerve to the locking stitches.
Result
With endoscopic-assisted technique, Krackow-type locking stitches can be formed in eight legs. In four legs, the stitches fell into the ruptured gap and lie deep to the tendon. The tendon rupture end was grasped by the suture rather than forming a Krackow-type locking stitch when the suture was tightened. There was no sural nerve laceration noted. However, in two legs, the sural nerves were found trapped in the sutures at around the proximal portal.
Conclusions
Krackow locking stitches can be formed by the minimally invasive technique. However, there are risks of stitches falling into the ruptured gap and lie deep to the tendon and risk of sural nerve entrapment at the proximal medial portal. The original technique is not suitable for clinical application. Modification of the technique by grasping the tendon end with Allis tissue forceps before passing the suture may prevent the suture from falling into the ruptured tendon gap.
Epidemiology and Outcomes of Achilles Tendon Ruptures in the National Football League
Selene G. Parekh, Walter H. Wray, III, Olubusola Brimmo, Brian J. Sennett, Keith L. Wapner Foot & Ankle Specialist, Vol. 2, No. 6, 267-270 (2009)
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The purpose of this study is to document the epidemiology of Achilles tendon ruptures in the National Football League (NFL) and to quantify the impact of these injuries on player performance. A retrospective review of several online NFL player registries identified 31 Achilles tendon ruptures in NFL players between 1997 and 2002. Nineteen percent of injuries occurred during preseason play, while another 18% occurred during the first month of the official season. There was a postinjury reduction of 88%, 83%, and 78% in power ratings for wide receivers, running backs, and tight ends, respectively, over a 3-year period. There was a 95%, 87%, and 64% postinjury reduction in power ratings for linebackers, cornerbacks, and defensive tackles over a 3-year period. On average, players experienced a greater than 50% reduction in their power ratings following such an injury. Thirty-two percent (n = 10) of NFL players who sustained an Achilles tendon rupture did not return to play in the NFL.
Positional effects of the knee and ankle on the ends of acute Achilles tendon ruptures.
Wray WH 3rd, Regan C, Patel S, May R, Parekh SG. Foot Ankle Spec. 2009 Oct;2(5):214-8
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Conservative management of acute Achilles tendon ruptures in a plantarflexed short leg cast or functional brace is a viable alternative to surgery. The ideal plantarflexion angle to allow the free ends of the tendon to oppose one another has not been clearly defined. The purpose of this cadaveric study was to define a plantarflexion angle where the free Achilles tendon ends reliably oppose one another. Ten cadaveric legs amputated at the distal femur were obtained. A laceration of the Achilles tendon was made 4 cm above the calcaneal insertion. A joint-spanning external fixator was placed across the knee. With differing degrees of knee flexion (0, 45, and 90 degrees), the diastasis between the free ends of the Achilles tendon was measured as the ankle was moved from 20 degrees of dorsiflexion to 30 degrees of plantarflexion (-20, -10, neutral, 10, 20, and 30 degrees). Regardless of knee flexion angle, the ankle plantarflexion angle where the free ends of the Achilles tendon opposed one another was 28.0 (95% confidence interval: 25.0-33.6) degrees. The ideal ankle angle in which to immobilize patients appears tightly clustered around 28 degrees of plantarflexion.
Positional effects of the knee and ankle on the ends of acute Achilles tendon ruptures.
Wray WH 3rd, Regan C, Patel S, May R, Parekh SG. Foot Ankle Spec. 2009 Oct;2(5):214-8
Hi all
What they are telling you is that the achilles or more importantly is that the gastroc is not a plantar flexor, it is a knee extensor, ie the synergist of the hamstrings and quads, nothing else.
Happily await the cries of damnation etc.
Regards
Paul Conneely www.musmed.com.au
BACKGROUND: There is abundant literature on the treatment of Achilles tendon rupture; however data on sports and recreational activities after this injury is scarce.
PATIENTS AND METHODS: 71 patients were assessed in a prospective cross-sectional study after an average of 3 years after Achilles tendon rupture. 44 patients were treated non-operatively, using a functional algorithm, and 23 patients were treated operatively. Outcome parameters were the AOFAS-Score and the SF-36 Score. The strength of plantar-flexion was measured using the Isomed 2000 system, the structural integrity of the tendon was assessed sonografically.
RESULTS: Patients treated operatively had a higher complication rate than patients treated non-operatively (p = 0.05). Re-rupture rate was identically in both groups. No difference was noted between the two groups for the AOFAS score (92 vs. 90). Moreover the SF-36 score did not show any significant difference between the groups. However, if compared to the age-adjusted normative population significant lower scores were achieved. A significant reduction in practicing sports was detected, as well as a reduction of plantar flexion of the affected foot (p = 0.04).
CONCLUSION: Except for complication rate no significant difference could be detected between the groups. Thus operative treatment in the recreational athlete should only be considered, if no adaptation of the ends of the tendon is diagnosed during the initial or repeated ultrasound. Regardless of the therapeutic intervention chosen an Achilles tendon rupture leads to marked changes in sports- and recreational activitie
Deep venous thrombosis (DVT) is common after lower limb injury, but the effect of prophylactic treatment has not been documented in large randomised trials or meta-analyses. As a result, evidence-based recommendations have not been established. The purpose of this study was to evaluate the incidence of venous thromboembolism in patients with Achilles tendon rupture. A total of 100 consecutive patients with an acute Achilles tendon rupture were included in a prospective study and randomised to either surgical or non-surgical treatment. At 8 weeks after the initiation of treatment, 95/100 patients were screened for DVT using colour duplex sonography (CDS) with blinded interpretation by two experienced examiners and adjudication in cases of disagreement by a third person. A total of 95 patients (79 male and 16 female) with a median (range) age of 41 (24-63) years were screened for CDS at 8 weeks. Of the 95 patients, 32 had a CDS-verified thrombosis, 5 proximal and 27 distal, whereas 3 had non-fatal pulmonary embolism. Surgical treatment was performed in 49 patients, non-surgical in 46. There were no significant differences in DVT frequency between the two treatment groups. The incidence of asymptomatic and symptomatic deep venous thrombosis is high after Achilles tendon rupture and there is a need to define the possible benefit of thromboprophylaxis.
Chronic Achilles Tendon Rupture Treated with Two Turndown Flaps and Flexor Hallucis Longus Augmentation - Two-year Clinical Outcome.
Tay D, Lin HA, Tan BS, Chong KW, Rikhraj IS. Ann Acad Med Singapore. 2010 Jan;39(1):58-3.
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Introduction: Both conservative and operative management have been described in the literature for the management of chronic Achilles tendon ruptures with surgical management generally having more favourable results. In our institution, the favoured reconstructive technique was the use of 2 turndown tendon fl aps fashioned from the proximal Achilles tendon augmented by a teno-myodesis of the fl exor hallucis longus. The purpose of this study was to assess the clinical outcome of all patients who underwent this procedure.
Materials and Methods: From the records, a total of 9 patients underwent the above-mentioned procedure of whom 6 patients had complete data collection sets [including SF-36, Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores, ankle range of motion (ROM), presence of residual symptoms and complications] at 2 years of follow-up.
Results: Our results showed an average AOFAS Ankle-Hindfoot score of 94.2, VAS of 0 in all but 1 patient, and generally high scores (75-96) in all 8 domains of the SF-36 questionnaire. Patient satisfaction was also rated to be high from the surgical procedure.
Conclusion: We submit that the procedure adopted at our institution is able to reproduce satisfactory results with low morbidity in patients with this challenging condition.
Achilles tendon rupture
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