Endoscopic “internal splinting” repair technique for acute Achilles tendon rupture

• Published in: Archives of orthopaedic and trauma surgery 2021-10, Vol.141 (10), p.1753-1760
• Main Authors: Wei, Shijun, Chen, Jia, Kong, Changwang, Xu, Feng, Zhi, Xiaosong, Cai, Xianhua
• Format: Article
• Language: English
• Subjects: Ankle; Arthroscopy and Sports Medicine; Endoscopy; Hospitals; Magnetic resonance imaging; Medicine; Medicine & Public Health; Orthopedics; Patients; Surgery; Surgical outcomes; Tendons; Trauma; Visualization
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-021-03818-y

Introduction Recently, endoscopically assisted Achilles tendon repair techniques have improved to overcome the surgical complications. However, the risk of sural nerve injury and the strength of repair are still the most concerning aspects. Material and methods Twenty three patients with acute Achilles tendon rupture were reviewed in the present study. We stitch the Achilles tendon above the ruptured site using the endoscopic locking loop suture technique, and the knotless anchor suture-bridge technique can be used to make the distal fixation of threads. The function was assessed using the muscle power (MRC0-5), ATRS scores, AOFAS ankle–hindfoot scores, and VAS scores at the final follow-up. Results The mean follow-up time was 15.74 ± 2.43 months (12–18). At the final follow-up, the average of the muscle power (MRC0-5), ATRS score, AOFAS ankle–hindfoot score, and VAS score are 4.74 ± 0.45, 97.83 ± 2.77, 96.52 ± 4.87, and 0.35 ± 0.49, respectively. Every patient returned to previous sports activity at 6 months postoperative. No wound infection and sural nerve injuries were encountered. Only one case suffers local irritation at the medial knotless anchor site. Conclusions Endoscopic “internal splinting” repair for acute Achilles tendon rupture using locking loop stitch with suture-bridge technique leads to an expedited return to activity with a low risk of complications. Level of evidence Level IV, case series.