scholarly journals Enveloping bioabsorbable polyglycolide membrane and immobilization in achilles tendon repair: A comparative experimental study on rabbits

2008 ◽  
Vol 26 (2) ◽  
pp. 264-270 ◽  
Author(s):  
Harri Pihlajamäki ◽  
Olli Tynninen ◽  
Pertti Karjalainen ◽  
Pentti Rokkanen
Keyword(s):  
Experimental Study ◽  
Achilles Tendon ◽  
Tendon Repair ◽  
Achilles Tendon Repair

scholarly journals Transverse versus longitudinal incision for minimally invasive Achilles tendon repair

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0016
Author(s):  
Daniel Bohl ◽  
Eric Barnard ◽  
Kamran Movassaghi ◽  
Kamran Hamid ◽  
Adam Schiff
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Suture Material ◽  
Tendon Repair ◽  
Wound Complications ◽  
Transverse Incision ◽  
Longitudinal Incision ◽  
Achilles Tendon Repair ◽  
Deep Suture ◽  
No Tourniquet

Category: Sports Introduction/Purpose: The rate of wound complications following traditional open Achilles tendon repair is reported at 7-8%. In an effort to reduce the rate of wound complications, orthopaedic surgeons have adopted novel minimally invasive techniques. The purpose of this study is to characterize the rate of wound and other early complications following a minimally invasive Achilles tendon repair, to identify any factors associated with increased risk. Methods: The postoperative courses of 55 patients who underwent minimally invasive Achilles tendon repair by two surgeons at separate academic medical centers were retrospectively reviewed. Repair technique was similar in all cases, making use of the same commercially available suture-guidance jig, silicone-impregnated deep suture material, and locking stitch technique. However, 31 procedures used a longitudinal incision and a tourniquet (one surgeon’s preference), while 24 procedures used a transverse incision and no tourniquet (the second surgeon’s preference). Of the 24 procedures using transverse incisions, 2 had to be converted to L-shaped incisions to achieve better access to the tendon. The rates of early complications within 3 months after surgery were characterized and compared between patients with differing procedural characteristics. Results: Of the 55 patients included in the study, 2 (3.6%) developed wound complications. Both wound complications appeared to be reactions to the deep suture material (see Table 1 for details). There was no statistical difference in the rate of wound complications between patients in the longitudinal incision/tourniquet group and patients in the transverse incision/no tourniquet group (6.5% versus 0.0%; p=0.499). Three patients (5.5%) developed sural neuropraxia, which manifested as mild-to-moderate subjective numbness with sensation remaining intact to light touch. There were no cases of re-rupture. At 3-month follow-up, all 55 patients had intact Thompson tests and well-healed wounds. Conclusion: The rate of wound complications following minimally invasive Achilles repair is low at 3.6%. The present study could not demonstrate a difference in risk for wound complications between patients treated with a longitudinal incision and tourniquet and patients treated with a transverse incision and no tourniquet. The wound complications we observed were primarily attributable to inflammatory reactions to the silicone-impregnated deep suture material. Patients should be counseled that although risk for wound complications may be lower with minimally invasive techniques, such techniques do risk sural neuropraxia and deep suture reaction. Further prospective analysis is warranted.

The Effect of Obesity on Achilles Rupture Repair

2018 ◽  
Vol 12 (6) ◽  
pp. 503-512 ◽  
Author(s):  
Jeffery S. Hillam ◽  
Neil Mohile ◽  
Niall Smyth ◽  
Jonathan Kaplan ◽  
Amiethab Aiyer
Keyword(s):  
Achilles Tendon ◽  
Tendon Repair ◽  
Wound Dehiscence ◽  
Comorbid Conditions ◽  
Improvement Program ◽  
Acs Nsqip ◽  
Achilles Tendon Repair ◽  
Increased Risk ◽  
American College Of Surgeons ◽  
Tendon Ruptures

Introduction. Obesity is an increasingly common comorbidity that may negatively affect outcomes following orthopaedic surgery. It is valuable to determine whether obese patients are vulnerable for postoperative complications. The purpose of this study was to analyze data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) to determine the effect of obesity on surgical treatment of Achilles tendon ruptures. Methods. Patients who underwent a surgical repair of the Achilles tendon were retrospectively identified through the ACS NSQIP. The patients were divided into 2 cohorts (obese and nonobese), then perioperative and postoperative factors were evaluated for association with obesity. Results. A total of 2128 patients were identified, of whom 887 (41.7%) were classified as obese. Obesity correlated with an increased operative time, 60.9 versus 56.1 minutes. The only postoperative complication associated with obesity was wound dehiscence. Logistic regression adjusted for comorbid conditions demonstrated that obesity was not associated with an increased risk of wound dehiscence. Conclusion. A large segment of the patient population undergoing Achilles tendon repair is obese. Obesity was found to have an increased association with wound dehiscence, likely related to comorbid conditions, following Achilles tendon repair. Obesity was not significantly associated with any other complication. Levels of Evidence: III, Retrospective Cohort Study

scholarly journals Arthroscopically-Asissted Achilles Tendon Repair; Long-Term Results

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0022
Author(s):  
Akın Turgut ◽  
Mert Zeynel Asfuroğlu
Keyword(s):  
Achilles Tendon ◽  
Range Of Motion ◽  
Sural Nerve ◽  
Plantar Flexion ◽  
Tendon Repair ◽  
Long Term Results ◽  
Calf Circumference ◽  
Achilles Tendon Repair ◽  
Arthroscopically Assisted

Objectives: The ruptures of the Achilles tendon (AT) are relatively common. Since there is no consensus on the best method of the repair of the AT; the treatment is determined on the preference of the surgeon and the patient. The study evaluating the cadaveric and short term clinical results done by our clinic in 2002, has shown us that arthroscopically Achilles tendon repair can be good choise in achilles tendon ruptures. Methods: Fortyfour patients who underwent arthroscopically assisted achilles tendon repair during 1997-2011 in Osmangazi University Orthopaedics and Traumatology Department were retrospectively observed. The mean follow-up time was 69,7 months. One of patients had bilateral rupture. The diagnosis was based on loss of plantar flexion strength, palpation of the gap in the tendon, and a positive Thompson test. MRI and USG were used when needed. The ruptures were left-sided in nineteen patients and right-sided in twentysix. The cause of the rupture was recreational sports activity in thirtyeight, fall from height in four, missing a step in a staircase in two. Return the regular activity, ankle range of motion as compared with the opposite side, calf circumference, and ability to walk and stand tiptoe were recorded. All patients were operated on within 2-32 days after the rupture. Thirtysix operations were performed under spinal anesthesia and eight operations were performed under general anesthesia. Tourniquet was always used. Before starting the procedure, the rupture site and location of the gap are marked. Using the common videoarthroscopic instruments, a 70 degrees scope was inserted into the AT through the stab incision made previously, and the torn ends of the tendon were visualized with plantar flexion an extension of the ankle. After the visualization of the torn ends of the tendon and repair by the technique of Ma and Griffith care was focused to contact the ends of the tendon anatomically; then the sutures were knotted. A short leg circular cast with the ankle in slight plantar flexion was applied. American Orthopaedics Foot-Ankle Society (AOFAS) score was used to evaluate the long-term results.. Results: All patients had satisfactory results that no reruptures had occurred. No significant difference in range of motion of the ankle and calf circumference between the opposite sides was observed in any patient. All patients could walk and stand on tiptoe. AOFAS mean score was 94.5 (65-100). The interval from injury to return to regular work and activities was 8-10 weeks. All the patients were able to return back to their activity level before surgery. In three patients temporary sural hypoestesia, in one patient permanent sural hipoestesia and in one patient wound enfection appeared. No sensory deficit was detected in the temporary sural hypoestesia patients after postoperative second year controls. Medical care was supported to the patient with the wound enfection and the enfection was under control in the early stages. Conclusion: In summary; arthroscopically-assisted percutaneous repair of AT appears to overcome some certain problems of open, conservative and percutaneous techniques; but the neurovascular structure damage risk especially the sural nerve remains a potent problem. Accurate knowledge of the anatomy appears to be a solution. Novel percutaneous repairs have been promising to minimize the risk of sural nerve damage.

Incidence and effect of calcifications after open-augmented Achilles tendon repair

2007 ◽  
Vol 128 (10) ◽  
pp. 1087-1092 ◽  
Author(s):  
Atesch Ateschrang ◽  
Christoph Gratzer ◽  
Kuno Weise
Keyword(s):  
Achilles Tendon ◽  
Tendon Repair ◽  
Achilles Tendon Repair
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