Channel-assisted minimally invasive repair of acute Achilles tendon rupture

Abstract

BackgroundPercutaneous (minimally invasive) suturing is a promising option for Achilles tendon (AT) repair with low rerupture and infection rates. Sural nerve lesions are the major problem to avoid with the technique. A new device was therefore designed for suturing the AT, resulting in channel-assisted minimally invasive repair (CAMIR). The purpose of this study was to compare the clinical and functional outcomes of CAMIR with traditional open techniques.MethodEighty two patients with AT rupture were included: 41 for CAMIR, 41 for open repair. All patients followed a standardized rehabilitation protocol. Follow-ups were at 12 and 24 months after surgery. Functional evaluation was based on the clinical American Orthopaedic Foot & Ankle Society score associated with neurologic deficit (sural nerve), calf circumference, range of motion (ROM), and isometric testing.ResultsThere was no difference between groups regarding plantar flexor strength, ankle ROM, or calf circumference. CAMIR significantly decreased the operative time compared to open repair (17 vs. 56 min, P < 0.0001). Mean scar length was greater in the open repair group (10 vs. 2 cm, P < 0.0001). There were no wound complications in the CAMIR group but four in the open repair group (P < 0.0001). No deep vein thrombosis, rerupture, or sural nerve injury occurred.ConclusionCAMIR and open repair yielded essentially identical clinical and functional outcomes. Sural nerve injuries can be minimized using CAMIR by carefully placing the suture channel with a stab incision and special trocar based on a modified Bunnell suture technique.

Achillon versus modified minimally invasive repair treatment in acute Achilles tendon rupture

“…In addition, we tried to preserve the paratenon, which is helpful in promoting tendon healing and smooth gliding and may also prevent superficial wound infections from spreading into deeper layers. 18 Percutaneous techniques using specialized equipment have been developed to minimize the risk of sural nerve injury. 25,26 The use of these devices allows the surgeon to accurately see the tendon ends to ensure direct apposition while minimizing nerve and wound-healing complications.…”

Intraoperative Ultrasonography assistance for minimally invasive repair of the acute Achilles Tendon Rupture

“…Based on the Achillon method, Chen et al 12 conducted a new method, which is called channel-assisted minimally invasive repair (CAMIR), to avoid sural nerve injury and yield essentially identical clinical and functional outcomes compared with open repair. But these devices (Achillon or CAMIR) are too expensive to apply beyond some patients' affordability in our hospital.…”

Erratum to: Channel-assisted minimally invasive repair of acute Achilles tendon rupture

“…Unfortunately, the original version of this article [ 1 ] contained errors. Firstly, in Table 2, the scar length for the CAMIR group is 2.0(0.5) cm and for open group 10.0(2.5) cm.…”

“…There is an overlap between the two articles. The 30 patients treated by CAMIR in the Chen et al [ 2 ], are included in the 41 patients treated by CAMIR in Chen et al [ 1 ]. The article [ 2 ] is a case report and the data is a retrospective analysis.…”

“…The article [ 2 ] is a case report and the data is a retrospective analysis. However, this study [ 1 ] is a comparative design, between CAMIR and open repair.…”