Mini-Open Achilles Repair With a Flat Braided Suture in a Low-Profile Configuration

Abstract

Achilles repair has evolved over the past 30 years, from large open procedures with high complication rates to shorter, less-invasive procedures with better outcomes. Percutaneous repair has comparable failure rates with open repairs, fewer complications, and faster recovery. However, percutaneous Achilles repairs risk sural nerve injury. A miniopen repair fuses the gap between percutaneous and open procedures, and this approach has the potential to mitigate nerve injury while maintaining the increased efficiency in procedure time and patient recovery. The purpose of this Technical Note and accompanying video is to outline the repair of the Achilles tendon using a mini open repair using a low-profile flat braided suture.

A clinical comparison of two different surgical techniques in the treatment of acute Achilles tendon ruptures: Limited-open approach vs. percutaneous approach

“…[ 2 , 10 , 19 ] Therefore, minimally invasive repair methods and surgical instruments for these procedures have been developed to prevent postoperative soft-tissue complications due to open repair of AATRs. [ 8 , 12 , 20 , 21 ] The soft tissue complication rates after open repairs of AATRs have been reported to be between 3 and 11%. In contrast, lower rates of soft-tissue complications were observed with minimally invasive techniques in the literature.…”

“…Important disadvantages include the risk of injuring the Sural nerve close to the tendon with a percutaneous needle, the inability to see the ruptured tendon ends due to the absence of an incision, and the inability to evaluate the quality of tendon repair. [ 11 , 12 ] To overcome the issues of open (skin complications) and percutaneous (risk of sural nerve injury) repair techniques, the “Limited-Open Repair” method was developed. [ 13 ]…”

“…Important disadvantages include the risk of injuring the Sural nerve close to the tendon with a percutaneous needle, the inability to see the ruptured tendon ends due to the absence of an incision, and the inability to evaluate the quality of tendon repair. [11,12] To overcome the issues of open (skin complications) and percutaneous (risk of sural nerve injury) repair techniques, the "Limited-Open Repair" method was developed. [13] Although many studies compare the results of minimally invasive methods and open repair, to the best of our knowledge, only one study compares the results of limited open and percutaneous approaches.…”

Combining electrospinning with hot drawing process to fabricate high performance poly (L-lactic acid) nanofiber yarns for advanced nanostructured bio-textiles

“…Textile techniques, including braiding, weaving and knitting, are attractive approaches to produce adjustable 2D and 3D fibrous architectures and patterns for surgical applications [42]. For instance, the braided structure offers excellent axial strength, which is widely utilized as surgical sutures [43,44]. Moreover, the braided pattern possesses hierarchical organizations similar to the fibril arrangement of natural tendons and ligaments, which also has wide applications as constructs to repair the damaged connective tissues [45,46].…”