Minimally invasive repair of acute Achilles tendon ruptures with Achillon device

Abstract

The subcutaneous rupture of the Achilles tendon is a frequently observed lesion. Its treatment, however, remains controversial. The treatment to be applied varies between the conservative method, open surgical procedure and percutaneous or minimally invasive techniques. While conservative treatment results in a high percentage of re-ruptures, the open surgical treatment also has its complications. Surgical wound dehiscence, delayed cutaneous healing due to infection, delayed weight-bearing capacity, and consequent hypertrophic scarring account for 4-19% of all complications. The need for a technique that minimizes these complications has led to the development of percutaneous techniques. From August 2005 to March 2009, 35 consecutive patients underwent reparative surgery of the Achilles tendon using a minimally invasive technique with the Achillon device. All patients were available for follow-up. Dynamometric evaluation was possible on 15 patients. Twenty-five patients reported being very satisfied and 10 as being satisfied. The average AOFAS score was 93.4 (range 88-100 points). No complications occurred as a result of surgery (re-rupture, infection, lesion of the sural nerve, wound complication). All patients returned to work within 2 months, to jogging within 3 months, and to their previous level of sporting activity within 6 months. The authors believe that the minimally invasive technique using the Achillon device is a reliable surgical treatment and provides satisfactory results with a low rate of complication.

Achilles tendon ruptures

“…In 2012, Diao et al [71] reported favorable short-term clinical outcomes using the Achillon device (Integra, Plainsboro, NJ). Similar favorable findings were demonstrated in numerous other studies [72][73][74][75] with regard to functional outcome, better cosmetic appearance, less wound complications, patient satisfaction, and imaging results using percutaneous techniques (Fig. 2).…”

The ruptured Achilles tendon: a current overview from biology of rupture to treatment

“…There were no re-ruptures at 1 year and most resumed sporting activities at 6 months. Other authors have been able to reproduce similar results with the Achillon technique whilst reporting none of the surgical complications above [77].…”

Operative versus nonoperative treatment for acute Achilles tendon rupture: a meta-analysis based on current evidence

“…Recently, percutaneous repair techniques have been adopted as new operative procedures that attempt to reduce complications caused by open surgery and has exhibited good efficacy. An up-to-date systematic review performed by Khan et al [25], along with several most recent studies [37][38][39][40][41][42], indicate that compared with open repair, percutaneous repair results in a lower complication rate. Moreover, Maffulli et al [43,44] proved that percutaneous repair of Achilles tendon was not only available for diabetic patients but also suitable for patients >65 years.…”