More Isn’t Always Better, But Is Less?

Ebeling, Patrick B.

doi:10.2106/jbjs.15.01165

Cited by 2 publications

(3 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results of our study also confirm the opinions expressed 9,24 and the results 39 reported by other researchers: no augmentation is needed when AT ruptures are repaired beyond the acute phase.…”

Section: Discussionsupporting

confidence: 92%

Delayed (14-30 Days) Percutaneous Repair of Achilles Tendon Ruptures Offers Equally Good Results As Compared With Acute Repair

et al. 2020

View full text Add to dashboard Cite

Background: Minimally invasive repair of acute Achilles tendon ruptures has been performed for several years, resulting in reduced morbidity as compared with open repair. Hypothesis: A minimally invasive technique can be used to manage Achilles tendon ruptures in patients presenting between 14 and 30 days from injury. Study Design: Cohort study; Level of evidence, 3. Methods: We prospectively recruited 21 consecutive patients who presented between 14 and 30 days after the index injury, and we compared them with 21 patients who were matched according to sex, age (±2 years), and level of activity, who presented within 14 days of the index injury. All patients underwent the same minimally invasive procedure under local anesthesia: a core suture repair consisting of a modified Bunnell suture in the proximal stump and a modified Kessler suture in the distal stump. Results: At 12 months after minimally invasive repair, patients with delayed treatment had a median Achilles tendon rupture score of 91 (SD, 2.4; range, 87-96) as compared with 91 (SD, 2.2; range, 86-96) in patients treated acutely, who presented at a median 2.4 days (range 1-6 days) from the injury. There were no significant differences between groups in terms of mean (SD) Achilles tendon resting angle: delayed repair group, −3.9° (2.0); acute repair group, −3.7° (1.9) ( P = .69). No patient in either group developed a wound infection. One patient in the acute group experienced an iatrogenic sural nerve injury. Conclusion: Patients with Achilles tendon rupture treated by percutaneous repair 14 to 30 days after injury achieved similar results at 1 year as patient treated <14 after injury.

show abstract

Section: Discussionsupporting

confidence: 92%

Delayed (14-30 Days) Percutaneous Repair of Achilles Tendon Ruptures Offers Equally Good Results As Compared With Acute Repair

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Prior to commencing the minimally invasive technique, the author's standard technique for chronic presentations was an open repair augmented with hamstring. For acute repairs, comparison studies have shown no difference in outcomes between end-to-end and augmented repairs [33] with the message that more is not necessarily better [8]. Patients presenting acutely repaired using an identical core suture technique were used as the best available comparison group permitting age matching.…”

Section: Discussionmentioning

confidence: 99%

“…Anathatee et al performed end-to-end repair using the Achillon jig (Integra, Plainsboro, NJ, USA) forming a box suture, at 11-31 days following rupture [1]. Percutaneous suture configurations, including the box suture, are weaker than open configurations on biomechanical testing [8,30] resulting in increased ankle dorsiflexion [15]. Good clinical outcomes are reported, using modified Bunnell and Kessler configurations following acute repair [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

No difference in strength and clinical outcome between early and late repair after Achilles tendon rupture

Carmont

Zellers

Brorsson

et al. 2018

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose This retrospective study aimed to determine the patient-reported and functional outcome of patients with delayed presentation, who had received no treatment until 14 days following injury of Achilles tendon rupture repaired with minimally invasive surgery and were compared with a group of sex-and age-matched patients presenting acutely. Based on the outcomes following delayed presentation reported in the literature, it was hypothesized that outcomes would be inferior for self-reported outcome, tendon elongation, heel-rise performance, ability to return to play, and complication rates than for acutely managed patients. Methods Repair was performed through an incision large enough to permit mobilisation of the tendon ends, core suture repair consisting of a modified Bunnell suture proximally and a Kessler suture distally and circumferential running suture augmentation. Results Nine patients presented 21.8 (14.9) days (range 14-42 days) after rupture. The rate of delayed presentation was estimated to be 1 in 10. At 12 months following repair, patients with delayed treatment had median (range) ATRS score of 90 (69-99) compared with 94 (75-100) in patients treated acutely presenting 0.66 (1.7) (0-5) days. There were no significant differences between groups: ATRA [mean (SD) delayed: − 6.9° (5.5), acute: − 6° (4.7)], heel-rise height index [delayed: 79% (20), acute: 74% (14)], or heel-rise repetition index [delayed: 77% (20), acute: 71% (20)]. In the delayed presentation group, two patients had wound infection and one iatrogenic sural nerve injury. Conclusions Patients presenting more than 2 weeks after Achilles tendon rupture may be successfully treated with minimally invasive repair. Level of evidence III.

show abstract

More Isn’t Always Better, But Is Less?

Cited by 2 publications

References 4 publications

Delayed (14-30 Days) Percutaneous Repair of Achilles Tendon Ruptures Offers Equally Good Results As Compared With Acute Repair

Delayed (14-30 Days) Percutaneous Repair of Achilles Tendon Ruptures Offers Equally Good Results As Compared With Acute Repair

No difference in strength and clinical outcome between early and late repair after Achilles tendon rupture

Contact Info

Product

Resources

About