2017 ISAKOS Biennial Congress ePoster #110

 

Percutaneus Repair of Achilles Tendon Rupture under Ultrasound Surveillance as Effective Method of Treatment in Patients with Other Diseases

Mikolaj Wrobel, MD, Warsaw POLAND
Andrzej Mioduszewski, MD, PhD, Warsaw POLAND
Jacek Mazek, MD, Warsaw POLAND
Juliusz Sroczynski, MD, Warszawa, mazowieckie POLAND
Grzegorz Klos, MD, Warszawa POLAND

Ortopedika - Centrum Chirurgii Specjalistycznej, Warszawa, POLAND

FDA Status Not Applicable

Summary

Percutaneus repair of the Achilles tears under ultrasound is effective and safe method of treatment.

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Abstract

Background

Open repair of torn Achilles tendon is a standard procedure, however complications may occure due to extensive approach, especially in older patients with general conditions. Different systems for minimally invasive procedures were also introduced but the risk of damaging sural nerve was pointed out.

Aims: We developed percutaneus repair of Achilles tendon rupture under ultrasound surveillance and assessed safety and results of the procedure.

Methods

Since May 2011 until September 2015 we performed 14 procedures. The tendons were repaired with Ethibond suture loop passed through the tendon below and above rupture through the skin with elastic needle under direct ultrasound visualization.
We analized results of patients with minimally 3 months follow up. Some of patients were also burden with diabetes, cardiac diseases, psychiatric disorders and thrombocytopenia. We qualified for treatment only acute ruptures (up to 10 days), with relative contraindications for open procedures.

Results

We assessed function of repaired tendon in clinical examination and ultrasound exam 6 weeks and three months after surgery. Also AOFAS score was used.
13 of 14 patients healed tendon and returned to their activities. In one case conversion to open surgery was necessary as patient experienced another trauma in postoperative period. Another patient reported persisting pain due to suture conflict with soft tissues. Release of the suture was necessary six months after surgery. There was no sural nerve entrapement nor skin healing problems. AOFAS score rised from 57,8 to 92,8 three months after surgery.

Conclusions

Percutaneus repair of Achilles tendon rupture under ultrasound surveillance is minimally invasive and effective method of treatment of acute ruptures. It is safe and allows to avoid both sural nerve entrapement and skin healing problems. However it requires some experience with ultrasound diagnostics.