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A New Minimally Invasive Technique for Achilles Tendon Repair in the Supine Position

CATEGORY: Tendon INTRODUCTION/PURPOSE: Achilles tendon repairs are a common procedure that, historically have been plagued by complications. Recent advanced in both operative and non-operative techniques have changed the landscape for this procedure. Minimally invasive approaches have become far mor...

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Autores principales: O’Donnell, Seth, Velasco, Brian, Whitehouse, Brianna, Kwon, John Y., Miller, Christopher P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8697225/
http://dx.doi.org/10.1177/2473011419S00325
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author O’Donnell, Seth
Velasco, Brian
Whitehouse, Brianna
Kwon, John Y.
Miller, Christopher P.
author_facet O’Donnell, Seth
Velasco, Brian
Whitehouse, Brianna
Kwon, John Y.
Miller, Christopher P.
author_sort O’Donnell, Seth
collection PubMed
description CATEGORY: Tendon INTRODUCTION/PURPOSE: Achilles tendon repairs are a common procedure that, historically have been plagued by complications. Recent advanced in both operative and non-operative techniques have changed the landscape for this procedure. Minimally invasive approaches have become far more common which have improved outcomes by decreasing the risk of wound complications. However, a further limiting factor is the traditional need to place the patient prone. This requires higher levels of anesthesia and careful positioning of the extremities. We present a technique that eliminates the need for prone position while maintaining the advantages of a minimally invasive approach. METHODS: The authors present a novel surgical technique to repair the Achilles tendon. The patient is maintained in the supine position on the pre-operative stretcher. The leg is externally rotated. A direct medial incision is made at the rupture site and the tendon is repaired by passing suture percutaneously through the eyelets of a bent ring forcep and delivered into the wound. This is performed proximally and distally and then the sutures are tied together to complete the repair. Clinical case time, wound complications and short term outcomes will be reported. RESULTS: 6 patients results will be presented including operative case times which average 57 minutes from the time the patient enters the room until they exit the room and arrive in PACU. This represents a decrease of nearly 30 minutes of OR time required for intubation and prone positioning. 4/6 of the patients received only MAC anesthesia and a nerve block with no tourniquet. The first two patients had general anesthesia with an LMA. 6 month PROMIS and FAAM scores will be obtained but are not available at the time of abstract submission. CONCLUSION: We present a novel technique to repair an Achilles tendon with the patient in the supine position. The technique is reliable and can be performed with a minimal learning curve. The operative case times are faster as the patient is kept on their recovery stretcher and do not need to be positioned prone. This decreases the amount of anesthesia required for the surgery as well. The authors believe that eliminating prone positioning will be both safer for the patient and results in a faster surgery without compromising outcomes.
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spelling pubmed-86972252022-01-28 A New Minimally Invasive Technique for Achilles Tendon Repair in the Supine Position O’Donnell, Seth Velasco, Brian Whitehouse, Brianna Kwon, John Y. Miller, Christopher P. Foot Ankle Orthop Article CATEGORY: Tendon INTRODUCTION/PURPOSE: Achilles tendon repairs are a common procedure that, historically have been plagued by complications. Recent advanced in both operative and non-operative techniques have changed the landscape for this procedure. Minimally invasive approaches have become far more common which have improved outcomes by decreasing the risk of wound complications. However, a further limiting factor is the traditional need to place the patient prone. This requires higher levels of anesthesia and careful positioning of the extremities. We present a technique that eliminates the need for prone position while maintaining the advantages of a minimally invasive approach. METHODS: The authors present a novel surgical technique to repair the Achilles tendon. The patient is maintained in the supine position on the pre-operative stretcher. The leg is externally rotated. A direct medial incision is made at the rupture site and the tendon is repaired by passing suture percutaneously through the eyelets of a bent ring forcep and delivered into the wound. This is performed proximally and distally and then the sutures are tied together to complete the repair. Clinical case time, wound complications and short term outcomes will be reported. RESULTS: 6 patients results will be presented including operative case times which average 57 minutes from the time the patient enters the room until they exit the room and arrive in PACU. This represents a decrease of nearly 30 minutes of OR time required for intubation and prone positioning. 4/6 of the patients received only MAC anesthesia and a nerve block with no tourniquet. The first two patients had general anesthesia with an LMA. 6 month PROMIS and FAAM scores will be obtained but are not available at the time of abstract submission. CONCLUSION: We present a novel technique to repair an Achilles tendon with the patient in the supine position. The technique is reliable and can be performed with a minimal learning curve. The operative case times are faster as the patient is kept on their recovery stretcher and do not need to be positioned prone. This decreases the amount of anesthesia required for the surgery as well. The authors believe that eliminating prone positioning will be both safer for the patient and results in a faster surgery without compromising outcomes. SAGE Publications 2019-10-28 /pmc/articles/PMC8697225/ http://dx.doi.org/10.1177/2473011419S00325 Text en © The Author(s) 2019 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
O’Donnell, Seth
Velasco, Brian
Whitehouse, Brianna
Kwon, John Y.
Miller, Christopher P.
A New Minimally Invasive Technique for Achilles Tendon Repair in the Supine Position
title A New Minimally Invasive Technique for Achilles Tendon Repair in the Supine Position
title_full A New Minimally Invasive Technique for Achilles Tendon Repair in the Supine Position
title_fullStr A New Minimally Invasive Technique for Achilles Tendon Repair in the Supine Position
title_full_unstemmed A New Minimally Invasive Technique for Achilles Tendon Repair in the Supine Position
title_short A New Minimally Invasive Technique for Achilles Tendon Repair in the Supine Position
title_sort new minimally invasive technique for achilles tendon repair in the supine position
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8697225/
http://dx.doi.org/10.1177/2473011419S00325
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