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Percutaneous and Minimally Invasive Surgical Technique for Achilles Tendon Repair

CATEGORY: Ankle; Sports; Trauma INTRODUCTION/PURPOSE: Achilles tendon rupture is a traumatic injury that can cause considerable morbidity and reduced function. The optimal treatment method for this injury remains controversial. Non-operative intervention puts patients at higher risk of re-rupture wh...

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Autores principales: Hoskins, Tyler, Goyette, David, Patel, Jay, Mazzei, Christopher, Gianakos, Arianna L., Koss, Justin, Wittig, James, Epstein, David M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705420/
http://dx.doi.org/10.1177/2473011420S00258
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author Hoskins, Tyler
Goyette, David
Patel, Jay
Mazzei, Christopher
Gianakos, Arianna L.
Koss, Justin
Wittig, James
Epstein, David M.
author_facet Hoskins, Tyler
Goyette, David
Patel, Jay
Mazzei, Christopher
Gianakos, Arianna L.
Koss, Justin
Wittig, James
Epstein, David M.
author_sort Hoskins, Tyler
collection PubMed
description CATEGORY: Ankle; Sports; Trauma INTRODUCTION/PURPOSE: Achilles tendon rupture is a traumatic injury that can cause considerable morbidity and reduced function. The optimal treatment method for this injury remains controversial. Non-operative intervention puts patients at higher risk of re-rupture whereas surgical intervention has risks of infection and iatrogenic nerve injury. Recently, surgeons have established a less invasive surgical approach to repairing the achilles tendon. The ‘Percutaneous or Mini-Invasive’ technique was adopted in order to reduce infection rates and wound breakdown. However, due to the scarce amount of literature reported, the efficacy of this procedure still remains under scrutiny. The goal of this study was to examine the functional outcomes of patients treated at our facility for a ruptured achilles tendon using the percutaneous and minimally invasive surgical technique. METHODS: From 2014 to 2020 eighty-one patients underwent a percutaneous or mini invasive surgery at our facility for the treatment of a ruptured achilles tendon. Functional outcome scores were assessed using the American Orthopaedic Foot & Ankle scoring system (AOFAS) and the Achilles Tendon Rupture Score (ATRS). Outcomes, complications, and any reoperations were recorded through retrospective chart review, direct patient examination, and phone calls to patients and their families. A statistical analysis was performed using Fischer’s Exact Test. Results were deemed statistically significant if the calculated p-value was less than 0.05. RESULTS: The mean follow up for our patient cohort was 36.40 months (range, 6 to 71). The average age was 41.46 years (range, 17- 65). Mean pre-op AOFAS and ATRS were 45.60 and 47.18 respectively, compared to 90.29 and 87.97 after surgery (p-value <0.05). There were two significant complications reported post-operatively. One patient re-ruptured their Achilles tendon four months post-operatively. This patient was successfully treated with a mini invasive approach and reconstruction of the tendon. A second patient developed a superficial infection ten months post-operatively. This patient successfully underwent irrigation and debridement of the wound. CONCLUSION: The pre-op and post-op AOFAS and ATRS scores were deemed statistically significant. A percutaneous and mini invasive approach to repair a ruptured achilles tendon, although new, offers promising functional outcome results and remains a viable treatment option to decrease the incidence rate of post-operative infection and iatrogenic nerve injury. However, a prospective randomized controlled trial comparing the efficacy of this procedure to other surgical methods would be necessary to further evaluate and validate our findings.
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spelling pubmed-87054202022-01-28 Percutaneous and Minimally Invasive Surgical Technique for Achilles Tendon Repair Hoskins, Tyler Goyette, David Patel, Jay Mazzei, Christopher Gianakos, Arianna L. Koss, Justin Wittig, James Epstein, David M. Foot Ankle Orthop Article CATEGORY: Ankle; Sports; Trauma INTRODUCTION/PURPOSE: Achilles tendon rupture is a traumatic injury that can cause considerable morbidity and reduced function. The optimal treatment method for this injury remains controversial. Non-operative intervention puts patients at higher risk of re-rupture whereas surgical intervention has risks of infection and iatrogenic nerve injury. Recently, surgeons have established a less invasive surgical approach to repairing the achilles tendon. The ‘Percutaneous or Mini-Invasive’ technique was adopted in order to reduce infection rates and wound breakdown. However, due to the scarce amount of literature reported, the efficacy of this procedure still remains under scrutiny. The goal of this study was to examine the functional outcomes of patients treated at our facility for a ruptured achilles tendon using the percutaneous and minimally invasive surgical technique. METHODS: From 2014 to 2020 eighty-one patients underwent a percutaneous or mini invasive surgery at our facility for the treatment of a ruptured achilles tendon. Functional outcome scores were assessed using the American Orthopaedic Foot & Ankle scoring system (AOFAS) and the Achilles Tendon Rupture Score (ATRS). Outcomes, complications, and any reoperations were recorded through retrospective chart review, direct patient examination, and phone calls to patients and their families. A statistical analysis was performed using Fischer’s Exact Test. Results were deemed statistically significant if the calculated p-value was less than 0.05. RESULTS: The mean follow up for our patient cohort was 36.40 months (range, 6 to 71). The average age was 41.46 years (range, 17- 65). Mean pre-op AOFAS and ATRS were 45.60 and 47.18 respectively, compared to 90.29 and 87.97 after surgery (p-value <0.05). There were two significant complications reported post-operatively. One patient re-ruptured their Achilles tendon four months post-operatively. This patient was successfully treated with a mini invasive approach and reconstruction of the tendon. A second patient developed a superficial infection ten months post-operatively. This patient successfully underwent irrigation and debridement of the wound. CONCLUSION: The pre-op and post-op AOFAS and ATRS scores were deemed statistically significant. A percutaneous and mini invasive approach to repair a ruptured achilles tendon, although new, offers promising functional outcome results and remains a viable treatment option to decrease the incidence rate of post-operative infection and iatrogenic nerve injury. However, a prospective randomized controlled trial comparing the efficacy of this procedure to other surgical methods would be necessary to further evaluate and validate our findings. SAGE Publications 2020-11-06 /pmc/articles/PMC8705420/ http://dx.doi.org/10.1177/2473011420S00258 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (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
Hoskins, Tyler
Goyette, David
Patel, Jay
Mazzei, Christopher
Gianakos, Arianna L.
Koss, Justin
Wittig, James
Epstein, David M.
Percutaneous and Minimally Invasive Surgical Technique for Achilles Tendon Repair
title Percutaneous and Minimally Invasive Surgical Technique for Achilles Tendon Repair
title_full Percutaneous and Minimally Invasive Surgical Technique for Achilles Tendon Repair
title_fullStr Percutaneous and Minimally Invasive Surgical Technique for Achilles Tendon Repair
title_full_unstemmed Percutaneous and Minimally Invasive Surgical Technique for Achilles Tendon Repair
title_short Percutaneous and Minimally Invasive Surgical Technique for Achilles Tendon Repair
title_sort percutaneous and minimally invasive surgical technique for achilles tendon repair
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705420/
http://dx.doi.org/10.1177/2473011420S00258
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