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Minimally Invasive Mid-Substance Achilles Tendon Repair Using the Percutaneous Achilles Repair System (PARS).

Kevin D Martin1, Nisha J Crouser1, Irfan A Khan2

  • 1The Ohio State University Wexner Medical Center, Columbus, Ohio.

JBJS Essential Surgical Techniques
|February 23, 2023
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Summary

This study details a minimally invasive surgical technique for Achilles tendon ruptures using the Percutaneous Achilles Repair System (PARS) Jig. This method facilitates early rehabilitation and a faster return to recreational activities compared to traditional open repair.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Musculoskeletal Repair

Background:

  • Achilles tendon ruptures significantly impact physically active individuals, hindering recreational activities.
  • Timely surgical intervention is crucial for maximizing functional recovery and enabling a return to prior activity levels.
  • The Percutaneous Achilles Repair System (PARS) Jig offers a minimally invasive option for acute mid-substance Achilles tendon ruptures.

Purpose of the Study:

  • To describe the surgical technique utilizing the PARS Jig for acute Achilles tendon ruptures.
  • To highlight the benefits of this minimally invasive approach, including reduced complications and early rehabilitation.
  • To compare outcomes with traditional open repair methods.

Main Methods:

  • A prone patient positioning with a thigh tourniquet is employed.
  • A small transverse incision is made, followed by paratenon dissection and placement of the PARS Jig.
  • Sutures are passed through the Achilles tendon using the jig, and then secured into the calcaneus via bilateral mini-incisions and cannulated devices, with fixation using bioabsorbable interference screws.

Main Results:

  • The PARS Jig technique allows for early postoperative rehabilitation.
  • It minimizes wound and soft-tissue complications, including infections.
  • Compared to open repair, 98% of PARS patients returned to baseline activities by 5 months, versus 82% in the open repair group (p=0.0001).

Conclusions:

  • The PARS Jig provides a safe and effective minimally invasive option for acute Achilles tendon ruptures.
  • This technique facilitates early functional recovery and a quicker return to sports and recreational activities.
  • It offers significant advantages over traditional open repair in terms of patient outcomes and complication rates.