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Open Achilles Tendon Repair.

M Lane Moore1, Jordan R Pollock1, Phillip J Karsen2

  • 1Mayo Clinic Alix School of Medicine, Scottsdale, Arizona.

JBJS Essential Surgical Techniques
|January 26, 2024
PubMed
Summary
This summary is machine-generated.

Open Achilles tendon repair offers faster return to activity for athletes with acute ruptures. While effective, it carries a higher complication risk than nonoperative methods, necessitating careful patient selection for optimal outcomes.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Musculoskeletal Rehabilitation

Background:

  • Acute Achilles tendon ruptures require careful consideration of treatment options, including open operative repair and functional rehabilitation.
  • Open repair is often preferred for high-level athletes and delayed presentations due to faster return to activity.
  • This injury typically affects young to middle-aged patients and athletes, emphasizing the need for timely and effective treatment.

Purpose of the Study:

  • To evaluate the outcomes of open Achilles tendon repair compared to alternative treatments.
  • To identify patient populations that benefit most from operative intervention.
  • To discuss the surgical technique, potential pitfalls, and expected results of open Achilles tendon repair.

Main Methods:

  • Description of the open surgical technique, including incision, dissection, tendon identification, and repair using fiber tape sutures.
  • Reinforcement of the repair with Vicryl suture and closure of the paratenon layer to minimize wound complications.
  • Postoperative immobilization in a splint with the ankle in maximum plantar flexion.

Main Results:

  • Literature review indicates good to excellent functional outcomes following open repair, with high rates of return to baseline activity.
  • Operative repair is associated with a faster return to sport and potentially greater peak torque (explosiveness) compared to nonoperative methods.
  • While open repair may have a higher complication rate than nonoperative treatment, it is associated with a lower risk of rerupture compared to primary immobilization.

Conclusions:

  • Open Achilles tendon repair is an effective treatment for acute ruptures, particularly in athletes seeking rapid return to sport.
  • Careful patient selection is crucial, balancing the benefits of faster recovery against potential surgical complications.
  • Adherence to proper surgical technique and postoperative management is essential to optimize outcomes and prevent rerupture.