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The Medial Mini-Open Supine Achilles Repair: Outcomes of a Medially Based Mini-Open Technique Compared With Prone
Christopher P Miller1, Katherine Stanwood, Caroline Williams
1From the Department of Orthopaedics, Beth Israel Deaconess Medical Center (Ms. Stanwood, Dr. Williams, Dr. Zhao, and Dr. Raduan), and the Department of Orthopaedics Brigham and Women's Hospital, Boston, MA (Dr. Miller).
Background:
Achilles tendon rupture treatment has changed substantially in the past decade, with an evolution toward less-invasive techniques and more convenient patient positioning. This review aims to report on the 1-year clinical outcomes of a medially based, mini-open, supine, Achilles tendon repair technique.
Methods:
In this retrospective review, all patients who underwent surgical management of an Achilles tendon rupture were included and analyzed based on approach, including (1) standard open prone technique, (2) mini-open repair, prone, and (3) medial mini-open repair, supine. Primary outcomes were the Patient-Reported Outcome Measures Information Systems (PROMIS) Physical Function, PROMIS Pain Interference, and PROMIS Depression scores. Secondary outcomes of interest were surgical time and complications.
Results:
Seventy-eight patients were included in this study who underwent Achilles tendon repair and were seen in follow-up at least 1-year postoperatively. Demographics are displayed in Table 1. No statistical difference was observed regarding sex, laterality, age, and mechanism between those with 1-year follow-up data and those who were lost to follow-up before the 1-year mark. Primary outcomes were notable for statistically significant difference in the PROMIS Depression score between the mini-open repair, prone group, and the mini-open repair, supine group. The remainder of the primary outcomes of interest were not statistically significant. Secondary outcomes were notable for markedly shorter surgical time for the mini-open repair, supine group compared with both the standard open prone and mini-open repair, prone groups, with times being 89, 72, and 58 minutes, respectively. Surgical time was defined as starting from the time the patient was anesthetized in the room and included positioning and time up until extubation.
Conclusion:
The medial mini-open repair, supine technique shows promise as a noninferior surgical option for acute Achilles tendon rupture repair with markedly decreased operating room time and 1-year outcomes with comparable results to both open and mini-open prone techniques.
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