Outcomes of a Novel Percutaneous Achilles Tendon Repair Technique: A Retrospective Case Series

The management of acute mid-substance Achilles tendon ruptures has shifted towards minimally invasive techniques to reduce soft tissue complications. However, many percutaneous repair methods require expensive, dedicated instrumentation or reusable devices with reprocessing needs. This study describes a novel percutaneous Achilles tendon repair technique using readily available disposable standard instruments (Achilles-tendon Soft Tissue Augmentation Regenerative Repair (A-STARR)) and evaluates its clinical outcomes.

A retrospective case series was conducted involving 21 patients (18 male, 3 female) with confirmed acute mid-substance Achilles tendon ruptures. All underwent percutaneous repair using the A-STARR technique between July 2017 and May 2018. Patients were followed up for a minimum of 12 months (range: 12-25 months). Primary outcomes included complication rates, time to return to work, return to sport, and the Achilles Tendon Total Rupture Score (ATRS) at one year.

No wound infections, re-ruptures, or sural nerve injuries were observed. The mean time to return to work was 40 days (range: 30-92 days). 18 patients (85.7%) returned to their pre-injury sport at a mean of 6.5 months (range: 4-12 months). The mean ATRS at one-year follow-up was 83.1 (range: 70-95).

The A-STARR percutaneous Achilles tendon repair using disposable standard instruments was safe and effective in this series, with no complications and good functional recovery. It may provide a practical and cost-efficient alternative for treating acute mid-substance ruptures, particularly where specialized equipment is unavailable.