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Related Experiment Video

Updated: Feb 18, 2026

Author Spotlight: Exploring the Complexities of Achilles Tendon Injuries — Research and Future Directions
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Walking on the Achilles tendons.

Nicola Maffulli1,2,3, Filippo Spiezia4,5, Filippo Migliorini6,7

  • 1Department of Trauma and Orthopaedic Surgery, Faculty of Medicine and Psychology, University La Sapienza, Piazzale Aldo Moro, Rome 00185, Italy.

British Medical Bulletin
|February 16, 2026
PubMed
Summary

The modified "walking Achilles tendon" technique offers comparable outcomes to traditional repair for Achilles tendon ruptures. This minimally invasive approach effectively addresses challenges with proximal stump grip without compromising patient results.

Keywords:
Achilles tendon rupturelocal anaesthesiapercutaneous repair

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Traumatology

Background:

  • Percutaneous repair of Achilles tendon ruptures can be challenging due to insufficient grip in the proximal stump.
  • The 'walking Achilles tendon' technique involves creating additional stab wounds to enhance suture grip.
  • This technique aims to facilitate minimally invasive repair when initial grip is inadequate.

Purpose of the Study:

  • To compare the outcomes of the 'walking Achilles tendon' technique with traditional suture repair for Achilles tendon ruptures.
  • To evaluate the efficacy and safety of a modified percutaneous approach for Achilles tendon repair.

Main Methods:

  • A study included 36 patients with Achilles tendon ruptures, divided into two groups: 'walking on the Achilles tendon' and 'traditional repair'.
  • The 'walking Achilles tendon' group utilized a modified technique with additional stab wounds for improved grip.
  • Outcomes were assessed using various measures including Achilles Tendon Resting Angle (ATRA), Achilles Tendon Total Rupture Score (ATRS), and functional scores.

Main Results:

  • No significant differences were observed between the two groups in ATRA, ATRS, calf circumference, isometric strength, return to sport time, European Foot and Ankle Society (EFAS) Score, or Patient-Reported Outcome Measures (PROMs).
  • The modified technique, involving nine stab wounds, added minor procedural time but yielded comparable results to the seven stab wound technique.
  • Percutaneous management of Achilles tendon ruptures presents challenges with varied reported outcomes.

Conclusions:

  • The 'walking Achilles tendon' technique effectively overcomes difficulties with proximal stump grip during minimally invasive percutaneous Achilles tendon repair.
  • This modified approach allows surgeons to continue with percutaneous repair without resorting to open procedures.
  • The study demonstrates comparable functional and patient-reported outcomes between the modified technique and traditional repair methods.