Augmented repair of Achilles tendon ruptures

We performed a series of repairs of Achilles tendon ruptures in athletes using suture augmented with a polyethylene terephthalate mesh synthetic graft. No postoperative immobilization was used. The 29 patients were aged 25 to 54 years and all practiced sports a minimum of 4 hours weekly. At the followup, ranging from 6 months to 5 years, ankle mobility was normal in all but one patient, who had lost 15 degrees of extension. All the patients were able to do a series of 10 single-limb heel raises without any impairment when compared with the uninjured side. Average ankle flexion strength was 96% that of the uninjured side (range, 87% to 110%). There were no reruptures, although in two instances problems with scarring occurred. All patients but one were able to resume their sports activities at the same level of intensity as they had before their injuries. These results testify to the advantage of not using postoperative immobilization and beginning functional rehabilitation immediately in patients with such lesions.