PeerJ (Jan 2025)
Surgical outcomes in patients with Achilles tendon rupture—a retrospective study
Abstract
Background There are two main methods used to treat Achilles tendon rupture (ATR): conservative treatment and surgical intervention. Surgical techniques are divided into three main categories: open surgical repair, mini-open surgical repair, and percutaneous repair (PR). We aimed to compare clinical outcomes in individuals with ATR who were treated with PR, primary repair, and flexor hallucis longus augmentation (FHL-A) with those treated with V-Y plasty and FHL-A. Methods The study involved 54 patients who underwent ATR surgical intervention retrospectively. Thirty-two of these were identified as acute and 22 were chronic rupture patients. PR was performed in 32 patients, primary repair and FHL-A in 14 patients, and V-Y plasty and FHL-A in eight patients. Results The mean forward jump was 142.69 ± 7.14 cm in individuals who received PR, 137.71 ± 4.51 cm in those who received primary repair + FHL-A, and 123.88 ± 3.09 cm in those who received V-Y plasty + FHL-A (p < 0.001). The decrease in the mean vertical jump distance on the operated side compared to the contralateral extremity was 0.97 ± 0.93, 2.07 ± 0.99, and 3.00 ± 1.69 cm in individuals who underwent PR, primary repair + FHL-A, and V-Y plasty + FHL-A, respectively (p < 0.001). The decrease in the mean dorsiflexion of the operated side ankle compared to the contralateral extremity was found to be 4.34 ± 1.18, 1.93 ± 1.07, and 2.38 ± 0.92 degrees in individuals who underwent PR, primary repair + FHL-A, and V-Y plasty + FHL-A, respectively (p < 0.001). Conclusion Although no surgical technique is completely superior to another, better performance tests were observed after PR repair compared to open surgery in individuals involved in sports, but rerupture, dorsiflexion restriction, and painful ankle were disadvantages. FHL-A, which has gained popularity in recent years, showed better performance in tests by contributing to more stable and stronger ankles in sporting individuals with chronic ruptures who had undergone open surgery. FHL-A can be utilized in addition to primary surgical intervention in individuals with high performance expectations before and after injury.
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