Achilles tendon rupture treated with open versus percutaneous repair: A Narrative review

Abstract

Background: The purpose of this study is to highlight the differences in functional outcomes and complication rates between percutaneous and open repair of Achilles tendon ruptures. Methods: A comprehensive database search of PubMed, Cochrane, Google Scholar, and MEDLINE was implemented to find literature that compared the two techniques up from 2000 until 2022. Inclusion criteria included randomized controlled trials and retrospective/prospective comparison studies of two types of techniques. Primary measurements of interest included functional outcome scores, time to return to work, and complication rates. Results: 12 comparative papers were selected for analysis. A total of 1047 ankles were included with 496 of them being the percutaneous technique and 551 the open technique. Percutaneous repair was found to be associated with a statistically significant increase in sural nerve injury occurrences and an earlier time to return to work. Open repair was linked to a statistically significant increase in delayed wound healing and wound infection. Differences in AOFAS function scores were found to be statistically insignificant between the two groups. Conclusions: Although there is an increased risk of sural nerve injury, the percutaneous repair technique is still the most desirable method in repairing Achilles tendon ruptures injury as it is associated with similar functional outcome, an earlier time to return to work, and a lower rate of wound infection and breakdown.

Keywords

• Achilles tendon rupture
• Open repair
• Percutaneous repair
• Function scores
• Complication
• Revision