Analysis of clinical effect of mini-invasive knotless bridge-suture technique for acute achilles tendon rupture

Objective To investigate clinical effect of minimally invasive knotless bridge-suture technique for acute achilles tendon rupture. Methods The clinial data of 23 patients with acute achilles tendon rupture treated in Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People′s Hospital from August 2017 to February 2018 were analyzed retrospectively. There were 21 males and 2 females, aged (37.1±5.6) years, with an age range of 29-51 years. Minimally invasive knotless bridge-suture technique was performed in all cases until the soft tissue condition of the patients improved. Patients were followed up by outpatient review at 3 weeks, 6 weeks, 3rd, and 6th months postoperatively, followed by every 3 months, followed up 12 to 18 months, and the deadline was April 2019. Ratio of perimeter of the affected lower extremity to that of the uninjuried, number of repetitions for one leg calf rise in one minute, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hind foot score, the achilles tendon total rupture score(ATRS) and time to return to work were investigated at last follow-up, as well as complications during the follow-up period. Results Twenty-three cases were followed up. At last follow-up, ratio of perimeter of the affected lower extremity to that of the uninjuried was (92.7±1.8)%, number of repetitions for one leg calf rise in one minute was (25±2) times, AOFAS ankle-hind foot score was (91.5±2.2) scores, ATRS was (92.6±2.4) scores, time to return to work ranged from 6 to 9 weeks. All patients underwent first-stage healing. No skin necrosis, superficial infection and sural nerve injury occurred. No achilles tendon re-rupture was seen during the follow-up period. Conclusion Minimally invasive knotless bridge-suture technique for acute achilles tendon rupture is applied easily and less invasive, enabling patients to return to work earlier and proved to be a secure and effective treatment. Key words: Achilles tendon; Suture technique; Rehabilitation; Knot