End-to-End Versus Augmented Repair in the Treatment of Acute Achilles Tendon Ruptures

• Published in: The Journal of foot and ankle surgery Vol. 46; no. 5; pp. 336 - 340
• Main Authors: Aktas, Seref, MD, Kocaoglu, Baris, MD, Nalbantoglu, Ufuk, MD, Seyhan, Mustafa, MD, Guven, Osman, MD
• Format: Journal Article
• Language: English
• Published: Baltimore, MD Elsevier Inc 01.09.2007; Data Trace
• Subjects: Achilles Tendon - injuries; Achilles Tendon - surgery; Achilles’ tendon; Acute Disease; acute rupture; Adult; Aged; augmentation; Biological and medical sciences; Combined Modality Therapy; Double-Blind Method; end-to-end suturing; Foot; Humans; Injuries of the limb. Injuries of the spine; Medical sciences; Middle Aged; Orthopedic surgery; Orthopedics; Prospective Studies; Rupture; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Suture Techniques; Tendon Injuries - surgery; Tendons - surgery; Traumas. Diseases due to physical agents; Treatment Outcome; Achilles’ tendon; augmentation; acute rupture; end-to-end suturing; Human; Tendo calcaneus; Acute; Lower limb; Ankle; Ankle joint; Treatment; Disease of the foot; Tissue rupture; Achilles' tendon; Skin; Repair; Comparative study
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2007.06.006

We prospectively analyzed the functional and clinical results of patients who underwent a single end-to-end suture and an augmented tendon repair with plantaris tendon at middle-term follow-up. From January 2003 to May 2005, 30 consecutive patients were operated on for the treatment of acute Achilles’ tendon rupture by means of 2 different methods. No cases required adjunctive procedures to allow for acceptable end-to-end apposition. All ruptures were acute and repairable. The patients were divided into 2 groups. In group 1, augmentation with plantaris tendon was performed in addition to the Krakow end-to-end suturing technique in 16 patients, and in group 2, only the Krakow end-to-end suturing technique was used in 14 patients. The average age of the patients was 40.6 years. Patients in the study groups were followed up at a mean of 17.8 months after surgery. At the end of the follow-up, functional and subjective outcome scores were evaluated. The American Orthopaedic Foot and Ankle Society hindfoot clinical outcome scores were 96.7 in group 1 and 98.8 in group 2. Although there was a numerical increase in group 2, no significant difference was determined between the 2 study groups statistically. The surgical outcome concerning local tenderness, skin adhesion scar, and tendon thickness was better in group 2 than in group 1 without a statistical significance. Although functional outcomes of both treatment groups were the same, the end-to-end suturing technique provided a safer and more reliable treatment with a low risk of complications in the treatment of acute Achilles’ tendon ruptures compared with the plantaris tendon augmentation technique.