The learning curve for minimally invasive Achilles repair using the "lumbar puncture needle and oval forceps" technique

• Published in: BMC musculoskeletal disorders Vol. 25; no. 1; p. 373
• Main Authors: Zhao, Yanrui, Wang, Hanzhou, Zhao, Binzhi, Diao, Shuo, Gao, Yuling, Zhou, Junlin, Liu, Yang
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11.05.2024; BioMed Central; BMC
• Subjects: Achilles tendon; Achilles Tendon - injuries; Achilles Tendon - surgery; Acute Achilles tendon rupture; Adult; Analysis; Ankle; Care and treatment; Clinical outcomes; Diagnostic tests; Evaluation; Female; Humans; Infections; Injuries; Learning; Learning Curve; Learning curves; Male; Methods; Middle Aged; Minimally invasive; Minimally Invasive Surgical Procedures - education; Minimally Invasive Surgical Procedures - instrumentation; Minimally Invasive Surgical Procedures - methods; Needles; Operative Time; Orthopedic surgery; Orthopedics; Patient outcomes; Patients; Retrospective Studies; Rupture; Rupture - surgery; Statistical analysis; Surgeons; Surgery; Surgical Instruments; Sutures; Tendon Injuries - surgery; Tendons; Treatment Outcome; Wound dehiscence; China; United States > US; Learning curves; Clinical outcomes; Acute Achilles tendon rupture; Minimally invasive
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-024-07489-9

An acute Achilles tendon rupture represents a common tendon injury, and its operative methods have been developed over the years. This study aimed to quantify the learning curve for the minimally invasive acute Achilles tendon rupture repair. From May 2020 to June 2022, sixty-seven patient cases who received minimally invasive tendon repair were reviewed. Baseline data and operative details were collected. The cumulative summation (CUSUM) control chart was used for the learning curve analyses. Achilles tendon rupture score (ATRS), American Orthopedic Foot and Ankle Society (AOFAS) ankle/hindfoot score, and visual analog scale (VAS) at 3/6/9/12 months were calculated to assess the clinical outcomes. Thirty-six cases underwent at least a year of follow up and were enrolled in this study. The gender ratio and average age were 80.5% and 32.5 years. The linear equation fitted well (R  = 0.95), and CUSUM for operative time peaked in the 12th case, which was divided into the learning phase (n = 12) and master phase (n = 24). No significant difference was detected between the two groups in clinical variables, except for the operative time (71.1 ± 13.2 min vs 45.8 ± 7.2 min, p = 0.004). Moreover, we detected one case with a suture reaction and treated it properly. Minimally invasive Achilles repair provides an opportunity for early rehabilitation. Notably, the learning curve showed that the "lumbar puncture needle and oval forceps" technique was accessible to surgeons.