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Re-rupture, infection may have long-term impact after MIS Achilles tendon rupture repair
Metz R, et al. Am J Sports Med. 2011; Feb. 2. [E-pub ahead of print].doi: 10.1177/0363546510392012.
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Investigators found high function at 6.2 years mean follow-up in patients who underwent minimally invasive Achilles tendon rupture repair, but observed low function in those with severe wound infections and noted a higher risk of changing sport among those with re-rupture.
Roderik Metz, MD, PhD, and colleagues reviewed the charts and completed questionnaires of 211 patients who had minimally invasive surgical repair of an acute Achilles tendon rupture. The patients had a mean follow-up of 6.2 years.
Overall, the investigators discovered that the patients had a mean Achilles tendon total rupture score (ATRS) of 84 points out of a maximum 100 points. Of the 135 patients who did not experience postoperative complications, the study revealed an ATRS of 89 points. The investigators found that 41 patients had sural nerve injuries, 17 had re-ruptures and 17 had other complications. The scores for these groups were 79, 71 and 75 points, respectively. Although investigators found that patients with minor wound healing complications had a score of 80 points, the one patient with a severe wound complication had a score of 28 points.
“Long-term outcome after minimally invasive Achilles tendon rupture repair is excellent,” the authors concluded. “Re-rupture and severe wound infection are the most important complications with lasting negative effect on outcome. It justifies the use of re-rupture as a relevant outcome measure in treatment evaluation.”