Comparison of the open primary repair with augmentation and without augmentation in acute achilles tendon rupture

Authors: DURMUŞ ALİ ÖÇGÜDER, METİN DOĞAN, SÜLEYMAN BÜLENT BEKTAŞER, ERKAN AKGÜN, TOLGA TOLUNAY, MAHMUT UĞURLU

Abstract: To compare the clinical and the functional efficiency of 2 surgical methods that are used in open primary repair of acute Achilles tendon ruptures: one that utilizes the augmentation of the plantaris tendon and one that does not. Materials and methods: Data were evaluated from 41 patients that underwent surgical repair for acute Achilles tendon ruptures with these 2 different surgery methods. In the first group, which included 21 patients (19 male, 2 female; mean age: 36.8 years; age range: 22 to 49), we performed augmentation with the plantaris tendon after an end-to-end primary repair with a modified Kessler technique. In the second group, which included 20 patients (19 male, 1 female; mean age: 41.4 years; age range: 23 to 52), we did not perform augmentation after the end-to-end primary repair with a modified Kessler technique. For both groups, we used polydioxanone suture (PDS) materials in Kessler knots. Results: The mean American Orthopedic Foot and Ankle Society (AOFAS) hindfoot clinical outcome score was 94 ± 6.4 (range: 73-100) in the first group. In the second group, the mean AOFAS score was 94.4 ± 6.1 (range: 76-100). The first group's mean Achilles tendon assessment score was 81.7 ± 10.9 (good, range of 60-96); the mean Achilles tendon assessment score of the second group was 82.4 ± 6.1 (good, range of 71 to 94). There was no statistically significant difference between these 2 groups in terms of functional scores (P > 0.05). In the first group, 2 patients (9.5%) had superficial skin infections and 1 patient (4.7%) had hypertrophic scar tissue. In the second group, 3 patients (15%) had superficial skin infections and 1 patient (5%) experienced a partial rerupture. Conclusion: Clinical and functional results did not show any statistically significant difference between methods with or without augmentation when appropriate and progressive rehabilitation programs were applied in treating acute Achilles tendon ruptures.

Keywords: Achilles tendon, injuries, augmentation, surgery

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