Advertisement for orthosearch.org.uk
Orthopaedic Proceedings Logo

Receive monthly Table of Contents alerts from Orthopaedic Proceedings

Comprehensive article alerts can be set up and managed through your account settings

View my account settings

Visit Orthopaedic Proceedings at:

Loading...

Loading...

Full Access

CLINICAL, ULTRASONOGRAPHIC AND ISOKINETIC STUDY OF 20 RUPTURES OF THE ACHILLES TENDON TREATED PERCUTANEOUSLY WITH TENOLIG® VERSUS OPEN SURGERY



Abstract

Purpose of the study: The aim of this work was to compare the long-term clinical, ultrasonographic and iso-kinetic results obtained with two approaches to repair of the torn Achilles tendon.

Material and methods: The patients were reviewed at mean six years follow-up (range 2–12 years) and served as their own control. The series was composed of two groups of ten patients. The first group underwent open suture (OS) (mean age 48 years, age range 38–64 years) and the second was treated percutaneously with Tenolig® (PCS) (mean age 43 years, age range 25–68 years). The Mann, McComis and Kitaoka scores were noted as was the distance from the heal to the ground in one leg stance (comparison with opposite side). Cybex® was used to measure the isokinetic force and an ultrasound control was performed (tendon structure, dimensions).

Results: The calf of the operated side displayed amyot-rophy compared with the healthy side in all cases of PCS (mean 2 cm, range 0.5–6 cm). The heal-ground distance was often smaller compared with the healthy side in PCS. The Mann scores were equivalent for OS and PCS. The Kitaoka and McComis scores were, on average 86 (80–100) and 94 (60–95) respectively for OS versus 82 (85–100) and 91 (60–95) for PCS. Mean caliber of the operated Achilles tendon increased compared with the healthy side for both suture techniques. Isokinetic force was 3–6% greater with OS for peak force, average force, and total work.

Discussion and conclusion: Both techniques have specific complications: recurrent tears and sural nerve injury for PCS, risk for the skin and adherences for OS. The long-term outcome after PCS of the Achilles tendon is comparable with that of OS in terms of healing quality. Recorded values are however slightly higher with OS. Our results are in line with data in the literature. OS can be reserved for particularly active patients who wish to recover maximum function.

Correspondence should be addressed to SOFCOT, 56 rue Boissonade, 75014 Paris, France.