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Re-ruptures and early outcomes after surgical repair of acute Achilles tendon ruptures: prospective, comparative multicenter study

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Abstract

Purpose

The primary objective of this study was to compare the re-rupture rate, clinical results, and functional outcomes six months after the surgical repair of an acute Achilles tendon rupture between three different techniques (open repair, percutaneous repair with the Tenolig®, and minimally invasive repair).

Methods

A prospective, comparative, multicenter, non-randomized study was performed and included 111 patients who had an acute ruptured Achilles tendon: 74 underwent an open repair, 22 underwent a percutaneous repair using the Tenolig® and 15 had a minimally invasive repair. At six months follow-up we analyzed the number of re-ruptures, phlebitis, infections, complex regional pain syndrome, clinical outcomes (muscle atrophy, ankle dorsal flexion), functional scores (ATRS, VISA-A, EFAS, SF-12), and return to running.

Results

There were more re-ruptures (p=0.0001) after repair with the Tenolig® (27%) than with open repairs (1.3%) and minimally invasive repairs (0%). The rate of other complications was not different. No clinical differences were found between the three groups. Only some functional scores EFAS Total (p=0.006), and VISA-A (p=0.015) were worse in the Tenolig® group. All the other results were similar between the three groups.

Conclusion

Despite heterogeneous studies in literature, the results of this comparative and prospective study between three surgical techniques of Achilles tendon repair confirmed that Tenolig® repair increased the rate of early re-rupture compared to open or minimally invasive techniques.

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Acknowledgements

The authors wish to thank all the research sites that participated in the study and the various learned societies that made this work possible: French Society of Sports Traumatology (SFTS), French Society of Orthopedic and Traumatological Surgery (SOFCOT), French Association of Foot Surgery (AFCP), Traumatology Study Group (GETRAUM). We are grateful to C. Charpail, A. Kaba, D. Mainard, C. Maynou, C. Verdeau, A. Ghorbani for their participation and to Joanne Archambault, PhD for English language assistance.

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Authors and Affiliations

  1. Directeur scientifique Société Française de Traumatologie du Sport (SFTS), C.E.R.S. Groupe Ramsay Santé, 83 av Maréchal de Lattre de Tassigny, 40130, Capbreton, France

    E. Laboute

  2. Hôpital Hôtel Dieu-APHP, Université Sorbonne Paris Nord, 1 place du Parvis Notre –Dame, 75004, Paris, France

    P. Thoreux

  3. Institut de la Cheville et du Pied, Clinique Blomet, 136 rue Blomet, 75015, Paris, France

    J. Beldame

  4. Service de Chirurgie Orthopédique et Traumatologie, Hôpital d’Instruction des Armées Sainte-Anne, 2, Bd Sainte Anne, 83800, Toulon, France

    A. Caubere

  5. Clinique du Parc Lyon, 155 Boulevard de Stalingrad, 69006, Lyon, France

    J.C. Giunta

  6. GHICL Hôpital Saint Vincent, 51 Boulevard de Belfort, 59462, Lille, France

    R. Coursier

  7. CHU Lille, Service d’Orthopedie–Traumatologie, F-59000, Lille, France

    M. Saab

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  1. E. Laboute
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  2. P. Thoreux
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by E. Laboute, P. Thoreux, J. Beldame, and M. Saab. The first draft of the manuscript was written by E. Laboute and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to E. Laboute.

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Authors disclose any financial and non-financial competing interests.

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Ethics approval

This study was approved by our regional ethics committee (CPP Paris Ile de France 1; N-2019-AO2365-52). Informed consent was obtained from all individual participants included in this study.

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Laboute, E., Thoreux, P., Beldame, J. et al. Re-ruptures and early outcomes after surgical repair of acute Achilles tendon ruptures: prospective, comparative multicenter study. International Orthopaedics (SICOT) 47, 1855–1861 (2023). https://doi.org/10.1007/s00264-023-05827-5

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