Initial surgical outcomes of two modified minimally invasive repair techniques for acute achilles tendon rupture

Despite numerous treatment modalities, there remains no clear consensus on the optimal surgical approach to mid-substance acute Achilles tendon ruptures (AATR). The purpose of this study is to present two novel minimally invasive surgery (MIS) approaches for AATR and compare their outcomes. Retrospective analysis of two surgeons's AATR patients (N=18) who underwent one of two modified minimally invasive repairs (MMIR). Group A received a modified Krackow suture repair via mini-open incision with percutaneous calcaneal anchors. Group B received a modified Kessler suture repair percutaneously. The mean follow-up period was 23.9 +/- 5.1 and 14.7 +/- 1.9 months respectively. Surgical outcomes were measured using Maryland Foot Score (MFS) and The Self-Reported Foot and Ankle Score (SEFAS). There was no statistically significant difference in patient outcomes between the two MMIR techniques. Overall, patient satisfaction with Maryland score was 95.7 +/- 9.0 in Group A and 89.6 +/- 19.0 in Group B (p=0.41). Overall SEFAS score was 43 +/- 4.73 in Group A and 39 +/- 11.6 in Group B (p=0.15). Sural nerve injury occurred in two of the eight patients in Group B (25%), with only one of the patients seeking further treatment for neuritic pain. There were no other complications in terms of wound dehiscence, infection, rerupture or functionality in either of the two surgical groups. These findings suggest that the reported MIS techniques may be an acceptable consideration for surgical treatment of acute Achilles tendon ruptures.