Abstract
Background: Changes in tendon structure after its rupture may also affect the likelihood of re-injury or strain injury to the musculotendinous complex of the plantar flexor.Purpose: The aim of our study is to investigate ankle biomechanical properties and clinical features of acute rupture of the Achilles tendon treated with open suture and PRF augmentation.Study design: Cohort study (NRS).Methods: This study has been conducted on twenty patients, divided in two groups; one group underwent conventional open repair of the Achilles tendon using the Krackow technique only, while the other group underwent surgery with Platelet-Rich-Fibrin (PRF) augmentation. We performed a clinical evaluation at 3 months, 6 months, and after 1 year. Morphological and functional tendons properties were analyzed by ultrasound and Gait Analysis.Results: The results obtained by the ultrasonographic assessment showed in the PRF group a statistically significant increasing of treated tendons the antero-posterior diameter, medio-lateral diameter. Statistically significant differences between the two groups have emerged in gait analysis performed with regard to network (Wnet). Furthermore, the network of healthy side and treated side was significantly different only in the group of patients not treated with PRF. Statistically significant values have emerged through the analysis of Pearson’s correlation between the diameter of the ultrasound treated tendon and the network, walking speed, swing speed and stride period.Conclusion: Treatment with suture and PRF shows significant morphological modifications and functional improvements compared to the results achieved with Achilles tendon suture without PRF.
Highlights
Treatment with suture and PRF shows significant morphological modifications and functional improvements compared to the results achieved with Achilles tendon suture without PRF
Our study focuses on acute Achilles tendon rupture (ATR), one of the most common tendon injuries
Similar study was performed by Sanchez M et al [3], the authors performed a ultrasounds evaluation of patients treated for Achilles tendon rupture, comparing open surgical treatment with perf vs those treated with open surgical treatment without PRF, concluding that the operative management of tendons combined with the application of autologous PRF may present new possibilities for enhanced healing and functional recovery
Summary
Our study focuses on acute Achilles tendon rupture (ATR), one of the most common tendon injuries. The anatomy of Achilles tendons is characterized by a poor vascularization supply in its middle section [6]; these features can be cause of disorganizing regenerative process and changing in physiological structure of the tendon after chronic inflammation due to chronic overuse or overload activity, and can lead to a tissue degeneration or to tendon rupture [6,7]. The literature reports the Krackow open suture as the treatment of choice in young and adult patients with a high functional demand, this kind of surgical procedure allows the achievement of the best construct and has the lowest rate of re-rupture [11]. Purpose: The aim of our study is to investigate ankle biomechanical properties and clinical features of acute rupture of the Achilles tendon treated with open suture and PRF augmentation
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