Curative analysis of suture anchors in repairing delayed Achilles tendon rupture

Abstract

Objective To summarize the clinical efficacy of suture anchors in repairing the delayed Achilles tendon rupture. Methods From January 2010 to December 2013, 23 patients with delayed Achilles tendon rupture were treated using the suture anchors. There were 19 males and 4 females, at mean age of 43 years (range, 35-53 years). Injury on the left side occurred in 5 patients and right side in 18 patients. Mean time from injury to operation was 26.3 days (range, 21-40 days). Ten patients were diagnosed by ultrasound and the other by MRI. All patients underwent suture anchor fixation without external support. Functional training started at the early stage. Incision complications were detected. Ankle flextion-extension range, American Orthopedic Foot and Ankle Society (AOFAS) score, maximum bilateral leg circumference, tendon rerupture and walking posture were recorded at postoperative 6, 12, 18 and 24 months. Achilles tendon muscular strength was measured with the Lunsford-Perry heel-rise test. Results Follow-up was 24 months. All incisions healed by first intention without sural nerve injury, adherence with skin and deep infection. Six months after operation, the ankle range of motion was dorsiflexion 10.8° (range, 9-15°) and plantar flexion 43.8° (range, 40-48°), with no significant difference in comparison to the health side (P>0.05). AOFAS score differed significantly before and after operation (P<0.01). Maximal leg circumference was 38.2 cm in the health side versus 35.8 cm in the injury side (P<0.05), but the difference was no more than 3 cm. All patients completed 25 times heel raising without difficulty. Four patients walked with a slight limp and recovered from the limp 12 months after operation. No Achilles tendon ruptured again during the follow-up time. Conclusions Repairing the old Achilles tendon rupture with suture anchors can supply strongly strain between broken ends of the tendon, and the outer cast is not needed after operation. Complications are less and functional practice can be commenced in the early postoperative period for better function restoration. Key words: Achilles tendon; Ligaments; Suture anchor