Percutaneous repair of acute achilles tendon rupture

Abstract

Achilles tendon ruptures are serious injuries both for athletes and sedentary individuals. Men are more frequently affected than women, especially between the ages of 30 and 40. Achilles tendon tears are usually the end result of an asymptomatic process of a failed healing response typical of tendinopathy. The diagnosis is clinical, based on careful history taking and detailed clinical examination, while imaging (ultrasound or MRI) are useful in doubtful cases. Operative management of acute ruptures provides lower re-rupture rate, early functional treatment, less calf atrophy, and better functional results, in particular in athletes. Minimally invasive Achilles tendon repair provides many advantages such as shorter hospitalization and lower risk of wound complications and infections compared to open surgery. It should be considered not only in young and active patients but also in older individuals because of the lower rate of postoperative complications and the early weight-bearing and mobilization regimen implemented after such repair. Simple parameters such as single-legged concentric strengthening, range of motion, and calf circumference can be used to predict the ability to return to activity. On the basis of the current published evidence, the routine use of PRP to improve Achilles tendon healing following repair is not recommended.