Xiaoyang Qi,1,* Danxia Zheng,2,* Zhijie Lei,3,* Jianglin Yu,3 Xusheng Qiu,1,3 Yixin Chen2 

1Department of Orthopedics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, People’s Republic of China; 2Department of Orthopedics, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, People’s Republic of China; 3Department of Orthopedics, Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, Jiangsu Province, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yixin Chen, Department of Orthopedics, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321, Zhongshan Road, Nanjing, Jiangsu Province, 210000, People’s Republic of China, Tel +86 15005149964, Email Chenyixin93@126.com

Purpose: Minimally invasive percutaneous techniques offer a promising alternative to open surgical repair of the Achilles tendon. However, the possibilities of recurrent rupture and nerve complications remain. Hence, the present study was conducted to describe a modified repair technique for the Achilles tendon able to overcome these limitations.
Patients and Methods: This retrospective study included 36 patients with acute closed Achilles tendon rupture treated at our institution between January 2020 and January 2022. All patients underwent surgery at our institution and were followed up for 12– 25 months. Functional evaluation was based on the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale and the Achilles tendon total rupture score (ATRS), along with local complications.
Results: None of the patients had sural nerve injury, infection or re-rupture at a minimum follow up of 12 months. At the final follow-up, the average AOFAS ankle-hindfoot score and ATRS were 95.5 and 90.0, respectively. The final magnetic resonance imaging showed continuity and thicker regeneration of the tendon.
Conclusion: The modified percutaneous repair of the Achilles tendon is an effective procedure which yields good functional outcome with few complications, and it could be widely promoted in clinical practice.

Keywords: Achilles tendon, acute rupture, percutaneous repair, minimally invasive technique, clinical outcome