#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Retrospective analysis of complications after treatment of acute Achilles tendon rupture by Kessler technique


Authors: V. Kunc 1,2;  K. Edelmann 1,3;  V. Bába 1,2;  M. Debnar 1,2;  P. Kmeť 1;  K. Kučera 1;  V. Kunc 4;  R. Mišičko 1;  L. Kopp 1,2
Authors‘ workplace: Klinika úrazové chirurgie Fakulty zdravotnických studií Univerzity J. E. Purkyně v Ústí nad Labem a Krajské, zdravotní a. s. – Masarykovy nemocnice v Ústí nad Labem 1;  Ústav anatomie, 2. lékařská fakulta Univerzity Karlovy, Praha 2;  Fakulta zdravotnických studií Univerzity J. E. Purkyně v Ústí nad Labem 3;  Fakulta elektrotechnická, České vysoké učení technické, Praha 4
Published in: Rozhl. Chir., 2021, roč. 100, č. 8, s. 384-389.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2021.100.8.384–389

Overview

Introduction: Open surgical treatment of Achilles tendon rupture comes with high ratio of complications. We have retrospectively evaluated those complications to find patients that would benefit from the mini-invasive technique.

Methods: We analysed all patients after surgical treatment of acute Achilles’ tendon rupture between the years 2014 and 2020. Information about the surgery, the following complications and patient’s characteristics were extracted from our documentation. Statistical analysis was concluded to evaluate their significance. We have included 134 patients with the Achilles tendon rupture in our analysis. The majority of patients were men (83.6%) and left-sided injuries were more common (51.5%). The average age was 45 years.

Results: Our results show that the most common complications after the treatment of Achilles tendon rupture in our clinic are wound dehiscence, thrombosis and infection. On the other hand, paresthesia and rupture are rare. We have confirmed that most complications occur in smoking patients. Our data show that age is a risk factor as well. Contrary to the previous study, our data did not show the female sex to be a risk factor.

Conclusion: Open surgical treatment of Achilles tendon rupture in our clinic is accompanied with relatively high complication rate. Mini-invasive techniques could improve the outcomes in the cohort of smoking older patients with acute Achilles tendon rupture. Please kindly refer to the corresponding author to obtain full data in English.

Keywords:

Achilles tendon − rupture − complications − treatment by Kessler technique


Sources

1. Arner O, Lindholm A. Subcutaneous rupture of the Achilles tendons: a study of 92 cases. Acta Chir Scand Suppl. 1959;116(Supp 239):1−51.

2. Wu Y, Mu Y, Yin L, et al. Complications in the managment of acute Achilles tendon rupture - a systematic review and network meta-analysis of 2060 patients. Am J Sports Med. 2019;47(9):2251−2260. doi:10.1177/0363546518824601.

3. Paavola M, Orava S, Leppilahti J, et al. Chronic Achilles tendon overuse injury: Complications after surgical treatment: An analysis of 432 consecutive patients. Am J Sports Med. 2000;28(1):77−82. doi:1 0.1177/03635465000280012501

4. Virtanen P, Gommers R, Oliphant TR, et al. SciPy 1.0: Fundametnal algorithms for scientific computing in Python. Nature Methods 2020;17(3):261−272. doi:10.1038/s41592-019-0686-2.

5. Bruggeman NB, Turner NS, Dahm DL, et al. Wound complications after open Achilles tendon repair. Clin Orthop Relat Res. 2014;427:63−66. doi:10.1097/01. blo.0000144475.05543.e7.

6. Houshian S, Tscherning T, Riegels-Nielsen P. The epidemiology of Achilles tendon rupture in a Danish country. Injury 1998; 29(9):651−654. doi:10.1016/s0020- 1383(98)00147-8.

7. Gebauer M, Beil FT, Becjmann J, et al. Mechanical evaluation of different techniques for Achilles tendon repair. Arch Orthop Trauma Surg. 2007;127(9):795−799. doi:10.1007/s00402-007-0325-8.

8. Barfod KW, Sveen TM, Ganestam A, et al. Functional debilitations after complications associated with acute Achilles tendon rupture. J Foot Ankle Surg. 2017;56(3):440−444. doi:10.1053/j. jfas.2017.01.004.

9. Dündar N, Güneri B, Uzel M, et al. Biomechanical comparison of Bunnel, modified Kessler, and Tsuge tendon repair techniques using two suture types, Acta Orthop Traumatol Turc. 2020;54(1):104−113. doi:10.5152/j.aott.2020.01.411.

10. Holm C, Kjaer M, Eliasson P, et al. Achilles tendon rupture – treatment and complications: A systematic review. Scand J Med Sci Sports 2015;25(1):e1−20. doi:10.1111/ sms.12209.

11. Costa PM, Achten J, Marian IR. Plaster cast versus functional brace for non-surgical treatment of Achilles tendon rupture (UKSTAR): a multicentre controlled trial and economic evaluation. Lancet 2020;395(10222):441−448. doi:10.1016/ S0140-6736(19)32942-3.

12. Patel A, Ogawa B, Charlton T, et al. Incidence of deep vein thrombosis and pulmonary embolism after Achilles tendon rupture. Clin Orthop Relat Res. 2012 470(1):270−274. doi:10.1007/s11999- 011-2166-6.

13. Nilsson-Helander K, Thurin A, Karlsoon J, et al. High incidence of deep venous thrombosis after Achilles tendon rupture: a prospective study. Knee Surg Sports Traumatol Arthrosc. 2009 17(10):1234−1238. doi:10.1007/s00167- 009-0727-y.

14. Makhdom AM, Cota A, Saran N, et al. Incidence of symptomatic deep venous thrombosis after Achilles tendon rupture. J Foot Ankle Surg. 2013;52(5):584−587. doi:10.1053/j. jfas.2013.03.001.

15. Molloy A, Wood EV. Complications of the treatment of Achilles tendon ruptures. Foot Ankle Clin. 2009;14(4):745−759. doi:10.1016/j.fcl.2009.07.004.

16. Kearon C, Kahn SR, Agnelli G, et al. Antithrombotic therapy for veous thromboembolic disease: American College of Chest Physicians; Evidence-based clinical practice quidlines (8th edition). Chest 2008;133(6 suppl):454S−545S. doi:10.1378/chest.08-0658.

17. Engler ID, Bragg JT, Miller SL. Incidence of deep venous thrombosis associated with proximal hamstring rupture. Orthop J Sport Med. 2019;7(12). doi:10.1177/2325967119888486.

18. Pajala A, Kangas J, Ohtonen P, et al. Rerupture and deep infection following treatment of total Achilles tendon rupture. J Bone Joint Surg Am. 2002;84(11):2016−2021. doi:10.2106/00004623-200211000- 00017.

19. Khan RJ, Carey Smith RL. Surgical interventions for treating acute Achilles tendon ruptures. Cochrane Database Svst Rev. 2010;8(9):CD003674. doi:10.1002/14651858.CD003674.pub4.

20. Fekete D, Carda M. Výsledky léčby ruptury Achillovy šlachy. Klasický, otevřený přístup versus perkutánní sutura. Úraz Chir. 2018;2:69−70.

21. Ceccarelli F, Calderazzi F, Pedrazzi G. Is there a relation between AOFAS Ankle- Hindfoot Score and SF-36 in evaluation of Achilles tendon ruptures treated by percutaneous technique? J Foot Ankle Surg. 2014;53(1):16−21. doi:10.1053/j. fas.2013.09.005.

22. Kitaoka HB, Alexander IJ, Aldelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux and lesser toes. Foot Ankle Int. 1994;15(7):349−353.

23. Ware JE, Shebourne CD. The MOS 36-item short form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30(6):473−483.

24. Leppilahti J, Forsman K, Puranen J, et al. Outcome and prognostic factors for Achilles rupture repair using a new scoring method. Clin Orthop Relat Res. 19988;346:152−161.

Labels
Surgery Orthopaedics Trauma surgery
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#