Functional outcome and complication rate after percutaneous suture of fresh Achilles tendon ruptures with the Dresden instrument
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Functional outcome and complication rate after percutaneous suture of fresh Achilles tendon ruptures with the Dresden instrument. / Manegold, Sebastian; Tsitsilonis, Serafim; Schumann, Jakob; Gehlen, Tobias; Agres, Alison N; Keller, Johannes; Gesslein, Markus; Wichlas, Florian.
in: J ORTHOP TRAUMATOL, Jahrgang 19, Nr. 1, 18.09.2018, S. 19.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Functional outcome and complication rate after percutaneous suture of fresh Achilles tendon ruptures with the Dresden instrument
AU - Manegold, Sebastian
AU - Tsitsilonis, Serafim
AU - Schumann, Jakob
AU - Gehlen, Tobias
AU - Agres, Alison N
AU - Keller, Johannes
AU - Gesslein, Markus
AU - Wichlas, Florian
PY - 2018/9/18
Y1 - 2018/9/18
N2 - BACKGROUND: The aim of this study was to evaluate the outcome of patients with a rupture of the Achilles tendon (ATR) treated percutaneously with the Dresden instrument in the hands of surgeons others than its inventors.MATERIALS AND METHODS: 118 patients (FU rate: 77.1%) with an acute ATR treated with the Dresden instrument were retrospectively evaluated. The following data were evaluated: pain intensity, functional limitation, Hannover score, Achilles tendon total rupture score (ATRS), AOFAS ankle-hindfoot score, Tegner activity score, complications, maximum calf circumference (MCC) on both sides, and the Matles test for tendon lengthening. The effect of the time point of the surgery after trauma was examined.RESULTS: Hannover scores and ATRSs were good; AOFAS scores were excellent. Almost all patients returned to sporting activities postoperatively, and 66.1% were able to return to their previous level. The Tegner activity score revealed a slight posttraumatic decrease (p = 0.009) in the level of physical activity overall (pre-injury: 5.37 ± 0.15; postoperatively: 4.77 ± 0.15). The re-rupture rate was 2%. No sural nerve lesions and no infections were reported. Even after 3 years, there was still a difference in MCC that was correlated with inferior clinical score and AT lengthening. Patients treated within the first 2 days after ATR showed inferior clinical outcomes in terms of AOFAS score, ATRS, and functional limitations.CONCLUSIONS: Percutaneous ATR suture with the Dresden instrument is a safe and reliable method. Low complication and re-rupture rates, good clinical results, and a high rate of return to play support this fact. The time point of the operation may influence the outcome.
AB - BACKGROUND: The aim of this study was to evaluate the outcome of patients with a rupture of the Achilles tendon (ATR) treated percutaneously with the Dresden instrument in the hands of surgeons others than its inventors.MATERIALS AND METHODS: 118 patients (FU rate: 77.1%) with an acute ATR treated with the Dresden instrument were retrospectively evaluated. The following data were evaluated: pain intensity, functional limitation, Hannover score, Achilles tendon total rupture score (ATRS), AOFAS ankle-hindfoot score, Tegner activity score, complications, maximum calf circumference (MCC) on both sides, and the Matles test for tendon lengthening. The effect of the time point of the surgery after trauma was examined.RESULTS: Hannover scores and ATRSs were good; AOFAS scores were excellent. Almost all patients returned to sporting activities postoperatively, and 66.1% were able to return to their previous level. The Tegner activity score revealed a slight posttraumatic decrease (p = 0.009) in the level of physical activity overall (pre-injury: 5.37 ± 0.15; postoperatively: 4.77 ± 0.15). The re-rupture rate was 2%. No sural nerve lesions and no infections were reported. Even after 3 years, there was still a difference in MCC that was correlated with inferior clinical score and AT lengthening. Patients treated within the first 2 days after ATR showed inferior clinical outcomes in terms of AOFAS score, ATRS, and functional limitations.CONCLUSIONS: Percutaneous ATR suture with the Dresden instrument is a safe and reliable method. Low complication and re-rupture rates, good clinical results, and a high rate of return to play support this fact. The time point of the operation may influence the outcome.
KW - Achilles Tendon/injuries
KW - Adult
KW - Aged
KW - Ankle Injuries/surgery
KW - Equipment Design
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Orthopedic Procedures/methods
KW - Retrospective Studies
KW - Rupture
KW - Suture Techniques/instrumentation
KW - Sutures
KW - Tendon Injuries/surgery
KW - Time Factors
KW - Treatment Outcome
KW - Young Adult
U2 - 10.1186/s10195-018-0511-1
DO - 10.1186/s10195-018-0511-1
M3 - SCORING: Journal article
C2 - 30229505
VL - 19
SP - 19
JO - J ORTHOP TRAUMATOL
JF - J ORTHOP TRAUMATOL
SN - 1590-9921
IS - 1
ER -