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Percutaneous Repair of Achilles Tendon Rupture Under Local Anesthesia: A Safe and Effective Treatment Option in Recent Years

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Percutaneous Repair of Achilles Tendon Rupture Under Local Anesthesia: A Safe and Effective Treatment Option in Recent Years

Tilemachos Papageorgiou, MD, GREECE Stefanos Christos Papageorgiou, MD, GREECE Ioannis Valanos, MD, GREECE Ioannis D. Theodosis, MD, GREECE Christos D. Papageorgiou, MD, PhD, GREECE

Univeristy Hospital Of Ioannina , Ioannina, Epirus, GREECE

2025 Congress ePoster Presentation 2025 Congress Not yet rated

Anatomic Location

Ankle / Foot / Calf

Anatomic Structure

Tendon

Diagnosis / Condition

Tears

Treatment / Technique

Repair / Reconstruction

Tendon

Rupture Tendon Achilles Tendon

Summary: This study aims to evaluate the clinical outcomes and complications associated with percutaneous Achilles tendon repair performed under local anesthesia.

Introduction

Open surgical repair of Achilles tendon ruptures is traditionally associated with risks such as skin necrosis and infection. Recent advances have led to the adoption of percutaneous repair techniques, which minimize these risks by preserving the critical hematoma phase of tendon healing. This approach allows sutures and knots to remain beneath the skin, thereby reducing healing time and the risk of infection.

Material And Methods

Between January 2017 and May 2024, 42 male patients (mean age: 42.4 years) with acute Achilles tendon ruptures underwent percutaneous repair under local anesthesia. The repair utilized a single or double absorbable suture in a "double square" configuration. Postoperatively, patients were immobilized in a cast fixed in the equinus position for 3 weeks, followed by 3 weeks in a functional orthosis with three heels. Patients were evaluated using the Visual Analogue Scale (VAS) at the time of surgery and at 3-month follow-up, as well as the Achilles Tendon Rupture Score (ATRS) and the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Score at 3 and 6 months postoperatively.

Results

The mean follow-up period was 34 months. Complications included 1 case of re-rupture at 3 months and 2 cases of superficial wound infection. Notably, no sural nerve lesions were reported. The mean time to return to work was 78 days. Clinical outcomes were favorable, with no significant loss of range of motion. The mean VAS scores were 2.54 (SD: 0.79) at the time of surgery and 1.87 (SD: 1.32) at 3 months postoperatively. The mean ATRS scores were 92.25 (SD: 6.34) at 3 months and 92.04 (SD: 4.37) at 6 months. The mean AOFAS scores were 88 (SD: 5.93) at 3 months and 95.42 (SD: 3.62) at 6 months.

Conclusions

Percutaneous Achilles tendon repair under local anesthesia is a low-cost, effective technique that promotes optimal healing by preserving the natural phases of tendon repair. It is associated with fewer wound complications, shorter hospital stays, and quicker return to work, making it a leading treatment option for acute Achilles tendon ruptures.

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Percutaneous Repair of Achilles Tendon Rupture Under Local Anesthesia: A Safe and Effective Treatment Option in Recent Years

Percutaneous Repair of Achilles Tendon Rupture Under Local Anesthesia: A Safe and Effective Treatment Option in Recent Years

Introduction

Material And Methods

Results

Conclusions

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Percutaneous Repair of Achilles Tendon Rupture Under Local Anesthesia: A Safe and Effective Treatment Option in Recent Years

Percutaneous Repair of Achilles Tendon Rupture Under Local Anesthesia: A Safe and Effective Treatment Option in Recent Years

Introduction

Material And Methods

Results

Conclusions