Re-rupture rate and complications after percutaneous Tenolig® repair in acute midsubstance rupture of Achilles tendon.

Purpose: Acute midsubstance Achilles tendon ruptures are the most common tendon injuries in adults and the choice of surgical technique is still debated. The objective of this study is to evaluate the rate of iterative ruptures and postoperative complications at a minimum follow-up of one year of percutaneous sutures of the Achilles tendon, as well as to investigate the risk factors for rupture.

Methods: In this single-center retrospective study, 142 patients (119 men and 23 women, mean age of 46 years) were reviewed at a mean follow-up of 24 (12-38) months. Percutaneous sutures with the Tenolig® device was performed by several senior surgeons. We studied the rate of re-ruptures, scar-related complications, sural nerve damage, and thromboembolic complications. The mechanism leading to the rupture was also identified, as were the risk factors.

Results: 3 patients (2.11%) presented a re-rupture. No damage of the sural nerve was found. Three superficial skin ulcerations were identified, and three patients presented superficial venous thrombosis of the lower limb. Football was the highest risk activity (34.51%). The risk factors for a first episode of rupture were smoking and a BMI over than 25 kg/m. Nevertheless, no statistically significant risk factors could be identified for re-ruptures.

Conclusion: Percutaneous sutures of the Achilles tendon using Tenolig® provides a low risk of re-rupture, a low complication rate, particularly scar-related complications, and a respect for tendon vascularization.

Level Of Clinical Evidence: 3.