Innovative usage of percutaneous repair technique for acute Achilles tendon rupture in diabetic patients

Author(s): Saikishan Sirasala, Anteshwar Birajdar, Subramanya Rao Sirasala, Purvam Jivrajani, Abhay Agarwal, Shubham Taori

Introduction: Infection following open Achilles tendon surgery in diabetic patients is a devastating complication and often leads to poor outcomes. Percutaneous repair of Achilles tendon rupture avoids possible complications of open repair. Our purpose was to evaluate the clinical and functional outcomes of patients treated with percutaneous repair technique for acute Achilles tendon rupture. Methods: This retrospective study included 24 patients with complete acute Achilles tendon rupture and type 2 diabetes mellitus treated with ultrasound-guided percutaneous repair. Clinical evaluation was performed using the American Orthopaedic Foot and ankle society (AOFAS) score, time to single heal raise and other scores. All patients were followed up for a mean of 14-16 months. Results: For patients throughout follow up, there were no signs of infection, the mean (AOFAS) score was 94.83 and all patients were able to single heel raise after 1 year of surgery. USG and MRI showed satisfactory healing of the Achilles in all patients in 3-4 months. All patients had a nearly full range of ankle movement recovery at the latest follow up. There was neither infection nor re-rupture observed during the follow-up period. Conclusion: Innovative percutaneous repair technique is safe, with a low rate of complications in diabetic patients. This technique neither avoids the possible complications of open surgery with neither infection nor re-ruptures as vascular supply is not disturbed in the percutaneous repair technique