Minimally Invasive versus Open Surgery in Patients with Complete Acute Achilles Tendon Rupture

Abstract

Introduction: The incidence of Achilles tendon ruptures is 18 per 100,000 habitants, its etiology is mechanical or degenerative, and surgical treatment is required in both cases. Evolution depends on several factors. Objective: To compare the functional results of minimally invasive and open surgery in Achilles tendon ruptures using the Leppilahti Scale. Methods: A cross-sectional study of patients with Achilles tendon rupture managed by open and minimally invasive surgery from January 2014 to August 2015. The following variables were studied: surgical time, complications, underlying diseases and functional grade according to the Leppilahti scale. Results: There were 41 patients, 38 (92.7%) of them men and 3 (7.3%) women. The right side was affected in 22 (53.7%) and the left in 19 (46.3%) cases. 19 (46.3%) patients underwent minimal invasive surgery and 22 (53.7%) open surgery. With the Leppilahti Scale, patients with minimal invasive surgery had excellent functionality in 6 (31.57%) and good functionality in 13 (68.42%) cases while conventional surgery had excellent functionality in 2 (9.1%), good functionality in 12 (54.5%), regular functionality in 6 (27.3%), and bad functionality in 2 (9.1%) patients. Minimally invasive management showed improvement in pain, muscle stiffness, muscle weakness of the tricep sural, range of motion differences between ankles, isokinetic muscle strength, overall outcome, and surgical time compared to open surgery (p ≤0.05). Conclusions: Minimally invasive surgery offers better surgical results than open surgery for repair of the Achilles tendon.