Clinical study on a novel minimally invasive Achilles tendon suture instrument for treating fresh closed Achilles tendon rupture_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 LU Shengzhu ¹ , TAN Meijuan ² , SUN Qiang ³ , KUANG Yanshun ³

1. Department of Orthopaedics, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan Hubei, 430063, P. R. China;
2. Department of Oncology, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan Hubei, 430063, P. R. China;
3. Department of Orthopaedics, Zhongshan Hospital of Dalian University, Dalian Liaoning, 116001, P. R. China;

Corresponding?author：

LU Shengzhu, Email: lushengzhu2023@163.com

Keywords：

Novel minimally invasive Achilles tendon suture instrument; Achilles tendon rupture; closed injury; minimally invasive technique; Achilles tendon repair

DOI：

10.7507/1002-1892.202305054

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Objective To assess the effectiveness of a novel minimally invasive Achilles tendon suture instrument in the treatment of fresh closed Achilles tendon rupture. Methods A retrospective study was conducted on 150 patients who underwent surgical intervention for fresh closed Achilles tendon rupture. Eighty patients were treated with the novel minimally invasive Achilles tendon suture instrument (minimally invasive group) and 70 patients with traditional open surgery (traditional group). The two groups were comparable in terms of gender, age, injured side, cause of injury, the interval between injury and operation, and the distance from the fracture end to the calcaneal tuberosity (P>0.05). The operation time, intraoperative blood loss, incision length, hospital stays, hospitalization expenses, and complications were recorded and compared. At 1 year after operation, the ankle joint function was evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. Results The minimally invasive group demonstrated significantly shorter operation time, smaller incision length, and lower intraoperative blood loss when compared with the traditional group (P<0.05). However, there was no significant difference in terms of hospital stays and hospitalization expenses between the two groups (P>0.05). All patients were followed up 12-24 months after operation (mean, 15.5 months). In the traditional group, 6 cases of incision necrosis and 7 cases of Achilles tendon adhesion occurred, while in the minimally invasive group, all incisions healed at first intention and no Achilles tendon adhesion occurred. The differences in the incidences of the two complications between the two groups were significant (P<0.05). At 1 year after operation, the AOFAS ankle-hindfoot score in the minimally invasive group was superior to that of the traditional group (P<0.05). Conclusion In comparison with traditional open surgery, the use of self-designed novel minimally invasive Achilles tendon suture instrument proves to be an ideal technique for treating fresh closed Achilles tendon ruptures. This approach offers the benefits of smaller incisions, fewer complications, and better postoperative functional recovery, without increasing hospital costs.

Citation： LU Shengzhu, TAN Meijuan, SUN Qiang, KUANG Yanshun. Clinical study on a novel minimally invasive Achilles tendon suture instrument for treating fresh closed Achilles tendon rupture. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(9): 1062-1067. doi: 10.7507/1002-1892.202305054 Copy

1.	陳華, 郝明, 張巍, 等. 經通道輔助縫合系統微創修復急性閉合跟腱斷裂的療效觀察. 中國修復重建外科雜志, 2015, 29(1): 35-38.
2.	Ganestam A, Kallemose T, Troelsen A, et al. Increasing incidence of acute Achilles tendon rupture and a noticeable decline in surgical treatment from 1994 to 2013. A nationwide registry study of 33, 160 patients. Knee Surg Sports Traumatol Arthrosc, 2016, 24(12): 3730-3737.
3.	中華醫學會骨科學分會創傷骨科學組, 中華醫學會骨科學分會外固定與肢體重建學組, 國家骨科與運動康復臨床醫學研究中心, 等. 跟腱斷裂臨床循證診療指南. 中華骨與關節外科雜志, 2022, 15(5): 321-333.
4.	Ding WG, Li H, Zhu YP, et al. Comparison between tenocutaneous suture and Kessler suture techniques in treating acute closed Achilles tendon rupture. Foot Ankle Surg, 2014, 20(2): 105-108.
5.	Cooper MT. Acute Achilles tendon ruptures: Does surgery offer superior results (and other confusing issues)? Clin Sports Med, 2015, 34(4): 595-606.
6.	周維波, 張宜, 梁文衛, 等. 有限切開無結橋接治療急性閉合性跟腱斷裂. 中國組織工程研究, 2023, 27(17): 2687-2691.
7.	尚林, 馬富強, 李琦, 等. 卵圓鉗引線橋接縫合治療急性閉合性跟腱斷裂. 中華創傷雜志, 2023, 39(3): 259-264.
8.	湯明, 李謂林, 魯齊林, 等. 塑型卵圓鉗經皮縫合與切開縫合治療新鮮閉合性跟腱斷裂的對照研究. 骨科, 2019, 10(3): 173-178, 183.
9.	王士波. 硬膜外針結合卵圓鉗微創治療新鮮閉合性跟腱斷裂16例臨床療效觀察//第七屆全國中西醫結合骨科微創學術年會論文集. 泉州: 中國中西醫結合學會, 2017.
10.	Keating JF, Will EM. Operative versus non-operative treatment of acute rupture of tendo Achillis: a prospective randomised evaluation of functional outcome. J Bone Joint Surg (Br), 2011, 93(8): 1071-1078.
11.	吳韜光, 陳華, 聶少波, 等. 完全清醒無止血帶局部麻醉技術在治療急性跟腱斷裂中的應用. 中國修復重建外科雜志, 2022, 36(3): 279-283.
12.	周曉東, 張維龍, 陳子龍, 等. 負壓封閉引流聯合皮膚牽張技術在跟腱斷裂修補術后創面軟組織缺損修復中的應用. 中華解剖與臨床雜志, 2020, 25(4): 429-432.
13.	郝云甲, 陶友倫, 范家強, 等. 全關節鏡技術治療急性閉合性非止點性跟腱斷裂的臨床效果. 中華外科雜志, 2022, 60(6) : 540-545.
14.	黃亮亮, 李青, 伍河霖, 等. 鏡下修復急性閉合性跟腱斷裂. 中國矯形外科雜志, 2022, 30(19): 1791-1794.
15.	Cetti R, Christensen SE, Ejsted R, et al. Operative versus nonoperative treatment of Achilles tendon rupture. A prospective randomized study and review of the literature. Am J Sports Med, 1993, 21(6): 791-799.
16.	齊紅哲. 通道輔助跟腱微創縫合系統 (CAMIR) 生物力學與臨床應用研究. 北京: 中國人民解放軍醫學院, 2017.
17.	Kupcha PC, Mackenzie WG. Percutaneous achilles tendon repair using ring forceps. Am J Orthop (Belle Mead NJ), 2008, 37(11): 586.
18.	楊明, 張曉萌, 張殿英, 等. 兩種微創技術治療跟腱斷裂的比較研究. 中華創傷骨科雜志, 2016, 18(3): 192-196.
19.	朱前拯, 王闖, 陳星佐, 等. Dresden微創縫合技術與切開縫合治療急性跟腱斷裂的比較. 中華創傷骨科雜志, 2019, 21(4): 358-361.
20.	Lansdown D, Bernardoni ED, Cotter EJ, et al. Arthroscopic anterior shoulder stabilization with incorporation of a comminuted bony Bankart lesion. Arthrosc Tech, 2017, 6(6): e2101-e2106.
21.	何家雄, 吳家盛, 朱俊德, 等. 超聲引導下改良Bunnell法經皮縫合術治療急性閉合性跟腱斷裂的療效. 川北醫學院學報, 2022, 37(3): 345-348.

1. 陳華, 郝明, 張巍, 等. 經通道輔助縫合系統微創修復急性閉合跟腱斷裂的療效觀察. 中國修復重建外科雜志, 2015, 29(1): 35-38.
2. Ganestam A, Kallemose T, Troelsen A, et al. Increasing incidence of acute Achilles tendon rupture and a noticeable decline in surgical treatment from 1994 to 2013. A nationwide registry study of 33, 160 patients. Knee Surg Sports Traumatol Arthrosc, 2016, 24(12): 3730-3737.
3. 中華醫學會骨科學分會創傷骨科學組, 中華醫學會骨科學分會外固定與肢體重建學組, 國家骨科與運動康復臨床醫學研究中心, 等. 跟腱斷裂臨床循證診療指南. 中華骨與關節外科雜志, 2022, 15(5): 321-333.
4. Ding WG, Li H, Zhu YP, et al. Comparison between tenocutaneous suture and Kessler suture techniques in treating acute closed Achilles tendon rupture. Foot Ankle Surg, 2014, 20(2): 105-108.
5. Cooper MT. Acute Achilles tendon ruptures: Does surgery offer superior results (and other confusing issues)? Clin Sports Med, 2015, 34(4): 595-606.
6. 周維波, 張宜, 梁文衛, 等. 有限切開無結橋接治療急性閉合性跟腱斷裂. 中國組織工程研究, 2023, 27(17): 2687-2691.
7. 尚林, 馬富強, 李琦, 等. 卵圓鉗引線橋接縫合治療急性閉合性跟腱斷裂. 中華創傷雜志, 2023, 39(3): 259-264.
8. 湯明, 李謂林, 魯齊林, 等. 塑型卵圓鉗經皮縫合與切開縫合治療新鮮閉合性跟腱斷裂的對照研究. 骨科, 2019, 10(3): 173-178, 183.
9. 王士波. 硬膜外針結合卵圓鉗微創治療新鮮閉合性跟腱斷裂16例臨床療效觀察//第七屆全國中西醫結合骨科微創學術年會論文集. 泉州: 中國中西醫結合學會, 2017.
10. Keating JF, Will EM. Operative versus non-operative treatment of acute rupture of tendo Achillis: a prospective randomised evaluation of functional outcome. J Bone Joint Surg (Br), 2011, 93(8): 1071-1078.
11. 吳韜光, 陳華, 聶少波, 等. 完全清醒無止血帶局部麻醉技術在治療急性跟腱斷裂中的應用. 中國修復重建外科雜志, 2022, 36(3): 279-283.
12. 周曉東, 張維龍, 陳子龍, 等. 負壓封閉引流聯合皮膚牽張技術在跟腱斷裂修補術后創面軟組織缺損修復中的應用. 中華解剖與臨床雜志, 2020, 25(4): 429-432.
13. 郝云甲, 陶友倫, 范家強, 等. 全關節鏡技術治療急性閉合性非止點性跟腱斷裂的臨床效果. 中華外科雜志, 2022, 60(6) : 540-545.
14. 黃亮亮, 李青, 伍河霖, 等. 鏡下修復急性閉合性跟腱斷裂. 中國矯形外科雜志, 2022, 30(19): 1791-1794.
15. Cetti R, Christensen SE, Ejsted R, et al. Operative versus nonoperative treatment of Achilles tendon rupture. A prospective randomized study and review of the literature. Am J Sports Med, 1993, 21(6): 791-799.
16. 齊紅哲. 通道輔助跟腱微創縫合系統 (CAMIR) 生物力學與臨床應用研究. 北京: 中國人民解放軍醫學院, 2017.
17. Kupcha PC, Mackenzie WG. Percutaneous achilles tendon repair using ring forceps. Am J Orthop (Belle Mead NJ), 2008, 37(11): 586.
18. 楊明, 張曉萌, 張殿英, 等. 兩種微創技術治療跟腱斷裂的比較研究. 中華創傷骨科雜志, 2016, 18(3): 192-196.
19. 朱前拯, 王闖, 陳星佐, 等. Dresden微創縫合技術與切開縫合治療急性跟腱斷裂的比較. 中華創傷骨科雜志, 2019, 21(4): 358-361.
20. Lansdown D, Bernardoni ED, Cotter EJ, et al. Arthroscopic anterior shoulder stabilization with incorporation of a comminuted bony Bankart lesion. Arthrosc Tech, 2017, 6(6): e2101-e2106.
21. 何家雄, 吳家盛, 朱俊德, 等. 超聲引導下改良Bunnell法經皮縫合術治療急性閉合性跟腱斷裂的療效. 川北醫學院學報, 2022, 37(3): 345-348.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical study on a novel minimally invasive Achilles tendon suture instrument for treating fresh closed Achilles tendon rupture

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