Maffulli Nicola, Longo Umile Giuseppe, Spiezia Filippo, Denaro Vincenzo
Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, London, England.
Open Access J Sports Med. 2010 Jul 5;1:95-103. doi: 10.2147/oajsm.s7752.
Minimally invasive trauma and orthopedic surgery is increasingly common, though technically demanding. Its use for pathologies of the Achilles tendon (AT) hold the promise to allow faster recovery times, shorter hospital stays, and improved functional outcomes when compared to traditional open procedures, which can lead to difficulty with wound healing because of the tenuous blood supply and increased chance of wound breakdown and infection. We present the recent advances in the field of minimally invasive AT surgery for tendinopathy, acute ruptures, chronic tears, and chronic avulsions of the AT. In our hands, minimally invasive surgery has provided similar results to those obtained with open surgery, with decreased perioperative morbidity, decreased duration of hospital stay, and reduced costs. So far, the studies on minimally invasive orthopedic techniques are of moderate scientific quality with short follow-up periods. Multicenter studies with longer follow-up are needed to justify the long-term advantages of these techniques over traditional ones.
微创创伤与骨科手术日益常见，尽管技术要求较高。与传统开放手术相比，其用于跟腱（AT）病变有望实现更快的恢复时间、更短的住院时间以及更好的功能结局，传统开放手术因血供薄弱可能导致伤口愈合困难，且伤口裂开和感染的几率增加。我们介绍了微创AT手术在肌腱病、急性断裂、慢性撕裂和慢性撕脱方面的最新进展。在我们的实践中，微创手术取得的结果与开放手术相似，围手术期发病率降低、住院时间缩短且成本降低。到目前为止，关于微创骨科技术的研究科学质量中等，随访期较短。需要进行随访期更长的多中心研究，以证明这些技术相对于传统技术的长期优势。
