Directeur scientifique Société Française de Traumatologie du Sport (SFTS), C.E.R.S. Groupe Ramsay Santé, 83 av Maréchal de Lattre de Tassigny, 40130, Capbreton, France.
Hôpital Hôtel Dieu-APHP, Université Sorbonne Paris Nord, 1 place du Parvis Notre -Dame, 75004, Paris, France.
Int Orthop. 2023 Jul;47(7):1855-1861. doi: 10.1007/s00264-023-05827-5. Epub 2023 May 13.
The primary objective of this study was to compare the re-rupture rate, clinical results, and functional outcomes six months after the surgical repair of an acute Achilles tendon rupture between three different techniques (open repair, percutaneous repair with the Tenolig®, and minimally invasive repair).
A prospective, comparative, multicenter, non-randomized study was performed and included 111 patients who had an acute ruptured Achilles tendon: 74 underwent an open repair, 22 underwent a percutaneous repair using the Tenolig® and 15 had a minimally invasive repair. At six months follow-up we analyzed the number of re-ruptures, phlebitis, infections, complex regional pain syndrome, clinical outcomes (muscle atrophy, ankle dorsal flexion), functional scores (ATRS, VISA-A, EFAS, SF-12), and return to running.
There were more re-ruptures (p=0.0001) after repair with the Tenolig® (27%) than with open repairs (1.3%) and minimally invasive repairs (0%). The rate of other complications was not different. No clinical differences were found between the three groups. Only some functional scores EFAS Total (p=0.006), and VISA-A (p=0.015) were worse in the Tenolig® group. All the other results were similar between the three groups.
Despite heterogeneous studies in literature, the results of this comparative and prospective study between three surgical techniques of Achilles tendon repair confirmed that Tenolig® repair increased the rate of early re-rupture compared to open or minimally invasive techniques.
本研究的主要目的是比较三种不同技术（开放式修复、Tenolig®经皮修复和微创修复）治疗急性跟腱断裂后 6 个月的再断裂率、临床结果和功能结局。
进行了一项前瞻性、对照、多中心、非随机研究，共纳入 111 例急性跟腱断裂患者：74 例行开放式修复，22 例行 Tenolig®经皮修复，15 例行微创修复。在 6 个月的随访中，我们分析了再断裂、静脉炎、感染、复杂性区域疼痛综合征的数量、临床结果（肌肉萎缩、踝关节背屈）、功能评分（ATRS、VISA-A、EFAS、SF-12）和恢复跑步的情况。
Tenolig®修复组（27%）的再断裂率（p=0.0001）高于开放式修复组（1.3%）和微创修复组（0%）。其他并发症的发生率没有差异。三组间的临床结果无差异。仅 EFAS 总评分（p=0.006）和 VISA-A 评分（p=0.015）在 Tenolig®组较差。其余所有结果在三组间相似。
尽管文献中存在异质性研究，但本项比较性前瞻性研究的结果表明，与开放式或微创技术相比，Tenolig®修复增加了早期再断裂的风险。
