Matsumae Yuta, Morimoto Shota, Nakamura Masashi, Morio Futoshi, Iseki Tomoya, Tachibana Toshiya
Department of Orthopaedic Surgery, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya 663-8501, Hyogo, Japan.
Department of Orthopaedic Surgery, Osaka Minato Central Hospital, 1-7-1, Isoji-cho, Osaka 552-0003, Osaka, Japan.
J Clin Med. 2024 Sep 29;13(19):5818. doi: 10.3390/jcm13195818.
An early accelerated rehabilitation is generally recommended after surgery for acute Achilles tendon ruptures (ATRs). The modified side-locking loop suture (MSLLS) is a surgical technique that provides high tensile strength to the repaired Achilles tendon and allows for a safe, early accelerated rehabilitation protocol without requiring postoperative immobilization. However, there are no reports investigating the clinical outcomes of the MSLLS technique with early accelerated rehabilitation for ATRs. To clarify the effectiveness of the MSLLS technique with an early accelerated rehabilitation protocol for ATR in athletes. We retrospectively analyzed 27 athletes (Tegner activity score ≥ 6) who underwent surgical treatment using the MSLLS technique for ATR between April 2017 and August 2022. All patients underwent an early accelerated rehabilitation protocol without immobilization. Outcome measures included the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS) score taken preoperatively and one year postoperatively, the time required to perform 20 continuous double-leg heel raises (DHR) and single-leg heel raises (SHR), the time to return to the original sport, and the presence of any complications. The mean AOFAS score significantly improved from 37.2 ± 9.7 preoperatively to 96.3 ± 5.3 one year postoperatively. The mean time to be able to perform 20 continuous DHR and SHR was 7.7 ± 1.2 weeks and 11.3 ± 1.6 weeks, respectively. All patients were able to return to their original sport at their pre-injury level in an average of 22.7 ± 3.7 weeks without complication. The MSLLS technique in conjunction with an early accelerated rehabilitation protocol for ATR in athletes produced satisfactory results, with all patients able to return to their original sport at their preinjury level without complication.
对于急性跟腱断裂（ATR）手术，一般建议早期进行加速康复。改良侧锁环缝合法（MSLLS）是一种手术技术，可为修复后的跟腱提供高拉伸强度，并允许采用安全的早期加速康复方案，无需术后固定。然而，尚无关于MSLLS技术联合早期加速康复治疗ATR临床疗效的报道。为阐明MSLLS技术联合早期加速康复方案治疗运动员ATR的有效性。我们回顾性分析了2017年4月至2022年8月间采用MSLLS技术手术治疗ATR的27名运动员（Tegner活动评分≥6）。所有患者均接受了无固定的早期加速康复方案。观察指标包括术前和术后1年的美国矫形足踝协会踝-后足评分（AOFAS）、连续进行20次双腿提踵（DHR）和单腿提踵（SHR）所需的时间、恢复原运动项目的时间以及有无并发症。平均AOFAS评分从术前的37.2±9.7显著提高到术后1年的96.3±5.3。能够连续进行20次DHR和SHR的平均时间分别为7.7±1.2周和11.3±1.6周。所有患者平均在22.7±3.7周后能够无并发症地恢复到受伤前的运动水平。MSLLS技术联合早期加速康复方案治疗运动员ATR取得了满意的结果，所有患者均能无并发症地恢复到受伤前的运动水平。
