Mini-invasive surgical repair of the Achilles tendon--does it reduce post-operative morbidity?
The surgical benefit of minimally invasive tendo Achilles repair (n = 25) with early weight-bearing mobilisation after rupture of the tendo Achilles was compared with operative treatment using an open technique (n = 34) with full weight-bearing after 8 weeks of surgical repair. The minimally invasive technique provided no evidence of wound problems and a functional benefit from early weight-bearing mobilisation. However, we noted that increased post-operative morbidity in terms of wound infection (n = 7) leading to delayed wound healing and wound pain requiring opiate-based analgesia post-operatively in the open repair group may have an additional impact on the patients and health care providers. This study showed that the mini-invasive open surgical repair of the Achilles tendon with the Achillon instrument and early weight-bearing mobilisation in an orthosis for the accelerated rehabilitation may offer cost-effectiveness and less financial burden on the health care provider in terms of associated nursing and physiotherapy costs.
Bhattacharyya
Mayukh
M
Department of Orthopaedics, University Hospital Lewisham, Lewisham High Street, London, SE13 6LH, UK. mayukhbhattacharyya@hotmail.com
Gerber
Bruno
B
D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery*; D000328:Adult; D003362:Cost-Benefit Analysis; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects* / Q000191:economics / Q000379:methods; D019637:Orthopedic Procedures / Q000009:adverse effects* / Q000191:economics / Q000379:methods; D009989:Orthotic Devices; D010146:Pain / Q000209:etiology*; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000209:etiology*; D013997:Time Factors; D016896:Treatment Outcome; D016474:Weight-Bearing; D014945:Wound Healing