Walking on the Achilles tendons.

Abstract Background The ‘walking Achilles tendon’ technique can be safely adopted when the initial percutaneous repair fails to achieve sufficient grip in the proximal stump of the ruptured tendon. In such instances, two additional stab wounds are produced proximal to the initial most proximal ones to increase the tendon area available for suture grip. Sources of data A total of 36 patients had who sustained Achilles tendon rupture were included in the present study, divided in two groups: ‘the walking on the Achilles tendon group’ and ‘traditional repair’ group. Areas of agreement There was no difference in the mean Achilles Tendon Resting Angle (ATRA), Achilles Tendon Total Rupture Score (ATRS), calf circumference, isometric strength, time to return to sport, European Foot and Ankle Society Score (EFAS Score), and Patient-Reported Outcome Measures (PROMs) Piedade, between the patient group who underwent ‘the walking on tendon technique’ and the traditional suture. Areas of controversy Percutaneous management Achilles tendon rupture remains challenging with mixed results reported in the literature. Growing points The results of the present investigation show that these additional steps, resulting in a total of nine stab wounds, add some time to the actual procedure, but produce comparable results to the seven stab wounds technique. Areas timely for developing research The ‘walking on the Achilles tendon’ technique allows to easily and effectively overcome the poor hold in the proximal stump of the torn Achilles tendon which surgeon may occasionally encounter and continue to perform minimally invasive percutaneous Achilles tendon repair without the need to shift to open procedures.