Introduction: With evolutions in surgical techniques, minimally invasive surgical (MIS) repair with Achillon\r\napplicator has been introduced. However, there is still a lack of literature to investigate into the clinical merits of\r\nMIS over open surgery. This study aims to investigate the correlation between clinical outcome, gait analysis and\r\nbiomechanical properties comparing both surgical methods.\r\nMaterials and methods: A single centre retrospective review on all the consecutive operated patients between\r\nJanuary 2004 and December 2008 was performed. Twenty-six patients (19 male and 7 female; age 40.4 �± 9.2 years)\r\nhad experienced a complete Achilles tendon rupture with operative repair. Nineteen of the patients, 10 MIS versus\r\n9 open repairs (13 men with a mean age of 40.54 �± 10.43 (range 23-62 yrs) and 6 women with a mean age of\r\n45.33 �± 7.71 (range 35-57 yrs) were further invited to attend a thorough clinical assessment using Holzâ��s scale and\r\nbiomechanical evaluation at a mean of 25.3 months after operation. This study utilized the Cybex II isokinetic\r\ndynamometer to assess the isokinetic peak force of plantar-flexion and dorsiflexion of both ankles. The patients\r\nwere also invited to return to our Gait Laboratory for analysis. The eight-infrared camera motion capture system\r\n(VICON, UK) was utilized for the acquisition of kinematic variables. Their anthropometric data was measured\r\naccording to the Davis and coworkersâ�� standard.\r\nResults: The mean operative time and length of hospital stay were shorter in the MIS group. The operative time\r\nwas 54.55 �± 15.15 minutes versus 68.80 �± 18.23 minutes of the MIS group and Open group respectively (p =\r\n0.045), whereas length of stay was 3.36 �± 1.21 days versus 6.40 �± 3.70 days respectively (p = 0.039). There is\r\nstatistically significant decrease (p = 0.005) in incision length in MIS group than the open surgery group, 3.23 �±\r\n1.10 cm versus 9.64 �± 2.55 cm respectively. Both groups attained similar Holzâ��s scores, 11.70 �± 0.95 versus 12.0 �±\r\n1.50 respectively (p = 0.262). The mean percentage stance time of the injured leg for MIS patient was 58.44%\r\nwhile the mean percentage stance time of the injured leg for patients with open repair was 56.57%. T-test has\r\nshown there were no significance differences between the results of the two groups of patients. The loss of\r\npeak torque and total work done with respect to the injured side were similar between the MIS and open\r\ngroup.\r\nDiscussion and conclusion: MIS using Achillon method can achieve smaller incisions, shorter operative time\r\nand hospital stay. There is no statistical significance difference in clinical outcome, the stance time to strike time\r\nratio and biomechanical properties on the leg receiving Achilles tendon repair using MIS method and open\r\nsurgery.
Loading....