Endoscopy-assisted percutaneous repair of acute achilles tendon tears

Background: We developed a technique for endoscopy-assisted percutaneous repair of acute Achilles tendon tears. Methods: Nineteen patients with acute Achilles tendon tears were prospectively recruited into the study. All patients (18 male, 1 female) had sports-related injuries. Preoperative diagnosis was made from patient history, physical examination, and sonography. The average patient age was 38.7 years, and follow-up averaged 24 months. All patients received endoscopyassisted percutaneous Achilles tendon repair with modified Bunnell sutures passed by bird beak and No. 5 Ethibond under direct visualization using 4.0-mm arthroscopy. Results were evaluated by physical examination, sonography, and magnetic resonance imaging (MRI). Results: All 19 patients achieved tendon healing. All patients were evaluated by sonography, and the tendons of 16 patients were imaged using MRI to evaluate the extent of healing. Final dorsiflexion was 16 degrees and plantar flexion 26 degrees, and 95% of the patients (18/19) returned to their previous level of sporting activity. One patient developed a superficial infection, and 2 patients had postoperative sural nerve injury with numbness for 1 month. There were no other major complications. Conclusion: Endoscopy-assisted percutaneous repair of the Achilles tendon allowed good tendon healing and return to sports at 6 months. Sural nerve injury during surgery was a potential complication of this procedure. Level of Evidence: Level IV, retrospective case series.