Delayed Achilles Rupture Repair Won’t Affect Outcomes

After an acute Achilles tendon rupture does the timing of the surgical repair matter?

That is what a new study, “Delayed (14-30 Days) Percutaneous Repair of Achilles Tendon Ruptures Offers Equally Good Results As Compared With Acute Repair,” published March 16, 2020 in The American Journal of Sports Medicine wanted to know.

And it turns out that delaying minimally invasive repair up to a month after injury will still deliver good results to patients.

In this new study, the authors compared 21 patients whose Achilles tendon was repaired 14 to 30 days after injury with patients who’d received treatment within 14 days of injury. All patients treated received the same minimally invasive procedure—which was a core suture repair consisting of a modified Bunnell suture in the proximal stump and a modified Kessler suture in the distal stump.

At 12 months post-op, patients in the delayed group had a median Achilles tendon rupture score of 91 (SD, 2.4; range , 87-96) as compared with 91 (SD, 2.2; range, 86-96) in patients who presented with the first 6 days after the injury.

No differences were found in mean Achilles tendon resting angle: delayed repair group, -3.9˚ (2.0); acute repair group, -3.7˚ (1.9) (p = .69).

None of the patients developed a wound infection; however, one of the patients who had the repair within the first six days after surgery did have an iatrogenic sural nerve injury.

The study authors summarized their study saying, “Patients with Achilles tendon rupture treated by percutaneous repair 14 to 30 days after injury achieved similar results at 1 year as patients treated < 14 after injury.”