Check-rein technique for Achilles tendon elongation following conservative management for acute Achilles tendon ruptures: a two-year prospective clinical study

Abstract Background Following conservative management for acute Achilles tendon (AT) ruptures, the tendon may heal in continuity, and some patients may present with an elongated Achilles tendon–gastrosoleus complex. This study investigated the efficacy and feasibility of a novel minimally invasive t...

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Auteurs principaux:	Nicola Maffulli, Francesco Oliva, Filippo Migliorini
Format:	article
Langue:	EN
Publié:	BMC 2021
Sujets:	Achilles tendon Achilles rupture Tendon elongation Check-rein procedure Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
Accès en ligne:	https://doaj.org/article/95f691d0b05f4eddb01edb772daaacde
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spelling	oai:doaj.org-article:95f691d0b05f4eddb01edb772daaacde2021-11-28T12:27:10ZCheck-rein technique for Achilles tendon elongation following conservative management for acute Achilles tendon ruptures: a two-year prospective clinical study10.1186/s13018-021-02830-71749-799Xhttps://doaj.org/article/95f691d0b05f4eddb01edb772daaacde2021-11-01T00:00:00Zhttps://doi.org/10.1186/s13018-021-02830-7https://doaj.org/toc/1749-799XAbstract Background Following conservative management for acute Achilles tendon (AT) ruptures, the tendon may heal in continuity, and some patients may present with an elongated Achilles tendon–gastrosoleus complex. This study investigated the efficacy and feasibility of a novel minimally invasive technique, which we named “check-rein procedure”, in patients with intact and elongated AT following conservative management for AT ruptures. Methods All patients who underwent the check-rein procedure for elongation of the gastrosoleus–AT complex by one experienced surgeon were prospectively enrolled. The AT resting angle (ATRA) and AT rupture score (ATRS) were assessed at baseline and repeated at 2-year follow-up, as were calf circumference and isometric plantarflexion strength of both ankles. Results Forty-three patients (43 procedures) were analysed. The mean time elapsed from injury to surgery was 28.7 ± 7.9 weeks. The mean age at surgery was 38.5 ± 5.7 years. At the last follow-up, ATRS, ATRA, isometric strength difference, and calf circumference of the affected side were increased (P < 0.0001). The rate of the return to sport was 98% (42 of 43). No wound complications or rupture were experienced by any patient. Conclusion The check-rein technique for AT elongation after conservative management of AT tears is effective and feasible to restore tendon length and calf function. The surgical outcome was influenced by the preoperative performance status, and longer time elapsed from injury to surgery worsens the outcomes.Nicola MaffulliFrancesco OlivaFilippo MiglioriniBMCarticleAchilles tendonAchilles ruptureTendon elongationCheck-rein procedureOrthopedic surgeryRD701-811Diseases of the musculoskeletal systemRC925-935ENJournal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Achilles tendon Achilles rupture Tendon elongation Check-rein procedure Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
spellingShingle	Achilles tendon Achilles rupture Tendon elongation Check-rein procedure Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935 Nicola Maffulli Francesco Oliva Filippo Migliorini Check-rein technique for Achilles tendon elongation following conservative management for acute Achilles tendon ruptures: a two-year prospective clinical study
description	Abstract Background Following conservative management for acute Achilles tendon (AT) ruptures, the tendon may heal in continuity, and some patients may present with an elongated Achilles tendon–gastrosoleus complex. This study investigated the efficacy and feasibility of a novel minimally invasive technique, which we named “check-rein procedure”, in patients with intact and elongated AT following conservative management for AT ruptures. Methods All patients who underwent the check-rein procedure for elongation of the gastrosoleus–AT complex by one experienced surgeon were prospectively enrolled. The AT resting angle (ATRA) and AT rupture score (ATRS) were assessed at baseline and repeated at 2-year follow-up, as were calf circumference and isometric plantarflexion strength of both ankles. Results Forty-three patients (43 procedures) were analysed. The mean time elapsed from injury to surgery was 28.7 ± 7.9 weeks. The mean age at surgery was 38.5 ± 5.7 years. At the last follow-up, ATRS, ATRA, isometric strength difference, and calf circumference of the affected side were increased (P < 0.0001). The rate of the return to sport was 98% (42 of 43). No wound complications or rupture were experienced by any patient. Conclusion The check-rein technique for AT elongation after conservative management of AT tears is effective and feasible to restore tendon length and calf function. The surgical outcome was influenced by the preoperative performance status, and longer time elapsed from injury to surgery worsens the outcomes.
format	article
author	Nicola Maffulli Francesco Oliva Filippo Migliorini
author_facet	Nicola Maffulli Francesco Oliva Filippo Migliorini
author_sort	Nicola Maffulli
title	Check-rein technique for Achilles tendon elongation following conservative management for acute Achilles tendon ruptures: a two-year prospective clinical study
title_short	Check-rein technique for Achilles tendon elongation following conservative management for acute Achilles tendon ruptures: a two-year prospective clinical study
title_full	Check-rein technique for Achilles tendon elongation following conservative management for acute Achilles tendon ruptures: a two-year prospective clinical study
title_fullStr	Check-rein technique for Achilles tendon elongation following conservative management for acute Achilles tendon ruptures: a two-year prospective clinical study
title_full_unstemmed	Check-rein technique for Achilles tendon elongation following conservative management for acute Achilles tendon ruptures: a two-year prospective clinical study
title_sort	check-rein technique for achilles tendon elongation following conservative management for acute achilles tendon ruptures: a two-year prospective clinical study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/95f691d0b05f4eddb01edb772daaacde
work_keys_str_mv	AT nicolamaffulli checkreintechniqueforachillestendonelongationfollowingconservativemanagementforacuteachillestendonrupturesatwoyearprospectiveclinicalstudy AT francescooliva checkreintechniqueforachillestendonelongationfollowingconservativemanagementforacuteachillestendonrupturesatwoyearprospectiveclinicalstudy AT filippomigliorini checkreintechniqueforachillestendonelongationfollowingconservativemanagementforacuteachillestendonrupturesatwoyearprospectiveclinicalstudy
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Check-rein technique for Achilles tendon elongation following conservative management for acute Achilles tendon ruptures: a two-year prospective clinical study

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