A Better, Cheaper Achilles Tendon

by Calvin J. Rushing, DPM

Open surgery to repair the Achilles tendon surgery faces high rates of wound-healing complications, prompting the introduction of minimally invasive surgery (MIS) techniques.  

Research on various MIS techniques, however, have shown higher rates of sural neuritis, increased risk of re-rupture, and higher overall costs due to implants additional to sutures.

The Modified Dresden technique  

In their recent article, Kostynski et al. describe their preferred MIS technique using two number 6 uterine curettes, four straight needles, and four strands of sutures (slip-knot technique). Performed through a 3cm posteromedial incision proximal to the rupture, the technique:

·       Preserves the vascular supply/paratenon

·       Minimizes the risk of sural nerve injury

·       Provides a non-locking/locking construct affording weight bearing at two weeks 

·       Eliminates unnecessary costs introduced by industry devices/implants

The cost-effective improvement on the original Dresden repair technique, as detailed in the article and supplementary videos,is worth 20 minutes of your day.