Postoperative evaluation of patients undergoing minimally invasive treatment for acute Aquilles tendon rupture

Abstract

Objective: To evaluate the clinical and functional outcomes of patients undergoing percutaneous repair of acute Achilles tendon rupture with the Tenolig® device, associated with a structured rehabilitation protocol with eccentric exercises adapted from Alfredson’s principles. Methods: Observational, retrospective, and descriptive study with 20 patients treated with rupture less than five days. Cases with clinical and ultrasound diagnosis and distal stump suitable for the device were included. Insertional injuries, re-rupture, previous surgeries in the affected limb, and comorbidities with potential functional or scarring impairment were excluded. The postoperative protocol included initial immobilization in plantar flexion, weight-bearing progression, protected physiotherapy, and eccentric exercises after week 12. The functional evaluation used the Achilles Tendon Total Rupture Score (ATRS) and timed monopodal exercise. The median follow-up was 24 ± 4.6 months. Results: The sample included 20 patients, with a mean age of 39.7 ± 13.2 years. The mean ATRS was 98.1 ± 3.4 points, with a median of 100 and a range of 86-100. The mean monopodal exercise time was 31.8 seconds. There was a re-rupture (5%) without infection, scarring complications, or sural nerve paresthesia. Conclusion: Minimally invasive repair with Tenolig®, combined with structured rehabilitation, showed favorable outcomes and a low complication rate in this case series. The interpretation is limited due to the small sample size, retrospective design, and absence of a comparison group. Level of Evidence IV; Descriptive Observational Study