Evolution of Technology

Minimally Invasive Achilles Tendon Repair

Advancements in tethering material has led to the development of FiberWire, which is the suturing material utilized in most modern day achilles repair system. FiberWire is constructed of a multi-strand, long chain ultra-high molecular weight polyethylene core with a braided jacket of polyester.

Although open techniques have historically been utilized for the repair, this approach is often complicated by wound-healing issues and infection, as the skin in the area of the achilles tendon is under high tension. This led to the development of achilles repair systems that are able to achieve equivalent load-failure strength through a percutaneous and minimally invasive surgical incisions.

This has shown to significantly mitigate the risk of wound healing complications including delayed healing, adhesions, and unsightly scaring. However, there does exist a slightly higher risk of damaging the nerve that provides sensation to lateral aspect of the foot and ankle with this technique.

Evolution of Procedure

Achilles Tendon Repair

Success of an achilles tendon repair relies on securing the ruptured ends of the tendon back together. This has traditionally been accomplished by making a large incision to expose the entire damaged section of the tendon (i.e. an “open” approach) and then sewing (i.e. suturing) the two ends back together.

There exists a large variety of suture material that has been used for this procedure. Suture material generally exists in two forms, absorbable and non-absorbable, both of which have been used for achilles tendon repair.

Non-absorbable suture is most often utilized in this setting as it has demonstrated superior load-to-failure strength compared to absorbable suture. There also exists a large variety of techniques for securing the two ends of the suture together.