Percutaneous Repair of Acute Achilles Tendon Ruptures

  • Nicola MaffulliEmail author
  • Francesco Oliva
  • Mario Ronga


The Achilles tendon (AT) is the strongest tendon in the human body, but despite its strength, is the most frequently ruptured tendon in the body. Ruptures usually occur between 2 and 6 cm of its insertion into the superior surface of the calcaneus, a relatively hypovascular area.8,17 The major blood supply to tendons is from the mesotendon, and the largest supply is from the anterior mesentery.2 The tendon is at the greatest risk of rupture when the it is obliquely loaded, the muscle is contracting maximally, and tendon length is short.5 This usually occurs as a result of pushing off with the foot against resistance, and occurs most frequently in males in their fourth decade.


Achilles Tendon Sural Nerve Transverse Incision Percutaneous Technique Stab Incision 
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  1. 1.
    Bradley JP, Tibone JE. Percutaneous and open surgical repairs of Achilles tendon ruptures. A comparative study. Am J Sports Med. 1990;18:188–195.PubMedCrossRefGoogle Scholar
  2. 2.
    Maffulli N, Longo UG, Hüfner T, Denaro V. Surgical treatment for pain syndromes of the Achilles tendon. Unfallchirurg. Sep 2010;113(9):721–725.Google Scholar
  3. 3.
    Carmont MR, Maffulli N. Modified percutaneous repair of ruptured Achilles tendon. Knee Surg Sports Traumatol Arthrosc. 2008;16:199–203.PubMedCrossRefGoogle Scholar
  4. 4.
    Cretnik A, Zlajpah L, Smrkolj V, et al. The strength of percutaneous methods of repair of the Achilles tendon: a biomechanical study. Med Sci Sports Exerc. 2000;32:16–20.PubMedGoogle Scholar
  5. 5.
    McMaster PE. Tendon and muscle ruptures: clinical and experimental studies on the causes and location of subcutaneous ruptures. J Bone Joint Surg. 1933;15:705–722.Google Scholar
  6. 6.
    Gorschewsky O, Vogel U, Schweizer A, et al. Percutaneous tenodesis of the Achilles tendon. A new surgical method for the treatment of acute Achilles tendon rupture through percutaneous tenodesis. Injury. 1999;30:315–321.PubMedCrossRefGoogle Scholar
  7. 7.
    Kauranen KJ, Leppilahti JI. Motor performance of the foot after Achilles rupture repair. Int J Sports Med. 2001;22:154–158.PubMedCrossRefGoogle Scholar
  8. 8.
    Langergren C, Lindholni A. Vascular distribution in the Achilles tendon. Acta Chir Scand. 1958;116:491–495.Google Scholar
  9. 9.
    Lim J, Dalal R, Waseem M. Percutaneous vs. open repair of the ruptured Achilles tendon - a prospective randomized controlled study. Foot Ankle Int. 2001;22:559–568.PubMedGoogle Scholar
  10. 10.
    Ma GW, Griffith TG. Percutaneous repair of acute closed ruptured achilles tendon: a new technique. Clin Orthop Relat Res. 1977;128:247–255.PubMedGoogle Scholar
  11. 11.
    Martinelli B. Percutaneous repair of the Achilles tendon in athletes. Bull Hosp Jt Dis. 2000;59:149–152.PubMedGoogle Scholar
  12. 12.
    Matles AL. Rupture of the tendo Achilles. Another diagnostic sign. Bull Hosp Joint Dis. 1975;36:48–51.PubMedGoogle Scholar
  13. 13.
    Simmonds FA. The diagnosis of the ruptured Achilles tendon. Practitioner. 1957;179:56–58.PubMedGoogle Scholar
  14. 14.
    O’Brien T. The needle test for complete rupture of the Achilles tendon. J Bone Joint Surg (A). 1984;66:1099–1101.PubMedGoogle Scholar
  15. 15.
    Webb J, Moorjani N, Radford M. Anatomy of the sural nerve and its relation to the Achilles tendon. Foot Ankle Int. 2000;21:475–477.PubMedGoogle Scholar
  16. 16.
    Webb JM, Bannister GC. Percutaneous repair of the ruptured tendo Achillis. J Bone Joint Surg Br. 1999;81:877–880.PubMedCrossRefGoogle Scholar
  17. 17.
    Williams PL, Warwick R, Dyson M, Bannister LH. Grays Anatomy. 37th ed. Edinburgh, UK/New York, NY: Churchill Livingstone; 1989.Google Scholar

Copyright information

© Springer London 2010

Authors and Affiliations

  1. 1.Centre for Sports and Exercise MedicineQueen Mary University of London, Barts and The London School of Medicine and Dentistry, Mile End HospitalLondonUK

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