• Shijun Wei, Jia Chen, Changwang Kong, Feng Xu, Xiaosong Zhi, and Xianhua Cai.
• Department of Orthopaedics, General Hospital of Central Theater Command (Wuhan General Hospital of Guangzhou Command, previously), Hubei, No. 627, Wuluo Road, Wuhan, 430030, People's Republic of China. wsj1974@yeah.net.
• Arch Orthop Trauma Surg. 2021 Oct 1; 141 (10): 1753-1760.

IntroductionRecently, endoscopically assisted Achilles tendon repair techniques have improved to overcome the surgical complications. However, the risk of sural nerve injury and the strength of repair are still the most concerning aspects.Material And MethodsTwenty three patients with acute Achilles tendon rupture were reviewed in the present study. We stitch the Achilles tendon above the ruptured site using the endoscopic locking loop suture technique, and the knotless anchor suture-bridge technique can be used to make the distal fixation of threads. The function was assessed using the muscle power (MRC0-5), ATRS scores, AOFAS ankle-hindfoot scores, and VAS scores at the final follow-up.ResultsThe mean follow-up time was 15.74 ± 2.43 months (12-18). At the final follow-up, the average of the muscle power (MRC0-5), ATRS score, AOFAS ankle-hindfoot score, and VAS score are 4.74 ± 0.45, 97.83 ± 2.77, 96.52 ± 4.87, and 0.35 ± 0.49, respectively. Every patient returned to previous sports activity at 6 months postoperative. No wound infection and sural nerve injuries were encountered. Only one case suffers local irritation at the medial knotless anchor site.ConclusionsEndoscopic "internal splinting" repair for acute Achilles tendon rupture using locking loop stitch with suture-bridge technique leads to an expedited return to activity with a low risk of complications.Level Of EvidenceLevel IV, case series.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.

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