Knotted or knotless? Efficacy analysis of the percutaneous Achilles repair system (PARS) for acute Achilles tendon ruptures: a retrospective cohort study

打结还是不打结?经皮跟腱修复系统(PARS)治疗急性跟腱断裂的疗效分析:一项回顾性队列研究

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Abstract

PURPOSE: The Percutaneous Achilles Repair System (PARS) has been applied in patients with acute Achilles tendon ruptures, encompassing both knotted and knotless methods. Whether these two approaches have different impacts on patient outcomes remains controversial. This study aims to investigate the clinical efficacy of these two surgical techniques in the treatment of acute Achilles tendon ruptures. METHODS: We retrospectively collected data from 61 patients with acute Achilles tendon ruptures treated at our center between January 2020 and January 2024. Patients treated with the knotless technique were classified as the experimental group, while those treated with the knotted technique were classified as the control group. Comparisons were made between the two groups regarding the American Orthopaedic Foot and Ankle Society Score (AOFAS) and Achilles Tendon Total Rupture Score (ATRS), surgical time, hospital stay duration, and hospitalization costs. Statistical analysis was conducted using the Student's t-test and the Chi-square test to compare differences between groups. RESULTS: The results of this study suggest that both techniques under the PARS are effective for patients with acute Achilles tendon rupture. Additionally, there were no statistically significant differences between the two groups in terms of the AOFAS, ATRS, surgery time, hospital stay, or hospitalization costs (P > 0.05). Notably, two patients in the experimental group experienced varying degrees of postoperative discomfort, whereas no complications were observed in the control group. CONCLUSIONS: The application of the PARS is an effective treatment for Achilles tendon ruptures. However, we observed certain specific complications associated with the knotless technique, such as anchor irritation and irritation caused by anchor sutures in areas with thin skin.

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