to surgery and technique as predictors of complications and outcomes after surgical treatment of Achilles ruptures. I'd like to thank my co-authors at the University of Colorado. I have no disclosures. So Achilles tendon ruptures are challenging injuries and complications following surgery can lead to poor outcomes. Although operative treatment does offer some benefits, it also introduces some potential complications. So the purpose of this study was determinative time to surgery and an open versus percutaneous surgical technique were related to postoperative complications. We also then did assess differences in functional outcomes between patients operated on at different time points. Hypothesis was an increased time to surgery and open surgical technique would correlate with an increase in complications as well as lower outcome scores. So this was a retrospective review looking at patients who underwent Achilles rupture repair surgery from October, 2016 to January, 2022 at one major center. All patients had a minimum of three months of follow-up. The data collected included injury and treatment time points as well as an open versus per technique complications as well as operative time. We then sent surveys to patients that included foot and ankle stain, B to A, PF promise and PI promise. Here's a flow sheet showing how we arrived at the 361 patients, 608 were identified in the medical record, 37 were excluded because of the operation for an Achilles pathology that was not deemed an acute rupture and then 210 patients were excluded due to follow-up of less than three months. Patients were then separated into three categories based on their time from rupture to surgery. The acute were less than two weeks, subacute two to six weeks and chronic greater than six weeks. Complications were categorized as minor, major, re-rupture, menothromba, embolus and other minor wounds were or minor complications were classified as wounds or infections that resolved without patient care while major required operative intervention. The analysis was then used to determine statistically significant relationships between the time of surgery and post-surgical complications as well as surgical technique in post-surgical complications as well as functional outcome scores between the group. So results, there were 361 patients included in the study, 262 in the acute group, 65 subacute, 34 chronic and then with regard to technique there were 177 in the open group and 184 in the percutaneous group. For the breakdown there were 68 total complications, 15 minor, 11 major, 13 re-ruptures, 15 DVTs and 14 other and here's a table below further illustrating that breakdown with additional details. You'll note here that in the chronic group there was a more frequent occurrence of complications by percentage and if you look specifically at re-ruptures there were more frequent re-ruptures in the chronic group which I'll talk about a little bit more. So in the acute group there are 51 complications, subacute, seven complications and 10 complications in the chronic group knowing a higher frequency in the chronic group. That being said there were no statistical differences determined between time to surgery or surgical technique and complications among groups after statistical analysis. That being said there was a trend toward increased complications in the chronic group, the most notable being re-rupture. The mean time from date of injury to surgery in this group of chronic re-rupture patients was 104 days while the mean time from surgery to re-rupture was 24 days. With regard to the the surveys 101 patients completed the survey which was 28 percent. There were no statistical differences in functional outcome scores between determined between these different groups. There was no statistical difference in determined between these different groups. You can see that data illustrated here. Of note to and of interest open surgery did have a significantly longer operative time by a mean of about 13 minutes and you see that data illustrated here. So in conclusion the study did not demonstrate any statistically significant relationship between time to surgery, open versus percutaneous surgical technique or functional outcome scores and post-surgical complications following operative repair of Achilles rupture. That being said complications and re-ruptures were more frequent in patients undergoing surgery greater than six weeks following injury. So increased time to surgery may be a predictor of increased risk for post-operative complications following Achilles repair surgery and we are continuing to analyze the data to identify significant variables. Thank you and here are my references.

study

time to surgery

surgical technique

complications

Achilles tendon ruptures