AUGMENTED VS NON-AUGMENTED SURGICAL REPAIR OF A FRESH TOTAL ACHILLES TENDON RUPTURE: A PROSPECTIVE, RANDOMIZED STUDY

Background: The aim of our prospective, randomized study was to compare two operative techniques for the treatment of acute Achilles tendon rupture and question the necessity of augmented repair. Null hypothesis: Augmentation with a down-turned gastrocnemius fascia flap does not give any better result than end-to-end suturation by the Krackow locking loop surgical technique. Study Design: A prospective, randomized clinical trial. Methods: Sixty patients with acute Achilles tendon rupture were randomized preoperatively to receive end-to-end suturation by the Krackow locking loop technique either without augmentation (Group I) or with one down-turned gastrocnemius fascia flap, as described by Silfverskiold (Group II). A dorsal brace allowed free active plantar flexion of the ankle postoperatively, whereas dorsiflexion was restricted to neutral for the first three weeks. Weight bearing was limited for six weeks. The follow-up period was one year, and evaluation was performed in terms of clinical measurements, an outcome score, isokinetic calf muscle performance tests and tendon elongation measurements. Results: The mean operation time was 25 minutes longer in the augmentation group and the incision 7 cm longer (p Conclusions: Routine use of augmentation does not seem to be necessary in surgery for fresh total Achilles tendon ruptures.