Evolution of Achilles Tendon Repair: From Open Surgery to Percutaneous Techniques.

Vlasak, Alexander; Metzl, Joshua · Foot Ankle Clin · 2026

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Abstract

This article examines the evolution of Achilles tendon repair, focusing on minimally invasive and percutaneous techniques that reduce complications and improve recovery. These approaches emphasize preserving anatomic structures like the paratenon and sural nerve while optimizing biomechanical repair strength. Modern suture configurations enhance stability, enabling early mobilization and better functional outcomes. Clinical evidence shows minimally invasive methods offer comparable or superior results to open surgery, with fewer wound complications and faster return to activity, though sural nerve injury remains a potential risk. These advancements reflect a balance between reduced surgical morbidity and improved patient outcomes.

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