Early active motion and weightbearing after cross-stitch Achilles tendon repair

Twenty-two closed Achilles tendon ruptures caused by sports injuries in 22 patients (average age, 37.6 years) were repaired with Kirschmayer core sutu re and cross-stitch epitenon suture, and early active ankle motion with wei ghtbearing was implemented after surgery. This study was undertaken to eval uate the effectiveness of the repair technique and rehabilitation protocol by assessing clinical results and magnetic resonance imaging findings. The follow-up period averaged 24.6 months. Twenty of the tendons (91%) healed w ithout rerupture, and two tendons (9%) suffered a partial rerupture at 23 a nd 56 days, respectively. Active ankle extension reached from the minus ran ge to 0 degrees in an average of 9.7 days, and ankle motion recovered to no rmal in an average of 6.0 weeks. Full weightbearing without heel raising be came possible in an average of 16.4 days, and heel raising with both legs b ecame possible in an average of 7.3 weeks. The patients returned to full sp orts activity in 13.1 weeks. The interval until the area of high-intensity signal at the tendon repair site on T2-weighted magnetic resonance imaging scans became intermediate-intensity signal averaged 6.9 weeks, and the tend on repair site became low-intensity signal in an average of 12.6 weeks, dem onstrating excellent tendon healing. Treatment employing Kirschmayer core s uture and cross-stitch epitenon suture may help athletes return to sports a ctivity in a shorter period than that allowed by previous methods of repair for Achilles tendon ruptures.