| Objective To investigate the effect of transcalcaneal bone tunnel suture technique on postoperative inflammation and stress response in patients with Achilles tendon rupture.Methods A retrospective case-control study was used to collect the case data of 106 patients with Achilles tendon rupture at or near the Achilles tendon that received surgical treatment at the Fourth People's Hospital of Hengshui from June 2012 to October 2022, and they were divided into anchor group and suture group according to different surgical plans. The anchor group (53 cases) was treated with the wire anchor technique, and the suture group (53 cases) received the transcalcaneal bone tunnel suture technique. Surgical outcomes (including intraoperative blood loss, duration of surgery, length of hospital stay, hospitalization costs, and Achilles tendon healing time), ankle range of motion and complete Achilles tendon rupture scoring system (ATRS), and American Foot and Ankle Association (AOFAS) ankle-posterior foot scoring system scores were compared between the two groups. Serum levels of inflammatory and stress indicators [interleukin-1β, norepinephrine (NE), etc.] were measured before and 1 day after surgery. Postoperative complications of the two groups were analyzed.Results All patients successfully underwent surgery and were followed up for 12 to 23 months, with an average time of (16.62±2.79) months. Intraoperative blood loss, hospital stay, hospital costs and Achilles tendon healing time were significantly lower in the suture group than in the anchor group, and operative time was significantly longer than that in the anchor group, with statistical significance (P<0.05). At 12 months after operation, ankle dorsiflexion, plantar flexion angle, ATRS and AOFAS scores in both groups were significantly better than those before surgery (P<0.05). There was no significant difference in ankle dorsiflexion, plantar flexion angle and ATRS evaluation between the two groups (P>0.05). At 12 months after surgery, the AOFAS score in the suture group was significantly higher than that in the anchor group (P<0.05). The levels of serum IL-1β, IL-6, NE and angiotensin Ⅱ (Ang Ⅱ) in the two groups were significantly higher than those before surgery 1 day after surgery (P<0.05), but the levels of serum IL-1β, IL-6, NE and AngⅡ in suture group were significantly lower than those in the anchor group 1 day after surgery (P<0.05). After operation, only 2 cases of incision redness and swelling appeared in the anchor group. After wound dressing change and delayed suture removal, the incisions were all healed in stage Ⅰ. No other complications such as Achilles tendon re-rupture, sural nerve injury, and skin necrosis around the incision occurred in all patients within 12 months of follow-up.Conclusion Treatment of patients with Achilles tendon rupture at or near the Achilles tendon can significantly reduce the inflammatory and stress response of patients after surgery, which is beneficial for postoperative rehabilitation. Compared with the wire anchor technique, the transcalcaneal bone suture technique has the advantages of less trauma, lower hospital costs and better therapeutic effect. |
