This retrospective cohort study compared outcomes of percutaneous Achilles repair (PARS) versus open Krackow repair in 270 consecutive operative Achilles ruptures at a single center (2005-2014). The primary question: does a limited 2-cm incision technique improve recovery and reduce complications compared to traditional open repair?
Percutaneous Achilles repair techniques were developed to address the wound complication burden of open repair, but early devices (Achillon) were costly, non-anatomic, and lacked locking suture options.
This paper establishes that PARS, using a 2-cm incision with both locking and nonlocking FiberWire sutures, achieves equivalent complication rates to open repair with meaningfully faster return to activity (98% vs 82% by 5 months).
For your young, active patient presenting within 1-2 weeks of injury, PARS is a reasonable first choice: smaller wound, faster rehab clearance, and zero sural neuritis in this series.
If you use PARS, keep knots away from the skin undersurface — both reoperations in the PARS group were for superficial FiberWire foreign-body reactions, a preventable complication with careful jig centering on the tendon midportion.
This retrospective cohort study compared outcomes of percutaneous Achilles repair (PARS) versus open Krackow repair in 270 consecutive operative Achilles ruptures at a single center (2005-2014). The primary question: does a limited 2-cm incision technique improve recovery and reduce complications compared to traditional open repair?
Percutaneous Achilles repair techniques were developed to address the wound complication burden of open repair, but early devices (Achillon) were costly, non-anatomic, and lacked locking suture options.
This paper establishes that PARS, using a 2-cm incision with both locking and nonlocking FiberWire sutures, achieves equivalent complication rates to open repair with meaningfully faster return to activity (98% vs 82% by 5 months).
For your young, active patient presenting within 1-2 weeks of injury, PARS is a reasonable first choice: smaller wound, faster rehab clearance, and zero sural neuritis in this series.
If you use PARS, keep knots away from the skin undersurface — both reoperations in the PARS group were for superficial FiberWire foreign-body reactions, a preventable complication with careful jig centering on the tendon midportion.