Abstract：
OBJECTIVE: The safety and reliability of endoscopic Achilles tendon rupture repair are still concerning aspects. This study\'s aim is to evaluate an all-inside endoscopic semiautomatic running locked stitch (Endo-SARLS) technique.
METHODS: Forty cases with acute Achilles tendon rupture were treated with the all-inside Endo-SARLS technique between 2020 and 2021. Under endoscopic control, the proximal tendon stumps were stitched with the running locked method using a semiautomatic flexible suture passer. The threads of the high-strength suture were grasped through the paratenon subspace and then fixed into calcaneal insertion with a knotless anchor. Magnetic resonance imaging (MRI), surgical time and complications were assessed. Achilles Tendon Total Rupture Score (ATRS), Achilles Tendon Resting Angle (ATRA) and Heel Rise Height Scale (HRHS) were utilised to evaluate final outcomes.
RESULTS: The average follow-up time was 25.4 ± 0.4 (range: 24-32) months. Appropriate tendon regeneration was observed on MRI after 12 months. At the final follow-up, the median value of ATRS score was 95 (interquartile range: 94, 98). Furthermore, there is no significant difference between the injured and contralateral side in the average ATRA (18.2 ± 1.8 vs. 18.3 ± 1.9°, ns) and median value of HRHS [14.5 (13.3, 15.5) vs. 14.8 (13.5, 15.6) cm, ns]. No infection and nerve injuries were encountered. Thirty-nine patients reported that they resumed casual sports activity after 6 months. One patient had a slight anchor cut-out, due to an addition injury, which was removed after 5 months.
CONCLUSIONS: An all-inside Endo-SARLS technique showed promising clinical results for acute Achilles tendon ruptures. This procedure reduces the risk of sural nerve injuries while establishing a reliable connection between the tendon stumps.
METHODS: Level IV.
METHODS: Forty cases with acute Achilles tendon rupture were treated with the all-inside Endo-SARLS technique between 2020 and 2021. Under endoscopic control, the proximal tendon stumps were stitched with the running locked method using a semiautomatic flexible suture passer. The threads of the high-strength suture were grasped through the paratenon subspace and then fixed into calcaneal insertion with a knotless anchor. Magnetic resonance imaging (MRI), surgical time and complications were assessed. Achilles Tendon Total Rupture Score (ATRS), Achilles Tendon Resting Angle (ATRA) and Heel Rise Height Scale (HRHS) were utilised to evaluate final outcomes.
RESULTS: The average follow-up time was 25.4 ± 0.4 (range: 24-32) months. Appropriate tendon regeneration was observed on MRI after 12 months. At the final follow-up, the median value of ATRS score was 95 (interquartile range: 94, 98). Furthermore, there is no significant difference between the injured and contralateral side in the average ATRA (18.2 ± 1.8 vs. 18.3 ± 1.9°, ns) and median value of HRHS [14.5 (13.3, 15.5) vs. 14.8 (13.5, 15.6) cm, ns]. No infection and nerve injuries were encountered. Thirty-nine patients reported that they resumed casual sports activity after 6 months. One patient had a slight anchor cut-out, due to an addition injury, which was removed after 5 months.
CONCLUSIONS: An all-inside Endo-SARLS technique showed promising clinical results for acute Achilles tendon ruptures. This procedure reduces the risk of sural nerve injuries while establishing a reliable connection between the tendon stumps.
METHODS: Level IV.
摘要：
目的：内镜下跟腱断裂修复的安全性和可靠性仍是值得关注的方面。本研究的目的是评估一种全内内窥镜半自动跑步锁缝线（Endo-SARLS）技术。
方法：于2020年至2021年采用全内Endo-SARLS技术治疗急性跟腱断裂40例。在内窥镜控制下,使用半自动柔性缝合器，以跑步锁定方法缝合近端肌腱桩。高强度缝合线的线通过邻子子空间抓住，然后用无结锚钉固定到跟骨插入中。磁共振成像(MRI),评估手术时间和并发症。跟腱总断裂评分(ATRS),采用跟腱静息角（ATRA）和脚跟上升高度量表（HRHS）评估最终结果。
结果：平均随访时间为25.4±0.4（范围：24-32）个月。12个月后在MRI上观察到适当的肌腱再生。在最后的后续行动中，ATRS评分的中位值为95(四分位距:94,98).此外，平均ATRA在受伤侧和对侧之间没有显着差异（18.2±1.8vs.18.3±1.9°,ns）和HRHS的中值[14.5（13.3，15.5）与14.8(13.5,15.6)cm,.没有感染和神经损伤。39名患者报告说，他们在6个月后恢复了休闲体育活动。一个病人有一个轻微的锚切口，由于额外的伤害，5个月后被删除。
结论：全内Endo-SARLS技术对急性跟腱断裂显示了有希望的临床结果。此过程降低了腓肠神经损伤的风险，同时在肌腱残端之间建立了可靠的连接。
方法：四级。
方法：于2020年至2021年采用全内Endo-SARLS技术治疗急性跟腱断裂40例。在内窥镜控制下,使用半自动柔性缝合器，以跑步锁定方法缝合近端肌腱桩。高强度缝合线的线通过邻子子空间抓住，然后用无结锚钉固定到跟骨插入中。磁共振成像(MRI),评估手术时间和并发症。跟腱总断裂评分(ATRS),采用跟腱静息角（ATRA）和脚跟上升高度量表（HRHS）评估最终结果。
结果：平均随访时间为25.4±0.4（范围：24-32）个月。12个月后在MRI上观察到适当的肌腱再生。在最后的后续行动中，ATRS评分的中位值为95(四分位距:94,98).此外，平均ATRA在受伤侧和对侧之间没有显着差异（18.2±1.8vs.18.3±1.9°,ns）和HRHS的中值[14.5（13.3，15.5）与14.8(13.5,15.6)cm,.没有感染和神经损伤。39名患者报告说，他们在6个月后恢复了休闲体育活动。一个病人有一个轻微的锚切口，由于额外的伤害，5个月后被删除。
结论：全内Endo-SARLS技术对急性跟腱断裂显示了有希望的临床结果。此过程降低了腓肠神经损伤的风险，同时在肌腱残端之间建立了可靠的连接。
方法：四级。
