Complications of Supine Surgical Achilles Tendon Repair

Abstract

Background: Open Achilles tendon surgery with the patient in the supine position potentially avoids the complications of the prone position, but the safety and viability of the supine position for this procedure are not known. The aim of this study was to test the hypothesis that supine positioning for open repair of acute Achilles tendon ruptures would be safe, with low wound and neurologic complication rates. Methods: Supine position safety in acute Achilles tendon repair was investigated. Consecutive cases of supine Achilles tendon surgical repair performed by one surgeon from 2010 to 2015 were retrospectively reviewed. Patients were included if they were surgically treated with primary repair in the supine position within 15 days of injury and did not undergo concomitant surgery. A paramedian incision 1 cm medial to the Achilles sheath was used. Initial chart review identified 161 patients who underwent any type of Achilles tendon surgery in the supine position, of whom 45 patients met the inclusion criteria. This group included 39 men and 6 women with an average age of 41 years (range, 20–66 years). Median length of follow-up was 116 days (range, 25–1,589 days). Average body mass index was 29 kg/m2 (range, 23–36 kg/m2). Results: There were no infections, sural nerve injuries, or reruptures. Conclusions: The supine position was safe for primary open Achilles tendon repair, with no wound or neurologic complications. Level of Evidence: Level IV, case series.