Achilles Tendon Rupture Repair Using Knotless Unidirectional Absorbable Barbed PDS Suture A Prospective Case Series of Five Patients

Abstract

This was a case series of five patients with closed Achilles tendon rupture between 2023 and 2024, with a mean follow-up of six months. The objective was to evaluate the applicability of knotless absorbable barbed sutures in the management of Achilles tendon rupture through short- to mid-term clinical and functional outcomes. All patients underwent open end-to-end tendon repair using the modified Bunnell technique with a total of six cores, with a size 1 knotless, unidirectional, absorbable barbed PDS suture, via the posteromedial approach. Surgeries were performed by multiple surgeons at Jose R. Reyes Memorial Medical Center, a tertiary hospital. Post-operative American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score and 36-Item Short Form Health Survey (SF-36) score were monitored. All five patients were satisfied, did not have wound complications or re-operations, and had negative Thompson and Matles tests with no limitation in ankle range of motion at six months. AOFAS score showed a mean difference of 62 at six months post-operative, indicating better foot and ankle function, reduced pain, and improved overall mobility. The SF-36 score showed a mean difference of 46, indicating better overall health-related quality of life, reflecting improvements in physical functioning, mental health, social functioning, and overall well-being. Knotless, unidirectional, absorbable barbed PDS suture using the modified Bunnell stitch is a novel and reproducible treatment option for closed Achilles tendon ruptures, providing good clinical and functional outcomes.