Achilles tendon repair using a paratenon-preserving technique: A case report

Background: Traditional Achilles tendon repair often requires incision of the paratenon, which may compromise tendon nutrition and healing. This report describes a novel paratenon-preserving repair technique that aims to maintain the biological environment and support functional recovery. Case presentation: A 41-year-old male sustained a complete Achilles tendon rupture while playing soccer. Surgery was performed within 24 h of injury. Intraoperatively, the paratenon was found to be completely intact. A locked cruciate suture technique was employed through the paratenon to repair the tendon without opening of the paratenon. The patient demonstrated uneventful recovery and returned to full activity by 6 months. Follow-up MRI at 3 months following surgery confirmed successful tendon healing within the preserved paratenon. Conclusion: Preserving the paratenon during Achilles tendon repair may promote biological healing and improve functional outcomes. This technique is especially useful in acute ruptures with an intact tendon paratenon.