Minimal invasive operative treatment: better or worse?

Achilles tendon ruptures provoke debate amoungst orthopaedic surgeons as to whether they should be treated operatively or conservatively. In the athlete surgical treatment is advocated. Complications of surgery include post-operative infection and wound problems such as scar pain, tethering, wound dehiscence and necrosis. Minimally invasive (MI) procedures appear to reduce these complications but there has been concern that clinical results may be inferior to those with standard open operations. This presentation summarises the literature which appears to show similar clinical results using MI techniques but reduced incidence of complications. The level of evidence supporting this conclusion and the grade of recommendation is explained.