Early Structural Healing and 12-Month Clinical Outcomes of Atelocollagen Patch Augmentation for Achilles Tendon Repair: A Prospective Cohort Comparison.

BACKGROUND

Achilles tendon rupture (ATR) is a common injury, yet achieving optimal biological healing remains a challenge despite various surgical techniques. This study aimed to investigate the effect of atelocollagen patch augmentation on ATR repair. We hypothesized that atelocollagen patch augmentation would show superior structural and clinical outcomes compared with the standard repair group.

METHODS

In this prospective cohort comparison, 17 patients were enrolled to undergo Achilles tendon repair with atelocollagen patch augmentation, while 18 patients receiving standard open ATR repair served as the control group. A comparison of outcomes between the 2 groups was performed. Outcomes were assessed at 1, 3, 6, and 12 months postoperatively via ultrasonography and clinical measures, including the Achilles Tendon Total Rupture Score (ATRS), visual analog scale (VAS) for pain, and isokinetic muscle strength. Ultrasonographic evaluation focused on the cross-sectional area (CSA) and intratendinous morphology of the repaired tendon.

RESULTS

Ultrasonographic evaluation revealed that the atelocollagen patch group had a significantly higher CSA ratio at 1 and 3 months postoperatively (p = 0.026 and p = 0.043, respectively), though this difference was not significant at 6 and 12 months. Morphology scores were also higher in the patch group at 3 and 6 months (p = 0.009 and p = 0.027, respectively). Clinical outcomes, including ATRS, VAS pain scores, and isokinetic muscle strength, showed no significant differences between groups at all follow-up points. No complications, such as rerupture, infection, or allergic reactions, were observed in either group.

CONCLUSIONS

Atelocollagen patch augmentation provides early structural benefits in tendon healing after ATR repair; however, these benefits did not translate into superior clinical functional outcomes within the 12-month follow-up period. Further large-scale studies are warranted to confirm the long-term clinical efficacy and safety of this technique.