Recurrent Achilles Tendon Rupture Following Open Surgical Repair, Treated Nonoperatively, and Enhanced With Biological Platelet-Rich Plasma (PRP) Therapy: A Case Report.

Abstract

Achilles tendon ruptures are common injuries, often occurring in active individuals, with surgical repair being a standard approach for complete ruptures. Cases of open re-rupture of the Achilles tendon represent a rare complication after open surgical repair of that tendon. Literature offers only one or two cases from every author without a consensus on how to deal with this pathology, so each patient should be treated according to the particularities of the case. This case report highlights the management and challenges associated with an open re-rupture of the Achilles tendon in a 35-year-old male patient following primary surgical repair. The patient, a smoker with a BMI of 28.6, initially presented with a complete mid-substance rupture sustained during recreational football. Surgical repair was performed using the Krackow suture technique, followed by structured postoperative rehabilitation. Despite favorable initial recovery, the patient experienced a traumatic open re-rupture of the tendon 14 weeks postoperatively during a sudden jumping motion. Emergency management involved wound closure and non-operative treatment of the incomplete re-rupture, including immobilization and gradual rehabilitation, enhanced with platelet-rich plasma (PRP) injected locally. The patient's subsequent recovery was favorable, allowing him to resume recreational sports six months post-treatment. This case underscores the importance of tailored rehabilitation combined with biological treatment (PRP) that enhances the healing process, the impact of modifiable risk factors, and the need for vigilance in post-repair activity to minimize re-rupture risk.