Dual-Incision Achilles Tendon Repair Using Krackow Sutures With Over-the-Top Knot Placement for Early…

Cohort studyFoot & ankle orthopaedics· Jul 2026

Dual-Incision Achilles Tendon Repair Using Krackow Sutures With Over-the-Top Knot Placement for Early Rehabilitation Without Immobilization: A Retrospective Case Series.

Kaho Yasuda, Akifumi Fujita, Gantaro Minami, Hiromitsu Moriuchi

Foot & AnkleCohort studyTreatmentQ2IF 1.6

Early mobilization without immobilization after Achilles repair had no reruptures.

Dual-Incision Achilles Tendon Repair Using Krackow Sutures With Over-the-Top Knot Placement for Early Rehabilitation Without Immobilization: A Retrospective Case Series.

Kaho Yasuda … Hiromitsu Moriuchi

Foot & ankle orthopaedics · Jul 2026 · Q2 in Orthopedics

Background

Early functional rehabilitation after Achilles tendon repair has gained increasing attention; however, most protocols still incorporate postoperative immobilization.

Methods

This retrospective case series evaluated patients who underwent dual-incision Achilles tendon repair using a Krackow locking stitch with over-the-top knot placement.

n = 38 patients

Results

0/38

No tendon reruptures occurred among 38 patients treated without postoperative immobilization.

n = 38 patients

More results

The mean time from injury to surgery was 5.5 ± 3.6 days.

The median preinjury and postoperative Tegner Activity Scale scores were 7 and 6, respectively (range, 3-8).

Median time to step-to gait was 10 days, and median time to independent ambulation was 30 days.

More results

Postoperative complications occurred in 3 patients (7.9%), all of which were superficial surgical site infections.

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Conclusion · 1 of 2

Dual-incision Achilles tendon repair using a Krackow locking stitch with over-the-top knot placement was associated with early functional rehabilitation without routine postoperative immobilization in this case series.

Conclusion · 2 of 2

Preservation of the paratenon and relocation of the knot away from the repair interface may confer biological and mechanical advantages. LEVEL OF EVIDENCE: Level IV, retrospective case series.

Dual-Incision Achilles Tendon Repair Using Krackow Sutures With Over-the-Top Knot Placement for Early Rehabilitation Without Immobilization: A Retrospective Case Series.

Dual-Incision Achilles Tendon Repair Using Krackow Sutures With Over-the-Top Knot Placement for Early Rehabilitation Without Immobilization: A Retrospective Case Series.

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