Purpose: To compare the clinical outcomes and complications of mini-open (MOT) and percutaneous techniques (PT) in the surgical repair of acute Achilles tendon rupture (AATR). Methods: We systematically searched PubMed, Scopus, Web of Science, Clinical Trials, and the Cochrane Library for studies comparing MOT with PT for AATR. We assessed functional outcomes, complication rates, and operation time. Statistical analyses were performed using RevMan Web. Odds ratios (ORs) and mean difference (MD) with 95% confidence intervals (CIs) were pooled with a fixed-effects model for dichotomous and continuous endpoints, respectively. Heterogeneity was evaluated with I² statistics. Results: Eight studies, comprising 484 patients, were included, of whom 226 (46%) underwent MOT. MOT was associated with a significantly lower re-rupture rate (1.48% vs. 6.11%; OR 0.28; 95% CI 0.09–0.86; p = 0.03; I² = 6%) and sural nerve injury rate (0.57% vs. 5.64%; OR 0.24; 95% CI 0.07–0.81; p = 0.02; I² = 0%). No significant differences were observed in venous thrombosis (OR 0.81; 95% CI 0.17–3.94; p = 0.33; I² = 0%), wound infection (OR 0.56; 95% CI 0.12–2.62; p = 0.46; I² = 0%), or operation time (MD 1.83 min; 95% CI -1.13–4.79; p = 0.23; I² = 88%). Functional outcomes showed higher American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores in the MOT group (MD 1.52 points; 95% CI 0.62–2.42; p = 0.001; I² = 3%), while (Achilles Tendon Total Rupture Score) ATRS, time to return to activities, and ankle plantar and dorsiflexion were comparable. Conclusions: MOT for AATR repair seems to reduce re-ruptures and sural nerve injuries while improving AOFAS scores, with no significant differences in other complications compared to PT. These findings suggest that the MOT may offer a safer and equally effective alternative to PT for AATR.

Atrial fibrillation (AF) and left ventricular dysfunction (LVD) are common conditions that often coexist, with about 25% of patients in NYHA classes I-II having AF. Efficacy and safety of surgical ablation (SA) in this population remains unclear. We aimed to perform a single-arm meta-analysis to assess the outcomes of standalone and concomitant SA in adult patients with AF and LVD. We searched PubMed, Scopus and the Cochrane Library. Endpoints of interest were maintenance of sinus rhythm, freedom from anti-arrhythmic drug (AAD) use, change in LVEF, 30-day mortality, 1 year mortality and major procedural complications. We calculated pooled proportions or means for binary and continuous endpoints, respectively, with a 95 % confidence interval (CI). Ten observational studies comprising 863 patients (mean follow-up of 19 months) were included. At 1 year, SA resulted in a sinus rhythm rate of 83.9 % (95 % CI: 69.5–92.3); freedom from AAD use of 81.6 % (95 % CI: 64.7–91.7); and mortality of 5.77 (95 % CI:3.7–8.9). 30-day mortality was 2.16 % (95 % CI: 0.9–4.9); major complications 16.73 % (95 % CI: 12–23); and an improvement in LVEF of 12 % (95 % CI: 9–17). This meta-analysis found that SA appears to be an effective strategy to achieve sinus rhythm in patients with AF and LVD, with a pooled 30-day mortality of 2.2%. Comparative studies are warranted to evaluate the relative safety and efficacy of SA compared with other rhythm control strategies in this population.