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The hypothesis was that the minimally invasive technique can reduce wound complications and facilitate early recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 29\u00a0men with chronic Achilles tendon rupture who underwent either minimally invasive technique (<jats:italic>n<\/jats:italic>\u2009=\u200913) or open repair (<jats:italic>n<\/jats:italic>\u2009=\u200916) at our department between 2013 and 2019 were retrospectively analyzed. The rate of complications, time to return to moderate\u2010intensity exercise, American Orthopedic Foot and Ankle Society ankle hindfoot score, Achilles tendon Total Rupture Score, heel\u2010rise repetitions in 1\u00a0min, heel\u2010rise height, and bilateral calf circumference at 6\u00a0months, 1 year, and 2 years postoperatively were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All incisions healed primarily in the minimally invasive technique group; however, three patients in the open repair group experienced wound complications. The time to return to moderate\u2010intensity exercise, American Orthopedic Foot and Ankle Society score, Achilles tendon Total Rupture Score, heel\u2010rise repetition ratio, and heel\u2010rise height ratio at 6\u00a0months postoperatively in the minimally invasive technique group were significantly better than those in the open repair group. However, it was not significantly different between both groups at 2 years postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Endoscopy allowed scar tissue and adhesions to be removed, allowing the tendon ends to be mobilized out of the small proximal and distal incisions. Minimally invasive technique may result in a lower wound complication incidence and provide better early functional recovery and return to moderate\u2010intensity exercise time than the conventional open procedure in treating chronic Achilles tendon ruptures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p>Wuxi Ninth People\u2019s Hospital Medical Ethical Committee, LW2021026.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07167-0","type":"journal-article","created":{"date-parts":[[2022,10,15]],"date-time":"2022-10-15T02:04:49Z","timestamp":1665799489000},"page":"86-93","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Endoscopic\u2010assisted locking block modified Krackow technique combined with a V\u2010Y flap for chronic Achilles tendon 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