Abstract  The surgical benefit of minimally invasive tendo Achilles repair (n = 25) with early weight-bearing mobilisation after rupture of the tendo Achilles was compared with operative treatment using an open technique (n = 34) with full weight-bearing after 8 weeks of surgical repair. The minimally invasive technique provided no evidence of wound problems and a functional benefit from early weight-bearing mobilisation. However, we noted that increased post-operative morbidity in terms of wound infection (n = 7) leading to delayed wound healing and wound pain requiring opiate-based analgesia post-operatively in the open repair group may have an additional impact on the patients and health care providers. This study showed that the mini-invasive open surgical repair of the Achilles tendon with the Achillon™ instrument and early weight-bearing mobilisation in an orthosis for the accelerated rehabilitation may offer cost-effectiveness and less financial burden on the health care provider in terms of associated nursing and physiotherapy costs. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00264-008-0564-5Authors Mayukh Bhattacharyya, University Hospital Lewisham Department of Orthopaedics Lewisham High Street London SE13 6LH UKBruno Gerber, University Hospital Lewisham Department of Orthopaedics Lewisham High Street London SE13 6LH UK Journal International OrthopaedicsOnline ISSN 1432-5195Print ISSN 0341-2695 (Source: International Orthopaedics)