Less Invasive Reconstruction of Chronic Achilles Tendon Rupture with free Semitendinosus Tendon Autograft - A case Series

Background: The purpose of this retrospective study was to clarify the operative outcomes of the side-locking loop suture (SLLS) technique accompanied by autologous semitendinosus tendon grafting for chronic Achilles tendon rupture. Methods: A chart review was conducted of consecutive patients treated with the SLLS technique at our department from 2012 to 2017. Postoperatively, a below-knee splint was applied for 2 weeks in 20 degrees of plantar flexion and then active range of motion exercise was started. Partial weightbearing exercise was allowed at 4 weeks according to patient tolerance, and full weightbearing without crutches was allowed at 8 weeks. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale score and the Achilles tendon rupture score (ATRS) were used to evaluate clinical outcomes preoperatively and at the final follow-up. Results: Ten patients (6 men, 4 women) were included in the analysis. Mean AOFAS ankle-hindfoot scale score increased significantly from 64.2 ± 5.6 points preoperatively to 95.0 ± 5.3 points at the final follow-up ( P < .001). The mean ATRS also increased significantly from 29.8 ± 4.4 points to 86.2 ± 7.7 points, respectively ( P < .001). Mean time between surgery and ability to perform 20 continuous double-leg heel raises of the operated foot was 13.5 ± 3.4 (range 10-18) weeks. One patient complained of postoperative hypoesthesia in the foot, which had spontaneously resolved by 3 months after surgery. Conclusion: The SLLS technique accompanied by autologous semitendinosus tendon grafting provided successful operative outcomes for patients with chronic Achilles tendon rupture regardless of the size of the defect, and thus long-term orthotic use was not needed after surgery. Level of Evidence: Level IV, retrospective case series.

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Augmented Repair of Acute Total Achilles Tendon Rupture With Peroneus Brevis Tendon Transfer Using Oblique Transosseous Calcaneal Tunnel: A Prospective Case Series

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2021.03.014 ◽

2021 ◽

Author(s):

Osama Gamal ◽

Ahmed Shams ◽

Mohamed Kamal Mesregah

Keyword(s):

Achilles Tendon ◽

Tendon Transfer ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Case Series ◽

Peroneus Brevis ◽

Prospective Case Series

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Achilles tendon repair by a minimally invasive technique using Tenolig®

Journal of the Foot & Ankle ◽

10.30795/jfootankle.2020.v14.1194 ◽

2020 ◽

Vol 14 (3) ◽

pp. 269-273

Author(s):

Vinicius Oliveira ◽

Sérgio Prata

Keyword(s):

Minimally Invasive ◽

Achilles Tendon ◽

Postoperative Infection ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Case Series ◽

Minimally Invasive Technique ◽

Invasive Technique ◽

Aofas Score ◽

Functional Scores

Objective: To assess the degree of postoperative satisfaction of patients with acute Achilles tendon rupture who underwent surgical reconstruction by a minimally invasive technique using Tenolig®. Methods: A retrospective observational study was conducted with 18 patients with acute Achilles tendon rupture diagnosed by a positive Thompson test who underwent surgery. Outcomes were assessed using the American arthopaedic Foot and Ankle Society (AOFAS) score and the Foot Function Index (FFI). Furthermore, quantitative variables were descriptively treated, and patients’ age was correlated with FII and AOFAS score using Spearman’s correlation coefficient at a significance level of 5%. Results: Patients underwent surgery from one to six days after injury and were discharged one day later. Only one patient had a superficial postoperative infection. Patients’ AOFAS scores ranged from 75 to 100 points, and FFI ranged from 0 to 20%. The patient withsuperficial postoperative infection had an AOFAS score and a FFI of 75 points and 20%, respectively. Conclusion: Percutaneous repair of complete Achilles tendon rupture with Tenolig® resulted in high functional scores and a low rate of complications. Level of Evidence IV; Therapeutic Studies; Case Series.

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Pediatric Achilles Tendon Rupture: A 10 Year Retrospective Case Series

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000761392.62287.26 ◽

2021 ◽

Vol 53 (8S) ◽

pp. 200-200

Author(s):

Daniel Chen ◽

Matthew Beran ◽

Molly Duncan ◽

Julie Young ◽

James MacDonald

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Case Series ◽

Retrospective Case ◽

Retrospective Case Series

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Achilles Tendon Rupture Repairs: A Case Series Reporting Clinical Outcomes of a Novel Technique

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00492 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0049

Author(s):

Caroline Williams ◽

Christopher P. Miller ◽

John Y. Kwon

Keyword(s):

Achilles Tendon ◽

Clinical Outcomes ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Case Series ◽

Patient Positioning ◽

Measurement Information ◽

Repair Technique ◽

Patient Reported ◽

Mini Open

Category: Trauma; Ankle; Sports Introduction/Purpose: Achilles tendon rupture repair has undergone several changes in the last ten years, aiming to minimize complications while maximizing clinical and functional outcomes. Selecting a less invasive approach instead of traditional open incision has shown through various studies to generate excellent results and significantly reduce post-operative infections. Choice of patient positioning during operative repair has also shown to be of great impact, with prone positioning being associated with elevated surgical times and anesthetic requirements, thus secondary affecting clinical outcomes. Other complications associated with prone positioning include neuropraxia and increased risk of iatrogenic ophthalmologic insults as compared to the supine position. This case report evaluates clinical outcomes of patients following treatment of Achilles rupture with a novel Medial Mini- Open Supine Achilles Repair Technique. Methods: Patients were selected for case series inclusion after undergoing novel Medial Mini-Open Supine Achilles Repair Technique for acute achilles rupture. Retrospective medical record review for demographic, perioperative and functional data was completed for each patient, with means, range and standard deviations calculated when appropriate. Patients were then followed postoperatively to monitor recovery. At a final follow up visit scheduled no sooner than six months post operatively, outcomes were assessed with three separate Patient-Reported Outcomes Measurement Information System (PROMIS) surveys; Physical Function, Pain Interference and Depression. Two separate Foot and Ankle Ability Measure (FAAM) assessments, ADLs and Sport, were also completed. Patients were also assessed for physical pain/discomfort using the Visual Analog Scale (VAS). Results: Eighteen patients were included in this study; fifteen male, three female. Mean age was 37.5 years (+-12, range= 20-68). Mean duration of surgery was 31.0 minutes (+- 7.0). Follow up duration averaged 11.8 months (range 6.0-13.5). All patients completed three Patient-Reported Outcomes Measurement Information System (PROMIS) studies and two Foot and Ankle Ability Measure (FAAM) surveys. Mean score for the PROMIS Physical Function survey was 52.3 (+-11.5), for Pain Interference, mean= 50.0 (+-7.30), and for Depression, mean=39.5 (+- 6.96). FAAM Sport survey showed a mean=71.3 (+-29.4), with ADLs form responses showing a mean of 90.7 (+-12.7). All patients reported 0/10 pain on Visual Analog Scale (VAS), and overall satisfaction with their outcomes. Conclusion: In reviewing data collected thus far, the Medial Mini-Open Supine Achilles Repair technique shows promise to serve as a viable option for achilles tendon rupture repair; ease of patient positioning preoperatively translates to decreased set up, operative, and sedation time, directly benefiting patients. No complications have been reported at this time; patients have demonstrated excellent outcomes in physical exam in postoperative clinic visits. All patients have expressed satisfaction with their results at final visit.

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Endoscopic Flexor Hallucis Longus Tendon Transfer for Reconstruction of the Achilles Tendon Rupture in High-Risk Patients: A Case Series

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2019.04.014 ◽

2019 ◽

Vol 58 (6) ◽

pp. 1257-1261

Author(s):

Jake I. Lee

Keyword(s):

High Risk ◽

Achilles Tendon ◽

Tendon Transfer ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Case Series ◽

Flexor Hallucis Longus ◽

Longus Tendon ◽

High Risk Patients ◽

Risk Patients

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Acute Achilles Tendon Rupture Treated by Double Side-Locking Loop Suture Technique With Early Rehabilitation

Foot & Ankle International ◽

10.1177/1071100716673589 ◽

2016 ◽

Vol 38 (2) ◽

pp. 167-173 ◽

Cited By ~ 3

Author(s):

Wataru Miyamoto ◽

Shinji Imade ◽

Ken Innami ◽

Hirotaka Kawano ◽

Masato Takao

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Plantar Flexion ◽

Weight Bearing ◽

Achilles Tendon Rupture ◽

Case Series ◽

Full Weight Bearing ◽

Aofas Score ◽

Accelerated Rehabilitation ◽

Athletic Activities

Background: Although early accelerated rehabilitation is recommended for the treatment of acute Achilles tendon rupture, most traditional rehabilitation techniques require some type of brace. Methods: We retrospectively analyzed 44 feet of 44 patients (25 male and 19 female) with a mean age of 31.8 years who had an acute Achilles tendon rupture related to athletic activity. Patients had been treated by a double side-locking loop suture (SLLS) technique using double antislip knots between stumps and had undergone early accelerated rehabilitation, including active and passive range of motion exercises on the day following the operation and full weight-bearing at 4 weeks. No brace was applied postoperatively. The evaluation criteria included the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Scale (AOFAS) score; active plantar flexion and dorsiflexion angles; and the intervals between surgery and the time when patients could walk normally without any support, perform double-leg heel raises, and perform 20 continuous single-leg heel raises of the operated foot. Results: Despite postoperative early accelerated rehabilitation, the AOFAS score and active dorsiflexion angles improved over time (6, 12, and 24 weeks and 2 years). A mean of 4.3 ± 0.6 weeks was required for patients to be able to walk normally without any support. The mean period to perform double-leg heel raises and 20 continuous single-leg heel raises of the injured foot was 8.0 ± 1.3 weeks and 10.9 ± 2.1 weeks, respectively. All patients, except one who was engaged in classical ballet, could return to their preinjury level of athletic activities, and the interval between operation and return to athletic activities was 17.1 ± 3.7 weeks. Conclusion: The double SLLS technique with double antislip knots between stumps adjusted the tension of the sutured Achilles tendon at the ideal ankle position and provided good clinical outcomes following accelerated rehabilitation after surgery without the use of a brace. Level of Evidence: Level IV, retrospective case series.

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Risk Factors for Failed Nonoperative Treatment and Rerupture in Acute Achilles Tendon Rupture

Foot & Ankle International ◽

10.1177/1071100717754042 ◽

2018 ◽

Vol 39 (6) ◽

pp. 694-703 ◽

Cited By ~ 7

Author(s):

Aleksi Reito ◽

Hanna-Liina Logren ◽

Katri Ahonen ◽

Heikki Nurmi ◽

Juha Paloneva

Keyword(s):

Risk Factors ◽

Achilles Tendon ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Case Series ◽

Nonoperative Treatment ◽

Activity Level ◽

Factors Associated ◽

Increased Risk ◽

Male Patients

Background: Nonoperative treatment is feasible in most patients with acute Achilles tendon rupture. Risk factors associated with failed nonoperative treatment are poorly understood. We investigated risk factors associated with rerupture after nonoperative treatment and otherwise failed nonoperative treatment of Achilles tendon rupture. Methods: All patients diagnosed with acute Achilles tendon rupture between January 2009 and June 2016 and who underwent 8 weeks of nonoperative treatment with functional rehabilitation were included in the study. Patients with rerupture or otherwise failed nonoperative treatment were identified retrospectively. Time to rerupture and association of age, sex, time from injury, diabetes, and visits to the physiotherapist for cases of reruptures and otherwise failed nonoperative treatment were investigated. A total of 210 patients were included in the study. Results: Fifteen patients sustained a rerupture. Rerupture incidence was 7.1%. Incidence of late reruptures, those occurring after return to daily activities at 12 weeks, was 1.9%. Six patients had otherwise failed nonoperative treatment. Median time to rerupture was 23 days (6 to 61) after the end of the treatment. The incidence of all-cause failure was 10.0%. Male gender was associated with reruptures ( P = .013) and failed nonoperative treatment for any reason ( P = .029). Conclusion: It is important to highlight the increased risk of rerupture in male patients during the first month after the end of the nonoperative treatment. Age alone, even in male patients, was a poor indication for operative treatment since it did not predict early failure. Further studies will hopefully clarify the influence of activity level on the risk of rerupture. Level of Evidence: Level IV, retrospective case series.

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