Clinical Outcomes and Return to Sports in Patients with Chronic Achilles Tendon Rupture after Minimally Invasive Reconstruction with Semitendinosus Tendon Graft Transfer

Abstract

Objective The purpose of the study is to evaluate the clinical results and return to sports in patients undergoing reconstruction of the Achilles tendon after minimally invasive reconstruction with semitendinosus tendon graft transfer. Methods Eight patients underwent surgical reconstruction with a minimally invasive technique and tendon graft augmentation with ipsilateral semitendinosus tendon for chronic Achilles tendon rupture (more than 30 days after the injury and a gap of >6 cm). Patients were evaluated at a minimum follow-up of 24 months after the surgery through the American Orthopaedic Foot and Ankle Society (AOFAS), the Achilles Tendon Total Rupture Scores (ATRS), the Endurance test, the calf circumference of the operated limb, and the contralateral and the eventual return to sports activity performed before the trauma. Results The mean age at surgery was 50.5 years. Five men and three women underwent the surgery. The average AOFAS was 92, mean Endurance test was 28.1, and the average ATRS was 87. All patients returned to their daily activities, and six out of eight patients have returned to sports activities prior to the accident (two football players, three runners, one tennis player) at a mean of 7.0 (range: 6.7–7.2) months after the surgery. No patient reported complications or reruptures. Conclusion Our study confirms encouraging results for the treatment of Achilles tendon rupture with a minimally invasive technique with semitendinosus graft augmentation. The technique can be considered safe and allows patients to return to their sports activity. Level of Evidence Level IV, therapeutic case series.

Endoscopically assisted reconstruction of chronic Achilles tendon ruptures and re-ruptures using a semitendinosus autograft is a viable alternative to pre-existing techniques

“…Open and minimally invasive techniques using a semitendinosus graft, both allograft and autograft, have been described [ 14 , 22 , 25 , 36 , 40 , 43 ]. Those studies report ATRS scores between 86 and99.…”

Secondary Effects of the Rupture and Reconstruction of the Interosseous Talocalcaneal Ligament on the Peritalar Joints

“…This study provided an animal model for a reconstruction of the ITCL with an autograft of the semitendinosus. The semitendinosus is a regular autograft for tendon transplant [ 31 ]. One strand of it is similar to the ITCL in diameter and intensity according to the results of our study for ligamentous biomechanics [ 32 ].…”

Fear Avoidance Beliefs and Kinesiophobia Are Presented in Athletes who Suffer from Gastrocnemius Chronic Myofascial Pain

“…Future clinical trials should include kinesiophobia and fear avoidance beliefs as covariables to determine the clinical effectiveness of psychological or physical therapy treatments such as dry needling or ischemic compression in athletes suffering from gastrocnemius MPS [7,8]. In addition, the influence of fear of movement and fear avoidance beliefs should be considered in future studies about clinical outcomes or return to sports in athletes suffering from chronic gastrocnemius MPS and Achilles tendinopathies [7,55]. Finally, future studies should be carried out to determine foot orthoses' effectiveness in order to reduce kinesiophobia and fear avoidance beliefs in athletes with gastrocnemius MPS, as prior studies have shown a pain reduction in other musculoskeletal conditions such as low back pain [56], knee pain [57], forefoot pain [58], and rheumatoid arthritis [59].…”