Complications After Tendon Transfers in the Foot and Ankle Using Bioabsorbable Screws

Abstract

Based on these early results, PLLA implants appear safe and effective for tendon transfers of the foot and ankle. However, until long-term outcomes are available, judicious use of these implants is recommended.

Graft osteolysis and recurrent instability after the Latarjet procedure performed with bioabsorbable screw fixation

“…Compared with PLLA, the reported degradation time varies from 3 to 7 years, 7,19 and progressive osteolysis up to 61% of the radius bone section has been reported after distal biceps repair. 42 However, pins made of PLLA and poly-D,L-lactic acid were used satisfactorily for forefoot osteotomy fixation with a complication rate of 0.7% 36 as well as for tendon transfer around the foot by Clanton et al, 14 even though they did not assess the resorption status of the screws or report on any osteolysis.…”

Flexor Hallucis Longus Tendon Transfer Fixation

“…Controversy remains in identifying the best method to achieve FHL tendon transfer for Achilles tendinopathy. Clinical studies almost universally report favorable outcomes [2][3][4][5][6][7][8][9][10][11][12][13][14][15]25,26 ; however, fixation techniques vary widely. No studies comparing clinical outcomes or commenting on complications between methods of fixation have been published.…”

“…[4][5][6][7][8][9][10][11][12][13] Several studies have identified intrinsic properties favoring transfer of the FHL above other tendons, 14 including axis of contractile force, 15 greater plantarflexion power 16,17 second only to the gastrocsoleus complex with which it fires in phase, 9,18 and proximity to blood supply. 15 Methods of fixation include interference tendon to bone tenodesis with either bioabsorbable 2,4,[18][19][20][21][22][23] or permanent screws, 24 anchor fixation, 25 bone tunnels with tendon-to-tendon tenodesis, and the use of buttons to attach FHL to the AT. 21 Many orthopaedists favor interference fixation with a poly-l-lactide biocomposite screw (PLLA) largely because of decreased donor site morbidity 3,4 and less tendon length needed 2 as compared with loop tenodesis through bone tunnels, either to itself 20 or incorporated into the AT.…”

Tendon Transfers in Foot Drop

“…The reported complications following tendon transfers of the foot and ankle include persistent deformity, pain and rigidity, wound infections and abscesses, tarsal tunnel syndrome, sural nerve injuries, and other causes of paresthesias, and neuropathic pain. 37 Postoperative surgical site infections are rare. Adhesions giving rise to reduced range of movements are noticed especially in interosseous route transfers which can be avoided if the window in the interosseous membrane is large enough.…”