Good outcomes at mid-term following the reconstruction of chronic Achilles tendon rupture with semitendinosus allograft

Song, Yujie; Chen, Gang; Jia, Shao-Hua; Xu, Wei; Hua, Yinghui

doi:10.1007/s00167-018-5113-1

Cited by 18 publications

(25 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…Semitendinosus tendon graft is routinely used in knee surgery for ligament reconstructions and it has also been shown to have good outcomes when used to treat chronic ATR [ 22 , 35 , 40 ]. Most of these studies have involved open reconstructions performed through a large single incision, with potential wound healing complications as reported for repairs of acute ruptures [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Nilsson

Gunnarsson

Carmont

et al. 2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose Achilles tendon ruptures are termed chronic after a delay in treatment for more than 4 weeks. The literature advocates surgical treatment with reconstruction to regain ankle push-off strength. The preferred technique is, however, still unknown and is often individualized. This study aims to present the technique and clinical outcome of an endoscopically assisted free semitendinosus reconstruction of chronic Achilles tendon rupture and Achilles tendon re-ruptures with delayed representation. It is hypothesized that the presented technique is a viable and safe alternative for distal Achilles tendon ruptures and ruptures with large tendon gaps. Method Twenty-two patients (13 males and 9 females) with a median (range) age of 64 (34–73) treated surgically with endoscopically assisted Achilles tendon reconstruction using a semitendinosus autograft were included. The patients were evaluated at 12 months post-operatively for Achilles tendon Total Rupture Score (ATRS), calf circumference, Achilles Tendon Resting Angle (ATRA), heel-rise height and repetitions together with tendon length determined by ultrasonography, concentric heel-rise power and heel-rise work. Results The patients reported a median (range) ATRS of 76 (45–99) out of 100. The median (range) ATRA on the injured side was 60° (49°-75°) compared with 49.5° (40–61°), p < 0.001, on the non-injured side. Eighteen out of 22 patients were able to perform a single-leg heel-rise on the non-injured side. Sixteen patients out of those 18 (89%) were also able to perform a single heel-rise on the injured side. They did, however, perform significantly lower number of repetitions compared with the non-injured side with a median (range) heel-rise repetitions of 11 (2–22) compared with 26 (2–27), (p < 0.001), and a median (range) heel-rise height of 5.5 cm (1.0–11.0 cm) compared with 9.0 cm (5.0–11.5 cm), (p < 0.001). The median calf circumference was 1.5 cm smaller on the injured side, 37.5 cm compared with 39 cm, when medians were compared. The median (range) tendon length of the injured side was 24.8 cm (20–28.2 cm) compared with 22 cm (18.4–24.2 cm), (p < 0.001), on the non-injured side. Conclusion The study shows that endoscopically assisted reconstruction using a semitendinosus graft to treat chronic Achilles tendon ruptures and re-ruptures with delayed representation produces a satisfactory outcome. The technique can restore heel-rise height in patients with more distal ruptures or large tendon defects and is therefore a viable technique for Achilles tendon reconstruction. Level of evidence IV.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Nilsson

Gunnarsson

Carmont

et al. 2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

“…Moreover, it has been proven that better repair effects through external implementation of growth factor and/or stem cell therapy (during the tendon healing) can be achieved [ 22 ]. Several authors presented restoration of full function of the operated Achilles tendon and the overall patient satisfaction when using semitendinosus tendon grafts [ 18 , 23 , 24 , 25 ] or gracilis tendon grafts [ 26 , 27 ]. However, to our knowledge, this is the first study which presents a detailed, versatile clinical, functional and isokinetic assessment of patients after Achilles tendon reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…However, to our knowledge, this is the first study which presents a detailed, versatile clinical, functional and isokinetic assessment of patients after Achilles tendon reconstruction. Multiple assessments, which described the outcomes of the Achilles reconstruction were based on two most popular subjective, patient-reported scales: Achilles tendon Total Rupture Score (ATRS) and American Orthopedic Foot and Ankle Society Score (AOFAS), combined with isokinetic tests or functional tests [ 15 , 16 , 17 , 18 , 19 , 22 , 23 , 24 , 25 , 26 , 27 ]. However, in these studies, a clear contradiction was observed between the subjective and the objective outcomes, which, in our opinion, might be the result of an insufficient number of the Achilles tendon parameters tested.…”

Section: Discussionmentioning

confidence: 99%

A Comprehensive Evaluation of Minimally Invasive Achilles Tendon Reconstruction with Hamstring Graft Indicates Satisfactory Long-Term Outcomes

et al. 2022

View full text Add to dashboard Cite

Background and objectives: The Achilles tendon, the largest tendon in the body, is vulnerable to injury because of its limited blood supply and the combination of forces to which it is subjected. Given the relevance of the Achilles tendon in the proper function of the foot and ankle, the primary goal of the present study was to use a holistic approach for a comprehensive evaluation of Achilles tendon reconstruction results on multiple levels. Materials and Methods: The study was designed in the following way: 30 patients with partial or total Achilles tendon tears were subjected to the minimally invasive Achilles tendon reconstruction. Patients were then subjected to the clinical, functional and isokinetic tests 12 and 24 months after the treatment. The clinical evaluation included calf circumference measurements and subjective patient-reported tests: ATRS, EQ-5D-5L and VAS scales. The functional evaluation was based on three tests: the weight-bearing lunge test, the heel rise test and single leg hop. Isometric and isokinetic evaluation was performed using a Biodex 3 dynamometer. Results: The calf circumference of the operated limbs was significantly lower than the non-operated limb 12 months after the surgical procedure, however this improved at the second evaluation. All subjective outcomes improved significantly 24 months after the surgery. Significantly better results in the function of the operated limbs were also obtained 24 months after the surgery. However, most of the muscle strength parameters of the operated limbs were already comparable to non-operated ones 12 months after the surgery and were comparable between two evaluation times. The overall results of this extensive evaluation are highly satisfactory and patients returned to their normal physical activity. From a medical point of view, it is assumed that the healing process is completed 12 months after the surgery, however, importantly, our results indicate that we should consider the healing process and the rehabilitation process separately.

show abstract

“…5,37 However, it has frequently been adapted as a research tool in injuries of other joints, including injuries of the Achilles tendon. 9,16,21,24,25,28,[33][34][35] Although the validity of the Tegner scale for use in patients with Achilles injuries rather than ligamentous knee injuries is less clearly defined, the tool has precedent in the literature and was the best tool available commonly used for quantifying sport and activity levels in lower extremity sports injuries. The study's retrospective design required patient recall of their preinjury Tegner activity level.…”

Section: Discussionmentioning

confidence: 99%

Association of Strength Following Achilles Tendon Repair With Return to Same Level of Play in High-Level Athletes

et al. 2020

View full text Add to dashboard Cite

Background: Rupture of the Achilles tendon is a common injury and the ability to return to the same level of sporting activity after treatment is an important outcome for patients. The objective of the current study was to examine the relationship between ankle strength and the ability to return to previous level of play following operative repair of an Achilles tendon rupture. Methods: Patients aged 18 to 50 years at a minimum 1 year postoperation from surgical repair of an Achilles tendon returned for a study visit. Patients reported both preinjury and current activity level using the 10-point Tegner Activity Level Scale. Isokinetic strength testing was performed and the Isokinetic Strength Score (ISS) was calculated. Logistic regression analysis was used to determine the relationship between ISS and return to play by Tegner level. A total of 36 patients (mean 35 years old, 72% male) completed the study protocol at a mean 1.8 years postoperatively. Results: Logistic regression revealed no association between ISS and return to play in the complete cohort. Subgroup analysis revealed that for 20 high-level athletes (preinjury Tegner ≥ 7), for every 16-point increase in ISS, the odds ratio (OR) for return to same level of play was 8.3 ( P = .055) and the OR for return to within 1 Tegner level of play was 6.3 ( P = .043). There was no association between ISS and return to previous activity in the 16 patients with lower preinjury levels of activity. Conclusion: Improved ankle strength was associated with return to previous level of activity in patients participating in high-level athletic activity, suggesting that these patients were more dependent on recovery of ankle strength in the postoperative time period in order to return to their previous high level of play. In contrast, regaining strength may be less important for returning to normal activities for less active patients. Level of Evidence: Level III, comparative series.

show abstract

Good outcomes at mid-term following the reconstruction of chronic Achilles tendon rupture with semitendinosus allograft

Abstract: Case series, Level IV.

Cited by 18 publications

References 29 publications

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

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

A Comprehensive Evaluation of Minimally Invasive Achilles Tendon Reconstruction with Hamstring Graft Indicates Satisfactory Long-Term Outcomes

Association of Strength Following Achilles Tendon Repair With Return to Same Level of Play in High-Level Athletes

Contact Info

Product

Resources

About