Outcomes of flexor digitorum longus (FDL) tendon transfer in the treatment of Achilles tendon disorders

Chinanuvathana, Apisan; Fonseca, Lucas Furtado da; Dein, Eric J.; Tan, Eric W.; Schon, Lew C.

doi:10.1016/j.fas.2017.12.003

Cited by 19 publications

(23 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, 4 of the studies reported a statistically significant improvement in pain, function, and activity level. 35,36,38,39 In van Sterkenburg et al, 38 the VAS pain scores decreased significantly following plantaris stripping and release, and VISA-A scores increased significantly postoperatively. In Costa et al, 39 results following tendon lengthening showed a long-term (7.5 years) reduction in VAS scores for sporting activity in 20 of the 21 procedures performed (P < .0005), which suggests excellent long-term reduction of Achilles pain after tendon lengthening.…”

Section: Other Surgical Treatment Methodsmentioning

confidence: 97%

Level of Evidence for the Treatment of Chronic Noninsertional Achilles Tendinopathy

Peters

Walsh

Day

et al. 2021

Foot & Ankle Specialist

View full text Add to dashboard Cite

Background Noninsertional Achilles tendinopathy affects both athletes and sedentary individuals, and its incidence is rising. Conservative management is the mainstay of treatment, but a variety of operative techniques have been described to treat recalcitrant cases. We seek to outline the current available evidence for surgical management of noninsertional Achilles tendinopathy. Study design and methods A systematic review was performed using the MEDLINE and EMBASE databases, and all articles were reviewed by at least 2 authors. Each article was assigned a level of evidence in accordance with the standards of Journal of Bone and Joint Surgery. The available data were reviewed and a level of evidence was assigned to each intervention of interest, based on the revised classifications of Wright. Results and conclusion A total of 46 articles met inclusion and exclusion criteria. There is fair evidence (grade B) in support of open debridement with 1 level II study, 1 level III study, and 8 level IV studies. There is fair evidence (grade B) in support of arthroscopic or minimally invasive surgical techniques. There is poor evidence (grade C) in support of flexor hallucis longus transfer, longitudinal tenotomy, peritenolysis, gastrocnemius recession, and plantaris excision. There is insufficient evidence (grade I) to provide a recommendation about other surgical treatment methods for noninsertional Achilles tendinopathy. Levels of Evidence: Level III: Systematic review

show abstract

Section: Other Surgical Treatment Methodsmentioning

confidence: 97%

Level of Evidence for the Treatment of Chronic Noninsertional Achilles Tendinopathy

Peters

Walsh

Day

et al. 2021

Foot & Ankle Specialist

View full text Add to dashboard Cite

show abstract

“…O estudo isocinético pode contribuir na determinação da fraqueza clínica de pacientes com quadros mais frustros e auxiliar o profissional na decisão terapêutica. 39,40 A evolução do conhecimento torna a realização de uma RM da perna (bilateral comparativa) uma importante arma em pacientes com rupturas crônicas do Aquiles. Estudos prévios demonstraram alterações no ângulo de bipenação e substituição gordurosa da musculatura com o decorrer da condição, como discutido no capítulo de tendinopatias (Lesões do Aquiles -Parte 1: Tendinopatias).…”

Section: Propedêutica Armadaunclassified

Lesões do Aquiles – Parte 2: Rupturas

Mansur

Fonseca

Matsunaga

et al. 2020

Rev Bras Ortop (Sao Paulo)

View full text Add to dashboard Cite

ResumoA crescente incidência de rupturas do tendão calcâneo tem impactado substancialmente o cuidado ortopédico e os custos relacionados ao seu tratamento e prevenção. Motivada principalmente pelo aumento da expectativa de vida, o crescimento do uso de drogas tenotóxicas e o acesso errático à atividade física, essa lesão gera morbidade considerável aos pacientes qualquer seja o desfecho a ser considerado. A evolução das técnicas cirúrgicas e de reabilitação permitiu que ortopedistas, nos últimos anos, tivessem melhores condições para decidir a conduta mais apropriada nas roturas agudas do tendão calcâneo. Por mais que ainda frequentes pela sua alta taxa de negligência, as rupturas crônicas do Aquiles hoje encontram opções operatórias biológicas mais simples e são amparadas por um novo paradigma que se debruça sobre a especialidade.

show abstract

“…Various methods have been adopted to achieve the desired effects to repair the gap, such as V‐Y tendon plasty, gastrocnemius fascial turndown flap, tendon transfer (flexor hallucis longus tendon transfer and flexor digitorum longus tendon transfer), allograft reconstruction, autograft reconstruction (semitendinosus tendon graft, fibularis brevis, and fibularis longus muscles), synthetic graft augmentation (ligament advanced reinforcement system, bio‐absorbable synthetic graft), and biologic matrix augmentation. The reconstruction of chronic Achilles tendon rupture is complex, and it might affect the choice of procedures.…”

Section: Introductionmentioning

confidence: 99%

V‐Y Tendon Plasty for Reconstruction of Chronic Achilles Tendon Rupture: A Medium‐term and Long‐term Follow‐up

Lin

Duan

Yang

2019

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective To evaluate the surgical results of V‐Y tendon plasty in the treatment of chronic Achilles tendon rupture during medium and long‐term follow‐up. Methods Between June 2005 and September 2017, 20 patients with chronic Achilles tendon rupture underwent V‐Y tendon plasty in our hospital. The mean injury‐to‐surgery time was 20.4 weeks (range, 4–96 weeks). The Matles test and an improved Thompson test was used to examine Achilles tendon rupture. These patients were not able to stand on the tiptoes of the injured lower extremity. X‐ray tests ruled out the chance of fracture and were used to examine the Kager triangle. MRI was used to confirm the final diagnosis. The function of the ankle and the foot was assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score and the Achilles Tendon Total Rupture Score (ATRS). V‐Y tendon plasty for Achilles tendon reconstruction was performed. A below‐knee cast was used to keep the ankle in plantar flexion (up to 20°) for 4 weeks. Non‐weight‐bearing exercise was allowed with crutches. After 4 weeks, partial weight‐bearing was allowed. Physical exercises were performed under rehabilitation guidelines. At 10–12 weeks postoperation, patients began to return to daily life activity levels without restrictions. Preoperative and postoperative MRI was obtained. Results The mean follow‐up period was 32.8 months. The mean operative gap of the Achilles tendon after debridement was 5 cm (range, 4–9 cm), with 85% of the gap less than or equal to 6 cm. The mean AOFAS score increased from 59.25 ± 12.28 preoperatively to 96.55 ± 3.75 at final follow‐up ( P < 0.05). The mean ATRS score increased from 39.55 ± 14.21 preoperatively to 94.05 ± 4.89 at final follow‐up ( P < 0.05). All patients had no recurrent Achilles tendon rupture during the follow up. No patient had developed serious complications, such as sural nerve injury or deep vein thrombosis. Patients were able to return to daily life activity levels without restrictions. At the latest follow‐up, all patients were able to perform repetitive single heel rise on the involved limb, and to walk without a visible limp. All of the postoperative MRI showed the continuity of the Achilles tendon with no signs of cysts or inflammation, indicating perfect healing at the final follow‐up. Conclusions V‐Y tendon plasty can be used in most cases of chronic Achilles tendon rupture. It yields satisfactory functional results and low complication rates. The advantage of this procedure is that it is an easy and economic method without the need for expensive synthetic implants. V‐Y tendon plasty should be considered an acceptable first‐choice treatment.

show abstract

Outcomes of flexor digitorum longus (FDL) tendon transfer in the treatment of Achilles tendon disorders

Cited by 19 publications

References 25 publications

Level of Evidence for the Treatment of Chronic Noninsertional Achilles Tendinopathy

Level of Evidence for the Treatment of Chronic Noninsertional Achilles Tendinopathy

Lesões do Aquiles – Parte 2: Rupturas

V‐Y Tendon Plasty for Reconstruction of Chronic Achilles Tendon Rupture: A Medium‐term and Long‐term Follow‐up

Contact Info

Product

Resources

About