Semitendinosus Tendon Autograft for Reconstruction of Large Defects in Chronic Achilles Tendon Ruptures

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.

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“…Dumbre et al 22 treated 35 patients with symptomatic chronic Achilles tendon ruptures. The average follow-up duration was 30.7 months.…”

Section: Discussionmentioning

confidence: 99%

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

Usuelli

D’Ambrosi

Manzi

et al. 2017

Joints

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“…2-0 sutures with the ankle in neutral position. In this case series, 6 defect sizes ranged from 5 to 9 cm. At an average follow-up of 30.7 months, no reruptures had occurred, and all patients had returned to their prerupture daily activity.…”

Section: Treatment Of Chronic At Rupturesmentioning

confidence: 96%

“…Autograft reconstruction of a chronic AT rupture has also been described with the use of a hamstring 6,9,10,23,36 or quadriceps tendon 1,28 autograft. As with allograft reconstruction, the use of an autograft may be indicated particularly in patients with large defects.…”

Section: Treatment Of Chronic At Rupturesmentioning

confidence: 99%

“…As with allograft reconstruction, the use of an autograft may be indicated particularly in patients with large defects. In a retrospective case series (Level IV evidence) of 35 patients with symptomatic chronic AT ruptures of more than 6 weeks’ duration, Dumbre Patil et al 6 performed tendon reconstruction using a semitendinosus autograft. After debriding the frayed AT ends and removing the calcified and hard tendon, the authors measured the defect size between stumps, and if the defect size was greater than 5 cm, the authors placed traction on the proximal stump for 5 minutes before attempting end-to-end opposition.…”

Section: Treatment Of Chronic At Rupturesmentioning

confidence: 99%

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Chronic Achilles Tendon Ruptures

2017

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The Achilles tendon (AT) is the strongest tendon in the human body, capable of heavy loading. 5 Despite its strength, 17 it is also one of the most commonly injured tendons. 25 The incidence of AT ruptures is between 7 and 37 per 100 000 person-years, 4 with most of these injuries occurring during athletics in men ages 30 to 40 years. 19 The AT reaches maximum tension during the eccentric phase of muscle/tendon action, 26 a mechanism that is associated with basketball, tennis, and football, all of which are sports commonly associated with AT ruptures. 35

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“…Though the FHL has been reported most successfully for chronic Achilles reconstruction, several recent reports exist that discuss the potential benefit of using a semitendinosus autograft, in isolation, to reconstruct chronic Achilles ruptures [3,4,8,11]. Furthermore, two previous reports, both by Piontek et al, present two different techniques to reconstruct the Achilles tendon using both a semitendinosus and gracilis autograft [13,14].…”

Section: Introductionmentioning

confidence: 99%

Revision Achilles Reconstruction with Hamstring Autograft and FHL Tendon Transfer in an Athlete

Karnovsky

Drakos

2017

HSS Jrnl

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Semitendinosus Tendon Autograft for Reconstruction of Large Defects in Chronic Achilles Tendon Ruptures

Abstract: Level IV, retrospective case series.

Cited by 45 publications

References 15 publications

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

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

Chronic Achilles Tendon Ruptures

Revision Achilles Reconstruction with Hamstring Autograft and FHL Tendon Transfer in an Athlete

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