The safety profile of a retrospective Accessory Postero-Lateral hind foot portal: The risk of sural nerve damage during visualisation of the Achilles tendon insertion

Carmont, Michael R.; Stroud, Robert E.; Bjorndalen, H.; Crowther, James D.; Ribbans, William J; Griffin, Damian R.

doi:10.1016/j.fas.2011.05.006

Cited by 6 publications

(9 citation statements)

References 16 publications

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“…For posterior ankle endoscopy, the postero-lateral portal described by Van Dijk et al [19] is adjacent to the lateral edge of the Achilles tendon, located just proximal to the line running through the tip of the lateral malleolus, and directed towards the first inter-metatarsal space. In patients with Haglund's deformity, an accessory portal can improve the visualisation of the Achilles tendon insertion site [6,20,21]. No published studies have assessed the risk of lateral calcaneal nerve injury related to the postero-lateral approach during ankle endoscopy (Fig.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk of sural nerve injury during lateral distal Achilles tendinoscopy: A Cadaver Study

Appy-Fedida¹,

Vernois²,

Krief³

et al. 2015

Orthopaedics & Traumatology: Surgery & Research

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Section: Discussionmentioning

confidence: 99%

“…Accessory postero-lateral portal as described by Wang et al [20]; 5. Accessory postero-lateral portal as described by Carmont et al [21]; P: distal lateral portal used for the Achilles tendinoscopy procedure described by Vega et al [2].…”

Section: Studiesmentioning

confidence: 99%

Risk of sural nerve injury during lateral distal Achilles tendinoscopy: A Cadaver Study

Appy-Fedida¹,

Vernois²,

Krief³

et al. 2015

Orthopaedics & Traumatology: Surgery & Research

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“…Standard posteromedial, posterolateral and accessory posterolateral portals were created (Fig. 1 ) [ 6 , 44 ]. An endoscopic calcaneoplasty was performed using a bone shaving burr to the level of the Achilles insertion to allow full visualization of the future tunnel site.…”

Section: Methodsmentioning

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

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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.

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“…L'abord postéro-latéral d'une endoscopie de la cheville postérieure définie par Van Dijk et al [19] est adjacent au bord latéral du tendon calcanéen, juste audessus de la ligne passant par la pointe de la malléole latérale, et vise le premier espace inter-métatarsien. Une voie d'abord accessoire peut permettre une meilleure visualisation de l'insertion du tendon calcanéen pour le traitement d'une maladie de Haglund [6,20,21]. L'évaluation du risque de lésion du nerf calcanéen latéral lors d'un abord endoscopique de la cheville postéro-latérale (Fig.…”

Section: Tableauunclassified

Risque de lésion du nerf sural lors de la tendinoscopie latérale distale du tendon achilléen : une étude cadavérique

Appy-Fedida

Vernois

Krief

et al. 2015

Revue de Chirurgie Orthopédique et Traumatologique

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The safety profile of a retrospective Accessory Postero-Lateral hind foot portal: The risk of sural nerve damage during visualisation of the Achilles tendon insertion

Cited by 6 publications

References 16 publications

Risk of sural nerve injury during lateral distal Achilles tendinoscopy: A Cadaver Study

Risk of sural nerve injury during lateral distal Achilles tendinoscopy: A Cadaver Study

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

Risque de lésion du nerf sural lors de la tendinoscopie latérale distale du tendon achilléen : une étude cadavérique

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