title: Functional outcome after percutaneous tendo-Achilles lengthening.
abstract: BACKGROUND
  Percutaneous tendo-Achilles lengthening (PTAL) is a common procedure performed as an adjunct to other procedures that are used to treat a variety of foot and ankle disorders. Despite the widespread use of PTAL, the only literature to substantiate its efficacy comes from the treatment of forefoot ulceration in diabetics. The complications of the procedure include pain along the Achilles tendon, difficulty using stairs, weakness with toe-off, inadvertent complete tenotomy, and cosmetic appearance. We sought to investigate the functional outcomes specific to PTAL when performed in tandem with triple arthrodesis and subtalar fusion.
  
  
  METHODS
  A retrospective review of 107 patients who underwent 117 procedures was performed. Outcomes were assessed by telephone interview using a standard questionnaire. The most common procedure in the study population was triple arthrodesis (91%).
  
  
  RESULTS
  Fifty-eight percent of the patients reported moderate improvement in motion postoperatively, but 80% reported some degree of persistent stiffness. Despite 38% of patients reporting postoperative weakness, 66% and 61% stated that ascending and descending stairs, respectively, was easier.
  
  
  CONCLUSIONS
  Overall, 81% of the study population had a positive opinion regarding their surgery. In this heterogeneous population, we showed modest improvement in Achilles tendon-related outcomes when PTAL was performed in tandem with other surgeries.
authors.affiliation: CPT, USA, MC, CMR 402 Box 1036, APO, AE 09180, United States. Michael.stauff@us.army.mil
authors.forename: Michael P
authors.initials: MP
authors.lastname: Stauff
authors.forename: William B
authors.initials: WB
authors.lastname: Kilgore
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Joyner
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Juliano
mesh_terms: D000125:Achilles Tendon / Q000601:surgery*; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery; D001174:Arthrodesis; D005413:Flatfoot / Q000601:surgery*; D006801:Humans; D008124:Locomotion; D019060:Minimally Invasive Surgical Procedures; D017060:Patient Satisfaction; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D013380:Subtalar Joint / Q000601:surgery