Chronic Achilles tendon rupture reconstruction using a free semitendinosus tendon graft transfer.
OBJECTIVE
The purpose of this study was to evaluate the outcomes following reconstruction of the chronic Achilles tendon ruptures with large gaps (>6 cm) using free semitendinosus tendon graft transfer.


METHODS
There were 11 consecutive patients underwent the above-mentioned surgical technique for the treatment of chronically ruptured Achilles tendon contributed in current study and were followed up prospectively for a mean of 25 ± 3 months. The intraoperative tendon defect was greater than 6 cm in all of the patients. Functional and clinical assessment was performed using The American Orthopaedic Foot and Ankle Society (AOFAS) and Achilles Tendon Rupture Score (ATRS).


RESULTS
The average AOFAS and ATRS improved significantly from 70 ± 5 and 32 ± 6 preoperatively, to 92 ± 5 and 89 ± 4 points post-operatively (P = 0.001). The range of dorsiflexion was significantly limited on the operated side (13 ± 4° vs. 17 ± 4°) (P = 0.04). All patients were able to stand on the tiptoe of injured leg, and no patient walked with a visible limp. Post-operative complications included one patient with symptomatic DVT and 2 patients with superficial infection treated nonoperatively.


CONCLUSIONS
The technique offers good clinical and functional outcomes and is safe. Reconstruction of the chronic Achilles tendon ruptures with free semitendinosus tendon graft in patients with defects greater than 6 cm is recommended.


METHODS
IV.
Department of Orthopaedics, Imam Hosein Hospital, Shahid Beheshti Medical University, Tehran, Iran. mmszaeem@gmail.com
Mohammad Mahdi
MM
Sarzaeem
Mohammad Mahdi Bagherian
MM
Lemraski
Farshad
F
Safdari
D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery*; D000328:Adult; D053587:Arthrometry, Articular; D002908:Chronic Disease; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D012421:Rupture / Q000601:surgery; D013709:Tendon Transfer / Q000379:methods*