title: Allograft Reconstruction of Chronic Tibialis Anterior Tendon Ruptures.
abstract: BACKGROUND
  Chronic ruptures of the tibialis anterior tendon are often associated with tendon retraction and poor-quality tissue, resulting in large segmental defects that make end-to-end repair impossible. Interpositional allograft reconstruction has previously been described as an operative option in these cases; however, there are no reports of the clinical outcomes of this technique in the literature.
  
  
  METHODS
  Eleven patients with chronic tibialis anterior tendon ruptures underwent intercalary allograft recon-struction between 2006 and 2013. Patient demographics, injury presentation, and details of surgery were reviewed. Postoperative outcomes at a mean follow-up of 43.8 (range, 6-105) months included the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score, Short Form-12 (SF-12) physical health score, Lower Extremity Functional Score (LEFS), visual analog scale (VAS) pain rating, dorsiflexion strength, gait analysis, and complications.
  
  
  RESULTS
  The average postoperative dorsiflexion strength, as categorized by the Medical Council grading scale, was 4.8 ± 0.45. The average postoperative VAS score was 0.8 ± 1.1. The average LEFS was 66.9 ± 17.2, SF-12 physical health score was 40.1 ± 14.4, and AOFAS score was 84.3 ± 7.7. One complication occurred, consisting of transient neuritic pain in the superficial peroneal nerve distribution. There were no postoperative infections, tendon reruptures, reoperations, or allograft-associated complications.
  
  
  CONCLUSIONS
  Allograft reconstruction of chronic irreparable tibialis anterior tendon ruptures yielded satisfactory strength, pain, and patient-reported functional outcomes. This technique offers a safe and reliable alternative, without the donor site morbidity associated with tendon transfer or autograft harvest.
  
  
  METHODS
  Level IV, retrospective case series.
authors.affiliation: Duke University Medical Center, Department of Orthopaedic Surgery, Durham, NC, USA Jeannie.huh@duke.edu.
authors.forename: Jeannie
authors.initials: J
authors.lastname: Huh
authors.affiliation: Boyette Orthopaedics and Sports Medicine, Greenville, NC, USA.
authors.forename: Deanna M
authors.initials: DM
authors.lastname: Boyette
authors.affiliation: Duke University Medical Center, Department of Orthopaedic Surgery, Durham, NC, USA.
authors.forename: Selene G
authors.initials: SG
authors.lastname: Parekh
authors.forename: James A
authors.initials: JA
authors.lastname: Nunley
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging / Q000601:surgery; D013536:Suture Techniques; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D013718:Tensile Strength / Q000502:physiology*; D013977:Tibia; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome
keywords: allograft; chronic; tendon reconstruction; tendon rupture; tibialis anterior tendon