title: Chronic Achilles tendon rupture reconstructed using hamstring tendon autograft.
abstract: BACKGROUND
  Chronic rupture of the Achilles tendon (delayed diagnosis of more than 4 weeks) can result in retraction of the tendon and inadequate healing. Direct repair may not be possible and augmentation methods are challenging when the defect exceeds 5-6 cm, especially if the distal stump is grossly tendinopathic.
  
  
  METHODS
  We describe our method of Achilles tendon reconstruction with ipsilateral semitendinosis autograft and interference screw fixation in a patient with chronic rupture, a 9 cm defect and gross distal tendinopathy.
  
  
  RESULTS
  Patient reported outcome measures consistently demonstrated improved health status at 12 months post surgery: MOXFQ-Index 38-25, EQ5D-5L 18-9, EQ VAS 70-90 and VISA-A 1-64. The patient was back to full daily function, could single leg heel raise and was gradually returning to sport. No complications or adverse events were recorded.
  
  
  CONCLUSIONS
  Reconstruction of chronic tears of the Achilles tendon with large defects and gross tendinopathy using an ipsilateral semitendinosis autograft and interference screw fixation can achieve satisfactory improvements in patient reported outcomes up to 1 year post-surgery.
authors.affiliation: Lower Limb Extended Scope Practitioner, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, United Kingdom. Electronic address: philip.ellison@aintree.nhs.uk.
authors.forename: Philip
authors.initials: P
authors.lastname: Ellison
authors.affiliation: Foot and Ankle Surgeon, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, United Kingdom.
authors.forename: Lyndon William
authors.initials: LW
authors.lastname: Mason
authors.affiliation: Foot and Ankle Surgeon, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Molloy
mesh_terms: D000125:Achilles Tendon / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D000328:Adult; D064592:Autografts; D001863:Bone Screws; D000070632:Hamstring Tendons / Q000637:transplantation*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012421:Rupture; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D013709:Tendon Transfer / Q000379:methods*
keywords: Achilles tendon; Autograft; Chronic rupture; Hamstring