title: The Neglected Achilles Tendon Rupture Repaired With Allograft: A Review of 14 Cases.
abstract: Various surgical techniques have been reported for the repair of neglected Achilles tendon ruptures, including V-Y advancements, synthetic augmentations, and collagen implants. The use of an Achilles tendon allograft allows bridging of large defects without donor site morbidity, with a relative ease of technique and adequate graft availability. The present retrospective report focused on the outcomes of a series of 14 patients with neglected ruptures treated with an Achilles tendon allograft. Patients were included in the present series if they had ≥12 months of postoperative follow-up data available and the allograft had been used without any adjunctive procedures. Of the 14 patients, 6 were female (43%) and 8 were male (57%), with a mean follow-up period of 16.1 ± 3 (range 12 to 27) months. The mean interval from the initial injury to surgery was 6.9 ± 5 (range 1 to 28) months. The mean intraoperative defect size was 7.0 ± 3 (range 4 to 15) cm. A calcaneal block was used in 2 patients (14%). All patients were able to perform a single heel rise at a mean of 27 ± 11 (range 12 to 37) weeks postoperatively. Weightbearing in normal shoe gear was achieved at a mean of 13.5 ± 3 (range 12 to 17) weeks. Complications included 1 delayed union (7%) of the calcaneal bone block. Repair of the neglected Achilles tendon rupture with an allograft appears to be an acceptable approach, with good overall outcomes and low risk. These results suggest that this method of repair compares favorably with established alternatives.
authors.affiliation: Attending Staff, Department of Orthopedics and Podiatry, Woodland Clinic Medical Group, Woodland, CA.
authors.forename: Kene P
authors.initials: KP
authors.lastname: Ofili
authors.affiliation: Attending Staff, Department of Podiatric Surgery, Kaiser Oakland Medical Center, Oakland, CA.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Pollard
authors.affiliation: Chief, Foot and Ankle Surgery, Kaiser San Francisco Medical Center. Electronic address: Jmfoot@aol.com.
authors.forename: John M
authors.initials: JM
authors.lastname: Schuberth
mesh_terms: D000125:Achilles Tendon / Q000293:injuries*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D012421:Rupture; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome; D016474:Weight-Bearing
keywords: Achilles tendon; allograft; neglected rupture