Functional Outcome Following Knotless Tendoachilles Repair and FHL Augmentation
Ramkinkar Jha MS, Raman Kant Aggarwal, Mohd Irfan Banday*, Ashish Kumar Goyal and Saksham Tripathi
Department of Orthopaedics, Artemis Hospital, Gurgaon, India
*Corresponding Author: Mohd Irfan Banday, Department of Orthopaedics, Artemis Hospital, Gurgaon, India.
Received:
January 23, 2023; Published: March 07, 2023
Abstract
Introduction: The achilles tendon is the strongest and largest tendon of the human body and can be exposed to forces six to eight times body weight. The spontaneous ruptures of the achilles tendon are relatively common and are frequently missed.
Materials and Methods: We present a prospective case series of 11 patients of spontaneous tendoachilles rupture treated with speed bridge technique and augmented with flexor hallucis longus tendon transfer from a period of January 2019 to April 2020 operated by a single orthopaedic surgeon.
Results: The mean FAOS score before surgery was 56.5 ± 7.7 (42 -66) and improved to a mean score of 88.2 ± 5.7 (78-96) postoperatively.
Conclusion: Speed bridge reconstruction technique combined with FHL transfer allows stable re- construction and early mobilisation of the patient with good to excellent results.
Keywords: Tendoachilles; Tendoachilles Rupture; Knotless Tendoachilles Repair
References
- Soma CA and Mandelbaum “Achilles tendon disorders”. Clinical Journal of Sport Medicine 13 (1994): 811-823.
- Paavola M., et al. “Achilles tendinopathy”. Journal of Bone and Joint Surgery America 84A (2002): 2062-2076.
- Theobald P., et al. “Review of the vascularisation of the human Achilles tendon”. Injury 36 (2005): 1267-1272.
- Astrom “Laser Doppler flowmetry in the assessment of tendon blood flow”. Scandinavian Journal of Medicine and Science in Sports 10 (2000): 365-367.
- Schmidt-Rohlfing B., et al. “The blood supply of the Achilles tendon”. International Orthopaedics 16 (1992): 29-31.
- Langberg H., et al. “Blood flow in the peritendinous space of the human Achilles tendon during exercise”. Acta Physiologica Scandinavica 163 (1998): 149-153.
- Zantop T., et al. “Quantitative assessment of blood vessels of the human Achilles tendon: an immunohistochemical cadaver study”. Archives of Orthopaedic and Trauma Surgery 123 (2003): 501-504.
- Inglis AE and Sculco TP. “Surgical repair of ruptures of the tendo Achillis”. Clinical Orthopaedics 156 (1981): 160-169.
- Martin RL., et al. “An outcome study of chronic achilles tendinitis after excision of the achilles tendon and flexor hallucis longus tendon transfer”. Foot and Ankle International 26 (2005): 691-697.
- Schepsis AA and Leach “Surgical management of Achilles tendinitis”. The American Journal of Sports Medicine 15 (1987): 308-315.
- Lui “Tendinopathy in diabetes mellitus patients- Epiidemiology, pathogenesis, and man- agement. Stand”. Journal of Science and Medicine in Sport 27 (2017): 776-787.
- Dodds WN and Burry “The relationship between Achilles tendon rupture and serum uric acid level”. Injury 16 (1984): 94-95.
- Dent CM and Graham GP. “Osteogenesis imperfecta and Achilles tendon rupture”. Injury 22 (1991): 239-240.
- Maffulli N., et al. “Achilles tendon rupture and sciatica: a possible correlation”. British Journal of Sports Medicine 32 (1998): 174-177.
- Maffulli “Current concepts review: rupture of the Achilles tendon”. Journal of Bone and Joint Surgery 81A (1999): 1019-1036.
- Kennedy JC and Willis “The effects of local steroid injections on tendon: a biomechanical and microscopic correlative study”. The American Journal of Sports Medicine 4 (1976): 11-21.
- Bruggeman NB., et al. “Wound complications after open achilles tendon repair: an analysis of risk factors”. Clinical Orthopaedics and Related Research (2004): 63-66.
- Turco VJ and Spinella “Achilles tendon ruptures-peroneus brevis transfer”. Foot Ankle 7.4 (1987): 253-259.
- Mann R., et al. “Chronic rupture of the Achilles tendon: a new tech nique of repair”. Journal of Bone and Joint Surgery 73A (1991): 214-219.
- Wapner LK., et al. “Repair of chronic Achilles tendon rupture with flexor hallucis longus tendon transfer”. Foot Ankle 14 (1993): 443-449.
- Silver R., et al. “The myth of muscle balance: a study of relative strengths and excursions of normal muscles about the foot and ankle”. Journal of Bone and Joint Surgery 67B (1985): 432-437.
- Simon “Gait Analysis. Normal and Pathological Function”. The Journal of Bone and Joint Surgery 75 (1993): 476-477.
- Coull R., et al. “Flexor hallucis longus tendon transfer: evaluation of postoper ative morbidity”. Foot and Ankle International 12 (2003): 931-934.
- Andrew R “Limited-Incision Knotless Achilles Tendon Repair”. American Journal of Orthopedics (Belle Mead NJ) 45.7 (2016): E487-E492.
- McWilliam JR and MacKay “The internal brace for midsubstance Achilles ruptures”. Foot and Ankle International 37.7 (2016): 794-800.
- Aoki M., et al. “Early active motion and weightbearing after cross-stitch Achilles tendon repair”. The American Journal of Sports Medicine6 (1998): 794-800.
- Kangas J., et al. “Achilles tendon elongation after rupture repair: a randomised comparison of 2 postoperative regimens”. The American Journal of Sports Medicine1 (2007): 59-64.
- Booth BA., et al. “Fatty infiltration of gastrosoleus lengthening and gastrocnemius recession in a rabbit model”. Foot and Ankle International 30 (2009): 778-782.
- Fanter NJ., et al. “Fixation of the Achilles tendon insertion using suture button technology”. The American Journal of Sports Medicine 40 (2012): 2085-2091.
- Michael AB., et al. “Suture-Only Repair Ver- sus Anchor-Augmented Repair for Achilles Tendon Ruptures with A Short Distal Stump. A Biomechanical Comparison”. The Orthopaedic Journal of Sports Medicine 1 (2017).
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