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Surgical management of Achilles tendon re-ruptures: a prospective cohort study

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Abstract

Purpose

The purpose of this study was to compare outcomes of different minimally invasive techniques for reconstruction of Achilles tendon re-ruptures.

Methods

We prospectively enrolled 21 patients undergoing minimally invasive reconstruction using a transfer of the ipsilateral peroneus brevis (PB) (five patients) or the free ipsilateral semitendinosus tendon (ST) graft with or without interference screw fixation (ten and six patients, respectively). We assessed the maximum calf circumference and isometric plantar flexion strength before surgery and at the last follow up. The Achilles tendon total rupture score (ATRS) and number of single-leg heel lifts on the affected leg were evaluated at the last follow up. The median follow up was 39 months.

Results

The outcome of surgery was excellent/good in 17 (81 %) of 21 patients. In the operated leg, the maximum calf circumference and isometric plantar flexion strength were significantly improved after surgery (P < 0.0001). The average ATRS was 86 (range 79-92), and the average number of single-legged heel lifts was 33 (range 11–48). No further re-ruptures were recorded.

Conclusions

Minimally invasive ipsilateral PB transfer and free ipsilateral ST graft with or without interference screw fixation are safe and effective procedures to reconstruct the Achilles tendon after a re-rupture, providing a significant improvement of the symptoms and function in the mid term.

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Authors and Affiliations

  1. Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy

    Nicola Maffulli

  2. Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, England

    Nicola Maffulli & Gayle Maffulli

  3. Department of Orthopaedic and Trauma Surgery, Tor Vergata University, Rome, Italy

    Francesco Oliva

  4. Department of Orthopaedics and Traumatology, Sant’Anna Hospital, Via Ravona, San Fermo della Battaglia, Como, Italy

    Angelo Del Buono & Antonietta Florio

Authors
  1. Nicola Maffulli
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  2. Francesco Oliva
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  3. Angelo Del Buono
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  4. Antonietta Florio
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  5. Gayle Maffulli
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Correspondence to Nicola Maffulli.

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Maffulli, N., Oliva, F., Del Buono, A. et al. Surgical management of Achilles tendon re-ruptures: a prospective cohort study. International Orthopaedics (SICOT) 39, 707–714 (2015). https://doi.org/10.1007/s00264-015-2686-x

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  • DOI: https://doi.org/10.1007/s00264-015-2686-x

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