Skip to main content
SpringerLink
Log in

Suture anchor tenodesis in repair of distal Achilles tendon injuries

  • Original Article
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Distal Achilles tendon avulsions are in the form of either bony and nonbony avulsion of Achilles tendon from its calcaneal insertion.

Methods

Four patients with distal Achilles tendon avulsions or ruptures which were treated with tendon to bone repair using suture anchors are presented here. Operated leg was immobilized in above-knee cast for 4 weeks while the patient walked non-weight-bearing. Then, cast was changed to below knee, and full weight-bearing was allowed. Patients underwent gait analysis minimum at first postoperative year.

Results

Mean American Orthopedics Foot Ankle Society ankle/hindfoot score of patients at last visit was 88.75 (range 85–100), and Achilles tendon total rupture score was 77.75 (range 58–87). Mean passive dorsiflexion of injured ankles (14° ± 5°) was lower than uninjured ankles (23° ± 9°). All the kinematic parameters of gait analysis were comparable to the uninjured side. Maximum plantar flexion power of injured ankle was 1.40 W/kg, and this was significantly lower than the contralateral side value 2.38 W/kg; (P = 0.0143).

Conclusions

There were no visually altered gait or problems in daily life. Suture anchor tenodesis technique of distal Achilles tendon avulsions was successful in achieving durable osteotendinous repairs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Maffulli N, Ajis A, Longo UG, Denaro V (2007) Chronic rupture of tendo Achillis. Foot Ankle Clin 12:583–596. http://dx.doi.org/10.1016/j.fcl.2007.07.007

    Google Scholar 

  2. Järvinen TA, Kannus P, Maffulli N, Khan KM (2005) Achilles tendon disorders:etiology and epidemiology. Foot Ankle Clin 10:255–266. http://dx.doi.org/10.1016/j.fcl.2005.01.013

    Google Scholar 

  3. Biehl WC 3rd, Morgan JM, Wagner Jr. FW, et al. (1993) Neuropathic calcaneal tuberosity avulsion fractures. Clin Orthop Relat Res 296:8–13. http://dx.doi.org/10.1097/00003086-199311000-00003

  4. Hedlund LJ, Maki DD, Griffiths HJ (1998) Calcaneal fractures in diabetic patients. J Diabetes Complicat 12:81–7. http://dx.doi.org/10.1016/S1056-8727%2897%2900052-4

    Google Scholar 

  5. Hess M, Booth B, Laughlin RT (2008) Calcaneal avulsion fractures: complications from delayed treatment. Am J Emerg Med 26:254.e1–254.e4. http://dx.doi.org/10.1016/j.ajem.2007.04.033

    Google Scholar 

  6. Cetti R, Henriksen LO, Jacobsen KS (1994) A new treatment of ruptured Achilles tendons. A prospective randomized study. Clin Orthop Relat Res 308:155–165

    PubMed  Google Scholar 

  7. Maniscalco P, Bettone C, Bonci E, etal (1998) Titanium anchors for the repair of distal Achilles tendon ruptures: preliminary report of a new surgical technique. J Foot Ankle Surg 37:96–100. http://dx.doi.org/10.1016/S1067-2516%2898%2980087-2

  8. Hanna JR, Russell RD, Giacopelli JA (1993) Repair of distal tendo Achillis rupture with the use of the Mitek Anchor System. J Am Podiatr Med Assoc 83:663–668

    CAS  PubMed  Google Scholar 

  9. Besse JL, Lerat JL, Moyen B, et al (1999) Achilles tendon repair using a bone-tendon graft harvested from the knee extensor system: three cases. J Foot Ankle Surg 38:70–74. http://dx.doi.org/10.1016/S1067-2516%2899%2980092-1

    Google Scholar 

  10. Bibbo C, Anderson RB, Davis WH, Agnone M (2003) Repair of the Achilles tendon sleeve avulsion: quantitative and functional evaluation of a transcalcaneal suture technique. Foot Ankle Int 24:539–544

    PubMed  Google Scholar 

  11. Don R, Ranavolo A, Cacchio A, et al (2007) Relationship between recovery of calf-muscle biomechanical properties and gait pattern following surgery for achilles tendon rupture. Clin Biomech 22:211–220. http://dx.doi.org/10.1016/j.clinbiomech.2006.10.001

    Google Scholar 

  12. Kitaoka HB, Alexander IJ, Adelaar RS et al (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle 15:349–353

    Article  CAS  PubMed  Google Scholar 

  13. Nilsson-Helander K, Thomeé R, Silbernagel KG, et al (2007) The Achilles tendon Total Rupture Score (ATRS): development and validation. Am J Sports Med 35:421–426. http://dx.doi.org/10.1177/0363546506294856

    Google Scholar 

  14. Davis R, Ounpuu S, Tyburski D, et al (1991) A gait analysis data collection and reduction technique. Hum Mov Sci 10:575–587. http://dx.doi.org/10.1016/0167-9457%2891%2990046-Z

  15. Beavis RC, Rourke K, Court-Brown C (2008) Avulsion fracture of the calcaneal tuberosity: a case report and literature review. Foot Ankle Int 29:863–866. http://dx.doi.org/10.3113/FAI.2008.0000

  16. Lui TH (2009) Fixation of tendo Achilles avulsion fracture. Foot Ankle Surg 15: 58–61. http://dx.doi.org/10.1016/j.fas.2008.06.004

  17. Pavlou G, Roach R, Salehi-Bird S (2009) Repair of the achilles tendon sleeve avulsion: a transcalcaneal suture technique. Foot Ankle Int 30:65–67. http://dx.doi.org/10.3113/FAI.2009.0065

    Google Scholar 

  18. Khazen GE, Wilson AN, Ashfaq S, et al (2007) Fixation of calcaneal avulsion fractures using screws with and without suture anchors: a biomechanical investigation. Foot Ankle Int 28:1183–1186. http://dx.doi.org/10.3113/FAI.2007.1183

  19. Kangas J, Pajala A, Ohtonen P, et al (2007) Achilles tendon elongation after rupture repair. Am J Sports Med 35: 59–64. http://dx.doi.org/10.1177/0363546506293255

    Google Scholar 

  20. Mullaney MJ, McHugh MP, Tyler TF, et al (2006) Weakness in end-range plantar flexion after Achilles tendon repair. Am J Sports Med 34:1120–1125. http://dx.doi.org/10.1177/0363546505284186

    Google Scholar 

  21. Cetti R, Christensen SE, Ejsted R, et al (1993) Operative versus nonoperative treatment of Achilles tendon rupture. A prospective randomized study and review of the literature. Am J Sports Med 21:791–799. http://dx.doi.org/10.1177/036354659302100606

    Google Scholar 

Download references

Conflict of interest

We declare that authors of this study do not have any financial disclosure and have not received any form of grant for this study.

Author information

Authors and Affiliations

  1. Department of Orthopedics and Traumatology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey

    Önder Kiliçoğlu, Fatih Yildız, Ekin Akalan & Yener Temelli

  2. Department of Orthopedics and Traumatology, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey

    Mehmet Türker

  3. Department of Orthopedics and Traumatology, İstanbul School of Medicine, Gait Analysis Laboratory, İstanbul University, İstanbul, Turkey

    Ekin Akalan

  4. Department of Orthopedics and Traumatology, İstanbul School of Medicine, İstanbul University, Millet Cad. 118, Topkapi, İstanbul, 34093, Turkey

    Önder Kiliçoğlu

Authors
  1. Önder Kiliçoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mehmet Türker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fatih Yildız
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ekin Akalan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yener Temelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mehmet Türker.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kiliçoğlu, Ö., Türker, M., Yildız, F. et al. Suture anchor tenodesis in repair of distal Achilles tendon injuries. Eur J Orthop Surg Traumatol 24, 117–122 (2014). https://doi.org/10.1007/s00590-012-1129-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-012-1129-2

Keywords

Search

Navigation