Chronic Achilles tendon rupture: a novel modification of surgical technique described by El Shewy

Gunaratne, Rajitha; Chong, Yu Chuan; Heng, Yi Ying; Hahn, Jayhee; Lek, Jeremy; Randazzo, Amy; Brankov, Boris

doi:10.1111/ans.16921

Cited by 4 publications

(3 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to Maffulli et al [5], 10% of patients experience incision complications due to long surgical incisions. To reduce the risk of wound complications, many researchers have proposed minimally invasive or endoscopic‐assisted techniques [7, 11, 17]. The locking block modified Krackow (LBMK) technique has been proven to be a minimally invasive repair of acute Achilles tendon rupture [37].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic-assisted locking block modified Krackow technique combined with a V-Y flap for chronic Achilles tendon rupture

Liu

Tian

et al. 2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

PurposeThe purpose of this study was to evaluate the clinical outcomes of the endoscopic‐assisted locking block modified Krackow technique with a V‐Y flap. The hypothesis was that the minimally invasive technique can reduce wound complications and facilitate early recovery. MethodsIn total, 29 men with chronic Achilles tendon rupture who underwent either minimally invasive technique (n = 13) or open repair (n = 16) at our department between 2013 and 2019 were retrospectively analyzed. The rate of complications, time to return to moderate‐intensity exercise, American Orthopedic Foot and Ankle Society ankle hindfoot score, Achilles tendon Total Rupture Score, heel‐rise repetitions in 1 min, heel‐rise height, and bilateral calf circumference at 6 months, 1 year, and 2 years postoperatively were recorded. ResultsAll incisions healed primarily in the minimally invasive technique group; however, three patients in the open repair group experienced wound complications. The time to return to moderate‐intensity exercise, American Orthopedic Foot and Ankle Society score, Achilles tendon Total Rupture Score, heel‐rise repetition ratio, and heel‐rise height ratio at 6 months postoperatively in the minimally invasive technique group were significantly better than those in the open repair group. However, it was not significantly different between both groups at 2 years postoperatively. ConclusionEndoscopy allowed scar tissue and adhesions to be removed, allowing the tendon ends to be mobilized out of the small proximal and distal incisions. Minimally invasive technique may result in a lower wound complication incidence and provide better early functional recovery and return to moderate‐intensity exercise time than the conventional open procedure in treating chronic Achilles tendon ruptures. Clinical trial registrationWuxi Ninth People’s Hospital Medical Ethical Committee, LW2021026. Level of evidenceIII.

show abstract

Section: Introductionmentioning

confidence: 99%

Endoscopic-assisted locking block modified Krackow technique combined with a V-Y flap for chronic Achilles tendon rupture

Liu

Tian

et al. 2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

“…hronic ruptures of the Achilles tendon present a unique surgical challenge for orthopedists [1][2][3][4][5] . While surgical intervention is often indicated, controversy remains as to a gold standard repair technique, and many patients are left with significant functional deficits 6,7 .…”

mentioning

confidence: 99%

“…Wesley J. Manz, MD 1 Jason Bowman, MD 1 Tee Pongastron, MD 1 Scot Sherwood, MD 1 Sameh A. Labib, MD 1…”

mentioning

confidence: 99%

Salvage Reconstruction of a 12-cm Tendon Defect Following Chronic Achilles Rerupture—15-Year Follow-Up

Manz,

Bowman,

Pongastron

et al. 2024

JBJS Case Connector

View full text Add to dashboard Cite

Case: A 39-year-old man with a chronic Achilles rupture status post (1) failed primary repair and (2) secondary xenograft repair with graft rejection, resulting in a 12-cm Achilles tendon defect, which was reconstructed utilizing an Achilles bone block allograft and flexor hallucis longus (FHL) tendon transfer. At 15-year follow-up, the patient reported good functionality and satisfaction with the repair, with positive patient-reported outcome measures. Physical examination revealed excellent strength and range of motion. Magnetic resonance imaging confirmed the integrity and incorporation of the Achilles/FHL graft composite. Conclusion: This case study provides valuable insight into successful long-term management of complex chronic Achilles ruptures with large defects.

show abstract

Both gastrocnemius aponeurosis flaps and semitendinosus tendon grafts are effective in the treatment of chronic Achilles tendon ruptures – a systematic review

Nilsson,

Stensöta,

Nilsson Helander

et al. 2023

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Introduction A chronic Achilles tendon rupture (ATR) is defined as an ATR that has been left untreated for more than four weeks following rupture. This systematic review aims to summarize the outcomes of chronic ATR treated using either a gastrocnemius aponeurosis flap or semitendinosus tendon graft. Methods A systematic search was conducted in three databases (PubMed, Scopus and Cochrane), for studies describing outcomes after surgical treatment of chronic ATR using gastrocnemius aponeurosis flaps or semitendinosus tendon grafts with more than 10 patients included. The studies were assessed for quality and risk of bias using the Methodological Items used to assess risk of bias in Non-Randomized Studies (MINORS). Results Out of the 818 studies identified with the initial search, a total of 36 studies with 763 individual patients were included in this systematic review. Gastrocnemius aponeurosis flap was used in 21 and semitendinosus tendon graft was used in 13 of the studies. The mean (SD) postoperative Achilles tendon Total Rupture Score (ATRS) for patients treated with a gastrocnemius aponeurosis flap was 83 (14) points and the mean (SD) American Orthopaedic Foot and Ankle Score (AOFAS) was 96 (1.7) points compared with ATRS 88 (6.9) points and AOFAS 92 (5.6) points for patients treated with a semitendinosus tendon graft. The included studies generally had low-quality according to MINORS, with a median of 8 (range 2–13) for all studies. Conclusion Both gastrocnemius aponeurosis flaps and semitendinosus tendon grafts give acceptable results with minimal complications and are valid methods for treating chronic ATR. The main difference is more wound healing complications in patients treated with a gastrocnemius aponeurosis flap and more sural nerve injuries in patients treated with a semitendinosus grafts. The current literature on the subject is of mainly low quality and the absence of a patient-related outcome measure validated for chronic ATR makes comparisons between studies difficult. Level of evidence Level IV.

show abstract

Chronic Achilles tendon rupture: a novel modification of surgical technique described by El Shewy

Cited by 4 publications

References 22 publications

Endoscopic-assisted locking block modified Krackow technique combined with a V-Y flap for chronic Achilles tendon rupture

Endoscopic-assisted locking block modified Krackow technique combined with a V-Y flap for chronic Achilles tendon rupture

Salvage Reconstruction of a 12-cm Tendon Defect Following Chronic Achilles Rerupture—15-Year Follow-Up

Both gastrocnemius aponeurosis flaps and semitendinosus tendon grafts are effective in the treatment of chronic Achilles tendon ruptures – a systematic review

Contact Info

Product

Resources

About