Functional outcome after percutaneous tendo-Achilles lengthening

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery
• Biomechanical Engineering

Background:

• Percutaneous tendo-Achilles lengthening (PTAL) is frequently used with other procedures for foot and ankle issues.
• Existing evidence for PTAL efficacy is limited, primarily from diabetic forefoot ulceration treatment.
• Potential complications include pain, stiffness, weakness, and inadvertent tenotomy.

Purpose of the Study:

• To evaluate functional outcomes of PTAL when performed concurrently with triple arthrodesis and subtalar fusion.
• To assess patient-reported improvements in motion, stiffness, and functional limitations.

Main Methods:

• Retrospective review of 107 patients (117 procedures).
• Outcomes assessed via telephone interview using a standardized questionnaire.
• Triple arthrodesis was the most common concomitant procedure (91%).

Main Results:

• 58% reported moderate improvement in motion; 80% experienced persistent stiffness.
• 38% reported postoperative weakness, yet 66% found ascending stairs easier and 61% descending stairs easier.
• 81% of patients had a positive overall opinion of their surgery.

Conclusions:

• PTAL, when combined with other surgeries like triple arthrodesis, shows modest benefits for Achilles tendon-related outcomes.
• The procedure can lead to improved stair mobility despite potential persistent stiffness and weakness.
• Overall patient satisfaction was high in this heterogeneous surgical population.