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Updated: May 30, 2026

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Endosopic achilles tendon augmentation with a graft loop anatomic and radiologic study.

Ossama El Shazly1, Maged M Abou Elsoud, Ahmed Desouky

  • 1Department of Orthopaedics, Ain Shams University, Cairo, Egypt. Ossama_elshazly@yahoo.com

Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons
|July 26, 2011
PubMed
Summary

This study presents a safe endoscopic technique for Achilles tendon (TA) augmentation using a graft loop. The method ensures the sural nerve and neurovascular structures remain intact during the mini-invasive repair.

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Area of Science:

  • Orthopedic Surgery
  • Minimally Invasive Procedures
  • Anatomy

Background:

  • Mini-invasive techniques are prevalent for Achilles tendon (TA) rupture repair.
  • Graft augmentation in TA rupture repair presents limitations with current mini-invasive methods.

Purpose of the Study:

  • To describe and evaluate a novel endoscopic-assisted technique for Achilles tendon augmentation using a graft loop.
  • To determine the safety and feasibility of this endoscopic approach for TA augmentation.

Main Methods:

  • A radiological study involving multi-slice CT scans of 18 normal ankles to identify endoscopic landmarks for Achilles tendon insertion.
  • Surgical procedure performed on six formaldehyde-preserved lower limb specimens, including endoscopic-assisted TA augmentation with a graft loop.

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  • Postoperative assessment of the created tunnel using multi-slice CT scans.

    • Main Results:

    • Anatomical dissection confirmed the integrity of the sural nerve and neurovascular bundle in all specimens.
    • The endoscopic technique successfully delivered a graft loop for Achilles tendon augmentation.
    • Postoperative CT scans evaluated the integrity of the augmented tendon and surrounding structures.

    Conclusions:

    • The described technique enables endoscopic delivery of a graft loop for Achilles tendon augmentation.
    • This endoscopic approach is demonstrated to be safe concerning the sural nerve and medial neurovascular structures.
    • The study validates a viable mini-invasive option for TA rupture repair requiring graft augmentation.