Modified Tension-Slide Technique for Endoscopy-Assisted Flexor Hallucis Longus Tendon Transfer

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Musculoskeletal Research

Background:

• Achilles tendon (AT) rupture commonly affects athletes but also low-demand individuals, particularly those using corticoids or quinolones.
• Delayed diagnosis of AT rupture can lead to poorer patient outcomes.
• Minimally invasive surgery is an attractive option for patients with high surgical risk or those seeking alternatives to traditional open repairs.

Purpose of the Study:

• To present a pioneering minimally invasive arthroscopic technique for Achilles tendon rupture repair.
• To describe a novel flexor hallucis longus tendon transfer method with extracortical fixation.
• To evaluate the feasibility and safety of this technique for Achilles tendon reconstruction.

Main Methods:

• A novel technique involving flexor hallucis longus tendon transfer via extracortical fixation with an interference screw.
• Direct tendon reinsertion through a bone tunnel on the superior and posterior calcaneus using an extracortical drilling system.
• Arthroscopic approach requiring advanced surgical skills.

Main Results:

• The described technique represents a pioneering approach for Achilles tendon rupture repair.
• Successful implementation requires a significant learning curve but is feasible and safe.
• This method offers an alternative to classical open repair techniques and tendon transfers with donor site morbidity.

Conclusions:

• The presented arthroscopic technique for Achilles tendon rupture using flexor hallucis longus transfer is a feasible and safe option.
• This minimally invasive approach addresses limitations of traditional methods, particularly for high-risk patients.
• Further evaluation and experience are needed to fully establish its long-term efficacy and benefits.