Salvage Reconstruction of a 12-cm Tendon Defect Following Chronic Achilles Rerupture-15-Year Follow-Up: A Case Report

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Regenerative Medicine

Background:

• Chronic Achilles ruptures present significant reconstructive challenges, especially after failed prior interventions.
• Large tendon defects require innovative surgical strategies for successful restoration of function.

Purpose of the Study:

• To present a long-term case study of a complex chronic Achilles rupture reconstruction.
• To evaluate the efficacy of an Achilles bone block allograft combined with a flexor hallucis longus (FHL) tendon transfer for large Achilles tendon defects.

Main Methods:

• A 39-year-old male patient with a 12-cm Achilles tendon defect underwent reconstruction.
• The procedure involved an Achilles bone block allograft and a flexor hallucis longus (FHL) tendon transfer.
• Outcomes were assessed at a 15-year follow-up.

Main Results:

• The patient reported high satisfaction and good functionality at 15 years post-surgery.
• Physical examination demonstrated excellent strength and range of motion.
• Magnetic resonance imaging confirmed graft integrity and incorporation.

Conclusions:

• This case demonstrates the viability of Achilles allograft and FHL transfer for complex, large Achilles tendon defects.
• Successful long-term management of challenging Achilles ruptures is achievable with appropriate reconstructive techniques.