Endoscopic Flexor Hallucis Longus Transfer With Interference Screw and Additional Tension Slide Cortical Button for...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Reconstructive Surgery

Background:

• Endoscopic flexor hallucis longus (FHL) tendon transfer is a viable option for managing Achilles tendon ruptures (ATR), including in athletes.
• Cadaveric studies suggest enhanced load capacity with a modified FHL transfer technique using an interference screw and cortical button.

Purpose of the Study:

• To evaluate patient-reported functional outcomes after endoscopic FHL tendon transfer for chronic ATR using a modified technique.
• To assess the safety and efficacy of this surgical modification.

Main Methods:

• Retrospective review of 17 patients undergoing endoscopic FHL transfer for chronic ATR.
• Assessment of imaging, history, PROMs (MOxFQ, EQ-5D, VAS-Pain), and complications.
• Mean follow-up of 1.5 years.

Main Results:

• All 17 patients showed statistically significant improvements in MOxFQ, EQ-5D, and VAS-Pain scores postoperatively.
• The mean time from injury to surgery was 33 weeks.
• One patient (5.9%) experienced symptomatic tibial neuritis.

Conclusions:

• Endoscopic FHL tendon transfer augmented with a cortical button and interference screw is a safe and effective treatment for chronic ATR.
• The procedure leads to significant improvements in patient-reported outcomes, including quality of life and pain reduction.