Endoscopically Assisted Reconstruction of the Achilles Tendon Using Semitendinosus Graft

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biotechnology

Background:

• Chronic Achilles tendon ruptures often result in persistent weakness, even after rehabilitation.
• Open reconstruction offers good outcomes but carries a significant risk of complications, particularly wound issues.
• Endoscopically assisted free semitendinosus transfer presents an alternative for restoring ankle function and preserving first MTPJ function.

Purpose of the Study:

• To describe the technique and outcomes of endoscopically assisted free semitendinosus transfer for chronic Achilles tendon ruptures.
• To evaluate the efficacy of this minimally invasive approach in restoring ankle function and preserving MTPJ function.

Main Methods:

• The procedure involves four key stages: graft harvest, preparation of the calcaneum and tunnels, proximal graft attachment, and graft passage with screw insertion.
• Post-operatively, patients are immobilized in a cast in full plantar flexion for two weeks.
• Following immobilization, a graduated walker is used to facilitate progressive weight-bearing.

Main Results:

• This technique successfully restores ankle function in patients with chronic Achilles tendon ruptures.
• Preservation of first metatarsophalangeal joint (MTPJ) function is a key benefit of this approach.
• The endoscopic method potentially reduces the wound complication rates associated with open surgery.

Conclusions:

• Endoscopically assisted free semitendinosus transfer is a viable and effective treatment for symptomatic chronic Achilles tendon ruptures.
• This minimally invasive technique offers a favorable alternative to open reconstruction, with good functional restoration and reduced complication risks.