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Endoscopically Assisted Reconstruction of the Achilles Tendon Using Semitendinosus Graft
Michael R Carmont1,2, Arunansu Saha1, John-Henry Rhind1
1Department of Trauma & Orthopaedic Surgery, Princess Royal Hospital, The Shrewsbury and Telford Hospital NHS Trust, Shropshire, UK.
Background:
Chronic ruptures of the Achilles tendon may lead to symptomatic weakness, despite rehabilitation. Open reconstruction yields good outcome but has a high complication rate, notably wound problems. Endoscopically assisted free semitendinosus transfer restores ankle and preserves first metatarsophalangeal joint (MTPJ) function.
Indications:
The main indication for the procedure is symptomatic chronic rupture of the Achilles tendon with a palpable tendon gap.
Technique Description:
The procedure can be split into 4 stages: graft harvest, calcaneum and tunnel preparation, proximal graft attachment, and finally graft passage and screw insertion.
Discussion/Conclusion:
Following reconstruction, patients use a cast in full plantar flexion for 2 weeks, then a graduated walker for full weight-bearing.
