Midterm Results of Large-Caliber Tendon Allografting for Chronic Achilles Tendon Rupture With Large Defects

Chronic Achilles tendon ruptures with large defects present a considerable challenge in treatment.

This study evaluated the midterm outcomes of fresh-frozen large-caliber allograft reconstruction for chronic Achilles tendon ruptures.

Case series; Level of evidence, 4.

A total of 32 patients (18 women and 14 men), with a mean age of 57.6 years (range, 21-81 years), were enrolled between 2007 and 2021. Of 32 ankles, 21 and 11 defects involved Achilles tendon ruptures at the middle and distal sections, respectively. The mean ruptured gap was 5.8 cm (range, 5-10 cm), and the mean follow-up period was 8.4 years (range, 3-16.9 years). The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, visual analog scale (VAS) score, and Achilles Tendon Total Rupture Score (ATRS) were used to evaluate the outcomes.

The patients' AOFAS ankle-hindfoot score increased from 64.8 ± 10.8 to 95.4 ± 4.2 (P < .001), their mean VAS score decreased from 6.3 ± 0.9 to 1.7 ± 0.5 (P < .001), and their mean ATRS increased from 49.9 ± 12.6 to 97.9 ± 5.7 (P < .001). Three complications, comprising 2 superficial infections and 1 partial retear, were reported. No complete rerupture, revision reconstruction, or non-tendon healing was reported. At the final follow-up, no patient required an assistive device for ambulation, and good tissue incorporation was observed.

Our midterm results revealed that fresh-frozen large-caliber tendon allografts represent a reasonable option for treating chronic Achilles tendon ruptures with large defects, achieving acceptable outcomes.