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

Area of Science:

• Orthopaedic Surgery
• Musculoskeletal Research
• Regenerative Medicine

Background:

• Chronic Achilles tendon ruptures with large defects pose significant treatment challenges.
• Effective reconstruction methods are crucial for restoring function and patient quality of life.

Purpose of the Study:

• To evaluate the midterm outcomes of using fresh-frozen large-caliber allografts for chronic Achilles tendon ruptures.
• To assess the efficacy and safety of allograft reconstruction in a clinical setting.

Main Methods:

• A case series of 32 patients (mean age 57.6 years) with chronic Achilles tendon ruptures (mean defect size 5.8 cm) treated with allograft reconstruction.
• Follow-up averaged 8.4 years, with outcomes assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score, visual analog scale (VAS) for pain, and Achilles Tendon Total Rupture Score (ATRS).

Main Results:

• Significant improvements were observed in AOFAS scores (64.8 to 95.4, P < .001), VAS pain scores (6.3 to 1.7, P < .001), and ATRS (49.9 to 97.9, P < .001).
• Low complication rates included 2 superficial infections and 1 partial retear; no complete reruptures or revision surgeries were required.
• All patients achieved good tissue incorporation and were able to ambulate without assistive devices at final follow-up.

Conclusions:

• Fresh-frozen large-caliber Achilles tendon allografts provide a reasonable and effective option for managing chronic ruptures with large defects.
• This reconstructive technique yields acceptable midterm functional outcomes and patient satisfaction with a low complication profile.