The Achilles Tendon: Practical Applications for Clinical Excellence Endoscopic Flexor Hallucis Longus Transfer

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Foot and Ankle Surgery

Background:

• Chronic Achilles tendon ruptures and tendinopathies present significant challenges in treatment.
• Minimally invasive surgical techniques are increasingly sought for improved patient outcomes and reduced morbidity.
• Flexor hallucis longus (FHL) tendon transfer is an established procedure for various foot and ankle conditions.

Purpose of the Study:

• To detail the endoscopic flexor hallucis longus (FHL) tendon transfer technique.
• To evaluate the efficacy of FHL tendon transfer for chronic Achilles tendon pathologies.
• To explore adjunctive gastrocnemius-soleus complex reconstruction for enhanced outcomes in specific patient populations.

Main Methods:

• Description of the endoscopic surgical technique for FHL tendon transfer to the calcaneus.
• Review of patient outcomes including American Orthopedic Foot and Ankle Society (AOFAS) scores and patient-reported measures.
• Assessment of the necessity for simultaneous gastrocnemius-soleus complex reconstruction in highly active individuals with significant tendon elongation.

Main Results:

• Endoscopic FHL tendon transfer demonstrates positive outcomes with improved functional scores.
• The procedure is associated with low complication rates.
• Simultaneous gastrocnemius-soleus reconstruction may be beneficial for highly active individuals with significant Achilles tendon elongation.

Conclusions:

• Endoscopic FHL tendon transfer is a promising, minimally invasive treatment for chronic Achilles tendon problems.
• Patient-reported outcomes and functional scores can be significantly improved with this technique.
• Careful patient selection and consideration of combined procedures are crucial for optimizing results in active individuals.