Dual Semitendinosus Allograft Reconstruction of Chronic Achilles Tendon Ruptures: Operative Technique and Outcomes

• Published in: Foot & ankle international Vol. 44; no. 1; pp. 48 - 53
• Main Authors: McCormick, Brian P., Trent, Sarah, Haislup, Brett D., Bolster, Drew, Bubnash, Kimberly, Miller, Stuart D.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-01-2023
• Subjects: Achilles Tendon - surgery; Allografts; Chronic Disease; Female; Hamstring Muscles - transplantation; Humans; Middle Aged; Retrospective Studies; Rupture - surgery; Tendon Injuries - surgery; Treatment Outcome; Achilles tendon; reconstruction; allograft
• ISSN: 1071-1007; 1944-7876
• DOI: 10.1177/10711007221138239

Background:
Dual semitendinosus allograft reconstruction of chronic Achilles tendon ruptures has several potential benefits including superior tensile strength compared with a turndown construct and avoidance of the morbidity and operative time associated with autograft augmentation. We present a series of chronic Achilles tendon ruptures reconstructed with dual semitendinosus allograft.
Methods:
We retrospectively reviewed the charts of patients aged 18 years and older who underwent reconstruction of chronic Achilles tendon ruptures using dual semitendinosus allograft. The primary outcome of this study was to evaluate the need for revision surgery. Secondary outcomes included patient-reported outcomes, for which Achilles Tendon Rupture Scores (ATRS) were collected at final follow-up. Nine patients with a mean age of 58.9 (range, 43-75) years met inclusion criteria.
Results:
Median follow-up was 66 months (range, 27-121 months). One patient (11.1%) required revision reconstruction after sustaining graft failure 9.5 years after her index procedure, and 1 patient reported a poor ATRS score at the 27-month final follow-up despite an intact surgical repair. At final follow-up, no patient required the use of an assistive device for ambulation or a walking boot. The median ATRS at final follow-up was 93 (range, 30-100).
Discussion:
Good clinical outcomes without rerupture were observed in 7 of 9 patients (77.8%) at short- to midterm follow-up, suggesting that dual semitendinosus allograft reconstruction is a viable option for the reconstruction of chronic Achilles tendon tears.
Level of Evidence:
Level IV, case series.