Accessory Posterior Leg Muscles Encountered during Surgery for Achilles Tendon Pathology: A Case Series

AbstractRecent epidemiological analyses in fencing have shown that injuries and pain linked specifically to fencing training/competition were evident in 92.8% of fencers. Specifically the prevalence of Achilles tendon pathology has increased substantially in recent years, and males have been identified as being at greater risk of Achilles tendon injury compared to their female counterparts. This study aimed to examine gender differences in Achilles tendon loading during the fencing lunge.Achilles tendon load was obtained from eight male and eight female club level epee fencers using a 3D motion capture system and force platform information as they completed simulated lunges. Independent t-tests were performed on the data to determine whether differences existed.The results show that males were associated with significantly greater Achilles tendon loading rates in comparison to females.This suggests that male fencers may be at greater risk from Achilles tendon pathology as a function of fencing training/ competition.

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The Role of Ultrasound Assessment in Achilles Tendon Pathology

The Medical Journal of Cairo University ◽

10.21608/mjcu.2019.69914 ◽

2019 ◽

Vol 87 (9) ◽

pp. 3657-3663

Author(s):

HOSSAM SAKR, M.D.; MENNATALLAH HATEM SHALABY, M.D. ◽

HUDA ABDELHADY ABDELHAMEED, M.D.

Keyword(s):

Achilles Tendon ◽

Ultrasound Assessment ◽

Tendon Pathology

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Operative Outcome of Side-Locking Loop Suture Technique Accompanied by Autologous Semitendinosus Tendon Grafting for Chronic Rupture of Achilles Tendon

Foot & Ankle Orthopaedics ◽

10.1177/24730114211003541 ◽

2021 ◽

Vol 6 (2) ◽

pp. 247301142110035

Author(s):

Keisuke Tsukada ◽

Youichi Yasui ◽

Maya Kubo ◽

Shinya Miki ◽

Kentaro Matsui ◽

...

Keyword(s):

Achilles Tendon ◽

Scale Score ◽

Tendon Rupture ◽

Plantar Flexion ◽

Achilles Tendon Rupture ◽

Case Series ◽

Semitendinosus Tendon ◽

Level Of Evidence ◽

Operative Outcomes

Background: The purpose of this retrospective study was to clarify the operative outcomes of the side-locking loop suture (SLLS) technique accompanied by autologous semitendinosus tendon grafting for chronic Achilles tendon rupture. Methods: A chart review was conducted of consecutive patients treated with the SLLS technique at our department from 2012 to 2017. Postoperatively, a below-knee splint was applied for 2 weeks in 20 degrees of plantar flexion and then active range of motion exercise was started. Partial weightbearing exercise was allowed at 4 weeks according to patient tolerance, and full weightbearing without crutches was allowed at 8 weeks. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale score and the Achilles tendon rupture score (ATRS) were used to evaluate clinical outcomes preoperatively and at the final follow-up. Results: Ten patients (6 men, 4 women) were included in the analysis. Mean AOFAS ankle-hindfoot scale score increased significantly from 64.2 ± 5.6 points preoperatively to 95.0 ± 5.3 points at the final follow-up ( P < .001). The mean ATRS also increased significantly from 29.8 ± 4.4 points to 86.2 ± 7.7 points, respectively ( P < .001). Mean time between surgery and ability to perform 20 continuous double-leg heel raises of the operated foot was 13.5 ± 3.4 (range 10-18) weeks. One patient complained of postoperative hypoesthesia in the foot, which had spontaneously resolved by 3 months after surgery. Conclusion: The SLLS technique accompanied by autologous semitendinosus tendon grafting provided successful operative outcomes for patients with chronic Achilles tendon rupture regardless of the size of the defect, and thus long-term orthotic use was not needed after surgery. Level of Evidence: Level IV, retrospective case series.

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Ultrasound and surgical inspection of plantaris tendon involvement in chronic painful insertional Achilles tendinopathy: a case series

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2020-000979 ◽

2021 ◽

Vol 7 (1) ◽

pp. e000979

Author(s):

Håkan Alfredson ◽

Lorenzo Masci ◽

Christoph Spang

Keyword(s):

Achilles Tendon ◽

Clinical Symptoms ◽

Fatty Infiltration ◽

Case Series ◽

Achilles Tendinopathy ◽

Level Of Evidence ◽

Plantaris Tendon ◽

Medial Pain ◽

Tendon Insertion ◽

Insertional Achilles Tendinopathy

ObjectivesChronic painful insertional Achilles tendinopathy is known to be difficult to manage. The diagnosis is not always easy because multiple different tissues can be involved. The plantaris tendon has recently been described to frequently be involved in chronic painful mid-portion Achilles tendinopathy. This study aimed to evaluate possible plantaris tendon involvement in patients with chronic painful insertional Achilles tendinopathy.MethodsNinety-nine consecutive patients (74 males, 25 females) with a mean age of 40 years (range 24–64) who were surgically treated for insertional Achilles tendinopathy, were included. Clinical examination, ultrasound (US)+Doppler examination, and surgical findings were used to evaluate plantaris tendon involvement.ResultsIn 48/99 patients, there were clinical symptoms of plantaris tendon involvement with pain and tenderness located medially at the Achilles tendon insertion. In all these cases, surgical findings showed a thick and wide plantaris tendon together with a richly vascularised fatty infiltration between the plantaris and Achilles tendon. US examination suspected plantaris involvement in 32/48 patients.ConclusionPlantaris tendon involvement can potentially be part of the pathology in chronic painful insertional Achilles tendinopathy and should be considered for diagnosis and treatment when there is distinct and focal medial pain and tenderness.Level of evidenceIV case series.

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Augmented Repair of Acute Total Achilles Tendon Rupture With Peroneus Brevis Tendon Transfer Using Oblique Transosseous Calcaneal Tunnel: A Prospective Case Series

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2021.03.014 ◽

2021 ◽

Author(s):

Osama Gamal ◽

Ahmed Shams ◽

Mohamed Kamal Mesregah

Keyword(s):

Achilles Tendon ◽

Tendon Transfer ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Case Series ◽

Peroneus Brevis ◽

Prospective Case Series

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Treatment options for chronic ruptures of Achilles tendon – case series

10.33699/pis.2021.100.8.398-402 ◽

2021 ◽

Vol 100 (8) ◽

Keyword(s):

Achilles Tendon ◽

Treatment Options ◽

Case Series

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Early Postoperative Results of Endoscopic Transfer of Flexor Hallucis Longus for Chronic Achilles Rupture

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000112 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0001

Author(s):

Daniel Baumfeld ◽

Fernando Raduan ◽

Caio Nery ◽

Benjamim Macedo ◽

Thiago Silva ◽

...

Keyword(s):

Achilles Tendon ◽

Achilles Tendon Rupture ◽

Case Series ◽

Invasive Technique ◽

Flexor Hallucis Longus ◽

Open Procedure ◽

Wound Healing Problems ◽

Major Increase ◽

Chronic Injuries

Category: Ankle, Arthroscopy, Hindfoot Introduction/Purpose: Background Achilles tendon chronic rupture lead to proximal retraction of the tendon and have a greater tendency to show poorer functional outcomes than acute ruptures. Numerous surgical procedures have been described to treat this pathology. The transfer of the flexor hallucis longus is a well-established treatment option, usually performed as an open procedure. The aim of this paper is to report a case series of six patients with chronic Achilles tendon rupture treated with endoscopic transfer of FHL. Methods: Six patients with Achilles tendon chronic injuries or re-ruptures were treated with endoscopic FHL transfer. There were four man and two women, average of 50 years, with four left and two right tendons involved, and no bilateral cases. All lesions were at zone 2 (between 2-6 cm proximal to insertion). We describe the surgical technique and report our results at an average of a nine-month follow-up. Results: The average follow-up of the series was 9 months (range, 5–12 months). Three patients had an associate procedure at the Achilles tendon to repair the pre-existent gap, using a minimally invasive technique. On average, we expend 56 minutes to perform the surgery, ranging from 45 to 70 minutes. All patients had a major increase in ATRS score values postoperatively, with an average of 17.8 preoperatively and 83,3 postoperatively No major complications or wound healing problems were noted. Tiptoe stance was possible for all patients without limitation. None of the patients noticed functional weakness of the hallux during daily life activity. Conclusion: Endoscopic FLH transfer is a reliable option for patients with higher skin risk and soft tissue complications. Other studies are needed to compare this technique with the open procedure, gold standard by now, to ensure its safety and efficacy.

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Achilles tendon repair by a minimally invasive technique using Tenolig®

Journal of the Foot & Ankle ◽

10.30795/jfootankle.2020.v14.1194 ◽

2020 ◽

Vol 14 (3) ◽

pp. 269-273

Author(s):

Vinicius Oliveira ◽

Sérgio Prata

Keyword(s):

Minimally Invasive ◽

Achilles Tendon ◽

Postoperative Infection ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Case Series ◽

Minimally Invasive Technique ◽

Invasive Technique ◽

Aofas Score ◽

Functional Scores

Objective: To assess the degree of postoperative satisfaction of patients with acute Achilles tendon rupture who underwent surgical reconstruction by a minimally invasive technique using Tenolig®. Methods: A retrospective observational study was conducted with 18 patients with acute Achilles tendon rupture diagnosed by a positive Thompson test who underwent surgery. Outcomes were assessed using the American arthopaedic Foot and Ankle Society (AOFAS) score and the Foot Function Index (FFI). Furthermore, quantitative variables were descriptively treated, and patients’ age was correlated with FII and AOFAS score using Spearman’s correlation coefficient at a significance level of 5%. Results: Patients underwent surgery from one to six days after injury and were discharged one day later. Only one patient had a superficial postoperative infection. Patients’ AOFAS scores ranged from 75 to 100 points, and FFI ranged from 0 to 20%. The patient withsuperficial postoperative infection had an AOFAS score and a FFI of 75 points and 20%, respectively. Conclusion: Percutaneous repair of complete Achilles tendon rupture with Tenolig® resulted in high functional scores and a low rate of complications. Level of Evidence IV; Therapeutic Studies; Case Series.

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