Endoscopic Flexor Hallucis Longus Transfer for the Management of Acute Achilles Tendon Ruptures in Professional Soccer Players

2021 ◽  
pp. 107110072110364
Author(s):  
Nasef Mohamed N. Abdelatif ◽  
Jorge Pablo Batista
Keyword(s):  
Achilles Tendon ◽  
Tendon Transfer ◽  
Case Series ◽  
Return To Play ◽  
Soccer Players ◽  
Flexor Hallucis Longus ◽  
Professional Soccer ◽  
Case Series Study ◽  
Tendon Ruptures ◽  
The Mean

Background: Acute Achilles tendon ruptures (AATRs) that occur in athletes can be a career-ending injury. The aim of this study was to describe return to play and clinical outcomes of isolated endoscopic flexor hallucis longus (FHL) transfer in active soccer players with AATR. Methods: Twenty-seven active male soccer players who underwent endoscopically assisted FHL tendon transfer for acute Achilles tendon ruptures were included in this study. Follow up was 46.2 (±10.9) months after surgery. Return to play criteria and clinical outcome measures were evaluated. Results: All players returned to playing professional competitive soccer games. Return to active team training was at a mean of 5.8 (±1.1) months postoperatively. However, return to active competitive match play occurred at a mean of 8.3 (±1.4) months. Twenty-two players (82%) were able to return to their preinjury levels and performances and resumed their professional careers at the same soccer club as their preinjury state. One player (3.7%) shifted his career to professional indoor soccer. At 26 months postoperatively, the mean Tegner activity scale score was 9.7 (±0.4), the mean Achilles tendon total rupture score was 99 (±2), and the mean American Orthopaedic Foot & Ankle Society ankle-hindfoot score was 99 (±3). No patients reported any great toe complaints or symptomatic deficits of flexion strength. Conclusion: The current study demonstrated satisfactory and comparable return to play criteria and clinical results with minimal complications when using an advanced endoscopically assisted technique involving FHL tendon transfer to treat acute Achilles tendon ruptures in this specific subset of patient cohort. Level of Evidence: Level II, prospective cohort case series study.

scholarly journals Return to Play and Player Performance After Achilles Tendon Rupture in UEFA Professional Soccer Players: A Matched-Cohort Analysis of Players From 1999 to 2018

2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110241
Author(s):  
Enrico M. Forlenza ◽  
Ophelie Z. Lavoie-Gagne ◽  
Yining Lu ◽  
Connor C. Diaz ◽  
Jorge Chahla ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Performance Metrics ◽  
Cohort Analysis ◽  
Achilles Tendon Rupture ◽  
Return To Play ◽  
Soccer Players ◽  
Professional Soccer ◽  
The Mean ◽  
Player Performance

Background: Achilles tendon rupture (ATR) is a potentially career-ending injury in professional athletes. Limited information exists regarding return to play (RTP) in professional soccer players after this injury. Purpose: To determine the RTP rate and time in professional soccer players after ATR and to evaluate player performance relative to matched controls. Study Design: Cohort study; Level of evidence, 3. Methods: We evaluated 132 professional soccer players who suffered an ATR between 1999 and 2018. These athletes were matched 2:1 to uninjured controls by position, age, season of injury, seasons played, and height. We collected information on the date of injury, the date of RTP, and player performance metrics (minutes played, games played, goals scored, assists made, and points per game) from official team websites, public injury reports, and press releases. Changes in performance metrics for the 4 years after the season of injury were compared with metrics 1 season before injury. Univariate comparisons were performed using independent-sample, 2-group t tests and Wilcoxon rank-sum tests when normality of distributions was violated. Results: The mean age at ATR was 27.49 ± 4.06 years, and the mean time to RTP was 5.07 ± 2.61 months (18.19 ± 10.96 games). The RTP rate was 71% for the season after injury and 78% for return at any timepoint. Overall, 9% of the injured players experienced a rerupture during the study period. Compared with controls, the injured players played significantly less (-6.77 vs -1.81 games [ P < .001] and -560.17 vs -171.17 minutes [ P < .05]) and recorded fewer goals (-1.06 vs -0.29 [ P < .05]) and assists (-0.76 vs -0.02 [ P < .05]) during the season of their Achilles rupture. With the exception of midfielders, there were no significant differences in play time or performance metrics between injured and uninjured players at any postinjury timepoint. Conclusion: Soccer players who suffered an ATR had a 78% RTP rate, with a mean RTP time of 5 months. Injured players played less and demonstrated inferior performance during the season of injury. With the exception of midfielders, players displayed no significant differences in play time or performance during any of the 4 postinjury seasons.

Professional soccer players; Return to play and performance after Achilles tendon ruptures

2017 ◽  
Vol 23 ◽  
pp. 121
Author(s):  
D. Trofa ◽  
P. Noback ◽  
C. Ahmad ◽  
J. Greisberg ◽  
J. Turner Vosseller
Keyword(s):  
Achilles Tendon ◽  
Return To Play ◽  
Soccer Players ◽  
Professional Soccer ◽  
Tendon Ruptures ◽  
And Performance

Return to Play After Hip Arthroscopic Surgery for Femoroacetabular Impingement in Professional Soccer Players

2017 ◽  
Vol 46 (2) ◽  
pp. 273-279 ◽  
Author(s):  
Renato Locks ◽  
Hajime Utsunomiya ◽  
Karen K. Briggs ◽  
Shannen McNamara ◽  
Jorge Chahla ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Arthroscopic Surgery ◽  
Case Series ◽  
Return To Play ◽  
Soccer Players ◽  
Professional Career ◽  
National Team ◽  
Professional Soccer ◽  
Chondral Damage ◽  
The Mean

Background: Arthroscopic hip surgery has been shown to be effective in returning professional athletes back to play at a high level of performance in different sports. Limited information exists regarding professional soccer players and their return to play. Purpose: To determine the rate and time to return to sport for professional soccer players after hip arthroscopic surgery for the treatment of femoroacetabular impingement (FAI) and to identify possible risk factors associated with a delay in returning to play. Study Design: Case series; Level of evidence, 4. Methods: Professional soccer players who underwent hip arthroscopic surgery for FAI by a single surgeon between 2005 and 2015 were evaluated. Data retrieved from www.mlssoccer.com , www.fifa.com , www.transfermarkt.co.uk , and www.wikipedia.org included information on each player’s professional career, participation on the national team, length of professional career before surgery, number of appearances (games) before surgery, time between surgery and first appearance in a professional game, and number of appearances after surgery. Other data were obtained from the patient’s medical records. Results: Twenty-four professional soccer players (26 hips) were included. The mean age at surgery was 25.0 ± 4.0 years (range, 19-32 years). A total of 96% of patients were able to return to play at the professional level. The mean time between surgery and the first professional game played was 9.2 months (range, 1.9-24.0 months). On average, players played in 70 games after surgery (range, 0-224). National team players were able to return to play significantly earlier than the rest of the players (median, 5.7 months vs 11.6 months, respectively; P = .018). Severe chondral damage and microfracture did not interfere with return to play. Conclusion: The arthroscopic management of FAI in symptomatic professional soccer players allowed 96% of them to return to play. Players with national team experience were able to return to play earlier than those without it. Severe chondral damage and microfracture did not interfere with return to play.

scholarly journals Chronic insertional achilles tendon ruptures treated by suture anchor repair and augmentation with flexor hallucis longus tendon transfer

2018 ◽  
Vol 4 (2) ◽  
pp. 227 ◽  
Author(s):  
Athar Ahemad M. A. ◽  
Naser Mohd Abdul ◽  
Mushir Ali Syed
Keyword(s):  
Achilles Tendon ◽  
Tendon Transfer ◽  
Suture Anchor ◽  
Interference Screw ◽  
Flexor Hallucis Longus ◽  
Reliable Technique ◽  
Good Outcome ◽  
Interference Screw Fixation ◽  
Tendon Ruptures

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Different surgical procedures have been used for treatment of chronic ruptures of the Achilles tendon with varying results. This study assesses the functional outcomes and complications of chronic insertional tears of Achilles tendon.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">10 patients with chronic ruptures of the Achilles tendon were followed for a mean period of 10.3 months. Only ruptures at or near (within 1 cm) insertion were included. They were treated by direct repair of tendon to calcaneum by suture anchor. Flexor hallucis longus (FHL) tendon transfer fixed to calcaneal tunnel with an interference screw was used to augment the repair</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Outcome was assessed by AOFAS Ankle-Hindfoot (AHS) score. The mean preoperative score of 41.2 improved to 85.4 at final follow-up out of a total 100 points. We achieved excellent results in 80% and good outcome in 20% cases. No re-ruptures were noted. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">In insertional chronic ruptures of Achilles tendon, FHL transfer to calcaneum with interference screw fixation and repair of Achilles tendon with suture anchor is a reliable technique with good outcome and is recommended.</span></p>

MRI Assessment of Degeneration of the Tendon in Achilles Tendon Ruptures

2019 ◽  
Vol 40 (8) ◽  
pp. 895-899 ◽  
Author(s):  
Henrik C. Bäcker ◽  
Tony T. Wong ◽  
J. Turner Vosseller
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Case Series ◽  
Distal Segment ◽  
Myotendinous Junction ◽  
Mr Images ◽  
Level Of Evidence ◽  
Tendon Length ◽  
Tendon Ruptures ◽  
The Mean

Background: The extent of tendinosis along the entire tendon in Achilles tendon ruptures (ATRs) has not previously been assessed. MR images of acute ATRs were evaluated to assess this extent, even in areas distant from the rupture. Methods: Patients who had MR images for an ATR were reviewed. Each tendon was divided into a proximal, middle, and distal segment with the full tendon length defined as the length measured from the myotendinous junction to the insertion. The site of tendon rupture, presence of tendinosis and/or additional tearing, and largest anteroposterior (AP) diameter in the remaining segments were noted. In total, 45 MR iamges were included in our study. Results: The mean total tendon length was 9.93 cm, while the length from the insertion to the tear was 5.86 cm. Of the 45 ruptures, 20 (44.4%) were in the proximal third, 19 (42.2%) in the middle third, and 6 (13.3%) in the distal third. In all remaining segments where no ruptured tendon was observed, tendinosis was seen. Further, of the 90 segments of a tendon without rupture, 87 (96.7%) had an AP diameter greater than 6 mm. Of those 90 segments without rupture, 24 (26.7%) had a secondary partial-thickness tear in another third. Conclusion: Tendinosis is a known precursor of an ATR that in the current study was not limited to the area of rupture. The finding of extensive tendon degeneration may have implications for the optimal surgical treatment. Level of Evidence: Level IV, case series.

scholarly journals Mid-term follow-up after surgical treatment of fifth metatarsal base fractures in professional soccer players

2019 ◽  
Vol 13 (2) ◽  
pp. 154-159
Author(s):  
Luis Paulo Vilela Lemos ◽  
Tiago Soares Baumfeld ◽  
Benjamim Dutra Macedo ◽  
Caio Augusto De Souza Nery ◽  
Jorge P. Batista ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Case Series ◽  
Return To Sport ◽  
Soccer Players ◽  
Level Of Evidence ◽  
Time To Surgery ◽  
Vas Score ◽  
Professional Soccer ◽  
The Mean

Objective: Fifth metatarsal fractures occur mainly in young athletes, with an estimated incidence of 1.8 per 1,000 people a year. The objective of this study was to evaluate the functional outcome of professional soccer players subjected to surgical treatment of fifth metatarsal base fractures. Methods: A total of 34 soccer players who underwent surgery from July 2001 to June 2016 were evaluated. All participants were evaluated by the American Orthopedic Foot and Ankle Score (AOFAS) and visual analogue scale (VAS) score before and after surgery, with a mean follow-up of 23 months. The need for grafting relative to time to surgery, time to fracture consolidation and Torg classification and graft use relative to return to sport were valuated. Results: There were 10 forwards, 7 offensive midfielders, 6 fullbacks, 5 center midfielders, 3 defenders, 2 goalkeepers and 1 defensive midfielder, with a mean age of 19 years. The mean pre- and postoperative AOFAS was 42 and 99 points whereas the mean VAS score was 6 and 0, respectively. The longer the time to surgery, the greater was the need for grafting (p=0.011). The time to return to sport was not influenced by the time to surgery, time to consolidation, Torg classification or graft use. Conclusion: The surgical treatment of fifth metatarsal base fractures in professional soccer players showed good clinical results. The return to activities after surgery is not influenced by the time to surgery, time to consolidation, Torg classification or grafting. Level of Evidence IV; Therapeutic Studies; Case Series.

Biomechanical Cadaveric Analysis of Biotenodesis Screw Versus Bone Tunnel Fixation Methods in Flexor Hallucis Longus Transfers

2013 ◽  
Author(s):  
B. Christian Balldin ◽  
Jacob R. Zide ◽  
George T. Liu ◽  
Christopher T. Chen
Keyword(s):  
Achilles Tendon ◽  
Human Body ◽  
Gold Standard ◽  
Tendon Transfer ◽  
Primary Repair ◽  
Bone Tunnel ◽  
Flexor Hallucis Longus ◽  
Fixation Methods ◽  
Tendon Ruptures ◽  
Cadaveric Analysis

The Achilles tendon is the largest tendon in the human body. It connects the gastrosoleus complex to the calcaneus bone in the foot. It thus allows for transfer of force and heel elevation during forward propulsion of the foot in gait. It is also one the most commonly injured tendons. (1). Acute repair or acute intervention for non-operatively treated tendons do well to restore function. However, chronic Achilles tendon ruptures often require tendon transfer rather than attempt at primary repair. The treatment considered the gold standard is the transfer of the flexor hallucis longus (FHL) tendon to the Achilles insertion of the calcaneus (2).

scholarly journals Return-to-Play Times and Player Performance After ACL Reconstruction in Elite UEFA Professional Soccer Players: A Matched-Cohort Analysis From 1999 to 2019

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110088
Author(s):  
Brian Forsythe ◽  
Ophelie Z. Lavoie-Gagne ◽  
Enrico M. Forlenza ◽  
Connor C. Diaz ◽  
Randy Mascarenhas
Keyword(s):  
Acl Reconstruction ◽  
Cohort Analysis ◽  
Acl Rupture ◽  
Return To Play ◽  
Soccer Players ◽  
Matched Cohort ◽  
Professional Soccer ◽  
The Mean ◽  
Player Performance ◽  
The Impact

Background: Anterior cruciate ligament (ACL) rupture is one of the most common injuries afflicting soccer players and requires a lengthy recovery processes after reconstructive surgery. The impact of ACL reconstruction (ACLR) on return to play (RTP) time and player performance in professional soccer players remains poorly studied. Purpose/Hypothesis: To determine player performance and RTP rate and time after ACLR in elite professional soccer players with a retrospective matched-cohort analysis. We expected that the RTP time and rate will be similar to those of other professional-level athletes. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 51 players from 1 of the 5 elite Union of European Football Associations (UEFA) soccer leagues who suffered a complete ACL rupture between 1999 and 2019. These athletes were matched by position, age, season of injury, seasons played, and height and compared to uninjured control players. Change in performance metrics for the 4 years after the season of injury were compared with metrics 1 season before injury. Univariate 2-group comparisons were performed using independent 2-group t tests; Wilcoxon rank-sum tests were used when normality of distributions was violated. Results: Overall, 41 players (80%) returned to play after ACL rupture, with 6 (12%) experiencing a subsequent ipsilateral or contralateral ACL tear. The mean (±SD) RTP time for soccer players after ACLR was 216 ± 109 days (26 ± 18 games). Injured athletes played significantly fewer games and minutes per season and recorded inferior performances for 2 seasons after their injury ( P < .001). However, the game performance of injured players equaled or exceeded that of their matched controls by season 3 after injury, with the exception of attackers, who demonstrated a continued decline in performance ( P < .001). Conclusion: Results indicated that the mean RTP time for soccer players after ACLR is short in comparison with other major sports leagues (216 days). However, RTP rates were high, and rerupture rates were comparable with those of other sports. With the exception of attackers, player performance largely equaled or exceeded that of matched controls by the third postinjury season.

Sign in / Sign up

Export Citation Format

Share Document