scholarly journals TL 18168 - Effect of obesity on the functional outcome of flexor hallucis longus tendon transfer surgery in patients with Achilles tendinopathy

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 99S
Author(s):  
Henrique Mansur ◽  
Thomás Almeida de Sousa Nogueira ◽  
Juan Benitez ◽  
Isnar Moreira de Castro Júnior
Keyword(s):  
Functional Outcomes ◽  
Tendon Transfer ◽  
Plantar Flexion ◽  
Achilles Tendinopathy ◽  
Flexor Hallucis Longus ◽  
Foot And Ankle ◽  
Aofas Score ◽  
Longus Tendon ◽  
Significant Difference ◽  
Nonobese Patients

Introduction: Several factors, including diabetes and smoking, increase the risk of and predisposition for complications of foot and ankle surgeries; however, studies assessing the effects of obesity remain scarce. The objective of this study is to assess the effects of obesity on functional outcomes of flexor hallucis longus (FLH) tendon transfer surgery in patients with chronic Achilles tendinopathy. Methods: A retrospective study was performed with patients aged 18 years or older who underwent FHL tendon transfer between March 2010 and May 2015. The characteristics recorded were sex, age, body mass index (BMI), American Orthopedic Foot and Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS) and ankle plantar flexion and dorsiflexion strength, assessed using an isokinetic dynamometer. Results: The sample had 24 participants (13 women and 11 men) with a mean age of 55.7 years; among them, 13 were obese (BMI>=30), and 11 were nonobese (BMI<30). After a mean follow-up time of 66 months, the FAOS of the sample increased from 28 to 91 points (p=0.000). No significant difference in the postoperative AOFAS score or FAOS was found between the subgroups (p>0.05), with values of 83 and 86.7 points (AOFAS) and 92.72 and 90 points (FAOS) for obese and nonobese patients, respectively. The comparison of the strength of each motion revealed no significant difference (p>0.05) between subgroups. There was no association between BMI and postoperative functional outcomes (AOFAS score and FAOS) (p>0.05) or correlation between BMI and the strength of the operated ankles. Conclusion: Our findings indicate that flexor hallucis longus tendon transfer surgery in Achilles tendinopathy is effective for obese and nonobese patients based on the AOFAS and FAOS scores and dynamometry results.

Anatomical study for flexor hallucis longus tendon transfer in treatment of Achilles tendinopathy

2014 ◽  
Vol 37 (6) ◽  
pp. 639-647 ◽  
Author(s):  
Haijiao Mao ◽  
Zengyuan Shi ◽  
Keith L. Wapner ◽  
Wenwei Dong ◽  
Weigang Yin ◽  
...  
Keyword(s):  
Tendon Transfer ◽  
Anatomical Study ◽  
Achilles Tendinopathy ◽  
Flexor Hallucis Longus ◽  
Longus Tendon

Surgical Treatment of Insertional Achilles Tendinopathy With or Without Flexor Hallucis Longus Tendon Transfer

2015 ◽  
Vol 36 (9) ◽  
pp. 998-1005 ◽  
Author(s):  
Kenneth J. Hunt ◽  
Bruce E. Cohen ◽  
W. Hodges Davis ◽  
Robert B. Anderson ◽  
Carroll P. Jones
Keyword(s):  
Surgical Treatment ◽  
Tendon Transfer ◽  
Achilles Tendinopathy ◽  
Flexor Hallucis Longus ◽  
Longus Tendon ◽  
Insertional Achilles Tendinopathy

Arthroscopic, Single-Incision, and Double-Incision Approaches to Flexor Hallucis Longus Tendon Transfer Following Achilles Tendon Rupture: A Literature Review

2021 ◽  
Vol 111 (3) ◽  
Author(s):  
Ashley V. Mosseri ◽  
Phillip Calaj ◽  
Dominick J. Casciato ◽  
Bibi N. Singh
Keyword(s):  
Postoperative Complications ◽  
Achilles Tendon ◽  
Tendon Transfer ◽  
Tendon Rupture ◽  
Single Incision ◽  
Achilles Tendon Rupture ◽  
Athletic Injury ◽  
Flexor Hallucis Longus ◽  
Longus Tendon ◽  
Significant Difference

Achilles tendon rupture is a common athletic injury that results in a painful and antalgic gait. Flexor hallucis longus tendon transfer through arthroscopic, single-incision, or double-incision techniques is used as a treatment approach to address this rupture; however, no studies have compared postoperative complications between these three techniques. A systematic search of published articles was conducted using keywords “Achilles rupture,” “flexor hallucis tendon,” “transfer,” and “recovery.” Articles were then selected based on their title, abstract, and content following full-text review. From each article's reported surgical outcomes, a comparison was made between arthroscopic and single- and double-incision postoperative complications using a χ2 test with significance set at a value of P &lt; .05 followed by post hoc analysis. The arthroscopic approach maintained the lowest rate of postoperative complications, followed by the single- and double-incision techniques. A significant difference in the number of postoperative complications was found between all incisional approaches. The pairwise comparisons, however, could not identify which incisional approaches significantly differed between each other. A reduction in postoperative complications places arthroscopy and the single-incision techniques as the preferred approaches for flexor hallucis longus tendon transfer following an Achilles tendon rupture. Although current literature shows arthroscopy to be superior to single- and double-incision methods, this review demonstrates the need for a greater number of published cases using arthroscopy to establish significance regarding postoperative complications.

Endoscopic Flexor Hallucis Longus Transfer for Achilles Noninsertional Tendinopathy: Description of Surgical Technique and Functional Outcomes

2020 ◽  
pp. 193864001989591
Author(s):  
Juan Bernardo Gerstner G ◽  
Ian Winson ◽  
Jimmy Campo ◽  
Michael Swords ◽  
Juan Camilo Medina ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Case Series ◽  
Functional Results ◽  
Achilles Tendinopathy ◽  
Flexor Hallucis Longus ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Flexor Hallucis Longus Transfer ◽  
The Mean ◽  
American Orthopaedic

Background. The transfer of the flexor hallucis longus (FHL) tendon is an established treatment for replacing a dysfunctional Achilles tendon. Objectives. (1) Describe a new technique for endoscopic FHL transfer for noninsertional Achilles tendinopathy and (2) describe the functional outcomes and complications after endoscopic and open FHL transfer. Materials and Method. Retrospective study of patients who underwent open or endoscopic FHL transfer between 2014 and 2016. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle/hindfoot scale was used preoperatively and postoperatively to measure the functional results. Results. We included 18 endoscopic FHL transfers and 24 open FHL transfers. The mean age of endoscopic and open procedures was 47.5 years (range 25-77 years) and 61.2 years (range 43-72 years), respectively. An improvement on the average AOFAS of 52.8% (31.9 points) was observed in the endoscopy group during the follow-up from the baseline. The mean improvement in AOFAS score for the open group was 41.4% (24.5 points). Four and 7 cases reported complications in the endoscopy and open FHL transfer groups, respectively. Conclusion. While both procedures were effective in treating noninsertional Achilles tendinopathy, the described arthroscopic treatment led to a greater improvement in the AOFAS score and is slightly less prone to lasting complications. Level of Evidence: Level IV: Case series

scholarly journals Evaluation of the results of flexor hallucis longus tendon transfer for chronic Achilles tendinopathy

2018 ◽  
Vol 12 (3) ◽  
pp. 240-246
Author(s):  
Juan Benitez ◽  
Henrique Mansur ◽  
Isnar Castro
Keyword(s):  
Case Control Study ◽  
Plantar Flexion ◽  
Case Control ◽  
Achilles Tendinopathy ◽  
Flexor Hallucis Longus ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Flexion Strength ◽  
Chronic Achilles Tendinopathy ◽  
Control Study

Objective: To demonstrate that transfer of the flexor hallucis longus (FHL) through a single access site for Achilles tendinosis provides good results and can allow satisfactory recovery of ankle flexion strength. Methods: This is a case-control study with 28 consecutive patients who underwent surgery for Achilles tendon debridement and FHL transfer between January 2009 and July 2015. The patients’ body mass index (BMI), plantar flexion strength and ankle dorsiflexion strength were assessed using an isokinetic dynamometer (Humac Norm model, CSMi) and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale. Results: Of the 28 patients, 53.8% were women, and the mean age was 55 years. After a median follow-up of 3.1 years, the plantar flexion strength of the operated ankles was 26.42 Nm (± 2.18), and the dorsiflexion strength was 16 Nm (± 1.99). The final AOFAS score was 85.3 points, with 82.1%of patients achieving good and excellent results. The results showed a significant difference in plantar flexion strength (p=0.0001) between the operated foot and the contralateral foot. No significant difference was found when comparing patients with different BMIs in relation to muscle strength and AOFAS score.Conclusion: FHL transfer surgery using a single posteromedial route for chronic Achilles tendinopathy presents good functional results and is a safe technique with a low complication rate. Level of Evidence III; Therapeutic Studies; Case Control Study.

scholarly journals Flexor hallucis longus tendon transfer for chronic Achilles tendon rupture. A retrospective study

2019 ◽  
Vol 25 (5) ◽  
pp. 630-635 ◽  
Author(s):  
Ole Kristian Alhaug ◽  
Gøran Berdal ◽  
Elisabeth Ellingsen Husebye ◽  
Kjetil Hvaal
Keyword(s):  
Retrospective Study ◽  
Achilles Tendon ◽  
Tendon Transfer ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Flexor Hallucis Longus ◽  
Longus Tendon
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