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Tytuł:
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Endoscopically assisted reconstruction of chronic Achilles tendon ruptures and re-ruptures using a semitendinosus autograft is a viable alternative to pre-existing techniques.
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Autorzy:
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Nilsson N; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborgsvägen 31, Mölndal, 431 80, Gothenburg, Sweden. .; Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden. .
Gunnarsson B; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborgsvägen 31, Mölndal, 431 80, Gothenburg, Sweden.; Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden.
Carmont MR; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborgsvägen 31, Mölndal, 431 80, Gothenburg, Sweden.; Department of Orthopaedic Surgery, Princess Royal Hospital, Shrewsbury and Telford Hospital NHS Trust, Shropshire, UK.
Brorsson A; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborgsvägen 31, Mölndal, 431 80, Gothenburg, Sweden.; IFK Kliniken Rehab, Gothenburg, Sweden.
Karlsson J; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborgsvägen 31, Mölndal, 431 80, Gothenburg, Sweden.; Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden.
Nilsson Helander K; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborgsvägen 31, Mölndal, 431 80, Gothenburg, Sweden.; Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden.
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Źródło:
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Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2022 Jul; Vol. 30 (7), pp. 2477-2484. Date of Electronic Publication: 2022 Apr 09.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: [Heidelberg, Germany] : Springer International, c1993-
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MeSH Terms:
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Achilles Tendon*/surgery
Ankle Injuries*
Hamstring Muscles*
Tendon Injuries*/surgery
Autografts ; Chronic Disease ; Female ; Humans ; Male ; Rupture/surgery ; Treatment Outcome
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References:
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J Bone Joint Surg Am. 2018 Nov 21;100(22):1969-1981. (PMID: 30480601)
Knee Surg Sports Traumatol Arthrosc. 2012 Jul;20(7):1386-91. (PMID: 22037808)
J Bone Joint Surg Br. 1987 May;69(3):416-20. (PMID: 3294839)
Knee Surg Sports Traumatol Arthrosc. 2020 May;28(5):1619-1624. (PMID: 30128686)
Foot Ankle Int. 2016 Jul;37(7):737-42. (PMID: 27036138)
Am J Sports Med. 2015 Oct;43(10):2591-8. (PMID: 25548149)
Foot Ankle Int. 1994 Sep;15(9):512-7. (PMID: 7820247)
Am J Sports Med. 2013 Apr;41(4):865-71. (PMID: 23393077)
J Trauma. 2001 Jan;50(1):71-8. (PMID: 11231673)
BMC Musculoskelet Disord. 2016 Jun 03;17:247. (PMID: 27256340)
Am J Sports Med. 2007 Mar;35(3):421-6. (PMID: 17158277)
J Orthop Sci. 2021 Sep;26(5):854-859. (PMID: 33191066)
BMC Musculoskelet Disord. 2008 Jul 08;9:100. (PMID: 18611249)
J Foot Ankle Surg. 2018 Sep - Oct;57(5):1042-1047. (PMID: 29784532)
Foot Ankle. 1987 Feb;7(4):253-9. (PMID: 3817670)
Knee Surg Sports Traumatol Arthrosc. 2011 Aug;19(8):1385-93. (PMID: 21533539)
Clin Biomech (Bristol, Avon). 2008 Jan;23(1):109-16. (PMID: 17949866)
Arch Orthop Trauma Surg. 2021 Mar;141(3):383-401. (PMID: 32266518)
Arch Orthop Trauma Surg. 2008 Feb;128(2):211-6. (PMID: 18057945)
Knee Surg Sports Traumatol Arthrosc. 2010 Feb;18(2):269-73. (PMID: 19838670)
Orthop Clin North Am. 1995 Apr;26(2):249-63. (PMID: 7724191)
J Bone Joint Surg Am. 2008 Jun;90(6):1348-60. (PMID: 18519331)
J Orthop Surg (Hong Kong). 2009 Aug;17(2):194-8. (PMID: 19721151)
Knee Surg Sports Traumatol Arthrosc. 2010 Feb;18(2):258-64. (PMID: 19690833)
Am J Sports Med. 2013 May;41(5):1100-7. (PMID: 23467554)
Foot Ankle Int. 2017 Aug;38(8):921-929. (PMID: 28553729)
Muscles Ligaments Tendons J. 2016 May 19;6(1):104-10. (PMID: 27331037)
Instr Course Lect. 1999;48:219-30. (PMID: 10098047)
Bone Joint J. 2018 May 1;100-B(5):584-589. (PMID: 29701092)
Orthop Surg. 2019 Feb;11(1):109-116. (PMID: 30809943)
J Bone Joint Surg Am. 2016 Jul 20;98(14):1168-75. (PMID: 27440564)
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2015 Feb 20;2(2):49-55. (PMID: 29264240)
J Orthop Surg (Hong Kong). 2019 Jan-Apr;27(1):2309499019832717. (PMID: 30808253)
J Bone Joint Surg Am. 1975 Mar;57(2):253-5. (PMID: 1089672)
Br Med Bull. 2014;109:45-54. (PMID: 24126569)
J Bone Joint Surg Am. 2009 Oct 1;91 Suppl 2:287-98. (PMID: 19805591)
Knee Surg Sports Traumatol Arthrosc. 2006 Nov;14(11):1207-17. (PMID: 16858560)
Foot Ankle Clin. 2005 Jun;10(2):357-70. (PMID: 15922924)
Foot Ankle Surg. 2012 Jun;18(2):128-31. (PMID: 22444001)
Knee Surg Sports Traumatol Arthrosc. 2008 Jun;16(6):614-20. (PMID: 18273601)
Am J Sports Med. 2009 Aug;37(8):1570-7. (PMID: 19521001)
Acta Orthop Belg. 2019 Mar;85(1):137-143. (PMID: 31023211)
Joints. 2017 Nov 13;5(4):212-216. (PMID: 29270558)
Bone Joint J. 2015 Mar;97-B(3):353-7. (PMID: 25737519)
Foot Ankle Surg. 2020 Oct;26(7):717-722. (PMID: 31635958)
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Contributed Indexing:
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Keywords: ATRS; Achilles tendon re-rupture; Chronic Achilles tendon rupture; Endoscopically assisted technique; Semitendinosus graft; Surgical repair
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Entry Date(s):
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Date Created: 20220409 Date Completed: 20220621 Latest Revision: 20221011
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Update Code:
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20240105
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PubMed Central ID:
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PMC9206609
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DOI:
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10.1007/s00167-022-06943-2
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PMID:
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35396938
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Purpose: Achilles tendon ruptures are termed chronic after a delay in treatment for more than 4 weeks. The literature advocates surgical treatment with reconstruction to regain ankle push-off strength. The preferred technique is, however, still unknown and is often individualized. This study aims to present the technique and clinical outcome of an endoscopically assisted free semitendinosus reconstruction of chronic Achilles tendon rupture and Achilles tendon re-ruptures with delayed representation. It is hypothesized that the presented technique is a viable and safe alternative for distal Achilles tendon ruptures and ruptures with large tendon gaps.
Method: Twenty-two patients (13 males and 9 females) with a median (range) age of 64 (34-73) treated surgically with endoscopically assisted Achilles tendon reconstruction using a semitendinosus autograft were included. The patients were evaluated at 12 months post-operatively for Achilles tendon Total Rupture Score (ATRS), calf circumference, Achilles Tendon Resting Angle (ATRA), heel-rise height and repetitions together with tendon length determined by ultrasonography, concentric heel-rise power and heel-rise work.
Results: The patients reported a median (range) ATRS of 76 (45-99) out of 100. The median (range) ATRA on the injured side was 60° (49°-75°) compared with 49.5° (40-61°), p < 0.001, on the non-injured side. Eighteen out of 22 patients were able to perform a single-leg heel-rise on the non-injured side. Sixteen patients out of those 18 (89%) were also able to perform a single heel-rise on the injured side. They did, however, perform significantly lower number of repetitions compared with the non-injured side with a median (range) heel-rise repetitions of 11 (2-22) compared with 26 (2-27), (p < 0.001), and a median (range) heel-rise height of 5.5 cm (1.0-11.0 cm) compared with 9.0 cm (5.0-11.5 cm), (p < 0.001). The median calf circumference was 1.5 cm smaller on the injured side, 37.5 cm compared with 39 cm, when medians were compared. The median (range) tendon length of the injured side was 24.8 cm (20-28.2 cm) compared with 22 cm (18.4-24.2 cm), (p < 0.001), on the non-injured side.
Conclusion: The study shows that endoscopically assisted reconstruction using a semitendinosus graft to treat chronic Achilles tendon ruptures and re-ruptures with delayed representation produces a satisfactory outcome. The technique can restore heel-rise height in patients with more distal ruptures or large tendon defects and is therefore a viable technique for Achilles tendon reconstruction.
Level of Evidence: IV.
(© 2022. The Author(s).)
Comment in: Knee Surg Sports Traumatol Arthrosc. 2022 Dec;30(12):4258-4259. (PMID: 36207459)
