Over-lengthened chronic post-Achilles rupture: an indirect approach to shortening an over-lengthened post-Achilles rupture using a knotless anchor fixation system at the Achilles insertion.

This case demonstrates an indirect approach to addressing an over-lengthening of a chronic Achilles tendon post-rupture. A knotless tissue anchor was used to provide stability and allow for an earlier weight-bearing regime. The patient returned to work activities by 12 weeks, demonstrating good functional outcome. The case fulfils the key aims of restoring anatomical length and physiological tension, providing adequate strength for proper propulsion, optimising functional return to activity, decreasing any associated pain and reducing potential complications.