Surgical treatment of chronic Achilles tendon rupture.

UNLABELLED: Chronic Achilles tendon ruptures are often challenging to repair because of muscle and tendon atrophy, retraction, and short distal stumps. We undertook a retrospective investigation of 14 patients who were treated with the Ligament Advanced Reinforcement System (LARS) ligament for the treatment of chronic, neglected rupture of the Achilles tendon. The patients pursued a course of early functional rehabilitation, and postoperative outcome scores were obtained at 3, 6, and 12 months, based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot scoring system, and the Tegner Activity score. The minimum duration of follow-up was 36 months. After a minimum of 28 months postoperative, and up to 41 months postoperative, there was no observed incidence of rerupture or recurrent pain. The mean time to return to full activity was 18.3 +/- 2.7 weeks, and >90% of the patients scored > or =80 points on the AOFAS scoring scale. Specifically, the mean AOFAS score increased from 48.64 +/- 12.67 to 85.86 +/- 6.6 after the operation, and this difference was statistically significant (P = .001). Furthermore, the Tegner activity scale score improved from 2.58 +/- 0.31 to 1.73 +/- 0.29 after the operation, and this difference was also statistically significant (P = .001). The results of this retrospective clinical study suggest that augmentation with the LARS ligament offers a satisfactory reconstructive option for the neglected Achilles tendon rupture.

LEVEL OF CLINICAL EVIDENCE: 4.