Endoscopically Assisted Reconstruction of the Achilles Tendon Using Semitendinosus Graft.

BACKGROUND

Chronic ruptures of the Achilles tendon may lead to symptomatic weakness, despite rehabilitation. Open reconstruction yields good outcome but has a high complication rate, notably wound problems. Endoscopically assisted free semitendinosus transfer restores ankle and preserves first metatarsophalangeal joint (MTPJ) function.

INDICATIONS: The main indication for the procedure is symptomatic chronic rupture of the Achilles tendon with a palpable tendon gap.

TECHNIQUE DESCRIPTION: The procedure can be split into 4 stages: graft harvest, calcaneum and tunnel preparation, proximal graft attachment, and finally graft passage and screw insertion.

DISCUSSION/

CONCLUSION

Following reconstruction, patients use a cast in full plantar flexion for 2 weeks, then a graduated walker for full weight-bearing.