Allogeneic semitendinosus tendon for reconstruction of large defects in chronic Achilles tendon ruptures
Objective To evaluate the efficacy of allogeneic semitendinosus tendon reconstruction for chronic Achilles tendon rupture with large defects.Methods A retrospective study of 11 cases of Myerson type 3 chronic Achilles tendon ruptures with large defects managed by allogeneic semitendinosus tendon reconstruction from July 2017 to August 2022 was conducted.Intra-operatively,it was observed that the Achilles tendon ends were separated by scar tissue.A comprehensive debridement was ex-ecuted to excise the fibrous scar and degenerated tissue,exposing fresh Achilles tendon ends.The defect size was measured with the ankle in a neutral position,and an appropriately sized allogeneic semitendinosus tendon was chosen for the reconstruction.For larger defects(8 to 10 cm),a combination of two allogeneic semitendinosus tendons was utilized.Results All 11 cases were subjected to follow-up for 12 to 48 months,averaging 24.9 months.None of the patients encountered infections,recurrent ruptures of the Achilles tendon,deep venous thrombosis in the lower extremities,sural nerve damage,or vascular injuries,with the exception of a single case reporting mild active pain.During the 3 to 5 month follow-up period,10 cases successfully demon-strated the ability to perform single-leg heel raises,while 1 case exhibited mild limitation.Three months after surgery,MRI T2 sequences showed a persisting high signal intensity,indicating granulation tissue occupying the residual tendon space,suggest-ing that fibrous tissue had yet to mature fully.By the six-month after surgery,MRI scans depicted a notable reduction in high sig-nal intensity,reflecting proper healing of the Achilles tendon and restoration of its continuity.Preoperative AOFAS Ankle-Hindfoot scores was 45 to 79,with an average of 64.3;postoperative AOFAS Ankle-Hindfoot scores at 12 months was 85 to 100,with an average of 95.5.Conclusion The reconstruction of large Achilles tendon defects using allogeneic semitendinosus ten-dons is a viable and effective surgical method.This technique enables the performance of surgery with minimal incisions and re-duced surgical disruption.
万方数据
维普
