Reconstruction of chronic achilles tendon ruptures
Patients dealing with chronic Achilles tendon ruptures have a weakness with plantarflexion and push-off, along with gait dysfunction. As such, patients diagnosed with a chronic Achilles tear are typically offered surgical reconstruction in order to most optimally improve the strength, tension, and function of the gastrocnemius-soleus complex. A variety of surgical options have been described and reported without high-level data to necessarily demonstrate one technique as superior to another, given the relatively small numbers of cases performed. As such, certain factors are taken into consideration, including rupture location, tissue quality, residual defect or gap size, chronicity, and patient-specific factors. Surgical reconstructive options can include direct repair, fascial advancements, local tendon transfer, free tendon transfer, allograft use, synthetic use, and combinations of these procedures. These options are detailed and reviewed herein in order to assist the treating surgeon in the appropriate management of these cases.
