Minimally invasive treatment of acute Achilles tendon rupture with endoscopic flexor hallucis longus transfer

Abstract

Objective: To evaluate the clinical and functional outcomes of acute Achilles tendon rupture or rerupture repaired with minimally invasive surgery and reinforcement with flexor hallucis longus transfer via posterior ankle arthroscopy in patients with poor compliance with follow-up. Methods: A retrospective study was conducted that evaluated five patients with more than 24 months of postoperative follow-up using the American Orthopaedic Foot and Ankle Society (AOFAS) scale, Victorian Institute of Sport Assessment-Achilles (VISA-A) scale, Achilles tendon total rupture score (ATRS), and visual analog scale (VAS) for pain, as well as the range of motion and flexion strength. Results: The mean scores on the VAS, AOFAS scale, and VISA-A scale and the ATRS were 0.6, 98, 98.2, and 100, respectively. The mean dorsiflexion range of motion was 4.8° on the operated side and 7.6° on the contralateral side. The mean plantar flexion strength was 24.02 kgf on the operated side and 24.64 kgf on the contralateral side. The flexion strength of the interphalangeal joint of the hallux was 13.94 kgf on the operated side and 17.6 kgf on the contralateral side. The patients had no functional complaints. Conclusion: The proposed surgical treatment had good clinical and functional outcomes in the evaluated patients. The surgical technique described may be a good alternative for treating patients with poor compliance diagnosed with acute tendon rupture or cases of rerupture. Level of Evidence IV; Therapeutic Studies; Case Series.