Tsukada Keisuke, Yasui Youichi, Kubo Maya, Miki Shinya, Matsui Kentaro, Sasahara Jun, Kawano Hirotaka, Miyamoto Wataru
Department of Orthopaedic Surgery, Teikyo University School of Medicine, Itabashi, Tokyo, Japan.
Foot Ankle Orthop. 2021 Jun 23;6(2):24730114211003541. doi: 10.1177/24730114211003541. eCollection 2021 Apr.
The purpose of this retrospective study was to clarify the operative outcomes of the side-locking loop suture (SLLS) technique accompanied by autologous semitendinosus tendon grafting for chronic Achilles tendon rupture.
A chart review was conducted of consecutive patients treated with the SLLS technique at our department from 2012 to 2017. Postoperatively, a below-knee splint was applied for 2 weeks in 20 degrees of plantar flexion and then active range of motion exercise was started. Partial weightbearing exercise was allowed at 4 weeks according to patient tolerance, and full weightbearing without crutches was allowed at 8 weeks. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale score and the Achilles tendon rupture score (ATRS) were used to evaluate clinical outcomes preoperatively and at the final follow-up.
Ten patients (6 men, 4 women) were included in the analysis. Mean AOFAS ankle-hindfoot scale score increased significantly from 64.2 ± 5.6 points preoperatively to 95.0 ± 5.3 points at the final follow-up ( < .001). The mean ATRS also increased significantly from 29.8 ± 4.4 points to 86.2 ± 7.7 points, respectively ( < .001). Mean time between surgery and ability to perform 20 continuous double-leg heel raises of the operated foot was 13.5 ± 3.4 (range 10-18) weeks. One patient complained of postoperative hypoesthesia in the foot, which had spontaneously resolved by 3 months after surgery.
The SLLS technique accompanied by autologous semitendinosus tendon grafting provided successful operative outcomes for patients with chronic Achilles tendon rupture regardless of the size of the defect, and thus long-term orthotic use was not needed after surgery.
Level IV, retrospective case series.
本回顾性研究的目的是阐明侧锁环缝合法（SLLS）联合自体半腱肌腱移植治疗慢性跟腱断裂的手术效果。
对2012年至2017年在我科接受SLLS技术治疗的连续患者进行病历回顾。术后，应用屈膝20度的膝下支具2周，然后开始主动活动度锻炼。根据患者耐受情况，4周时允许部分负重锻炼，8周时允许无拐杖完全负重。采用美国矫形足踝协会（AOFAS）踝后足评分量表和跟腱断裂评分（ATRS）对术前及末次随访时的临床结果进行评估。
10例患者（6例男性，4例女性）纳入分析。AOFAS踝后足评分量表平均分术前为64.2±5.6分，末次随访时显著提高至95.0±5.3分（P<.001）。平均ATRS也分别从29.8±4.4分显著提高至86.2±7.7分（P<.001）。患侧足部能够连续进行20次双腿提踵的平均手术时间间隔为13.5±3.4（范围10 - 18）周。1例患者术后诉足部感觉减退，术后3个月自行缓解。
侧锁环缝合法联合自体半腱肌腱移植为慢性跟腱断裂患者提供了成功的手术效果，无论缺损大小如何，术后无需长期使用矫形器。
IV级，回顾性病例系列。
