Maffulli Nicola, Ziello Salvatore, Maisto Gianluca, Migliorini Filippo, Oliva Francesco
Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84084 Baronissi, Italy.
Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi d'Aragona, 84131 Salerno, Italy.
J Clin Med. 2023 Jan 16;12(2):707. doi: 10.3390/jcm12020707.
Introduction: A rupture of the Achilles tendon with a delay in diagnosis or treatment for more than 6 weeks is considered a chronic tear. Local tendon transfer procedures can be used in chronic Achilles tendon ruptures. This study evaluated the outcome, return to sport, and complications of local tendon transfer in patients with chronic Achilles tendon rupture. Material and methods: The present study was conducted according to the PRISMA 2020 guidelines. PubMed, Google Scholar, Embase, and Web of Science databases were accessed in November 2022. Results: Data were retrieved from 23 articles (463 patients, mean age 50.9 ± 13.5 years). The mean duration of the follow-up was 58.3 ± 76.8 months. The VAS improved by 1.8/10 (p = 0.4), the AOFAS by 33.4/100 (p < 0.0001), and the ATRS by 32.5/100 (p = 0.0001) points. Patients were able to return to sport after a mean of 19.6 ± 16.4 weeks. A total of 79% of patients were able to return to their previous activities. The rate of complications was 13.3%. Conclusions: The use of local tendon transfer for chronic Achilles tendon ruptures using the FHL or PB tendon resulted in good clinical outcomes and a reliable return to daily activities and sports. The rate of complications reflects the chronicity of the condition and the technical complexity of the procedure. Level of evidence: IV.
跟腱断裂后诊断或治疗延迟超过6周被视为慢性撕裂。局部肌腱转移手术可用于慢性跟腱断裂。本研究评估了慢性跟腱断裂患者局部肌腱转移的疗效、恢复运动情况及并发症。
本研究按照PRISMA 2020指南进行。于2022年11月检索了PubMed、谷歌学术、Embase和科学网数据库。
从23篇文章（463例患者，平均年龄50.9±13.5岁）中检索到数据。平均随访时间为58.3±76.8个月。视觉模拟评分（VAS）改善了1.8/10（p = 0.4），美国足踝外科协会评分（AOFAS）改善了33.4/100（p < 0.0001），跟腱修复术后评分（ATRS）改善了32.5/100（p = 0.0001）分。患者平均在19.6±16.4周后能够恢复运动。共有79%的患者能够恢复到之前的活动水平。并发症发生率为13.3%。
使用趾长屈肌（FHL）或腓骨短肌（PB）肌腱进行局部肌腱转移治疗慢性跟腱断裂可获得良好的临床疗效，且能可靠地恢复日常活动和运动。并发症发生率反映了病情的慢性程度和手术的技术复杂性。证据等级：IV级。
