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经跟骨横向锚定自体游离半腱肌腱重建治疗急性跟腱断裂:临床评估

Transversal calcaneal anchored Achilles tendon reconstruction with free semitendinosus tendon autograft for acute rupture of Achilles tendon: clinical evaluation.

作者信息

Xue Han, Xiao Fengxu, Li Ruochen, Wu Guangwei, Zhu Zheyue, Zhang Chen, Li Miao

机构信息

Department of Orthopedic Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China.

Department of Ultrasound, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China.

出版信息

Sci Rep. 2024 Aug 1;14(1):17815. doi: 10.1038/s41598-024-68582-6.

Abstract

Achilles tendon reconstruction is an effective method of repairing Achilles tendon rupture defects. We introduce a new approach for Achilles tendon reconstruction using transversal calcaneal anchored autogenous semitendinosus tendon graft. The study aimed to evaluate the clinical role of this new Achilles tendon reconstruction. We retrospectively enrolled patients who underwent Achilles tendon reconstruction using transversal calcaneal anchored autogenous semitendinosus tendon graft for acute Achilles tendon rupture defects from 2016 to 2021. The clinical and radiological results were assessed at the preoperative and the final postoperative follow-up with Visual Analog Score (VAS) scores, American Orthopaedic Foot & Ankle Society (AOFAS) scores and Achilles tendon Total Rupture Scores (ATRS). Besides, at the last postoperative follow-up, the difference in ankle range of motion between the two side of the patients and the incidence of postoperative complications were recorded. Results revealed patients had significantly lower VAS and higher AOFAS and ATRS (P < 0.01). Compared to the healthy ankle, the operative ankle showed significant deficits in ankle range of motion (P < 0.01). Additionally, radiological results showed no noticeable signs of tunnel enlargement in the calcaneus and no patient had re-rupture. Transversal calcaneal anchored Achilles tendon reconstruction with free semitendinosus tendon autograft is an effective treatment option for patients with acute Achilles tendon rupture with large defects and have high postoperative exercise demands.

摘要

跟腱重建是修复跟腱断裂缺损的一种有效方法。我们介绍一种使用经跟骨横向锚定的自体半腱肌腱移植进行跟腱重建的新方法。本研究旨在评估这种新的跟腱重建方法的临床作用。我们回顾性纳入了2016年至2021年期间因急性跟腱断裂缺损而接受经跟骨横向锚定的自体半腱肌腱移植进行跟腱重建的患者。在术前和术后最终随访时,采用视觉模拟评分(VAS)、美国矫形足踝协会(AOFAS)评分和跟腱完全断裂评分(ATRS)对临床和影像学结果进行评估。此外,在术后最后一次随访时,记录患者双侧踝关节活动范围的差异以及术后并发症的发生率。结果显示患者的VAS显著降低,AOFAS和ATRS升高(P<0.01)。与健侧踝关节相比,手术侧踝关节的活动范围存在明显缺陷(P<0.01)。此外,影像学结果显示跟骨隧道无明显扩大迹象,且无患者再次断裂。对于急性跟腱断裂且缺损较大、术后运动需求较高的患者,采用游离自体半腱肌腱经跟骨横向锚定跟腱重建是一种有效的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afaa/11294335/8a996707259c/41598_2024_68582_Fig1_HTML.jpg

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