Kiedrowski Bartosz, Kaszyński Jakub, Piontek Tomasz
Rehasport Clinic, Poznan University of Medical Sciences, Poznan, Poland.
Foot Ankle Orthop. 2025 Sep 9;10(3):24730114251363880. doi: 10.1177/24730114251363880. eCollection 2025 Jul.
The Achilles tendon is prone to rupture, particularly in middle-aged men, and chronic injuries are often due to missed diagnoses or inadequate treatment. While acute ruptures can be managed with primary repair, chronic cases with tendon gaps >3 cm require reconstruction. A minimally invasive technique using autologous semitendinosus and gracilis tendon grafts has previously shown favorable short-term outcomes. This study evaluates longer-term outcomes with a minimum 5-year follow-up.
This study analyzed 21 patients undergoing minimally invasive Achilles tendon reconstruction with autologous hamstring grafts, compared with 21 healthy controls. magnetic resonance imaging confirmed diagnoses, and surgeries (2016-2019) used the EndoButton system for graft stabilization. Assessments included Achilles tendon Total Rupture Score (ATRS) for patient-reported outcomes, EuroQoL-5 Dimensions, 5 Levels (EQ-5D-5L) for overall health, and visual analog scale (VAS) for pain and satisfaction. Functional tests measured dorsiflexion (lunge test), calf endurance (heel rise test), and muscle strength (single-leg hop test), comparing operated vs unoperated legs.
ATRS and EQ-5D-5L Index improved from 2 to 5 years ( = .0136, = .0396), although significance was lost after Bonferroni correction. Functional test results remained stable. The operated limb achieved >90% of the nonoperated side across tests. Compared with controls, patients reported lower EQ-5D-5L scores and greater pain ( < .05), but satisfaction remained high (VAS score 9/10). One retear occurred due to infection.
Minimally invasive Achilles tendon reconstruction using hamstring autografts results in sustained functional and subjective improvements at a minimum of 5 years postoperatively. Despite modest residual deficits compared with uninjured controls, high satisfaction and strong limb symmetry support the long-term efficacy of this approach. This study demonstrates that the functional and subjective results of patients after Achilles tendon reconstruction with hamstring graft remain stable and satisfactory at a minimum of 5 years postoperatively.
Level III, retrospective cohort study.
跟腱容易断裂，尤其是在中年男性中，慢性损伤通常是由于漏诊或治疗不当所致。虽然急性断裂可以通过一期修复进行处理，但肌腱间隙>3 cm的慢性病例需要进行重建。先前一项使用自体半腱肌和股薄肌腱移植物的微创技术已显示出良好的短期效果。本研究评估了至少5年随访期的长期效果。
本研究分析了21例行自体腘绳肌腱移植微创跟腱重建术的患者，并与21名健康对照者进行比较。磁共振成像确诊病情，手术（2016 - 2019年）使用EndoButton系统稳定移植物。评估包括用于患者报告结局的跟腱全断裂评分（ATRS）、用于整体健康状况的欧洲五维健康量表（EQ - 5D - 5L）以及用于疼痛和满意度的视觉模拟量表（VAS）。功能测试测量背屈（弓步试验）、小腿耐力（提踵试验）和肌肉力量（单腿跳跃试验），对手术侧与未手术侧进行比较。
ATRS和EQ - 5D - 5L指数在2至5年期间有所改善（P = 0.0136，P = 0.0396），尽管在Bonferroni校正后显著性消失。功能测试结果保持稳定。在各项测试中，手术侧肢体达到了未手术侧的90%以上。与对照组相比，患者报告的EQ - 5D - 5L评分较低且疼痛更严重（P < 0.05），但满意度仍然较高（VAS评分为9/10）。有一例因感染发生再断裂。
使用腘绳肌自体移植物进行微创跟腱重建术后至少5年可实现持续的功能和主观改善。尽管与未受伤的对照组相比仍有适度的残留缺陷，但高满意度和较强的肢体对称性支持了该方法的长期疗效。本研究表明，腘绳肌腱移植跟腱重建术后患者的功能和主观结果在术后至少5年保持稳定且令人满意。
III级，回顾性队列研究。
