Outcomes of Chronic Insertional Achilles Tendinosis Using FHL Autograft Through Single Incision

Abstract

Background: The purpose of this study was to evaluate the clinical outcomes and objective isokinetic dynamometry on a cohort of patients with chronic insertional Achilles tendinosis, who underwent surgical reconstruction using an FHL tendon autograft transfer through a single incision. Materials and Methods: Forty patients (16 male and 24 female; mean age, 57 years; age range, 39 to 76 years) with persistent chronic Achilles tendinosis were evaluated after surgical reconstruction at an average of 27 months after surgery. At the time of final followup, ankle strength and active range of motion (AROM) were evaluated using Biodex® isokinetic dynamometry. Additionally, patients were assessed with AOFAS Ankle Hindfoot scores, pain on a Visual Analog Scale (VAS) and their self-reported level of satisfaction (Very Good, Good, Fair, Poor). Results: We found no loss of plantarflexion strength or plantarflexion power in the operated ankles; an average of 4-degree loss of AROM was found. The study population scored an average of 96/100 for the total AOFAS-AH score post-repair. The average VAS decreased from 7.5 pre-op to 0.3 post-op. Thirty-eight of 40 patients (95%) were satisfied with their outcome (rated Very Good or Good), two patients rated their outcome as Fair and none as Poor. Conclusion: For individuals with chronic insertional Achilles tendinosis, operative repair using an FHL tendon with the single-incision technique achieved a high percentage of satisfactory results as well as excellent functional and clinical outcomes including significant pain reduction. Level of Evidence: IV, Retrospective Case Study