Local Tendon Transfers for Chronic Ruptures of the Achilles Tendon: A Systematic Review
Abstract
:1. Introduction
2. Material and Methods
2.1. Search Strategy
2.2. Eligibility Criteria
- P (Problem): Chronic rupture of the mid-portion Achilles tendon;
- I (Intervention): Transfer;
- C (Comparison): FHL, PB, FDL, and PL tendon transfers;
- O (Outcomes): Clinical outcomes, complications, and return to sport;
- T (Timing): ≥6 months of follow-up.
2.3. Selection and Data Collection
2.4. Methodological Quality Assessment
2.5. Data items
2.6. Outcomes
2.7. Statistical Analysis
3. Results
3.1. Study Selection
3.2. Study Risk of Bias Assessment
3.3. Study Characteristics and Results of Individual Studies
3.4. Results of Syntheses
4. Discussion
- The FHL is the second strongest plantar flexor muscle of the ankle;
- Its axis of action is in line with that of the AT;
- It maintains normal ankle muscle balance;
- Its harvest carries a low risk of iatrogenic neurovascular injury;
- It increases the vascularity of the reconstruction given its low-lying muscle belly [32].
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
AOFAS | American Orthopaedic Foot and Ankle Society |
AT | Achilles tendon |
ATRS | Achilles tendon Total Rupture Score |
BMI | Body Mass Index |
CMS | Coleman Methodology Score |
FDL | flexor digitorum longus |
FHL | flexor hallucis longus |
IBM SPSS | International Business Machines Statistical Package for the Social Sciences |
PB | peroneus brevis |
PICOT | Problem, Intervention, Comparison, Outcomes, Timing |
PL | peroneous longus |
PRISMA | Preferred Reporting Items for Systematic Reviews and Meta-Analyses |
PROMs | patient-reported outcome measures |
VAS | Visual Analogue Scale |
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Authors, Years | Part A: Only One Score to Be Given for Each of the 7 Sections | ||||||
---|---|---|---|---|---|---|---|
Study Size | Mean Follow-Up | Surgical Approach | Type of Study | Description of Diagnosis | Descriptions of Surgical Technique | Description of Postoperative Rehabilitation | |
Abubeih et al., 2018 [14] | 4 | 4 | 10 | 10 | 5 | 10 | 5 |
Ahn et al., 2022 [15] | 4 | 7 | 10 | 0 | 5 | 10 | 5 |
Alauddinet al., 2022 [16] | 4 | 0 | 10 | 10 | 5 | 5 | 0 |
Alhaug et al., 2019 [17] | 4 | 7 | 10 | 0 | 5 | 10 | 5 |
Elias et al., 2007 [18] | 4 | 4 | 10 | 0 | 5 | 10 | 5 |
Khalid et al., 2019 [19] | 0 | 4 | 10 | 0 | 5 | 10 | 5 |
Koh et al., 2019 [20] | 4 | 4 | 0 | 0 | 5 | 10 | 5 |
Lever et al., 2018 [21] | 4 | 10 | 10 | 0 | 5 | 10 | 5 |
Lui et al., 2012 [22] | 0 | 7 | 10 | 10 | 5 | 10 | 0 |
Maffulli et al., 2010 [8] | 4 | 7 | 10 | 10 | 5 | 10 | 5 |
Maffulli et al., 2012 [23] | 4 | 10 | 10 | 10 | 5 | 10 | 5 |
Maffulli et al., 2015 [24] | 4 | 7 | 10 | 0 | 5 | 10 | 5 |
Maffulli et al., 2018 [25] | 4 | 4 | 7 | 10 | 5 | 10 | 5 |
Mahajan et al., 2009 [26] | 4 | 4 | 10 | 0 | 5 | 10 | 5 |
Miao et al., 2016 [27] | 4 | 4 | 10 | 0 | 5 | 10 | 5 |
Oksanen et al., 2014 [28] | 0 | 4 | 10 | 0 | 5 | 10 | 5 |
Ozer et al., 2018 [29] | 4 | 10 | 10 | 10 | 5 | 10 | 5 |
Pintore et al., 2001 [30] | 7 | 7 | 7 | 10 | 5 | 10 | 5 |
Singh et al., 2014 [31] | 4 | 4 | 10 | 0 | 5 | 10 | 5 |
Tay et al., 2010 [32] | 0 | 4 | 10 | 10 | 5 | 10 | 5 |
Vega et al., 2018 [33] | 4 | 4 | 10 | 0 | 5 | 10 | 5 |
Wegrzyn et al., 2010 [5] | 0 | 10 | 10 | 0 | 5 | 10 | 5 |
Yeoman et al., 2012 [34] | 0 | 0 | 10 | 10 | 5 | 10 | 5 |
Authors, Years | Part B: Scores May Be Given for Each Option in Each of the Three Sections If Applicable | Total | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Outcome Criteria | Procedure Used to Assess Outcomes | Description of the Subject Selection Process | ||||||||||
Outcome Measures Clearly Defined | Timing of Outcome Assessment Clearly Stated | Use of Outcome Criteria That Have Reported Reliability | General Health Measure Included | Participants Recruited | Investigator Independent of Surgeon | Written Assessment | Completion of Assessment by Patients Themselves with Minimal Investigator Assistance | Selection Criteria Reported and Unbiased | Recruitment Rate Reported > 80% | Recruitment Rate Reported < 80% | ||
Abubeih et al., 2018 [14] | 2 | 2 | 3 | 0 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 80 |
Ahn et al., 2022 [15] | 2 | 2 | 3 | 3 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 76 |
Alauddin et al., 2022 [16] | 2 | 2 | 3 | 0 | 5 | 0 | 0 | 3 | 5 | 5 | 0 | 59 |
Alhaug et al., 2019 [17] | 2 | 2 | 3 | 0 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 73 |
Elias et al., 2007 [18] | 2 | 2 | 3 | 0 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 70 |
Khalid et al., 2019 [19] | 2 | 2 | 3 | 0 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 66 |
Koh et al., 2019 [20] | 2 | 2 | 3 | 0 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 60 |
Lever et al., 2018 [21] | 2 | 2 | 3 | 0 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 76 |
Lui et al., 2012 [22] | 2 | 2 | 3 | 0 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 74 |
Maffulli et al., 2010 [8] | 2 | 2 | 3 | 0 | 5 | 0 | 3 | 3 | 5 | 5 | 0 | 79 |
Maffulli et al., 2012 [23] | 2 | 2 | 3 | 0 | 5 | 0 | 3 | 3 | 5 | 5 | 0 | 82 |
Maffulli et al., 2015 [24] | 2 | 2 | 3 | 3 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 76 |
Maffulli et al., 2018 [25] | 2 | 2 | 3 | 3 | 5 | 0 | 3 | 3 | 5 | 5 | 0 | 76 |
Mahajan et al., 2009 [26] | 2 | 2 | 3 | 3 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 73 |
Miao et al., 2016 [27] | 2 | 2 | 3 | 3 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 73 |
Oksanen et al., 2014 [28] | 2 | 2 | 3 | 3 | 5 | 4 | 3 | 3 | 5 | 0 | 0 | 64 |
Ozer et al., 2018 [29] | 2 | 2 | 3 | 3 | 5 | 0 | 3 | 3 | 5 | 5 | 0 | 85 |
Pintore et al., 2001 [30] | 2 | 2 | 3 | 3 | 5 | 0 | 3 | 3 | 5 | 5 | 0 | 82 |
Singh et al., 2014 [31] | 2 | 2 | 3 | 3 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 73 |
Tay et al., 2010 [32] | 2 | 2 | 3 | 3 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 79 |
Vega et al., 2018 [33] | 2 | 2 | 3 | 3 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 73 |
Wegrzyn et al., 2010 [5] | 2 | 2 | 3 | 3 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 75 |
Yeoman et al., 2012 [34] | 2 | 2 | 3 | 3 | 5 | 4 | 3 | 3 | 5 | 5 | 0 | 75 |
Author et al., Year | Journal Name | Design | Technique | Follow-Up (Months) | Patients (n) | Age (Mean) | Female (n) |
---|---|---|---|---|---|---|---|
Abubeih et al., 2018 [14] | Int Orthop | Prospective | open FHL | 15 | 21 | 40.3 | 6 |
Ahn et al., 2022 [15] | J Foot Ankle Surg | Retrospective | open FHL | 57 | 28 | 51 | 11 |
Alauddin et al., 2022 [16] | Mymensingh Med J | Prospective | open FHL | 6 | 21 | 39.5 | |
Alhaug et al., 2019 [17] | Foot Ankle Surg | Retrospective | open FHL | 54 | 21 | 54.5 | 6 |
Elias et al., 2007 [18] | Foot Ankle Int | Retrospective | open FHL | 24.4 | 15 | 55.8 | 5 |
Khalid et al., 2019 [19] | Foot Ankle Spec | Retrospective | endoscopic FHL | 30.9 | 10 | 58.4 | 5 |
Koh et al., 2019 [20] | Foot Ankle Surg | Retrospective | open FHL | 12 | 29 | 56 | 13 |
Lever et al., 2018 [21] | Bone Joint J | Retrospective | open FHL | 73 | 20 | 53 | 4 |
Lui et al., 2012 [22] | Foot Ankle Spec | Prospective | endoscopic FHL | 37 | 5 | 46 | 2 |
Maffulli et al., 2010 [8] | Am J Sports Med | Prospective | open PB | 48.4 | 32 | 47.13 | 4 |
Maffulli et al., 2012 [23] | J Bone Joint Surg Am | Prospective | open PB | 186 | 16 | 55.6 | 0 |
Maffulli et al., 2015 [24] | Bone Joint J | Retrospective | mini-open PB | 55.2 | 17 | 39 | 3 |
Maffulli et al., 2018 [25] | Foot Ankle Surg | Prospective | mini-open FHL | 35.8 | 21 | 42.7 | 9 |
mini-open PB | 36.4 | 20 | 45.8 | 6 | |||
Mahajan et al., 2009 [26] | J Orthop Surg | Retrospective | open FHL | 12 | 36 | 70 | 12 |
Miao et al., 2016 [27] | Indian J Orthop | Retrospective | mini-open FHL | 32.2 | 32 | 42.1 | 14 |
Oksanen et al., 2014 [28] | Foot Ankle Surg | Retrospective | open FHL | 27 | 7 | 53 | 3 |
Ozer et al., 2018 [29] | J Foot Ankle Surg | Prospective | open FHL | 280 | 19 | 47.4 | 1 |
Pintore et al., 2001 [30] | J Trauma | Prospective | open PB | 53 | 21 | 43.3 | 1 |
Singh et al., 2014 [31] | J Orthop Surg | Retrospective | mini-open PB | 12 | 22 | 28 | |
Tay et al., 2010 [32] | Ann Acad Med Singap | Prospective | open FHL | 24 | 6 | 59.5 | |
Vega et al., 2018 [33] | Foot Ankle Int | Retrospective | endoscopic FHL | 30.5 | 22 | 69 | 6 |
Wegrzyn et al., 2010 [5] | Int Orthop | Retrospective | open FHL | 79 | 11 | 44 | 4 |
Yeoman et al., 2012 [34] | Foot (Edinb) | Prospective | open FHL | 6 | 11 | 52.6 | 5 |
Endpoint | Baseline | Last Follow-Up | Mean Deviation | p-Value |
---|---|---|---|---|
VAS | 2.6 ± 0.6 | 0.8 ± 0.8 | −1.8 | 0.04 |
AOFAS hindfoot | 57.1 ± 8.5 | 91.4 ± 4.7 | 34.3 | <0.0001 |
ATRS | 44.4 ± 19.2 | 85.7 ± 7.5 | 41.3 | <0.0001 |
Complications | FHL (338 Procedures) | PB (128 Procedures) | |||
---|---|---|---|---|---|
Open | Mini-Open | Endoscopic | Open | Mini-Open | |
Pain | 2 | ||||
Superficial infection | 11 | 5 | |||
Deep infection | 4 | ||||
Deep venous thrombosis | 1 | ||||
Focal numbness | 4 | ||||
Wound complications | 9 | 1 | 1 | 2 | |
Scar adhesion | 1 | ||||
Weak push-off | 3 | ||||
Hypertrophic scarring of the incision | 2 | ||||
Re-rupture | 1 | ||||
Claw toes | 2 | ||||
Reduced skin sensation | 6 | ||||
Neurological complications | 4 |
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Maffulli, N.; Ziello, S.; Maisto, G.; Migliorini, F.; Oliva, F. Local Tendon Transfers for Chronic Ruptures of the Achilles Tendon: A Systematic Review. J. Clin. Med. 2023, 12, 707. https://doi.org/10.3390/jcm12020707
Maffulli N, Ziello S, Maisto G, Migliorini F, Oliva F. Local Tendon Transfers for Chronic Ruptures of the Achilles Tendon: A Systematic Review. Journal of Clinical Medicine. 2023; 12(2):707. https://doi.org/10.3390/jcm12020707
Chicago/Turabian StyleMaffulli, Nicola, Salvatore Ziello, Gianluca Maisto, Filippo Migliorini, and Francesco Oliva. 2023. "Local Tendon Transfers for Chronic Ruptures of the Achilles Tendon: A Systematic Review" Journal of Clinical Medicine 12, no. 2: 707. https://doi.org/10.3390/jcm12020707
APA StyleMaffulli, N., Ziello, S., Maisto, G., Migliorini, F., & Oliva, F. (2023). Local Tendon Transfers for Chronic Ruptures of the Achilles Tendon: A Systematic Review. Journal of Clinical Medicine, 12(2), 707. https://doi.org/10.3390/jcm12020707