Clinical Application And Experience Of Arthroscopic Autogenous Tendon Reconstruction In The Treatment Of Chronic Achilles Tendon Rupture

ObjectiveThrough the follow-up analysis of patients with relevant data,to clarify the clinical safety and effectiveness of arthroscopic autologous hamstring tendon reconstruction technology in the treatment of Chronic achilles tendon rupture,and to explore the clinical efficacy and treatment experience of this operation.MethodsThis study reviewed the relevant data of 16 patients from June 2015 to June2018.All of them underwent total arthroscopic reconstruction of Achilles tendon with autologous tendon due to old achilles tendon rupture.Among the 16 patients,11 were male and 5 were female;the age was 21-55 years old(average 40.7 years old),including 9 cases on the left side and 7 cases on the right side.All patients were diagnosed with poor continuity of Achilles tendon by MRI and musculoskeletal ultrasonography before operation.The length of Achilles tendon defect was 5.0-10.3cm(average 5.8 cm).Among the 16 cases,4 cases were located above the Achilles tendon insertion point,and 12 cases were at the tendon ventral junction.All patients were followed up for 12 ～ 18 months(average 16 months),and 10 patients were followed up for more than 12 months.The operation time,blood loss,postoperative hospital stay and complications were recorded.The improvement of Achilles tendon function and pain before and 1,3,6 and 12 months after operation were compared by AOFAS score and VAS score.Results1.The operation time was 60-90 min(average 77.2 min),intraoperative blood loss was 15-30 ml(average 20.5 ml),postoperative hospital stay was 5-10 days(average 7.2 days).2.All the grafted tendons healed well and the incisions healed in stage I.there was no skin necrosis,infection and DVT formation in lower limbs.3.All the 16 patients were followed up for 12-18 months(average 16 months),and 10 patients were followed up for more than 12 months.During the follow-up period,none of the patients had secondary rupture of Achilles tendon,swelling pain and heel lifting failure symptoms were significantly improved compared with those before operation.MRI reexamination showed that the continuity of Achilles tendon was restored.4.The AOFAS scores of 1 month,3 months,6 months and 12 months after operation were significantly higher than those before operation,and the VAS score was significantly lower than that before operation.Except 1 month after operation,the score data at other time points were significantly lower than those before operation,and the difference was statistically significant(P < 0.05);ConclusionArthroscopic autologous tendon reconstruction in the treatment of chronic Achilles tendon rupture has the advantages of small trauma,light pain,rapid functional recovery,satisfactory surgical efficacy,and is worthy of wide clinical promotion,and it could benefit more patients.