Chronic Achilles tendon rupture reconstructed using hamstring tendon autograft

• Large chronic defects in the Achilles tendon are challenging to treat surgically.
• Ipsilateral semi-tendinosis autograft allows for satisfactory reconstruction.
• Patient reported outcomes at one year are favourable.

BackgroundChronic rupture of the Achilles tendon (delayed diagnosis of more than 4 weeks) can result in retraction of the tendon and inadequate healing. Direct repair may not be possible and augmentation methods are challenging when the defect exceeds 5–6 cm, especially if the distal stump is grossly tendinopathic.MethodsWe describe our method of Achilles tendon reconstruction with ipsilateral semitendinosis autograft and interference screw fixation in a patient with chronic rupture, a 9 cm defect and gross distal tendinopathy.ResultsPatient reported outcome measures consistently demonstrated improved health status at 12 months post surgery: MOXFQ-Index 38–25, EQ5D-5L 18–9, EQ VAS 70–90 and VISA-A 1–64. The patient was back to full daily function, could single leg heel raise and was gradually returning to sport. No complications or adverse events were recorded.ConclusionReconstruction of chronic tears of the Achilles tendon with large defects and gross tendinopathy using an ipsilateral semitendinosis autograft and interference screw fixation can achieve satisfactory improvements in patient reported outcomes up to 1 year post-surgery.