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Surgical technique of treatment breaks or iterative neglected the Achilles tendon hamstring graft

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New surgical technique of treating neglected or iterative rupture of the Achilles tendon hamstring graft: report of 3 cases.

In patients with a rupture or iterative neglected Achilles tendon, the recommended treatment is usually surgical. Many surgical techniques have been reported in the literature with varying functional results.
We propose a novel technique using a registry of domestic law, half tendon (hamstring) free transplant creating a transplant to 6 or 8 beams.

Clinical case

We treated three men with neglected or iterative rupture of the Achilles tendon:
- The first case was a 50 year old man with an old neglected rupture of more than a year with a tendon retraction and a tendon defect of 12 cm.
- The second is a 35 year old man originally operated by a percutaneous technique with early failure and re-rupture at 6 months with a loss of tendon substance of approximately 6 cm.
- The third case is a 60 year old patient, who had a distal old achilles tendon rupture operated by transosseous rehabilitation with early recurrent tears to 3 months require a transplant of 6 cm.

surgical Technique

The surgical technique was the same for all 3 patients: removal of domestic law and the half tendon by a short incision at the knee and graft preparation self transplant length for the defect creating a registry of good caliber with 6-8 beams, graft suture directly to the proximal and distal Achilles tendon banks of the two cases and transosseous reintegration by anchors in the third case.


The postoperative need immobilization in a cast for a minimum of 2 months and gradual recovery of walking accompanied by rehabilitation.
At 5 years, 2 years, 6 months follow-up functional results are satisfactory with good engraftment in 3 cases (controlled by MRI), a satisfactory functional recovery: a perimeter unlimited walking, mobility normal ankle a stable support. In both cases a return to sport recreation was possible after the 6th month.


In conclusion this original technique to cover major losses of substance of Achilles tendon with a quality graft (hamstring tendon) free transplant, limiting the local disease grafts nearby.


Nicolas Lefevre, Martine Bloch, Serge Herman

Doctor Nicolas LEFEVRE, Doctor Serge HERMAN. - 25 janvier 2009.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.


Knee arthroscopy: treatment of meniscus injury

By Dr. Nicolas LEFEVRE , Dr. Serge HERMAN , Dr. Yoann BOHU

Meniscus - Arthroscopic knee surgery is the gold standard of meniscal lesions of the knee. The goal is to treat meniscal tear (tear, crack, tongue, bucket handle ...) being the least traumatic possible for the knee and the most conservative to the meniscus.


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